Premenstrual Dysphoric Disorder

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What Is PMDD?

Premenstrual dysphoric disorder (PMDD) is a very severe form of premenstrual syndrome (PMS), which can cause many emotional and physical symptoms every month during the week or two before you start your period. It is sometimes referred to as 'severe PMS'.

While many women may experience mild symptoms of PMS, if you have PMDD these symptoms are much worse and can have a serious impact on your life. Experiencing PMDD can make it difficult to work, socialise and have healthy relationships. In some cases, it can also lead to suicidal thoughts.

“The best way for me to describe it is that – once a month – I decided to press my own ‘self-destruct’ button and literally let my life (my normally very happy and satisfying life...) implode around me. Then when the dark thoughts lifted and completely cleared, I spent the next 2 weeks trying to pick up the pieces.”
What Are The Symptoms Of PMDD?
  • If you have PMDD, you might find that you experience some of symptoms listed below.

But it's different for different people, so you might also experience other kinds of feelings which aren't listed here.

Emotional experiences:

  • mood swings
  • feeling upset or tearful
  • feeling angry or irritable
  • feelings of anxiety
  • feeling hopeless
  • feelings of tension or being on edge
  • difficulty concentrating
  • feeling overwhelmed
  • lack of energy
  • less interest in activities you normally enjoy
  • suicidal feelings

Physical and behavioural experiences:

  • breast tenderness or swelling
  • pain in your muscles and joints
  • headaches
  • feeling bloated
  • changes in your appetite such as overeating or having specific food cravings
  • sleep problems
  • finding it hard to avoid or resolve conflicts with people around you
  • becoming very upset if you feel that others are rejecting you

You will typically only experience these symptoms for a week or two before your period starts. The symptoms follow your menstrual cycle, so you might find they start to get better when you get your period and will usually have disappeared by the time your period is finished.

“In the depths of my PMDD I tend to just retreat to my bed – I get very depressed and my anxiety goes sky high. I get hugely fatigued and can’t keep my eyes open – I sleep for about 18 hours a day.”
What Are The Causes of PMDD?

The exact causes are still not fully understood but some possible factors are:

  • Being very sensitive to changes in hormone levels. Recent research suggests that PMDD is associated with increased sensitivity to the normal hormonal changes that occur during your monthly menstrual cycle
  • Genetics. Some research suggests that this increased sensitivity to changes in hormone levels may be caused by genetic variations

Some other research has shown that in some cases PMDD may be linked to stressful and traumatic past events (such as emotional or physical abuse), but there's no evidence to explain how or why.

“It very much got worse as I went into my 30s and by my mid-30s I was losing 3 days going downhill, a week in a depression feeling like I was going through a bereavement, and then a few days to recover and feeling like I’ve been chewed up and spat out. It’s exhausting to know that once it passes you have to brace yourself for it all to happen all over again in a couple of weeks' time.”
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