Pre-Menstrual Dysphoric Disorder (PMDD) is an endocrine disorder affecting about 8% of menstruating women. It presents as a severe form of PMS during the luteal phase of menstruation (the time between ovulation and menses) causing physical and mental pain, including acute and often debilitating mood swings, irritability, depression, anxiety, and, in severe cases, suicide. Your GP or OB/GYN typically diagnoses PMDD, and for more details of the diagnostic criteria for PMDD, please visit this site.
There are many treatment options available for those that suffer, including Dialetical Behavioural Therapy (DBT) and Cognitive Behavioural Therapy (CBT) along with medically advised treatments (such as SSRI medications, birth control pills, and naturopathic options - all under the supervision of a doctor), vitamins, exercise, and meditation. At Impart Therapy, we take a holistic, integrated approach to treatment, including a focus on DBT/mindfulness as well as wellness coaching. PMDD is a serious isssue, and those that suffer need a comprehensive approach to help.
Pre-Menstrual Exaberation (PME) is extremely common for those that have previously been diagnosed with mental ailments, such as bipolar disorder, anxiety, and/or depression, and during one's luteal phase (again - the timeframe between ovulation and period) symptoms get much worse. PME is different from PMDD in that during the follicular phase (the time between onset of period and ovulation) the initial symptoms do not disappear, but may lessen. Similar to PMDD, PME can be treated with a holistic approach.
Severe PMS is often a term used to describe those who face extreme mental, emotional, and physical hardships during luteal phase, without meeting the criteria for PMDD. Like PME, treatment for severe PMS is similar to PMDD.
Whether you suffer from PMDD, PME, or Severe PMS, our approach and treatment is similar.
Four times a year, we run a DBT focused support group for PMDD/PME sufferers. These groups are aimed at peer support and education, providing the tools to help our clients. If you are interested in learning more about our PMDD/PME Support Groups, please click below!
Experts are uncertain what causes PMDD, but it is linked to the brain's reaction to the fluctuating hormones during our cycle. PMDD is caused not by an abnormal sensitivity to elevated levels of hormones, but rather by an abnormal sensitivity to the normal cyclical changes in hormones that occur each month following ovulation (Eisenlohr-Moul, 2019).
PMDD sufferers do not have a hormonal imbalance, but rather a sensitivity to the hormonal fluctuations. This sensitivity likely exists on a continuum or spectrum, with severity ranging from absent, mild, moderate, or severe. This can change month by month or even year by year. Permimenpause (the transition into menopause which on average lasts about 4 years) is a reported particularly difficult time for PMDD sufferers.
The follicular phase of your cycle is between menstruation and ovulation (typically 1 to 14 days, although this range is different for everyone). During this time, there are little to no symptoms reported, and some refer to this phase as our "magical time."
The luteal phase starts after ovulation and continues until the onset of bleeding. It is during this timeframe when sufferers notices symptoms. Some experience the majority of symptoms the week or so leading up to their period, but others notice immediately upon ovulation. During menstruation (either immediately or a few days after onset), PMDD sufferers report their symptoms abating.