What are the symptoms of PMDD?

What are the symptoms of PMDD?

• Mood swings
• Depressed mood or feelings of hopelessness, even suicidal thoughts, feelings of guilt
• Marked anger, increased interpersonal conflicts, sometimes not realizing your verbal outbursts or remembering exactly what upset you or what you said  
• Tension and anxiety
• Irritability
• Decreased interest in usual activities
• Difficulty concentrating
• Fatigue
• Change in appetite
• Feeling out of control or overwhelmed
• Sleep problems
• Physical problems, such as bloating, joint pain, irritable bowel

Most medical websites will claim that in order to have PMDD, a woman:

a) must have these symptoms the week before menstruation, and/or

b) the symptoms must end just after menstruation begins, and/or

c) you cannot have symptoms at all during the week following menstruation. 

This would be true if every female ovulated at the exact same time, but some ovulate (believe it or not!) DURING menstruation and some ovulate just before or even just after menstruation. Some ovulate multiple times during a cycle (twins!) and some even have trouble ovulating the first time their body attempts it, so the body attempts it again (and again). 

There are women who experience PMDD three weeks out of every month! (The week of no PMDD is usually the opposite week of menstruation. In other words, the week before, the week of, and the week after menstruation are the PMDD weeks. The remaining week is the "bliss" week, as some joke, and there are no PMDD symptoms or episodes. However, everyone is different.) 

If you find that you have these symptoms constantly with no breaks, there is a good chance that it is not PMDD... UNLESS you are already being treated with antidepressants. A lot of women find that antidepressants make them feel depressed even on their non-PMDD days (see this article about it). 

If you've already been diagnosed with bipolar disorder (especially bipolar type 2, in which depression is felt more often than mania), it's worth looking into. It could very well be PMDD. The manic episode(s) you may have experienced might have been PMDD or just feeling better after recovering from a PMDD episode. Some find that the PMDD irritability pushes them to do things and be more productive (which can be mistaken for irritable mania), and some find themselves scrambling to get the things they had put off because of the PMDD finished quickly, which can appear to be mania.

How do I find out for sure if this is PMDD, you ask? Your best bet would be to chart your symptoms with the Daily Record of Severity of Problems for a full two months or more and see if you notice a pattern of when you have the symptoms and when you menstruate. If you know when you ovulate, that's even more helpful. Some even go so far as buying ovulation test strips (you can get a pack of 50 for about $20 at Amazon.com) and finding out exactly when they ovulate (or at least when they have an LH surge, which occurs about a day before ovulation). If they have symptoms right around the LH surge, there is a very high chance it is PMDD. 

But I'm on birth control pills, you might be thinking. Ahhh.. now this is where it gets tricky. Many women with PMDD still have PMDD episodes while on birth control pills. How is that possible? We are noticing that it's not always ovulation or an LH surge that triggers PMDD. It could be an overly sensitive reaction to very small fluctuations in hormone levels. This is why we need more research. Not only to find out exactly what causes PMDD but also to find an effective treatment that doesn't involve surgery!

If you have PMDD, are your episodes "typical" (occur the week before menses and alleviate after you begin bleeding) or "atypical" (occur other times in your cycle and do not always stop with menstruation)?