PMS vs PMDD
Do you Have It? | Ways to Manage It | Confusion City | The Imposters
If you’re here, you probably already know you have PMDD, but just in case, here are the symptoms:
The Diagnostic Criteria for PMDD
In most menstrual cycles during the past year, five or more of the following symptoms must be present during the last week of the luteal phase of a woman’s menstrual cycle, begin to remit within a few days after the onset of the follicular phase, and were absent in the week post-menses, with at least on of the symptoms being (1), (2), (3) or (4).
1. Markedly Depressed Mood
2. Marked Anxiety or Tension
3. Marked Affective Lability
4. Persistent and Marked Anger or Increased Interpersonal Conflicts
5. Decreased Interest in Usual Activities
6. Subjective Sense of Difficulty in Concentrating
7. Lethargy, Fatigue, Marked Lack of Energy
8. Marked Change in Appetite, Overeating or Food Cravings
9. Hypersomnia or Insomnia
10. A Subjective Sense of Feeling Overwhelmed or Out of Control
11. Physical Symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, bloating and weight gain.
So What Does That Mean In Language I Can Understand?
The following section breaks the symptoms down into everyday language.
Markedly Depressed Mood
Major episodes of depression, plain and simple. The hallmark of PMDD. PMDD is so much more than a bad case of the blues. During the latter half of a woman’s menstrual cycle, the depression that comes is clinical in nature, and can include thoughts of hurting yourself or others, and even suicide.
Marked Anxiety or Tension
This goes beyond simple edginess, nervousness, or jitters. You feel like you want to jump out of your skin, slap somebody--anybody--or something really bad is about to happen and you don’t know what it is or how to stop it. Panic attacks fall under this heading.
Marked Affective Lability
One minute you’re laughing, the next you’re crying – What’s up with that? Split-second shifts in emotions come without warning and are as uncontrollable as an allergic reaction. Know that you’re not at fault for this and stop apologizing to people for it! Do you apologize when you have an allergic reaction? If you do, you might want to check into some classes to boost your self-esteem because there’s more going on here than just PMDD. Never let your PMDD make you feel badly about yourself as a person.
Persistent and Marked Anger or Increased Interpersonal Conflicts
You’re angry all the time and can’t stop snapping at or arguing with people, and fear the loss of friends and family relationships, or may have already lost them. There’s suddenly a mean streak in you a mile wide and you lash out at your significant others, children, friends and co-workers, and don’t know how to stop. You hate yourself afterward, and spend a ton of time either apologizing or doing damage control.
Decreased Interest in Usual Activities
Some days nothing seems like a good idea. You can’t even muster the energy to get out of bed, shower, or see to your simplest needs, much less the needs of your loved ones. This takes a devastating toll on family life, especially for those with children.
Difficulty in Concentrating
How about some multi-tasking ADD-style, forgetfulness a la Alzheimer’s, with a side order of clumsiness and foggy thinking? How can you get through the day when you can’t stay focused, can’t remember anything, keep dropping or bumping into things, and can’t seem to string two coherent thoughts together--much less make a decision? This includes women who appear to be extremely flighty, maybe forget to pay bills, pick up or feed the kids, comb their hair or put shoes on before they go out, as well as lose the ability to control their balance.
Lethargy, Fatigue, Marked Lack of Energy
You can’t stop yawning, and you feel like you’re moving uphill through molasses. It’s almost like narcolepsy, at times preventing women from being able to drive or use heavy equipment, including the stove. PMDD also lowers immunities, making women more susceptible to colds and flues for at least one to two weeks of every month. This can lead to chronic illness and debilitating fatigue from simply being run down physically.
Marked Change in Appetite
When you want to eat everything in sight, especially everything you shouldn’t. The good news is it’s not all in your head, it’s not a matter of willpower, and there are reasons why you crave the things you do. But until you understand that, you’ll keep binge eating and having cravings that don’t occur during any other time of the month.
Hypersomnia or Insomnia
You’re exhausted, but you still can’t sleep at night, or you just can’t wake up no matter what. You toss and turn all night, or wake up feeling like a wet, heavy blanket of fog has rolled into your brain, or both.
A Subjective Sense of Feeling Overwhelmed or Out of Control
You think you’re going crazy (but the good news is you’re not.) You feel like you’re losing your mind. One day everything can be running smoothly and life is good, and the next day nothing has changed, but everything suddenly seems out of control and too overwhelming. The train of negative thoughts runs through your mind in loops and won’t stop, especially those about what your behavior is doing to your loved ones.
At this point some beg God to just get it over with, and “Take me now.” Others attempt suicide.
Physical Symptoms
Just like depression, PMDD hurts. Joint pain, muscle pain, back pain, pelvic pain, headaches, and cramping. Bloating, swelling, inflammation, upset stomach, and allergies are intensified. Excessive bleeding and anemia can come into play here. You can lose the ability to control normal body temperature, making you feel extremely cold, or very hot, no matter the weather.
Other Symptoms Include (But Are Not Limited To)
Impulse Control
Sensitivity to Touch
Sexual Aggression
Sexual Disinterest
Suicidal Thoughts
Suicide
Rare Symptoms of PMDD
Delusions and Hallucinations
Psychosis
Psychotic Episodes
Sensory Disturbances
PMDD in the News: A Word About Homicide
Yes, a woman can and does feel angry enough to kill. In the 1980s in England, the currently-called “PMS defense” freed Christine English after she confessed to killing her married boyfriend by ramming him into a utility pole with her car. After killing a co-worker, Sandie Smith was put on probation with one condition: she had to report monthly for injections of progesterone to control symptoms of PMS. By the 1990s, the PMS defense had paved the way for other hormonal defenses.
Charting Your Symptoms is a Must
The best way to find out if your symptoms are PMDD or part of an ongoing condition not related to your menstrual cycle is to chart the symptoms. A chart for you to print out is provided here (link coming soon). You’ll need to do this for at least two months, to get a proper diagnosis of PMDD. Three would be ideal, but who wants to wait that long for relief?
The main thing you need to watch for is whether your symptoms are present at all times, or whether they come and go. It can also be confusing if you have an underlying condition that worsens in concert with your menstrual cycle, both around the times of ovulation and when your period is due. More on this in the sections labeled Confusion City and The Imposters (coming soon).
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