All too often, we have a habit of downplaying our own pain. We decide it’s just one tough menstrual cycle, even though the last one was just as stressful. We don’t have it as bad as others do, or we’re just being whiny. But this kind of downplaying can keep us from receiving the help we need, especially for conditions like premenstrual dysphoric disorder (PMDD). In today’s blog, let’s break the silence on PMDD and gain a better understanding of what it is — and what you can do about it.
PMDD Is Not PMS
Part of the reason that PMDD so often goes unnoticed is because it seems similar to premenstrual syndrome (PMS). With PMS, you may experience some moodiness, lethargy, tenderness, or pain during your menstrual cycle. This is fairly common among those who have menstrual cycles. PMDD has similar symptoms, such as:
- Depression and irritability
- Mood swings
- Lack of energy and fatigue
- Breast swelling and tenderness
- Changes in diet
However, PMDD is not limited to the menstrual cycle itself. It can begin as early as 1-2 weeks before your menstrual cycle. Because of this, those with PMDD often find themselves suffering from symptoms for at least half of the month. Unfortunately, many simply brush it off as PMS and do not receive the help they need.
Prevalence of PMDD
PMDD affects roughly 1.6% of people with menstrual cycles globally, or about 31 million people. The same study found that 3.2% had provisional diagnoses — meaning they met the criteria for PMDD but were not studied long enough to confirm the diagnosis.1 There is a strict criteria for PMDD in order to separate it from PMS, so there is a likelihood that the 1.6% underestimates the true number of individuals suffering from PMDD.
The Need For PMDD Awareness
The main reason that we need PMDD awareness is simply so that those suffering from PMDD awareness understand that they’re not alone, that there is a name for what they experience and, more importantly, there is treatment. But the need for awareness spans beyond raising awareness in patients. It’s also important to promote PMDD awareness in the ways psychiatrists and mental health professionals are trained.
Psychiatrists, and medical professionals as a whole, are often given little training when it comes to PMDD. This results in patients who have PMDD and want to reach out for help often not being able to find the help they need. Diagnoses can be missed when medical professionals are not trained to look for the symptoms of PMDD. Without competent, understanding care, some patients might give up on treatments. This can all be prevented if the awareness and training around PMDD increases.
Treatments For PMDD
PMDD can be a debilitating disease that disrupts your daily life and overwhelms you for half of the month or more. The good news is that PMDD can be highly treatable, like any other mood disorder. As awareness increases for PMDD, so will the accessibility of PMDD treatments.
Primarily, the two ways to treat PMDD are through therapy and medication management. Your psychiatrist will talk to you about your symptoms and may recommend one treatment over the other, or a combination of the two. There are also lifestyle changes that can help to reduce symptoms.
Medication Management For PMDD
PMDD is a mood disorder that is caused by the hormonal fluctuations surrounding the menstrual cycle. Medication management for PMDD focuses on adjusting the chemical imbalance that may be causing feelings of anxiety or depression during the weeks surrounding your menstrual cycle.
- SSRIs or SNRIs. Selective Serotonin Reuptake Inhibitors or Serotonin and Norepinephrine Reuptake Inhibitors can reduce your PMDD symptoms by increasing the levels of serotonin in your mind. Serotonin promotes feelings of calm, happiness, focus, and motivation. These medications are often prescribed to those with anxiety or depression. They may be taken throughout the month or during the period of time in which your PMDD symptoms are the most present. If you also suffer from depression and anxiety, these may be prescribed daily throughout the month.
- GnRH Injections. Gonadotropin releasing hormone (GnRH) analogue injections are designed to give patients temporary menopause symptoms for a period of up to six months. These are taken with hormone replacement therapy (HRT) due to certain side effects.
- Birth Control. Your OBGYN may recommend birth control as a way of regulating your menstrual cycle, thus reducing your PMDD symptoms.
Therapy For PMDD
Therapy allows you to develop coping skills and distress tolerance strategies in order to manage the worst days of your PMDD symptoms. Evidence-based therapies such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) can be helpful for PMDD. These help you reframe negative thought patterns and better understand your individual vulnerabilities while making goals to reach your life worth living. Therapy also offers an opportunity to vent and discuss what you’re going through emotionally during PMDD in a safe space.
Lifestyle Changes
Lifestyle changes will not make your PMDD disappear but they may help your symptoms to be less intense. These include:
- Getting a full 8 hours of sleep each night
- Eating a balanced, nutritious diet
- Avoiding caffeine, alcohol, and excess sugar
- Participating in aerobic exercise
- Taking daily vitamins
Try not to isolate too much when you experience PMDD. Spending time connecting with loved ones can also help to raise your mood, thus combatting the emotional symptoms of PMDD. When you can, try to make time for self-care in order to decompress on the worst days of PMDD symptoms.
At Rivia Mind, our skilled and compassionate providers are experienced with PMDD and are here to help you. We can offer diagnostic assessments, medication management, therapy, and more. Contact us today to find a provider and schedule a free 15-minute consultation.
Resources:
- New Data Shows Prevalence of Premenstrual Dysphoric Disorder — University of Oxford
