Premenstrual Dysphoric Disorder

Premenstrual Dysphoric Disorder (PMDD)is considered a type of depressive disorder. It should not be confused with Premenstrual Syndrome (PMS) because PMDD causes considerable interference with usual work, school, social, and relationship activities. In addition, PMS is characterized by short-term mood changes, while PMDD is generally more severe and has different symptoms.

In PMDD, symptoms usually start the week before menstruation and end a few days after menstruation starts. Some women also experience these symptoms during ovulation. The symptoms are much like those of clinical depression, but the shorter duration distinguishes the two. Although 20% to 50% of women experience PMS or prementrual syndrome (variously defined), it is estimated that 3% to 5% of women suffer this disorder as defined below.

A woman is considered to have Premenstrual Dysphoric Disorder if she has these symptoms for most of the months in the past year. The appropriate criteria for this disroder are still be researched. However, the DSM-IV is suggesting that at least five of the symptoms listed below should be present for diagnosis.

Suggested criteria for PMDD

- symptoms occur in most cycles in the past year
- ability to function impaired, i.e. symptoms interfere with work, relationships etc.
- symptoms must be absent for at least one week soon after menstruation

At least 5 of the these symptoms:

- depressed mood and feelings of hopelessness
- feeling tense or anxious
- unstable mood with frequent tearfulness
- constant irritability and anger which increases conflicts with other people
- decreased interest in usual activities
- difficulty concentrating
- lacking energy
- changes in appetite
- insomnia or hypersomnia (excessive sleepiness)
- feeling overwhelmed
- physical symptoms like breast tenderness and swelling, headaches, bloating, weight gain, joint pain, or muscle pain