How to tell if your monthly moods are more than PMS

Many women agree they suffer symptoms of premenstrual syndrome (PMS) at a certain time every month – perhaps crankiness, cramps, or a propensity to cry when watching emotional things on telly.

However, Andrea Rapkin (professor of obstetrics and gynecology at the University of California) believes this general moodiness is not PMS at all. She says PMS is only experienced by around 8-18% of women and that this condition can severely impair a sufferer’s life.

For some women, these symptoms can be even more debilitating. Premenstrual dysphoric disorder (PMDD) is a condition thought to affect around 3-8% of women in the UK. It begins one to two weeks before menstruation and eases off around four days after. According to Samantha Meltzer-Brody, director of the Perinatal Psychiatry Programme at the UNC Centre for Women with Mood Disorders, this condition can severely impair social and occupational functioning.

Sufferers find themselves feeling highly irritable, angry, sad and disinterested in things that previously interested them. These emotions can lead them to lash out at loved ones, become overly paranoid and to feel particularly guilty. Because sufferers experience a change in how they feel about themselves and others, they can often find themselves with relationship issues.

According to the DSM-IV (the American manual for all diagnosed mental health problems), women must have five symptoms to be diagnosed with PMDD, including:

• irritability
• mood swings
• depressed mood/hopelessness
• tension and anxiety
• appetite changes
• loss of interest
• lack of energy
• feeling overwhelmed or out of control
• physical problems including bloating.

PMDD can often be misdiagnosed as depression (and vice versa) because the symptoms are very similar. Dr, Meltzer-Brody says: “At least 50% of women who self refer for PMDD actually have depression.”

Life can be difficult for a woman suffering from PMDD. The symptoms can have a big impact on the decisions they make. They might find themselves sending angry and seemingly irrational texts, having sudden angry outbursts or feeling the need to hide away from social occasions. This makes it difficult to have relationships and keep friends.

Counselling may be able to help sufferers deal with their emotions and find ways to let them out without damaging other parts of their lives. To find out how a counsellor may be able to help, please visit our Therapies page.

View and comment on the original PsychCentral article or visit National Association for Premenstrual Dysphoric Disorder.