PMS vs PMDD – What’s the Difference?

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PMDD is the acronym for Premenstrual Dysphoric Disorder, a more severe form of PMS or Premenstrual Syndrome. Both PMS and PMDD may present physical symptoms such as breast pain, headaches, weight gain and bloating, and emotional symptoms, such as mood swings, depression, angry outbursts and anxiety. However, the diagnosis of PMDD is determined by the level of severity of those symptoms and how they impact on a woman’s quality of life, especially with respect to relationships with family and friends.

Like PMS, PMDD occurs the week prior to the beginning of menstruation and disappears a few days after. It is not unusual for women to experience sadness or mild depression during PMS but with PMDD, depression, anxiety, anger and sadness, can reach critical levels to the point where the sufferer may want to harm herself, or others. Women experiencing these feelings may be reluctant to seek help for many reasons. They may fear becoming the brunt of jokes or feel they should be able to manage the symptoms on their own. Many may be concerned about the stigma attached to emotional disorders. Nevertheless, thoughts of suicide and violence must always be taken seriously, and it is imperative that anyone that anyone having those thoughts, obtain medical help, immediately.

Theories on the cause of PMDD vary as this disorder is not well understood. Research in the studies of premenstrual syndrome only began in the early 1950s, challenging the widely accepted view that the condition was a figment of the imagination. Since the late 1970’s real progress has made, mostly due to an increasing number of women in scientific research and medical fields, and a push by feminist groups to recognize the validity of disorders peculiar to women and attempt to discredit the previous assumption that PMS symptoms were purely psychological. A current theory is that women that experience PMS and PMDD are particularly sensitive to normal hormonal changes occurring during each menstrual cycle. Vitamin deficiencies and inadequate diet have also been proposed as possible causes.

Treatment for PMDD varies widely. A popular treatment is SSRI’s (selective serotonin reuptake inhibitors) otherwise known as anti-depressants. Serotonin is a hormone, produced by a gland in the brain, related to mood regulation. Research has shown that anti-depressants such as Prozac or Paxil, can significantly decrease symptoms. In many cases the drug is only taken at the onset of symptoms and continued for six or seven days. It may also be prescribed in conjunction with oral contraceptives. Proponents of the diet and vitamin deficiency theories recommend decreasing caffeine, sugar and sodium and cutting back on alcohol intake. Daily doses of Vitamin B6 and E, and calcium are also recommended. Some research indicates that Light Therapy can ease the symptoms of PMDD. Light therapy or phototherapy is exposure to daylight, or to specific wavelengths of light using lasers, light-emitting diodes, fluorescent lamps or very bright full-spectrum light for a prescribed amount of time each day. Cognitive behavioral therapy (CBT) has been used with great success, but, as in all types of psychotherapy, it requires a commitment on the part of the patient/client, with the therapist, to affect change.

If you are suffering from PMDD, you are not alone. It is estimated that one in 20 women who have a regular menstrual period also have PMDD. Research is on-going to find a definitive treatment, but in the meantime here’s what you can do:

  1. Go see your doctor. He/she can order the tests and ask the questions that will determine whether it is PMDD or another disorder. The symptoms of PMDD are similar to those for thyroid disease, depression, heart disease, irritable bowel syndrome and chronic fatigue syndrome, to name a few.
  2. Tell your family. If you are experiencing severe mood swings, they too, are affected. PMDD is not your fault and it is treatable but you owe an explanation to those around you who might be on the receiving end of displays of emotion. And you need their support. Reaching out for help is always a first step towards any kind of recovery.
  3. Take the medication if it is offered. There is no shame in treating PMDD with drugs. It is a treatable disorder. You wouldn’t refuse insulin, if you were diabetic, would you?
  4. If your doctor won’t help you, get another doctor. PMDD must be taken seriously. It affects the quality of your life and you deserve to feel better.

For anyone living with PMDD, there is hope and there is help. If you would like more information about this disorder, go online or contact a local women’s health facility. There are also online chat communities or you might find a support group in your area. Whatever you decide to do, remember, this is your life. You should be enjoying it.


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