Like PMS, But so Much Worse: Premenstrual Dysphoric Disorder

Mother Nature’s monthly gift. Surfing the crimson wave. A visit from Aunt Flo. Communists in the fun house. A red dot special.


In case you haven’t caught on yet, we are talking about periods today. Specifically, premenstrual dysphoric disorder. Yep, periods AND mood disorders meet! All of the “taboo” topics for you today!

I’ll give you all a chance to compose yourselves. Or run away, if you can’t handle a little ~lady talk~.

If you do have lady parts below the belt, then you are probably familiar with PMS–premenstrual syndrome. AKA bloating, cramps, headache, fatigue,  bowel issues, irritability, and general blegh feelings a starting a couple of days before your period and ending around the first or second day of the crimson tide. Premenstrual dysphoric disorder  or PMDD is much rarer, but it also has much more serious symptoms. Some experts classify PMDD as a separate issue from PMS, and others put it on a spectrum of PMS.

Symptoms of PMDD include:

  • Lack of interest in daily activities (AKA anhedonia)
  • Fatigue
  • Sadness, hopelessness, and possible suicidal ideation
  • Anxiety
  • Feeling of being “out of control”
  • Binge eating or food cravings
  • Mood swings
    • Possibly with seemingly random bouts of crying
  • Panic attacks
  • Irritability or anger
  • Difficulty sleeping
  • Difficulty concentrating

….plus all the fun symptoms of PMS too!

But why??

Much like PMS, doctors and researchers don’t know exactly what causes PMDD. Hormones are likely involved (duh) but other than that, it’s up for grabs.

Some things can increase the probability of woman suffering from PMDD. It has a high rate of comorbidity with:

  • Anxiety
  • Depression
  • Seasonal affective disorder (SAD)

Not surprising, right? Keep in mind thought that one of the criteria for a PMDD diagnosis is that your symptoms are not just a worsening of another disorder that you have. However, women with depression are more likely to commit suicide during the second half (days 15-28, roughly) of their menstrual cycle. Estimates place the number of women who experience PMDD at about 5%.

So what can you do if you think you are in that 5%?

Taking the Pill is a good place to start. Also, doing that good stuff that we should be doing anyways–exercising, eating healthily, limiting alcohol and caffeine–is recommended. You can keep a journal to track your symptoms too, to see if anything seems to trigger or worsen them. Plus, if you decide to see a doctor or a psychologist about your symptoms, it will be helpful you already have been tracking them. They may also prescribe an anti-depressant medication either daily or just during the second half of your cycle to help manage the symptoms.

And as always, if you have any thoughts of suicide or self-harm, contact a crisis hotline. (1-800-273-8255 is the national suicide hotline.)

Subscribe to the mailing list for worriers:

* indicates required

Email Format


premenstrual dysphoric disorder

Leave a Reply

Your email address will not be published. Required fields are marked *