Premenstrual dysphoric disorder (PMDD)

If your monthly crankiness feels like PMS to an extreme, you may be suffering from premenstrual dysphoric disorder (PMDD), a menstruation-linked disorder that triggers severe depression.


“PMDD occurs when depressive symptoms, such as crying, tiredness and sadness, occur one week prior to menstruation and disappear  soon afterward,” Doctors say.

The severe mood swings resemble clinical depression and interfere with normal day-to-day functioning but they’re always temporary. 

Symptoms are as follows:

• No interest in daily activities and relationships
• Fatigue or low energy
• Feeling of sadness or hopelessness, possible suicidal thoughts
• Feelings of tension or anxiety
• Feeling out of control
• Food cravings or binge eating
• Mood swings with periods of crying
• Panic attacks
• Irritability or anger that affects other people
• Physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain
• Problems sleeping
• Trouble concentrating
  
  Treatment for this:
  
  
  A healthy lifestyle is the first step to managing PMDD.
• Eat healthy foods with more whole grains, vegetables, fruit, and little or no salt, sugar, alcohol, and caffeine.
• Get regular aerobic exercise throughout the month to redue the severity of PMS symptoms.
• If you have problems sleeping, try changing your sleep habits before taking medicines for insomnia.

Keep a diary or calendar to record:

• The type of symptoms you are having
• How severe they are
• How long they last

Antidepressants may be helpful.
The first option is usually an antidepressant known as a selective serotonin-reuptake inhibitor (SSRI). You can take SSRIs in the second part of your cycle up until your period starts, or for the whole month. Ask your doctor.
Cognitive behavioral therapy (CBT) may be used either with or instead of antidepressants. During CBT, you have about 10 visits with a mental health professional over several weeks.
Other treatments that may help include:

• Birth control pills may decrease or increase PMS symptoms, including depression
• Diuretics may be useful for women who gain a lot of weight from fluid retention
• Nutritional supplements -- such as vitamin B6, calcium, and magnesium -- may be recommended
• Other medicines (such as Depo-Lupron) suppress the ovaries and ovulation
• Pain relievers such as aspirin or ibuprofen may be prescribed for headache, backache, menstrual cramping and breast tenderness