PMDD, or premenstrual dysphoric disorder, is often referred to as the most severe form of PMS.
It differs from PMS in that the premenstrual symptoms markedly impair your ability to function in everyday activities, responsibilities, and relationships.
Symptoms of PMDD include:
- Markedly depressed mood, feelings of hopelessness, or self-depreciating thoughts
- Marked anxiety, tension feelings of being keyed up or on edge
- Marked affective lability (as is, feeling suddenly sad or tearful or increased sensitivity to rejection)
- Persistent and marked anger or irritability or increased interpersonal conflicts
- Decreased interest in usual activities (such as, work, school, friends, hobbies)
- Subjective sense of difficulty in concentrating
- Lethargy, easy fatigability, or marked lack of energy
- Marked change in appetite, overeating, or specific food cravings
- Hypersomnia or insomnia
- A subjective sense of being overwhelmed or out of control
- Other physical symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, weight gain.
Initial treatment for PMDD is similar to that for PMS; stress reduction, regular exercise, avoidance of alcohol, caffeine, and sugar. Vitamins B6, E and omega-3 essential fatty acids may improve symptoms. Because of the severity of symptoms, oral contraceptives or serotonin drugs are often required for improvement of symptoms. Your physician can tell you which therapy would be most effective for you.