PMDD: Understanding the Difference


As it is finals week, I’ve been wrapping up in my final lectures. It’s a bittersweet feeling. There are so many things that I wish that I had done differently. It’s also a time to reflect on all of the things I’ve learned, all the things I’ve written, all the new subjects I’ve encountered.

In one of my last classes the professor mentioned PMDD (premenstrual dysphoric disorder) in reference to the DSM diagnoses of mental disorders. In the back, someone snickers.

PMS is still funny, which makes PMDD really funny. What comes to mind? Women acting irrationally, tears, anger, depression, fighting, snacking. That stereotypical “crazy woman” is funny because people don’t know how to deal with it. It doesn’t fit the comfortable and convenient view of women that is subdued and easy to moderate. If someone has PMS or PMDD (or simply if a woman is acting in a loud or strongly behaved way) that is entertaining.

Unfortunately for those who suffer from PMS or PMDD, the symptoms are nothing to laugh about. They can severely impact the quality of your day and influence how you feel about life, and yourself. Getting treatment for these symptoms may require a diagnoses from the DSM-V. A friend of mine recently was diagnosed with PMDD and suggested that I write a bit about what it is.

I’ve been unable to get my hands on a copy of the new DSM, but this is what I was able to find regarding its inclusion in the book.

Based on strong scientific evidence, premenstrual dysphoric disorder has been moved from DSM-IV Appendix B, “Criteria Sets and Axes Provided for Further Study,” to the main body of DSM-5. (

Inclusion in the DSM is important because many people are unable to gain access to medication for what troubles them without a diagnoses from this book. It is, however, a controversial decision as well.

“I think any time a disorder occurs more frequently in women or only in women, there’s going to be a group of individuals who have concern that this will diminish women’s role in society, their sense of being capable,” Epperson says.

The article this quote is grabbed from is from the NPR: Should Severe Menstrual Symptoms Be A Mental Disorder? It is worth a read. When discussing mental illness it is important to consider how a diagnoses will positively and negatively influence that group of people afflicted by those symptoms.

Here is a breakdown on PMDD:

PMDD is a more severe and disabling form of PMS. It is much less common than PMS. Statistics I found cited between 1-8% of menstruating women.

The difference between PMS is that PMDD symptoms disrupt her normal daily activities in the time period that she has them. Unlike PMS, which may be more mild.

Strong emotional and physical reactions come ~10 days before a woman’s period. These symptoms can include anxiety, stress, depression, tension, and anger.

Treatment involves symptom reduction, which is one reason that medication might prove useful to women who are having these experiences around this time in their cycle. Other non-medicalized treatments like exercise and diet changes are also important. Counseling may help some women find coping strategies.

What I would recommend:

Many of you know that I keep a journal documenting various moods, emotions, and other various symptoms. Doing this can help you notice trends in your cycle as well as help you notice if there are any irregularities. I wrote up a mock of what this looks like on a blank page in one of my old moleskin notebooks. I didn’t really want to post my real one 🙂 It’s a pretty realistic replication though.

  • Hearts – Intercourse
  • Circles – High fertility days + Prediction of Periods
  • Dots – Days of bleeding
  • Numbers – Tracking cycle (day 1 – first day of period, typical cycle is 28 days, this is how you can predict your period if you have a normal cycle)

Generally I only write down moods when I have one that is particularly present. You can see that in the example there might be more negative emotions right before the start of a cycle (near the 23-28th days). These are PMS symptoms, light, generally manageable negative moods and physical discomfort.

Processed with VSCOcam with b5 preset


Creating a journal like this can also help you discover if your symptoms are more severe and are serious disrupting what you get done. If you’re worried that you might be suffering from PMDD I would recommend going further than a journal in this style and actually writing out how your day went, if you struggled with anything in particular, and keeping track of things in a more detailed way.

Questions? Have something you’d like me to write about? Submit by clicking ask advice at the top of the page and I’ll answer it on my blog. 

2 Comments Add yours

  1. LaNeshe ( says:

    There are some good apps to keep track too.


    1. ST says:

      Agreed. I used one for a while but found I liked being able to see everything all at once on paper. Having it on your phone is super convenient for on the go entries.


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