While most women experience some form of premenstrual symptoms such as bloating, mood swings, or fatigue, Premenstrual Dysphoric Disorder (PMDD) is a far more severe and often debilitating condition. But for decades, women's health—especially anything linked to menstrual cycles—has been under-researched, overlooked, or dismissed as "emotional exaggeration." This historical gap in scientific understanding means that many women still don’t even know PMDD exists, let alone that it could be the reason they’re struggling so deeply each month. Unlike regular PMS, PMDD can profoundly disrupt daily life, work, and relationships—yet it often goes undiagnosed, hiding in plain sight.

According to the American Psychiatric Association, PMDD affects approximately 3-8 per cent of menstruating women. It is classified as a mood disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), not just a reproductive issue. This highlights the deep psychological and physiological roots of the condition. Reasons behind this disorder are often linked to an abnormal response to hormonal fluctuations, especially estrogen and progesterone.

Related article: An Introduction to Premenstrual Dysphoric Disorder: It’s More Than PMS

Signs of PMDD - When PMS Crosses the Line

The key difference between PMS and PMDD symptoms is the intensity and their impact on mental health and everyday functionality. If one needs to mark a timeline, then PMDD symptoms typically occur during the luteal phase of the menstrual cycle, roughly 7-10 days before menstruation and tend to resolve within a few days of the onset of the period.

Observe these signs to confirm that your PMS might actually be PMDD:

1. Severe Mood Swings: Feelings of sadness, hopelessness, or sudden tearfulness are common. Women may report feeling “not like themselves,” with emotional lows mimicking clinical depression.

2. Irritability and Anger: Heightened anger, sometimes disproportionate or unprovoked, is a defining symptom. This can strain personal and professional relationships.

3. Anxiety and Panic Attacks: Unlike PMS, PMDD often causes intense anxiety or feelings of being overwhelmed. Some women even experience panic attacks.

4. Fatigue and Lethargy: Extreme tiredness, lack of energy, and difficulty concentrating — often mistaken for chronic fatigue — are frequently reported.

5. Physical Symptoms: These may include breast tenderness, joint/muscle pain, bloating, and headaches, similar to PMS but more pronounced.

6. Disrupted Sleep Patterns: Insomnia or sleeping excessively can occur, further worsening mood and hindering cognitive function.

7. Suicidal Thoughts: This is one of the most concerning signs of PMDD. A 2017 study published in the Journal of Women’s Health found that women with PMDD are at a sixfold higher risk for suicidal ideation compared to those without it.

Related article: How to Calm the Mind and Get a Good Night’s Sleep

How to Deal With This Monthly Storm?

From the looks of it, PMDD might seem like a difficult-to-tame beast, but it is treatable. Noticing & accepting your monthly patterns, getting an early diagnosis and sticking with a treatment plan are key.

1. Track Your Cycle: Keep a diary of your symptoms for at least two or three cycles. This helps your doctor figure out if it's PMDD or something else, like depression or bipolar disorder.
2. Cognitive Behavioural Therapy (CBT) can really help by teaching you how to change negative thought patterns and manage stress, which can lessen PMDD symptoms.
3. Medication: Your doctor might suggest SSRIs (Selective Serotonin Reuptake Inhibitors), like fluoxetine or sertraline, which are approved for PMDD. Sometimes, hormonal birth control can also help by evening out your hormone levels.
4. Eat Well: Some women find relief with supplements like calcium, magnesium, and Vitamin B6. Cutting back on caffeine, sugar, and alcohol can also make a difference.
5. Move Your Body & Get Sleep: Regular exercise releases feel-good chemicals that can boost your mood and ease bloating. Getting enough quality sleep is also super important.

Related article: 5 PMS Self-Care Hacks That Work And 5 That Don’t

While some people casually whip out “Is it that time of the month card”, it is imperative to know and understand that some of us might be battling something much more than just normal mood swings, i.e PMDD. It is best not to shy away from the symptoms, talk and seek guidance openly, accept & work towards betterment. 

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