PMS Or PMDD? Here’s How to Spot The Difference

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Does your time of the month seemingly take over your life? You might have PMDD. And if you're ready to put the worst of your period woes behind you, you must start by figuring out if you do.

Do you feel extra down and depleted during your period? Does your PMS seem worse than it once did? It might be PMDD, or premenstrual dysphoric disorder. But let’s not jump to conclusions. The first step to feeling better is identifying the true culprit of your cramps, crying, and whatever else ails you during that time of the month.

When it comes to PMS and PMDD, distinguishing between these closely related cycle cousins can be tricky. Both are the product of hormone fluctuations during our menstrual cycles and both can be cause notably unpleasant symptoms. However, one is definitely worse than the other, often causing much more debilitating symptoms. In many cases, those with PMDD report that it derails their daily life.

And so, it’s important to spot the difference in order to get back on track and find real relief. Here are some ways to figure out if you suffer from PMDD, according to period experts.

The Difference Between PMS & PMDD

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Around 80% of people with menstrual periods deal with PMS. The symptoms can be physical (like bloating, fatigue, or cramps) and emotional (like heightened irritability, mood swings, or crying spells). They typically range from mild to moderate, but they’re mostly manageable.

PMDD, on the other hand, is best described as a magnified version of PMS. All of the not-so-pleasant physical, emotional, and behavioral symptoms are cranked up a notch… or sometimes ten. If the time frame right before and at the start of your period seems so severe that it disrupts your ability to function, it could very well be PMDD.

PMDD affects about 10 percent of those with periods. Those with a family history of depression and mood disorders are at notably higher risk. People dealing with this turned-up version of PMS usually notice it start during their 20s with worsening symptoms as they age. And if you think you might have PMDD, start paying close attention to your body with the following symptoms in mind.

Common Symptoms of PMDD

As noted, PMDD is a more serious form of PMS. It’s defined by a severe and chronic combination of psychological, physical, and behavioral symptoms that can greatly affect one’s overall well-being. Again, these symptoms are similar to what people experience with PMS every month, but they’re often way more unpleasant and problematic.

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Psychologically, those with PMDD frequently experience severe bouts of depression, overwhelming anxiety, sharp mood swings, sudden outbursts of anger, increased irritability, heightened sensitivity, paranoia, negative rumination, social withdrawal, and a sudden lack of interest in activities formerly enjoyed.

Physically, those with PMDD may suffer from bloating, breast tenderness, increased appetite, stomach problems, recurring headaches, extreme fatigue, flu-like body aches, and insomnia. PMDD can also lead to difficulty concentrating, forgetfulness, cognitive confusion, feelings of overwhelm, or feeling out of control.

To learn more, here’s a full list of symptoms caused by premenstrual dysphoric disorder, compliments of John Hopkins Medicine.

When it Happens

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If you have PMDD, you’ll likely notice symptoms creeping in about 7 to 10 days before your period. They’ll usually carry over into the first few days of your period as well. For some, it can go last even longer, taking up half of every month.

While the timeframe is somewhat similar to PMS, PMDD can feel like it lasts much longer due to the severity of the symptoms. Daily tasks are often disrupted, causing problems for many at home, at work, and in their relationships.

In turn, PMDD inevitably subsides for a while, but some of its damage can prove lasting and difficult to overcome.

Why it Happens

It’s not entirely clear how or why PMDD comes to be, but scientists know that it’s definitely tied to hormones. More specifically, PMDD is most likely triggered by the period-related hormonal changes that occur when a female’s body is preparing to shed uterine lining each month.

Also, various studies have shown that these hormonal shifts can exacerbate symptoms connected to underlying and existing depression or anxiety.

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Per The Cleveland Clinic, “experts don’t know why some women get PMDD. Decreasing levels of estrogen and progesterone hormones after ovulation and before menstruation may trigger symptoms.” According to many researchers, PMDD has also been linked to lower serotonin levels. Serotonin is the brain chemical that serves as the much-needed messenger between nerves, controlling our mood, attention span, pain response, and sleep patterns.

