Bad Periods? How to Tell If It’s PMDD or Just PMS

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Is it just PMS, or something more serious? Here’s how to tell. | iStock.com

You may be feeling a little under the weather the week before your period begins — you might be having intense cravings for sugary snacks, cramps that leave you hunched over your desk, or headaches that last for days. The physical symptoms of your looming period are certainly annoying, but they’re normal and not much cause for concern. Some psychological symptoms are common as well — it’s typical to feel a little bit more stressed, angry, or emotional than usual. There are times, however, when the psychological symptoms can feel overwhelming, enough that they’re affecting your life and your relationships more than they should.

According to Massachusetts General Hospital’s Center for Women’s Mental Health, up to 75% of women experience unpleasant premenstrual symptoms that effect them physically, psychologically, or both. Typically, these symptoms occur one to two weeks before your period actually begins, and they fade once it starts.

Physical symptoms of PMS include stomach bloat, an increase in appetite, breast tenderness, headaches, fatigue, swelling in the extremities, and sleep disturbances. Psychologically, you may feel angry, anxious, irritable, or depressed. If you’re also feeling forgetful or have trouble concentrating, this is also a normal sign of PMS. You’re likely to experience a few of these symptoms at once, but they should only seem like minor annoyances to you. If they feel more severe, or you feel as if they are lasting for longer than they should, then you may be experiencing premenstrual dysphoric disorder (PMDD), a more extreme condition.

Signs of PMDD

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PMDD feels like extreme PMS. |iStock.com

PMDD feels like PMS in overdrive. Netdoctor explains PMDD is primarily a mood disorder, which means that while the average uncomfortable physical symptoms may not seem any worse than normal, you will feel like your mood has taken a turn for the worse. PMDD symptoms are significant enough to impair your home life and personal relationships, and you may have great difficulty working, studying, or doing enjoyable activities. While PMS affects a great deal of women, PMDD only impacts between 3% and 5% of women.

How PMDD affects your mental state

African American depressed woman

PMDD can feel like depression. | iStock.com/Rawpixel Ltd

Many symptoms of PMDD mimic those of depression — the big difference between the two disorders is that PMDD comes in time with your menstrual cycle, and the symptoms come and go in this cyclical pattern. Common PMDD symptoms include an inability to see positivity in the future, feeling worthless, an intense feeling of dissatisfaction and unhappiness, and irritability that causes more conflicts than usual with others. Many women with PMDD find themselves sleeping more and avoiding spending time with others while these symptoms persist.

While this disorder primarily affects your mood, MedlinePlus states that a few physical symptoms that you may experience from PMDD include binge eating, unusual food cravings, and joint pain. If you feel as if you’re experiencing any of the extreme psychological symptoms accompanied by these physical ones, then it’s a good idea to keep track of when you’re experiencing these. Having a calendar or a journal where you can document the date and symptoms can help your or a health care provider give you the proper diagnosis.

Diagnosing PMDD

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Here’s what you need to know about getting a PMDD diagnosis. | iStock.com

When it comes to diagnosing PMDD, ObGyn.net explains there should be at least five symptoms present, with one of the primary ones being depression, mood swings, tension, or irritability. If it’s PMDD, these symptoms should be severe enough to interrupt your everyday life. Keep track of any warning signs for a few menstrual cycles to see if you notice any patterns.

It’s important to note that young girls who are not yet menstruating, pregnant women, and post-menopausal women cannot experience PMDD. If you fall into one of these categories, then you may just be experiencing symptoms of depression, in which case your symptoms will not come and go in a cyclical pattern. In this case, your doctor can help establish a treatment plan that’s right for you.

What causes PMDD?

Three young happy women with face masks at spa resort.

It can be tough to pinpoint what causes PMDD. | iStock.com/petrenkod

Though the causes of PMDD are unknown, Cleveland Clinic states most researchers believe hormonal changes related to your menstrual cycle may be to blame for these severe symptoms. There is also a possible connection between PMDD and low levels of serotonin in the brain, which is the chemical responsible for transmitting nerve signals. It helps control mood, sleep, attention, and pain.

The birth control pill Yaz has been FDA approved for treatment of PMDD, and other oral contraceptives may also help relieve these severe symptoms. Lifestyle changes like exercise, proper nutrition, and a caffeine-free diet can also help control either PMDD or PMS symptoms. While PMS symptoms can be managed with lifestyle choices, your doctor may recommend anti-depressants for those who have a PMDD diagnosis and fail to see any change in their symptoms through their own management. Individual and group counseling can also be beneficial for managing stress and negative thoughts.