Premenstrual Dysphoric Disorder can often be confused with Premenstrual Disorder (PMS). It is a severe mood disorder with heightened anxiety and irritability. In an interview with HT lifestyle, CPsy. Ruchi Sharma, clinical psychologist, Manipal Hospitals, Dwarka, New Delhi said, “PMDD is accompanied by severe disturbances in mood, heightened irritability/anger outbursts and/or anxiety, sometimes panic symptoms too.”

Dr. Geetu Gaba, Consultant- Obstetrics and Gynaecology, Manipal Hospitals, Dwarka, New Delhi, added, “Typically occurring in the luteal phase, which is the week or two leading up to menstruation, PMDD involves both emotional and physical symptoms that can significantly impact daily functioning and quality of life.”

Premenstrual dysphoric disorder: Causes

While the exact cause of PMDD is unknown, Dr Ruchi Sharma noted down PMS, low serotonin levels, family history, poorly-managed stress, endocrine disturbances and poor gut health as some of the contributing factors to PMDD. “Think of it like the pain and discomfort of PMS paired with symptoms of depression and/or anxiety before menstruation, which subside once periods begin. It is a recognised disorder in both ICD & DSM,” added Dr Ruchi Sharma.

Premenstrual dysphoric disorder: Symptoms

PMDD shares some symptoms with PMS but is more intense. Common symptoms include:

• Severe mood swings, irritability, or anger
• Depressive thoughts, feelings of hopelessness, or sadness
• Anxiety, tension, or edginess
• Trouble concentrating
• Fatigue or low energy
• Physical symptoms like bloating, breast tenderness, headaches, and joint or muscle pain
• Changes in appetite and sleep patterns

Premenstrual dysphoric disorder: Treatment options

Dr Geetu Gaba noted down the treatment options that can help to manage PMDD:

Lifestyle changes: Regular exercise, a balanced diet, and good sleep hygiene can help manage symptoms.

Medication: Antidepressants, especially SSRIs, are often effective in treating mood symptoms. Hormonal treatments, such as birth control pills or GnRH agonists, may help stabilize hormone fluctuations.

Therapy: Cognitive Behavioral Therapy (CBT) can help with coping mechanisms and mood regulation.

Supplements: Calcium, magnesium, and vitamin B6 may be beneficial for some people, though consultation with a healthcare provider is recommended.

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