As with PMS, no two cases of PMDD are exactly the same. The causes, triggers, duration, combination of symptoms, and severity may look drastically different from one person to the next. However, there are some ways that anyone can assess whether or not what was once thought to be a really bad case of PMS is actually PMDD.

How to Figure Out if You Have PMDD

The tricky part about pinpointing PMDD is that the symptoms tend to overlap with other conditions, such as chronic fatigue syndrome, migraines, IBS, fibromyalgia, depression, anxiety, bipolar disorder, borderline personality disorder, and other mood disorders.

So before you self-diagnose based on the symptoms noted above, you should talk to your doctor. If you feel like you definitely suffer from PMDD, you still need to rule out other conditions first with the help of a medical professional.

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Until you talk with a doctor, it won’t hurt to do some research to help figure out if you’re suffering from PMDD or something else. Start by charting your symptoms, when they occur, how long they last, and what they entail. Make note of the patterns you see. If it’s PMDD, your symptoms will only occur at certain times during your cycle, so keep up with those dates on a calendar.

With that said, don’t make this more complicated than it has to be. There are tons of apps to help you easily (and thoroughly) track all aspects of your cycle, including mood changes, physical symptoms, ovulation, and fertility. I’d highly recommend them to anyone with a menstrual cycle, no matter what you’re up against. During your research and period tracking, you may not be able to establish definitively if you have PMDD, but you may be able to rule it out.

Read More: 5 Cycle Tracking Apps to Help You Have a Better Period

How to Deal With PMDD (Without Medication)

PMDD can be a lot to deal with. The good news is, there are tons of ways to mitigate the worst of it and make things easier. The first steps to feeling better might be easier than you think, especially if you’re currently struggling with its most hellacious symptoms.

Experts say that simple lifestyle changes can bring you relief, both immediately and over time. Consider cutting back on caffeine, sugar, sodium, alcohol, and if you smoke, you might want to consider quitting. Starting today, work on improving your sleep quality and increasing your level of exercise.

It’s also been suggested that taking calcium, B6, B12, magnesium, iron, and Vitamin E can alleviate or lessen your symptoms. And there’s never a bad time to make healthy adjustments to your diet.

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If you’re not thrilled about the idea of medication, you may also want to consider taking the herbal route. There are tons of herbal remedies that have been shown to help with striking a better hormonal balance. Not to mention, women have been treating period-related problems with ancient herbs for centuries upon centuries.

For instance, herbs like agnus castus fruit extract, Ginko Biloba, black cohosh, St. John’s Wort, and Kava Kava have been found to do wonders for issues associated with both PMS and PMDD. And the modern-day vitamin market has caught on. Hum now makes a period-oriented supplement called Moody Bird, boasting a potent combination of chaste berry and dong Quai. If you’re already taking medication, make sure you talk to your doctor before you invest in supplements. Your current medicines might not mix well with certain herbs. In fact, some combinations could be dangerous. So make sure you’re fully informed before stocking up on herbs.

Read More: Eat These Foods to Help Ease Depression and Anxiety

Prioritize Your Mental and Emotional Health

There’s no need to go through this alone or in secret. If you struggle more with the emotional and mental symptoms just as much, if not more than the physical ones, clearing your head and emotionally stabilizing is an important part of regulating your system. Due to PMDD-induced depression, the desire to fully isolate might be higher than usual but don’t give in.

Along with adding mindfulness practices like meditating and journaling to your PMDD-combatting routine, you may benefit from talking to someone. Many who suffer from PMDD find psychotherapy, counseling, or cognitive-behavioral therapy helpful in alleviating their symptoms. So never be ashamed to seek help, especially at a time when you likely need outside support the most.

The Bottom Line

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For those living with PMDD, it can feel like an ongoing battle. Many diagnosed report that it affects a significant chunk of their life far beyond their period. Untreated PMDD can lead to deep feelings of hopelessness. And if you’re suffering, it’s time to take care of yourself.

Your menstrual cycle shouldn’t get to control or inhibit you from living your fullest life. You are the one who decides what every day looks like. Moving forward, those days don’t have to include half a month of crying.

If this article only made you feel more certain you have PMDD, now is the time to make arrangements with your doctor and finally figure out the solutions that work for you. And remember, tomorrow is a new day. So make today count by preparing for it.

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