Vicky Pattison has bravely opened up about her experience with Premenstrual Dysphoric Disorder (PMDD) on TV this week. She shared how her most difficult moments led her to suicidal ideation, and a desperate struggle to cope with her emotions that made her feel like a stranger to herself.
Despite PMDD first being recognised as a clinical disorder by the DSM-5 in 2013, a significant lack of awareness remains regarding its prevalence, severity and life altering impact. Many people are still wondering, what is PMDD?
What is PMDD?
The DSM-5 categorises PMDD as a debilitating mood disorder characterised by “severe emotional, cognitive and somatic symptoms during the luteal phase of the menstrual cycle, significantly impairing daily functioning and interpersonal relationships”
PMDD symptoms can be emotional such as extreme anger or irritability, severe depression or hopelessness, intense anxiety, mood swings, brain fog or feeling generally out of control. Physical symptoms can include fatigue, insomnia, eating more or less than usual, joint or muscle pain, bloating, digestive issues or breast tenderness.
PMDD Symptoms typically emerge after ovulation, around day 14 of the cycle, and persist until menstruation begins, the part of the menstrual cycle referred to as the luteal phase. This means that for many, the struggle lasts between 10 to 14 days every single month.
While the onset of a period can bring hormonal relief, it often marks the start of a different struggle: the “repair” phase. Many find themselves spending their “good weeks” clearing up the wreckage caused by the previous two, apologising to loved ones and “taking back” expressions of despair to reassure loved ones of their safety.
As symptoms soften, many women find themselves in disbelief, “How could I have felt so low?”. Yet just as life stabilises, the next wave hits. The cyclical nature of the symptoms can leave people overwhelmed and exhausted.
PMS vs PMDD?
Premenstrual Symptoms (PMS) and Premenstrual Dysphoric Disorder (PMDD) share many symptoms; however, the difference is primarily one of severity and functional impact.
PMS is much more common, affecting up to 90% of people, compared with PMDD which affects around 3-8% of people.
While PMS may cause feelings of irritability or saddess, this is often more manageable, more temporary and has a less severe impact on the day-to-day functioning of an individual.
How to treat PMDD?
PMDD treatment options include lifestyle changes, such as targeted nutrition, stress management or CBT. SSRI’s and hormonal contraception are also often used as a pharmaceutical way to manage the symptoms, in extreme cases, some women have turned to inducing early menopause through chemical or surgical means.
Because it can be difficult to identify the source of such intense hopelessness, cycle tracking is a vital tool for regaining a sense of control and self-compassion.
Finding support for PMDD.
Vicky, like many other women, was routinely dismissed by medical professionals who mistook a debilitating disorder for “normal period symptoms.”
The narrative that intense suffering is an inherent part of the menstrual cycle is a harmful misconception. It creates a culture of silence that prevents people from seeking life-changing intervention. We must be clear: suicidal ideation is never a “normal” hormonal side effect.
To truly improve the lives of those with PMDD, we must acknowledge that the path to a diagnosis is not the same for everyone. Women of colour often face more systemic biases leading to even more delays in receiving support. Transgender men and non-binary individuals experience the double burden of managing PMDD symptoms while navigating processes that may not align with their gender identity. Finally, the “hidden costs” of PMDD, such as missed workdays, specialised therapy, and expensive prescriptions, disproportionately impact those in lower socio-economic groups who may not have the ability to access those resources.
PMDD Awareness Month
This PMDD Awareness Month, we continue to advocate for support that prioritises non-discriminatory treatment and ensures that every individual regardless of their identity or background, has access to the care they need.
This month is a reminder that while the PMDD cycle can feel relentless and isolating, you do not have to fight it alone.
If you, or someone you know, are struggling to navigate the emotional weight of PMDD, please reach out, counselling can provide a vital space for validation and regulation. We are here to support you.
Disclaimer: This article is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Premenstrual Dysphoric Disorder (PMDD) is a serious medical condition. Always seek the advice of your GP, mental health professional, or other qualified health provider with any questions you may have regarding a medical condition.