Premenstrual Dysphoric Disorder Symptoms, Risk Factors, Diagnosis, Treatment, and Coping

Premenstrual Dysphoric Disorder Symptoms, Risk Factors, Diagnosis, Treatment, and Coping Depression Types Print An Overview of Premenstrual Dysphoric Disorder By Kendra Cherry facebook twitter Kendra Cherry, MS, is an author, educational consultant, and speaker focused on helping students learn about psychology. Learn about our editorial policy Kendra Cherry Medically reviewed by Medically reviewed by Steven Gans, MD on August 15, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD on August 15, 2019 Verywell / Brianna Gilmartin More in Depression Types Causes Symptoms Diagnosis Treatment Childhood Depression Suicide In This Article Table of Contents Expand Symptoms Causes Diagnosis Treatment Coping View All Back To Top Premenstrual dysphoric disorder is a mood disorder that occurs during the premenstrual phase of the menstrual cycle. While similar to that of premenstrual syndrome (PMS), the symptoms of PMDD are much more severe and can lead to extreme mood changes that can disrupt daily life and functioning. Research indicates that women with premenstrual dysphoric disorder may have alterations in the genes that influence how the body processes stress and sex hormones. These differences mean that women with PMDD have a greater sensitivity to the hormones that influence both mood and general well-being. While PMS can have an impact on a womans life and functioning, it is not classified as a disorder and the symptoms can usually be self-managed. Premenstrual dysphoric disorder is classified as a mental disorder by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Premenstrual irritability and PMS are quite common, but approximately 3â€"8% of all menstruating women will experience symptoms of PMDD.   Different Types of Mood Disorders Symptoms Some of the major symptoms of PMDD include: Severe mood swingsPhysical symptoms including breast tenderness, bloating, and headachesFeelings of sadnessIrritability and anger that is directed toward othersLack of interest in activitiesLack of energy and fatigueSleep disturbancesFood cravings and bingesTrouble concentrating or thinking Symptoms begin during the luteal phase, or after ovulation, and end shortly after menstruation starts.   Causes Research on the causes and treatments of PMDD is emerging, but the evidence has shown that the condition is heavily influenced by a genetic sensitivity to sex hormones.  While PMDD is believed to have biological causes, research has shown that environmental variables such as perceived stress can also increase the risk and severity of the condition.   The condition is estimated to be about 50% heritable.   Research suggests that PMDD may be related to alterations in the cellular responses involved in the metabolism of estrogen and progesterone.   Diagnosis The diagnosis of premenstrual dysphoric disorder usually begins with your doctor taking a health history and doing a physical exam. In most cases, you will need to keep a calendar to track your symptoms over at least two menstrual cycles.   In order to be diagnosed with PMDD, women must experience at least five symptoms across two domains, one involving mood and the other physical symptoms. Women must experience these symptoms during the premenstrual phase and symptoms must be mostly absent within the week following menses. These symptoms must also interfere with functioning in work, school, relationships, and other important life areas and must not be related to an existing condition or caused by substance use. Treatment Treatments for PMDD are focused on minimizing and managing the symptoms of the condition. Some of the treatment options include: Antidepressants, such as selective serotonin-reuptake inhibitors (SSRIs), have been shown to be effective for treating PMDD symptomsBirth controlLifestyle adaptations including changes in diet, exercise, and stress management techniquesMedications to treat physical symptoms including diuretics for fluid retention and anti-inflammatory drugs for painChanges in menstrual products, particularly if these tend to cause discomfort or irritation In 2010, the FDA approved a birth control pill (sold under the brand-name Beyaz) to treat PMDD. This oral contraceptive contains a combination of drospirenone and ethinyl estradiol that may help alleviate symptoms of this condition, but you should talk to your doctor to determine if this option is right for you. Cognitive-behavioral therapy (CBT) may also be used alone or in conjunction with other treatments.   Get Treatment With the 9 Best Online Therapy Programs Coping The mood changes and physical symptoms of PMDD can make it difficult to cope with daily life and manage your relationships. You might feel irritable, depressed, and angry, which can lead to taking out those feelings on the people around you. In addition to getting treatment from a medical professional, there are self-care steps you can take to help manage the symptoms of this condition. Natural treatments such as meditation, regular exercise, and yoga can be effective for helping manage stress. Such practices may also help you cope with symptoms of anxiety and depression.  You should use caution and talk to your doctor before you try using any herbal remedies to alleviate your symptoms. Some herbal supplements such as St. John’s wort, can have adverse reactions when taken with other medications.Getting plenty of rest and eating a healthy diet can also help. Avoiding high-salt foods may help prevent bloating and water retention. Minimize sugar and simple-carbohydrate consumption in order to prevent fluctuations in blood sugar levels. Focus on eating complex carbs, getting plenty of fiber and protein, and drinking enough fluids. One study also found that acupuncture may be a promising treatment for reducing the symptoms associated with PMDD, but further research is needed. A Word From Verywell Coping strategies can be helpful, but you should contact your healthcare provider if your symptoms do not improve with self-treatment or if your symptoms interfere with your daily functioning including your mental well-being, your relationships, or your job.   You can call the National Suicide Prevention Lifeline at 1-800-273-8255 if you are experiencing thoughts of suicide. Or you can reach out to the Crisis Text Line for 24-hour support via text by sending a message to 741-741. What to Know About Different Types of Depression