What Is PMDD and How Is It Different From PMS?
Have you noticed your mood shift or felt more irritable right before your period? Many people brush off severe premenstrual symptoms as “just PMS,” but sometimes it’s something more serious — PMDD (Premenstrual Dysphoric Disorder).
Understanding the difference between PMS (Premenstrual Syndrome) and PMDD is important, especially if your symptoms are disrupting daily life, relationships, or work. In this post, we’ll break down the key differences between PMS and PMDD and when to consider reaching out for support.
Understanding PMS (Premenstrual Syndrome)
Common symptoms of PMS (Premenstrual Syndrome) can look a lot like depression. They may include mood swings, crying spells, changes in appetite, trouble sleeping, and wanting to isolate yourself. People who experience PMS may also notice difficulty concentrating and changes in libido. Many healthcare providers believe that PMS symptoms are linked to hormonal changes during the menstrual cycle. Research also suggests that people with a history of depression or other mental health conditions may be more likely to experience symptoms of PMS.
PMS is very common, many people who menstruate experience some symptoms of PMS. While these symptoms can be uncomfortable, they are usually mild to moderate and do not significantly interfere with daily functioning.
What Is PMDD (Premenstrual Dysphoric Disorder)?
PMDD (Premenstrual Dysphoric Disorder) is a cyclical, hormone-based mood disorder. Symptoms begin during the luteal, or premenstrual, phase of the menstrual cycle. The luteal stage usually occurs 1–2 weeks before a period.
Common PMDD symptoms include:
Intense irritability
Anxiety or panic attacks
Depressive episodes
Mood changes that may contribute to suicidal thoughts
Brain fog and difficulty concentrating
Crying spells
Because symptoms happen in the luteal phase, PMDD can often look like a severe mood disorder. Unlike PMS, these symptoms can seriously disrupt daily life causing problems in relationships, difficulty keeping up with work or school, and challenges with communication.
How is PMDD different from PMS?
Impact on Daily Life
PMS is frustrating and uncomfortable but usually manageable. Most people can continue with work, school, and daily activities despite symptoms.
PMDD, on the other hand, is much more severe. Symptoms can significantly disrupt a person’s ability to function day to day, often affecting relationships, work, and overall quality of life.
How Common Is It?
PMS is extremely common — most people who menstruate experience some level of PMS symptoms.
PMDD affects a smaller percentage, with about 3–8% of people who menstruate meeting the criteria for the disorder.
Severity of Symptoms
PMS symptoms are milder, such as irritability, mood changes, or physical discomfort.
PMDD symptoms include intense mood swings, depression, anxiety, and in some cases suicidal thoughts. These symptoms go far beyond typical PMS and are classified as a serious premenstrual mood disorder.
Onset of Symptoms
PMDD symptoms appear during the luteal phase, about 1–2 weeks before a period begins, and usually resolve once menstruation starts.
PMS symptoms may begin a few days before the period and sometimes continue into the first days of menstruation.
How PMDD Impacts Mental Health
PMDD often goes undiagnosed because its symptoms overlap with other mental health conditions such as anxiety disorders, depression, or ADHD. The cyclical nature of PMDD can also make it difficult for both individuals and healthcare providers to recognize the clear pattern of symptoms that occur during the luteal phase of the menstrual cycle.
Stigma around menstrual health adds another barrier—many people feel uncomfortable bringing up mental health changes connected to their cycle. In addition, some providers may be unfamiliar with PMDD and mistakenly diagnose symptoms as another condition. As a result, people with PMDD often feel dismissed or misunderstood, which can make them less likely to seek support in the future.
How Do You Know If It’s PMDD?
I encourage patients to track their symptoms for at least 1–3 menstrual cycles. One of my favorite resources for PMDD education, screening, and tracking is the International Association for Premenstrual Disorders (IAPMD). They offer a free PMDD self-screening tool and a downloadable symptom-tracking PDF to help identify patterns.
If your symptoms are affecting your work or school, it may be time to seek help. Ongoing challenges in relationships are also a sign to reach out. Professional support could include a therapist, primary care physician, gynecologist, endocrinologist, or psychiatrist. Make sure they understand PMDD and menstrual-related mental health concerns.
Getting Help for PMDD in Michigan
If you’re struggling with PMDD and live in Jackson or anywhere in Michigan, Create Wellness Counseling offers virtual therapy. Therapy can help you manage mood, anxiety, and stress related to PMDD. It also helps you build coping skills for better emotion regulation and handling daily challenges.
Resources
The International Association for Premenstrual Disorders (IAPMD). https://www.iapmd.org/
PMDD ≠ PMS. The International Association for Premenstrual Disorders (IAPMD). https://www.iapmd.org/pmdd-not-pms
Premenstrual syndrome (PMS). Mayo Clinic. (Feb 2022). https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780
What is PMDD? The International Association for Premenstrual Disorders (IAPMD). https://www.iapmd.org/pmdd.
