Month: <span>May 2026</span>

Depression Mental Wellness Therapy Women's Health • • • • • • • By Beth Church 0 Comments

Understanding PMDD: Shedding Light on a Hidden Struggle

Written by: Sarah Engels, MS, TLLP

For many, the days leading up to their period can be a little tougher– mood swings, irritability, or fatigue are common symptoms. But for those living with Premenstrual Dysphoric Disorder (PMDD), these symptoms are far more intense and can disrupt daily life, relationships, and work. PMDD is more than just a “bad period,” or PMS. PMDD is a serious, hormone-related condition that affects mental, emotional, and physical health. 

How is PMDD different from a normal period?

PMDD is a much more severe version of PMS (premenstrual syndrome). PMDD is a health condition that affects people of child bearing age and requires attention and treatment. Key differences between PMDD and PMS are summarized in the following chart:

Feature PMS PMDD
Severity Mild-Moderate, manageable Severe, often debilitating
Mood Irritability, mild mood swings Extreme irritability, anger, and intense anxiety/depression
Physical symptoms Bloating, breast tenderness, headaches, etc. Higher intensity of normal PMS physical symptoms
Functioning Mild to moderate impact on daily functioning Significant impairment to life, work, and relationships
Prevalence Very common (around 90% of women report symptoms) Less common (around 3% -8% of women report PMDD)
Treatment Self-care, over the counter remedies May require medical intervention (e.g., CBT, SSRIs)

How can I tell if I have PMDD and how is it diagnosed? 

Typically, symptoms of PMDD start around 1 week before your period starts, and end a few days in. They disrupt daily activities and can impact home, work, and relationships at this time. The difference in mood and functioning is notably different than other times during the month. 

The following are common symptoms of PMDD: 

  • Depressed mood, hopelessness, or feelings of worthlessness
  • Increased anxiety, tension, or feeling on edge
  • Mood swings
  • Sensitivity to rejection
  • Frequent/sudden tearfulness
  • Increased irritability
  • Increased relationship conflicts
  • Difficulties concentrating
  • Changes in sleep (excessive sleep or difficulty sleeping)
  • Changes in appetite (lack of appetite or overeating)
  • Physical symptoms like breast tenderness, headaches, joint/muscle aches, weight gain, or bloating

If you are experiencing any of these symptoms, reach out to a medical professional. It is likely that your provider will ask you to keep a diary or journal of symptoms, coinciding with your menstrual cycle to differentiate between PMDD and other disorders with similar symptoms such as depression or anxiety. 

Living life with PMDD: treatment approaches and more

PMDD is a serious and chronic condition. However living with PMDD can be manageable with appropriate care and treatment. Lifestyle changes, therapy and medication can decrease symptoms of PMDD. A combination of the following approaches can be pivotal in symptom reduction: 

  • Changes in diet, such as; decreasing sugar, salt, caffeine, and alcohol, and increasing protein and carbohydrates
  • Getting regular exercise
  • Practicing stress management, like mindfulness and relaxation techniques
  • Therapies such as CBT (cognitive behavioral therapy)
  • Vitamin supplements, like magnesium or calcium
  • SSRIs (selective serotonin reuptake inhibitors)
  • Birth control pills

Conclusion

May is Women’s Mental Health Month, and in turn, we draw attention to the unique challenges that women face and their impacts on mental health. PMDD is often a hidden struggle for many women, dealing with the stigmas surrounding women’s health, both physical and mental. But you and your loved ones are not alone. If you believe that you or a loved one is experiencing symptoms of PMDD, do not hesitate to make an appointment with a clinician at Monarch Behavioral Health to discuss your concerns and make a plan for treatment and support. 

Make an appointment at Monarch Behavioral Health: https://www.mbh-mi.com/make-an-appointment/ 

Further resources: