Pre Menstrual Dysphoric disorder (PMDD) is a very severe form of premenstrual syndrome (PMS). Every month, it creates a variety of mental and physical symptoms during the week or two before your menstrual cycle. It is sometimes referred to as 'severe PMS.' PMDD develops during your menstrual cycle's luteal phase. This is the interval between ovulation and the start of your menstruation. Most people's luteal phase lasts around two weeks, however it might last longer or shorter. During this period, you may suffer PMDD symptoms every day or only for a few days.

What are the symptoms of PMDD?

Many people who can have periods suffer some moderate PMS symptoms. These symptoms are significantly severe if you have PMDD and can have a serious influence on your life. PMDD can make it difficult to work, socialise, and maintain healthy relationships. It can also lead to suicidal thoughts in rare circumstances.

Emotional experiences

• Mood swings.

• Feeling upset or tearful.

• Lack of energy.

• Less interest in activities you normally enjoy.

• Feeling hopeless.

• Suicidal feelings.

• Feeling angry or irritable.

• Feeling anxious.

• Feeling tense or on edge.

• Feeling overwhelmed or out of control.

• Difficulty concentrating.

Physical and behavioural experience

• 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.

• Increased anger or conflict with people around you.

• Becoming very upset if you feel that others are rejecting you.

Because PMDD is associated with your menstrual cycle, you are unlikely to suffer symptoms if you are pregnant. However, the symptoms may return once you begin ovulating again.

What are the causes of PMDD?

Although the specific origins are unknown, experts suspect that PMMD is caused by being too sensitive to variations in hormone levels. According to new study, PMDD is linked to greater sensitivity to the natural hormonal changes that occur throughout your monthly menstrual cycle.

There is evidence pointing to additional probable causes of PMDD, as well as things that may aggravate your PMDD. Some of these potential causes include:

Genetics

According to some study, heightened sensitivity to changes in hormone levels may be caused by genetic differences.

Smoking

According to some studies, smoking might affect your hormone sensitivity.

Trauma and stress

Other studies have found that in certain situations, PMDD is associated to stressful and traumatic prior events, such as mental or physical abuse. Stress may also aggravate your PMDD symptoms. 

Is PMDD a mental health problem?

PMDD is typically classified as an endocrine condition, which means it is a hormonal disorder. However, in addition to physical symptoms, patients with PMDD have a variety of mental health symptoms such as despair, suicidal thoughts, and anxiety. For these reasons, it is classified as a mental health condition in the DSM-5, one of the primary manuals used by clinicians to categorise and diagnose mental health issues.

Finally, keep in mind that how you interpret your symptoms and experiences is entirely up to you. The most essential thing is that you receive the assistance you require and deserve to help you cope with the impact of PMDD on your life..

How is PMDD diagnosed?

To get a diagnosis of PMDD the best place to start is visiting your doctor. To help them understand your symptoms your doctor may:

• Ask you to keep a detailed record of your symptoms for at least two months, to see if your symptoms have a pattern over time. This may be in your diary or they may give you some daily questionnaires to fill out.

• Ask you about your medical history, such as any history of mental health problems.

• Ask about your lifestyle, such as if you smoke, drink alcohol or are overweight.

• Give you a physical examination along with some blood tests, so that they can rule out other medical problems. When you're asked to keep a record of your symptoms over several months, getting a diagnosis can feel like a very slow process. This can be frustrating if you have to wait a long time to get treatment.

What if I'm struggling to get a diagnosis?

Some people find getting a diagnosis of PMDD really difficult. This might be because it can take a long time to realise that your symptoms follow a cycle and that they are linked to your period. It can also be because PMDD is not very well known, even amongst health professionals. It can be really upsetting and frustrating if you feel like your doctor is overlooking something, or not taking you seriously. There are things you could try though:

• Keep your own detailed record of your symptoms over time. You could also do this in a diary or you can download mood charts from the internet. The more information you collect over a long period of time, the better prepared you'll be to explain your symptoms to you doctor.

• Take this article with you to your Medical Practitioner if you reach out to seek treatment.

• Ask your medical practitioner if you could speak to a doctor who specialises in mental health, gynaecology or endocrinology. Gynaecology is the branch of medicine that deals specifically with the female reproductive system, and endocrinology deals with hormones.

Treatment 

Self care

o Physical exercise

o Stress management

Drugs

o Birth control

o SSRIs

o Anxiolytics

Therapies

o Cognitive behavioural therapy

o Hypnosis for pain management