Everything you need to know about PMDD

Everyone has down moments now and then. But what if you have mood swings every month that send shivers down your spine? That you can't see reality clearly anymore and everything seems pitch black? It sounds like a thriller, but it's real, and it's called Premenstrual Dysphoric Disorder (PMDD). PMDD is a serious mood disorder that causes depressive feelings, rage attacks, and more, and affects approximately one in twenty women .

You might be thinking, "Another PMS-like disorder?" Think again.

Because if you recognize yourself in this description, it's important that you read on. PMDD is real, and women with PMDD often require medical attention and are almost always treated with antidepressants or hormones—no small matter at all.

So no, it's not a PMS-like illness, it's not "just part of life," and it's not your fault. And you don't have to fight this battle alone.

How does PMDD develop and what are the symptoms?

PMDD is difficult to recognize. It's not physical, but primarily psychiatric (a mental health condition). And although PMDD is directly related to the menstrual cycle, it's not caused by a hormonal imbalance.

PMDD is a severe negative reaction to the natural rise and fall of estrogen and progesterone.

Here's the thing: your body, at its best, maintains a wonderful balance of hormones. This balance ensures you feel good and that everything functions as it should.

Your hormones fluctuate throughout your cycle, and that's normal. But some women are sensitive to these fluctuations (and sometimes they fluctuate too much). If you experience this a lot, you have PMS. If you experience this 10,000 times more, we call it PMDD.

So all women have fluctuating hormones, but women with PMDD experience this problem particularly badly. Why is that?

PMDD is thought to be a cellular disorder, with symptoms worsening over time and sometimes worsening during menstruation, pregnancy, childbirth, miscarriage, and perimenopause.

PMDD and your cycle

PMDD is also linked to certain phases of your cycle – you feel good for a few days, and then incredibly bad for a few days. Women mainly experience PMDD during the luteal phase (after ovulation, before your period).

On Levenmetpmdd.be, a woman explains: "I made the connection with my menstrual cycle when I got a Fitbit. That was five years ago now. A Fitbit constantly monitors your heart rate. On days when I felt bad, my heart rate would skyrocket. As soon as my period started, my heart rate would drop again. That was the first time in my life I made the connection between my body and how bad things were going in my head."

The symptoms of PMDD

As we mentioned earlier, one in twenty women will experience it, but a diagnosis often takes a long time. Women with PMDD are typically depressed, anxious, irritable, tense, and often struggle with suicidal thoughts . But they often receive misdiagnoses that further destabilize them: bipolar disorder, borderline personality disorder, or perhaps worst of all: people telling you you're overreacting.

The only way to diagnose PMDD is by tracking symptoms for at least two cycles. These are the symptoms of PMDD:

• Mood/emotional changes (e.g., suddenly sad or tearful, sensitivity to rejection).
• Irritability, anger or increased inner conflict.
• Depressed mood, feelings of hopelessness, feeling worthless or guilty.
• Anxiety, tension, or feelings of being tense or stressed.
• Decreased interest in usual activities (e.g., work, school, friends, hobbies).
• Difficulty concentrating, focusing, or thinking; brain fog.
• Fatigue or low energy.
• Changes in appetite, food cravings, overeating, or binge eating.
• Hypersomnia (excessive sleepiness) or insomnia
• (difficulty falling asleep or staying asleep)
• Feeling overwhelmed or out of control.
• Physical symptoms such as breast tenderness or swelling, joint or muscle pain, bloating, or weight gain

A diagnosis of PMDD requires the presence of at least five of these symptoms , one of which must be an 'emotional core symptom' (one of the first four).

Is there a solution for PMDD?

Unfortunately, there is no ready-made solution for PMDD and treatments do not solve the problem, but counteract the symptoms (the complaints).

Women with PMS often benefit from lifestyle changes: getting regular sleep, getting enough exercise, eating a healthy and varied diet, avoiding sugar, caffeine and alcohol, and not smoking.

For women with PMS this can often help a lot, and if you have PMDD it can help, but it is often not enough.

Many women with PMDD are therefore also prescribed antidepressants (often SSRIs), use hormonal contraception or are artificially induced into menopause, and receive cognitive behavioral therapy.

There are several hormonal treatments that can regulate your hormones, thus reducing the severity of PMDD symptoms. So, while PMDD cannot be cured, there are many ways to alleviate the symptoms and learn to live with this condition.

For many women, the journey to diagnosis, a solution, or living with PMDD is a long one. What can you do in the meantime?

• track your cycle and your moods
• set your boundaries clearly and be kind to yourself
• allow emotions and keep talking about your mental health
• let those around you know what's going on
• listen to your body – it doesn't tell you for nothing that you need to rest for example
• keep looking for the right treatments
• find fellow sufferers

And on that last point… at Guud Woman, you're not alone. If you're struggling with PMDD, we're here to help, so chat with us . We're here to listen and offer advice and support. You're never alone.