Another Set of Initials to Reek Havoc

When I was growing up, the “m” (menstruation) word was not mentioned in polite conversations, let alone mixed company. I remember telling my mother that I got my period and her happily telling my dad. I was embarrassed and excited at the same time.

Well, that has surely changed. You see print ads and TV commercials extolling the use of one menstrual product over another. And those three letters “PMS” are heard anywhere from news shows to comedy routines. They are as well known to the masses as TNT and ABC.

There’s another set of initials that has not yet received such notoriety. This is PMDD or premenstrual dysphoric disorder. PMDD is a much more severe form of the collective symptoms known as premenstrual syndrome (PMS). It affects about 5 percent of women of reproductive age and is considered a severe and chronic medical condition that requires attention and treatment. PMDD usually begins when a woman is in her teens to late 20s, although women who seek treatment are usually in their 30s. Depression is one of the most common symptoms. PMDD is a term that was created in recent years by the American Psychiatric Association.

PMDD is not the same as PMS because it greatly impacts one’s work, schooling, social, and relationship activities. PMS leads to short-term mood changes; PMDD is usually more more acute and has different symptoms, including:

Feeling blue, hopeless ,tense or anxious Having mood shifts with frequent tearfulness Being constantly irritable and angry Having a decreased interest in usual activities Concentrating poorly Lacking energy Binging on foods or having a loss of appetite Experiencing problems sleeping Having no interest in sexual relations Experiencing physical symptoms like breast tenderness, headaches, bloating, weight gain, or joint/muscle pain.

To be considered PMDD, the symptoms must be present in severe form, but only during the last two weeks of the cycle. Some women also experience these symptoms during ovulation. If it sounds a lot like clinical depression, it’s because it is. The only difference between the two is that PMDD lasts for a shorter length of time and that PMDD is closely linked to a female’s menstrual cycle.

Although any woman can develop PMDD, some women may be at a greater risk:

Women with a personal or family history of mood disorders Women with a personal or family history of postpartum depression Women with a personal or family history of depression

Although the definitive answer about cause is still unknown, studies indicate that PMDD could be caused by an abnormal, biochemical response to normal hormonal changes. Some research shows that the routine increase in estrogen and progesterone before menstruation causes, in some women, a serotonin deficiency that induces PMDD. Once again it appears that serotonin levels may play a role in depression.

If you expect that you are suffering from PMDD, don’t ignore it. The mental pain can be just as debilitating as clinical depression. Talk to your primary care physician, psychiatrist or OB/GYN about your symptoms. Keep a diary of symptoms and their timing to establish a cycle of reoccurrence.

The treatment for PMDD is similar to that for major depression: the use of antidepressants and psychotherapy. A woman with PMDD needs to take antidepressants on an ongoing basis, not just during the time when her symptoms appear. Psychotherapy can help her cope with the symptoms and with other challenges in her life.

How do you know if you are suffering from clinical depression and not PMDD? According to the site Women’s Health Interactive, you can differentiate between the two in the following ways.

The mood swings experienced around periods aren’t a mental disorder. These may be obvious to us and to our loved ones, but probably aren’t particularly noticeable to other people.

In a woman who already has a mood disorder such as major depression or anxiety, the disorder may make premenstrual symptoms seem worse. However, that doesn’t mean she has PMDD. A medical condition such as a thyroid disorder, cancer, endometriosis, or other infections may intensify premenstrual mood symptoms, but again, that doesn’t mean a woman has PMDD.

PMDD symptoms are clearly linked to the menstrual cycle, and disappear during menstrual flow.

Laboratory testing and medical and mental examinations can distinguish PMDD from other physical and mental conditions.

The Women’s Health Interactive site also has a quick-self test that you can take to determine whether or not you are suffering from PMDD. The questions are from the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), 4th edition, 1994.

DMDD can be extremely painful and cause a major disruption in a woman’s life and career. If you have any reason to believe you suffer from this illness, make an appointment with a doctor now.