Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Dysphoric Disorder (PMDD) is a very specific type of depression in women when woman suffer from severe depression symptoms (significant irritability, sadness, tension, pains, etc.) during premenstrual period (about 6-14 days before menstruation). Usually PMDD symptoms are severe – much stronhger than those seen during ordinary Premenstrual Syndrome (PMS). All symptoms of PMDD are temporal – appearing during premenstrual period and disappearing shortly after menstrual period begins.

About 3-7% women could suffer from Premenstrual Dysphoric Disorder which can appear only during reproductive period of women life.

Symptoms of Premenstrual Dysphoric Disorder could be severe enough to interfere with women’s life (daily life, professional activities, sexual relations, parenting). Women with different types of depression could additionally suffer from Premenstrual Dysphoric Disorder during premenstrual period which could complicate treatment algorithms.

Women with Premenstrual Dysphoric Disorder could be considered as risk group for suicidal thoughts and suicidal attempts. Suicide in women with depression is much more likely to occur during the premenstrual period of the menstrual cycle.

Specialists specialized in eating disorders also often meet women with Premenstrual Dysphoric Disorder because changes in eating habits are also a common symptom of PMDD.

Premenstrual Dysphoric Disorder – Causes

The exact cause of Premenstrual Dysphoric Disorder is not known yet but most scientists highlight the role of hormonal changes during premenstrual period.

Premenstrual Dysphoric Disorder – Risk Factors

Medical professional discovered several risk factors which could increase chances for PMDD development including:

• Previous or present hormonal dysfunctions;
• Family history of Premenstrual Dysphoric Disorder in mothers, sisters, grandmothers, aunts;
• Stressful life conditions (long-term stress at work or in family, stressful relations, traumatic life event, social and/or sexual abuse, etc.);
• History of depression or other mental diseases;
• Alcohol abuse and/or drug abuse;
• Obesity or overweight with high BMI;
• Caffeine using habits (drinking large amounts of caffeine every day);
• Passive lifestyle – absence of exercises, spending a lot of time on the chair or divan, watching TV for 6-10 hours.

Premenstrual Dysphoric Disorder – Symptoms

Symptoms of Premenstrual Dysphoric Disorder are very similar to Premenstrual syndrome but they are generally more severe and debilitating and always include a least one mood-related symptom. All Premenstrual Dysphoric Disorder symptoms usually start 6-14 days before start of menstrual period and usually improve within a few days after the period starts.

It is important to mention that Premenstrual Dysphoric Disorder is characterized by always severe symptoms which could include the following:

• Extreme sadness and Anxiety;
• Frequent crying with and/or without any objective reasons;
• Sleep disorders – problems sleeping, insomnia, and interrupted sleep;
• Persistent irritability, tension or anger that affects people around;
• Extreme mood swings – from laugh to cry, from irritation to aggression, from sadness to panic attack;
• Lost interest in life, in daily activities, in previously pleasant hobbies, in relationships (including sexual relations);
• Unusual strong food cravings, binge eating, food addictions, overeating;
• Difficulty concentrating on important topics, troubles concentration, memory problems;
• Decreased body energy – fatigue, passive behavior, lack of physical activities;
• Negative feelings – sadness, hopelessness, reduced self-esteem, suicidal thoughts, suicidal attempts;
• Difficulties in decision making and feeling out of control;
• Physical symptoms such as bloating, sore breasts, breast tenderness, headaches, and joint or muscle pain.

Generally speaking doctor consider the condition as Premenstrual Dysphoric Disorder (PMDD) only if at least 5 or more of above mentioned symptoms are present including at least one mood-related symptom.

Many women with Premenstrual Dysphoric Disorder have anxiety, major depression or seasonal affective disorder (SAD).

Premenstrual Dysphoric Disorder – Diagnosis

There is no physical examination or laboratory test which can definitely prove the diagnosis of Premenstrual Dysphoric Disorder (PMDD). Mainly complete history, physical examination and psychiatric evaluation should be done just for excluding other health conditions. Above mentioned symptoms of Premenstrual Dysphoric Disorder (at least 5 or more, including at least one mood-related symptom) which appear before expected menstrual period could be considered as diagnostic evidences for PMDD.

Premenstrual Dysphoric Disorder – Solutions

• Exercise regularly (at least 30-40 minutes per day);
• Devote a special time for relaxation (meditation, listening music, reading books, relaxing with friends);
• Eat very balanced food with plenty of fruits, vegetables, and whole grains;
• Avoid alcohol, tobacco, drugs, energizing drinks and caffeine;
• Discover stress management techniques;
• Never forget about Sleep Hygiene;
• Use birth control pills (oral contraception);
• Use anti-depression supplements;
• Use pain relievers such as aspirin or ibuprofen (in cases of headaches, backaches, menstrual cramps and breast tenderness).

Premenstrual Dysphoric Disorder Prevention

There are only few very simple strategies which can reduce your risks for Premenstrual Dysphoric Disorder:

• Stress management – control stressful situations, avoid potential stressful evens and stress creating people, use stress control equipment, prevent stress as much as possible;

• Maintenance of healthy lifestyle – physical activities, healthy food, reduced use of caffeine, avoiding smoking (including passive smoking), absence of alcohol and drug abuse;

• Body strengthening – regular physical activities, supplements for strengthened immune system, adequate treatment of all health problems.