Premenstrual Dysphoric Disorder (PMDD): Explained and tips to help

by | Feb 4, 2021 | Health & Wellness

PMDD is not your regular PMS. This serious condition creates marked distress that interferes with your daily life, work, and relationships. Starting ten days to two weeks prior to the onset of your period, some women experience a wide variety of severe period symptoms that include mood swings, anxiety, depression, irritability, and multiple additional physical symptoms.

According to the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, this is a real condition that is estimated to affect 3-8% of menstruating women.

Do I have PMDD?

To understand if you have PMDD, you need to keep a journal for a few menstrual cycles. See if there is a pattern of physical and emotional symptoms in the ten days to a week prior to your period. Write down how you are feeling, your physical and emotional symptoms, and assess if your severe period symptoms improve significantly or are absent the week post menses.


The difference between PMS and PMDD is severity. While PMS is not seen as fun or enjoyable, it is generally normal and manageable. PMDD, on the other hand, is severe, affecting women’s sense of self, relationships, and ability to function at work.

Below is a list of some common emotional and physical symptoms associated with PMDD as mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

  1. Mood swings
  2. Increased interpersonal conflict
  3. Depression, anger, anxiety, and self deprecating thoughts
  4. Feeling overwhelmed and irritable
  5. Changes in appetite and sleep
  6. Decreased interest in usual activities
  7. Low sexual drive
  8. Low energy
  9. Suicidal thoughts
  10. Bloating, headaches, and back pain

What is it like to live with PMDD?

Women describe PMDD as having half of the month feel normal and the other very emotionally intense. They describe the premenstrual dysphoric days as confusing, frustrating, and the feeling of being out of control. They report a lot of feelings of shame, guilt, and self criticism. Women with this condition often feel embarrassed and are tired of apologizing for the anger they experience.

How can I reduce my PMDD symptoms?

  1. Discuss your symptoms with your OBGYN to assess your hormone levels and treatment options.
  2. Antidepressants are an option you can explore with your OBGYN or psychiatrist. This medication is often prescribed for only half of the month, during the two weeks prior to your period, on the days you experience most PMDD symptoms.
  3. Keep a calendar to anticipate the time of the month that you are experiencing PMDD symptoms.
  4. Make healthy lifestyle choices:
    •  Healthy eating
    •  Moderate exercise
    • Reduce alcohol and caffeine consumption
    • Don’t smoke
    • Get plenty of rest and sleep
    • Get a massage
    • Meditation
  1. Dr. Gabrielle Peacock, an Australian medical doctor specializing in mental health, emphasizes that your thoughts are valid, even when you have the worst PMDD symptoms. She recommends journaling your thoughts during the week prior to your period when you have your most extreme thoughts and feelings. She highlights, however, not to act on your thoughts and feelings at this time— just to journal. In the week post-period, when your symptoms subside, read your journal and decide what you want to act on. This would be the time, when you feel more calm, to talk about what is bothering you in your work or relationships and make a change.
  2. Let your friends and the significant others know that you are struggling and ask them for support.

How Therapy Can Help

Therapy is a place to express yourself and to be heard, validated, and challenged. It’s a private place for you to share what is important to you and gain tools to treat PMDD symptoms so you can get back to your normal day to day life.

What Resources Can I Gain from Therapy?

  1. Education on PMDD
  2. Suggestions on how to talk to friends and family about PMDD so they can be supportive during this challenging time.
  3. How to keep a positive sense of self, keep perspective, and find balance.
  4. Treatment for depressive, agitation, anxious feelings, and other symptoms.
  5. Explore thoughts and feelings that are triggered and create a plan on how to address these issues constructively.
  6. Repair relationships with partners and colleagues.
  7. Learn to express yourself assertively so you can address issues respecting both your needs and the needs of others.
  8. Work on parenting issues that arise and craft a plan for positive parenting.

If you are struggling with severe symptoms 10 days to a week before your period, consider reaching out to a physician or psychologist to learn more about PMDD. Therapy is a very useful tool in helping women with PMDD feel in balance and control again. If you are seeking therapy, you are welcome to call (760) 930-0886 to set up an appointment with me, Rakefet Benderly PH.D, a Carlsbad psychologist. Together, we can heal in connection.

Dr. Benderly is a psychologist practicing in San Diego, CA. She provides psychotherapy services to residents of San Diego including Carlsbad, Encinitas, Solana Beach, Del Mar, Rancho Santa Fe, Fairbanks, Oceanside, Vista, La Jolla, San Marcos, Escondido, and La jolla.

Dr. Benderly specializes in treating: Depression & AnxietyGrief & LossRelationshipsPremenstrual Dysphoric DisorderAssertiveness & Social SkillsStress Managementand more.

Therapy offered in Hebrew and English.

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