PMDD-PMS Only Worse

We've probably all seen the t-shirt that says, "I'm PMSing and I have a gun." Almost all women laugh knowingly-as do many men-shaking their heads in agreement. PMS, premenstrual syndrome, has been at the center of many jokes over the years but it can lead to a condition that is no laughing matter.

PMDD-No Laughing Matter

Although we can laugh at PMS, there is a more severe form of the syndrome that is no laughing matter. Premenstrual dysphoric disorder or PMDD presents debilitating premenstrual symptoms that can be so severe women become almost suicidal. Like PMS, PMDD occurs a week before the onset of menstruation and disappears a few days afterward. The disorder is characterized by intense mood swings and physical symptoms that interfere with day-to-day life, especially personal relationships with family and friends. They are neither manageable nor are they normal. They require medical attention. However, until recently most women had no idea that what they were experiencing was not PMS, but something far more serious.

Criteria For Diagnosing PMDD

The symptoms of PMDD may include irritability, depressed mood, anxiety, sleep disturbance, difficulty concentrating, angry outbursts, breast tenderness, and bloating. When the disorder is diagnosed, the primary characteristics emphasized are depressed mood, anxiety, mood swings, or irritability. PMDD affects at least one in 20 women in the US who have regular monthly periods.

The physical symptoms are identical to PMS, and while the emotional symptoms are similar, they are definitely much more serious with PMDD. The criteria for diagnosing PMDD focus on the mood rather than the physical symptoms. Feelings of sadness or mild depression are common with PMS. However, with PMDD these feelings are more intense. Significant depression and hopelessness may occur and in some instances and a woman may feel like killing herself or someone else. These feelings must be taken seriously-they are not "just PMS" and a professional should be consulted.

Women Who Suffer With Depression At Increased Risk

Women who suffer with depression tend to be at increased risk for PMDD and conversely, women who have had PMDD during their lifetime are at increased risk for depression after menopause. Sadly, most women who suffer with PMS and PMDD never talk to their doctors about it, saying they can handle it themselves. One in four women surveyed about PMS and PMDD said they did not think their doctors would take them seriously, so they preferred not to say anything at all.

PMDD is listed as an official psychiatric diagnosis. Jean Endicott, Ph.D., Director of the Premenstrual Evaluation Unit at Columbia Presbyterian Medical Center said, "I frequently work with patients who have waited years to ask a doctor about premenstrual problems or have been turned away by their health care provider when they tried to discuss symptoms. They fear becoming the target of jokes or feel that seeking help is a sign of weakness. Informing women and providers about diagnosing and treating PMDD helps clear the way to effective medical care."


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