How do you know if you've got PMS versus PMDD?
If you thought premenstrual syndrome, or PMS, was bad, weâre introducing its more aggressive cousin: premenstrual dysphoric disorder (PMDD).
The research differs between studies, but a 2012 review showed it affects 2-5% of women of reproductive age. Other studies suggest it could be closer to 15%, depending on the criteria.
To call PMDD a very severe form of PMSÂ is a bit of an understatement, but itâs still probably the best way to describe it.
PMDD is âa very severe depression that occurs cyclically every four or five weeks,â explains Dr. Meenu Vaish, director at Meher Hopsital, Dehradun.
Of course, there's more to it than that â and as with many women's health issues there are more questions than concrete, studied answers. But we want to raise the profile of PMDD, and that starts with making sure more people can identify it.
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What is PMDD?
PMDD is described as an extreme form of PMS that includes physical and psychological symptoms, often so severe that they can strain social, family, and professional relationships to breaking point.
After years of debate, PMDD finally appeared as a distinct psychiatric condition in the Diagnostic and Statistical Manual of Mental Health Disorders (5th edition) of the American Psychiatric Association in 2013.
Despite the growing body of scientific research into its causes and cures, itâs still a condition that is widely under or misdiagnosed; leaving women to discover it for themselves.
Why is this? The sheer lack of support services for womenâs mental health and reproductive support could be one major clue, but medical literature explains the importance of getting the diagnosis right.
PMDD is a disorder of consistent yet irregular change in mental health and behaviours, which can make it difficult to diagnose.
Whatâs incredibly alarming is the link between suicide and PMDD; itâs a huge differentiating factor when compared with PMS.
The International Association For Premenstrual Disorders (IAPMD) says 30% of women with PMDD will attempt suicide in their lifetime while a larger percentage experience suicidal thoughts and self-harm.
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What are the 11 PMDD symptoms?
There is actually no test used to diagnose PMDD, which makes paying attention to your symptoms even more important â particularly the 11 listed below. It can even be useful to keep a symptom diary so you can keep track.
If you experience 5 or more of these physical and emotional symptoms in a way that impacts your life, you might meet the diagnostic criteria for PMDD:
- Mood changes
- Irritability or anger
- Depression
- Anxiety
- Lack of interest in things you usually enjoy
- Difficulty concentrating
- Fatigue
- Change in appetite
- Insomnia
- Feelings of overwhelm
- Bloating and breast tenderness
Why do people get PMDD?
PMDD is related to hormonal changes that happen naturally in the body as a result of the menstrul cycle.
However, researchers have yet to figure out why it affects 5% of the female population.
The exact cause of PMDD isnât known, although we do know that it has a heritability of around 30-80%. This means that women with a family history of PMS or PMDD are at a higher risk of developing the disorder.
There have been some discoveries made by the researchers at the National Institute of Mental Health (NIMH), that help us understand how genetic factors can contribute to a womanâs susceptibility to experience PMDD.
And it has a lot to do with how a woman responds to the sex hormones produced by the ovaries during the luteal phase.
NIMHâs study has found that women with PMDD have an altered gene complex that processes the bodyâs response to hormones produced by the ovaries.
Why is this important? Well, it has established a biological basis for the mood disturbances of PMDD.
What this means is that the extreme emotional or physiological behaviours of a woman suffering from PMDD are completely out of her voluntary control. Â
Theyâve also published data that supports the theory that the changes in hormone levels, not just the hormones themselves, trigger the symptoms of PMDD.
Other risk factors include pre-existing mental disorders, high stress levels, trauma, inflammation and immune activation. Some research has also linked smoking to an increased risk of PMDD.
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5 lifestyle changes to help you manage your symptoms
Besides medication, there are also habits you can adopt that may have a positive impact on your symptoms:
1. Incorporate cardio into your fitness routine
Working out is an amazing way of managing both emotional and physical symptoms. Cardio is particularly effective at increasing your serotonin levels.Â
Serotonin also plays a role in satiety, which can be helpful if you experience higher hunger levels than usual as a result of PMDD.
If you're not into running or cycling, don't worry: swimming, dancing and even walking all count as cardio!
2. Eat a healthy diet
For women with PMDD, a healthy diet is one rich in high-quality protein, healthy fats, fibre and complex carbs. Our tasty millet flour staples are a perfect source of protein, calcium, dietary fibre that your body needs.
Together, all these essential nutrients will help keep your blood sugar levels under control, prevent inflammation, maintain gut health, stabilise your mood and minimise cravings.
You also want to incorporate anti-inflammatory foods into your diet. Turmeric and saffron have both been shown to help with several symptoms of PMDD, so they should become staples in your pantry. As for what to avoid, it's best you steer clear of simple carbs, particularly during your luteal phase, as they can cause spikes in blood glucose levels.Â
3. Consider taking a supplement
We've mentioned that taking certain medications can help reduce PMDD symptoms, and the right supplement can also be beneficial.Â
Keep in mind, as well, that a supplement can't and shouldn't replace a balanced diet. Plus, it's always a good idea to speak with your doctor before you start taking it, so make sure it is the right choice for you.
4. Find effective stress management techniques
Stress can worsen PMDD symptoms so it's important you find relaxation techniques that work for you.
This can be something as simple as going on a daily walk in nature, painting, stretching or listening to music. Journalling is also proven to reduce stress, as is breathwork, mindfulness, and yoga.
5. Minimise your coffee and alcohol consumption
Drinking coffee can increase your cortisol levels and alcohol leads to a drop in serotonin levels (after an initial boost), which explains why both drinks can negatively impact your mood and mental health.
Treating PMDD requires careful counselling with a doctor to ensure you are properly informed and recommended the right hormonal contraceptive care.
What to do if you think you have PMDD
If you think that you might have PMDD, the best thing to do is speak to your doctor and get a diagnosis.
This way, youâll be able to discover your options and find out if medication may be able to ease your symptoms.
If you are looking for some support with balancing your hormones but want to do it in a non restrictive way, we are here to help. To book a free 15 minute discovery call, write to us at support@bcosfoods.in .