Premenstrual dysphoric disorder (PMDD): mood disturbances before the period

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Many people have not heard of premenstrual dysphoric disorder (PMDD). PMDD is a disorder that is significantly more debilitating than premenstrual syndrome (PMS). There are many different statistics out there but PMDD may affect 5% of North American people or 10% of people worldwide. 

Symptoms

Similar to PMS, symptoms start before the period. They usually start a week before but the window of time can be longer for some women. Symptoms improve as the period starts. The symptoms are so disruptive that they interfere with a person’s life. Symptoms of PMDD include but are not limited to:

  • Significantly depressed mood, anxiety, mood swings and/or irritability

  • Fatigue

  • Difficulty concentrating

  • Significant changes in appetite 

  • Bloating and/or swelling 

  • Breast tenderness

  • Headaches

What Causes PMDD

The cause of PMDD is a bit of a mystery. Those with a history of depression, high stress and anxiety are at a higher risk of developing PMDD. PMDD seems to involve changes in brain activity and neurotransmitters like serotonin (the “happiness hormone”), GABA and dopamine that negatively affect the mood. For example, women with PMDD may have poorer functioning serotonin systems during the pre-period stage of their cycle.  

Many wonder if a hormone imbalance may be at play with PMDD. That information is not completely clear in studies but researchers have found that women with PMDD have nervous systems that are more sensitive to the natural hormonal fluctuation that happen throughout the month. This leads to greater changes in mood and physical symptoms. An increase in inflammation may also contribute to symptoms. 

Treatment 

As a naturopathic doctor, my role in helping those with PMDD is to use nutritional supplements, diet and lifestyle recommendations to help improve symptoms alongside herbal remedies when it makes sense for the patient.

When patients are in the midst of their PMDD symptoms, it can be really hard to take care of themselves. It’s important to have a plan that is easy to follow when feeling really down or anxious. Sometimes, it can be helpful to have a longer list of health recommendations (diet, supplements, lifestyle changes etc.) during “non-PMDD” weeks and a more bare-bones list during “PMDD weeks”. Every case is a little different.

If your PMS or PMDD is interfering with your life and you need support, set up a free 15 minute meet and greet to learn more about how I can help. 

Samantha DassHolland Landing Health Centrepmdd, pms, depression, anxiety, periods