What is PMDD – Premenstrual Dysphoric Disorder

The majority of women experience some degree of physical and/or psychological symptoms during the days leading up to and during their menstrual cycle. For some women, the symptoms may be relatively mild, making them more of an annoyance than a significant issue. Other women may experience such significant and cyclic symptoms, however, that interfere with their functioning in everyday life and adversely affect their relationships. This condition is known as Premenstrual Dysphoric Disorder (PMDD).

Causes of PMDD

As is true with any mental health issue, it is not possible to pinpoint the specific cause of PMDD. It is likely that genetic, neurobiological, endocrine, and environmental factors all interact in some way in order to lead to the development of PMDD. In addition to possible genetic predisposition to the condition, current thinking proposes that the function of neurotransmitters (chemicals used to carry the nerve signal in the brain and body) are affected during the premenstrual time period leading to the symptoms. Because certain hormones (progesterone and estrogen) interact with neurotransmitters and are known to have cyclic effects on mood and behavior leading up to the start of the menstrual cycle, some researchers think that the changing hormone levels occurring during this time period can create an instability in the brain chemistry. Lastly, environmental factors such as stress, sleep patterns, diet, and substance use can all play a role in the expression of PMDD.

Signs and Symptoms of PMDD

PMDD is marked by a constellation of symptoms related to behavioral, affective (mood), cognitive, and somatic (relating to physical body system) domains. These symptoms appear anywhere from seven to fourteen days prior to the start of menstrual bleeding, and are generally relieved once the start of the period begins. In order to receive a diagnosis of PMDD, the symptoms must interfere markedly with functioning in everyday life, cause significant distress, and not be explained better by another mental health condition.

The behavioral symptoms can include increased sensitivity to rejection, decreased interest in activities, feeling overwhelmed and a need to avoid others. The affective symptoms can include depressed mood; feeling out of control; feeling irritable, angry and/or moody. Cognitive symptoms may include difficulty concentrating, focusing and/or making decisions. Lastly, the somatic symptoms can include sleep disruption; abdominal bloating; breast tenderness and/or pain; joint or muscle pain; and headaches.

Treatment for PMDD

As with other mental health issues, treatment for PMDD is multi-faceted and should be tailored to each individual’s needs. It typically consists of both pharmacological and psychotherapeutic interventions. Additionally, lifestyle modifications often play an important role in treatment.

In terms of medication, various SSRIs (selective serotonin reuptake inhibitors) have been found to be effective in treating the symptoms of PMDD. These medications work by helping the brain process and regulate neurotransmitters that can contribute to symptoms. Additionally, certain birth control pills can be used to prevent or reduce the severity of PMDD

symptoms.

Psychotherapy typically consists of cognitive behavioral therapy, in which dysfunctional thought patterns are identified and challenged, and skills are taught to manage the symptoms. As previously mentioned, lifestyle modifications also play an important role, such as dietary changes, stress management techniques, improving sleep patterns, and exercise.

In conclusion, PMDD is a severe and disabling condition that can greatly impact the quality of life for some women. Although the exact cause is unknown, treatments such as pharmacological and psychotherapeutic interventions do exist, and are possible avenues of relief for those suffering from PMDD.