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What is PMDD? When It’s More Than Just Premenstrual Tension

by Andrea M. Darcy

Do your low moods and anxiety tend to hit every month, then suddenly disappear? Leaving you wondering if you are bipolar, or something similar? And do you suffer worse pre-menstrual tension (PMT) than anyone you know? You might have PMDD. 

[Are your out-of-control mood swings ruining your life? Want to talk to someone who can help? Book a therapist today, be talking as soon as tomorrow.]

What is PMDD?

Premenstrual dysphoric disorder (PMDD) isn’t just PMT/PMS.

It is a condition where your hormones heavily affect your moods. In the days leading up to your period you feel totally out of control. 

Think of it like PMT on overdrive. If PMT is like a storm passing, PMDD is like a tsunami. And it can certainly feel that way, as it tends to wreck your relationships and life each month. 


PMDD is different than anxiety or depression because it happens at around the same time each month (before your period). When you start menstruating, your symptoms stop and you feel yourself again.

And it’s not just PMT, which just makes you more sensitive and moody but means you can carry on as usual. PMDD really affects your life. You snap out of it to find you’ve ruined a relationship, skipped a day of work, missed something important. You can start to feel like Dr Jekyll and Mr. Hyde, spending half the month cleaning up for the other half when you are out of control.

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But my doctor said I just have PMT and depression

Post menstrual dysphoric disorder is a recognised diagnosis in America. It is now even found in the DSM-5, the diagnostic manual all mental health practitioners in the USA use.

Unfortunately, here in the United Kingdom, it’s not yet an official diagnosis. Some doctors might not be as willing to take you seriously. It can be helpful to track your moods for several months, so your doctor can see that the moment you begin menstruating you go back to normal.

Even in America, where PMDD is diagnosed, it is still often seen as an endocrine disorder.  This is helpful as it recognises it’s a hormone-related condition, but undermines how very serious this condition is when it comes to moods.

At its very worse, cases of PMDD have been found to lead to suicidal thinking and even psychosis, complete with hallucinations. So it is time that doctors take it seriously.

Symptoms of PMDD

Emotional and mental symptoms include:

Physical symptoms include:

Why do I have PMDD?

It’s not fully known what exact causes are. But it’s thought to be a mix of genetics and possibly environment. So you can be born more sensitive to hormones, and perhaps a traumatic past event then triggered your PMDD.

What treatment helps PMDD?

There is controversial advice when it comes to PMDD, and it can be a case of trial and error until you find what works for you.

Talk therapy can help. It can be a great relief to talk to someone who doesn’t judge you and understands. It can particularly help if there is any past trauma in your life that might be making your PMDD worse.

Some doctors will suggest anti-depressant medication, and/or oral or injected contraception. Although it’s not really proven that contraception does help with PMDD, with some women reporting that it made their PMDD worse.

At the very extreme end some women opt to have a hysterectomy.

Self care is important. Track your periods, so you start to get an idea of when your worse days are and can be prepared, such as planning for early nights to get more rest. Many people feel that diet and exercise can be of help, as can avoiding things like alcohol and smoking.

Need to talk to a top therapist in Central London about your PMDD? We connect you with psychotherapists psychologists, and psychiatrists. Not in London or even the UK? Book online therapy now and be talking to someone as soon as tomorrow.

Andrea M. Darcy mental health expertAndrea M. Darcy is a mental health and wellbeing expert and personal development teacher with training in person-centred counselling and coaching, as well as a popular psychology writer. Follow her on Instagram for useful life tips @am_darcy

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Blog Topics: Depression

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