Regular PMS Or Something More Serious? Our Psychiatrist Tell Us The Signs

More than half of all menstruating individuals experience some form of premenstrual syndrome, or PMS, at least once in their lifetime, according to The Office on Women's Health. This often consists of physical symptoms, like bloating and cramps, as well as emotional ones like mood swings.

But while many people experience relatively mild PMS, for others, PMS can be absolutely debilitating. This extreme form of the condition is sometimes referred to as premenstrual dysphoric disorder, or PMDD for short. The condition is marked by more severe mental and emotional symptoms around the time of one's cycle, such as anxiety. In extreme cases, some individuals may experience thoughts of suicide. Currently, it's estimated around 2% of individuals who are of menstruation age in the U.S. suffer from the condition.

However, it's important to keep in mind that not all cases of anxiety around your period necessarily mean you have PMDD. Experiencing stress and anxiousness during one's cycle is actually quite common, meaning it can be difficult to determine exactly whether your PMS warrants a PMDD conversation. To get more clarity on the distinction, chat exclusively with Dr. Veerle Bergink, M.D., Ph.D., psychiatry professor at the Icahn School of Medicine for answers on how to tell the difference between the two.

PMDD is significantly more severe than regular PMS

Diagnosing PMDD is notoriously tricky because of how similar it is to other conditions. Cleveland Clinic highlights that some key symptoms of PMDD include difficulty concentrating, anger and irritability, fatigue, panic attacks, and anxiety — all symptoms of depression. What makes it classified as PMDD and not just depression on its own is its timing relative to your cycle. Some experts hypothesize the change in progesterone, as well as a potential drop in serotonin levels around ovulation is the catalyst for the symptoms. "We know hormones play a role, but we do not know enough about the underlying biology," explains Dr. Bergkink to "We suspect there is a group of women out there who are more vulnerable. But any woman is susceptible to hormone changes."

Because of this, as Mind UK points out, it can be a struggle to get an official diagnosis. After all, many menstruating people experience a bad bout of PMS from time to time. But the key difference with premenstrual dysphoric disorder is that those symptoms are not only chronic, but so severe that they impact daily life. "We call [it] a disorder [or start to consider PMDD] if it really interferes with your functioning, meaning you cannot do your work anymore, you cannot help your kids, you are not functioning, you are in bed, you are in sweatpants, you cannot go outside, you're miserable,"  Dr. Bergink exclusively tells They add that PMDD is typically considered if a person is persistently experiencing these symptoms for several cycles, not just one or a few times. "In PMDD, symptoms continue for months," Dr. Bergink added. 

If you're unsure if your anxiety is related to your period, try using a period-tracking app or manually using a journal to monitor your moods. This way, you'll be able to notice symptom patterns and better predict when you may start feeling more anxious than usual. Not only does this help you, but it can help you to adjust your lifestyle accordingly too.

Treating PMDD involves a holsitic aproach

Because PMDD is often regarded as both a mental and physical health issue, treatment usually requires getting both psychiatry and gynecology involved. However, Dr. Bergkink points out exclusively to that there is not enough research on PMDD currently available for there to be universally defined treatment guidelines on what works. Because of this, there is no set pill one can take to manage the symptoms associated with it. 

Instead, other treatments used to manage mental health conditions, such as SSRIs are typically prescribed to help manage anxiety, Dr. Bergink exclusive tells However, people are evaluated on case-by-case basis, as what works for one person may not work for the other. "It's trial and error [with each patient]," Dr. Bergink adds. "Some women try contraceptives, or if they're perimenopausal, hormone replacement therapy (HRT). [..] it's always highly individual whether that works for [helping] someone's mood or not."

If you have concerns about your moods around your cycle, it's important to talk to your doctor. Even though what your symptoms may not necessarily result in a PMDD diagnosis, that doesn't mean you can't receive treatment for them.