Many women recognize the feeling of irritability, fatigue or a dip right before their period. But what if your mood symptoms are so intense that they take over your life? Where is the line between "regular" PMS and the lesser-known but even more intense condition PMDD? In this blog, we explain what the difference is, how to recognize it, and what you can do about it.
PMS vs. PMDD: what's the difference?
PMS stands for premenstrual syndrome. It includes both physical and emotional symptoms in the second half of your cycle (the luteal phase), such as:
● Irritability
● Tense breasts
● Headache
● Fatigue
● Sleep problems
These PMS symptoms are incredibly annoying, but usually manageable and disappear as soon as your period starts.
PMDD (premenstrual dysphoric disorder) is different. This is not a more severe PMS, but a recognized mood disorder in which you can completely lose yourself in the days or weeks before your period. The symptoms are much more intense emotionally and mentally, and can seriously interfere with your daily functioning.
Typical symptoms of PMDD are:
● Extremely fluctuating moods
● Bouts of crying or panic attacks
● Feeling of hopelessness or depression
● Outbursts of anger
● Self-reproach or even suicidal thoughts
These symptoms usually disappear again as soon as your period begins, but can return every month.
The cause: not a deficiency, but a hypersensitivity
In PMDD, there is usually no hormonal deficiency or excess. The hormones themselves are normal, but the brain responds to them differently.
What happens:
● During your cycle, your hormones fluctuate naturally. This is normal.
● In the second half of your cycle, the hormone progesterone drops. At the same time, a substance formed from it also drops: ALLO (allopregnanolone).
● ALLO normally has a calming effect on the brain, via the GABA-A receptor: a kind of "brake pedal" in your brain that causes relaxation.
● With PMDD, this calming effect does not work as well. Your brain reacts hypersensitively to hormonal fluctuations during your cycle.
● This leads to mental symptoms such as extreme mood swings, gloom, anxiety or panic.
This hypersensitivity does not come out of nowhere. Early stress, trauma, or a chronically overstimulated nervous system can contribute to it. So PMDD is not just hormonal, it is also neurological and neurobiological.
What can you do about PMDD?
You don't have to keep struggling with this. There are steps you can take to get a better grip on your cycle and your mental well-being.
1. Chart your cycle
Keep a cycle diary. Record your mood, energy, symptoms and menstruation every day. After a few months, you'll see patterns and be able to act on them.
2. Lifestyle as a foundation
● Exercise (especially outdoors) has a proven positive effect on mood.
● Stress reduction through breathing, meditation or yoga helps calm your nervous system.
● Limit alcohol, caffeine and refined sugars, which can negatively affect your mood.
3. Sleep and nutrition
Get enough sleep and nourish your brain with omega 3, B vitamins, magnesium and tryptophan-rich foods (such as bananas, seeds, chicken or oats).
4. Psychological support
Therapy (such as cognitive behavioral therapy or EMDR) can help regulate emotions and process underlying stress or trauma.
5. Professional guidance
Ask for help. You don't have to go it alone. Consider guidance from an orthomolecular therapist, psychologist or specialist doctor.
Summary
PMDD is not an affectation, not "severe PMS," and certainly not something you should "just learn to live with. It is a real condition with a neurobiological basis that requires understanding, recognition and a personalized approach. Understanding what is happening in your body is the first step. Then, step by step, you can learn how to better deal with the sensitivity, not to push your feelings away, but to make room again for peace, stability and yourself.
