PMDD (premenstrual dysphoric disorder) is a severe form of PMS that causes intense mood symptoms, such as depression, anxiety and irritability, in the one to two weeks before a period.
PMDD symptoms start in the luteal phase, after ovulation, and usually ease within a few days of a period starting. Emotional symptoms include low mood, anxiety, anger, mood swings, feeling out of control and finding it hard to concentrate. Physical symptoms can include tiredness, bloating, headaches and breast tenderness. Some people have thoughts of suicide. Anyone with these thoughts should get urgent help from a doctor.
Premenstrual syndrome is common and usually mild to moderate. PMDD is much less common, and its symptoms are severe enough to affect relationships, work and daily life. Experts think PMDD is linked to how the brain reacts to normal hormone changes, not to abnormal hormone levels.
A doctor will usually ask you to track symptoms for at least two cycles to see if they follow a pattern. A PMDD quiz can help you prepare for this talk, but it cannot replace a diagnosis. Treatment options a doctor may discuss include talking therapies, antidepressants and hormonal treatments.
PMDD can make some days of each cycle much harder at work. Helpful support may include flexible hours, the option to work from home, quiet space, regular breaks and time off for appointments.
Sources: NHS, MedlinePlus.
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