Really Bad PMS or a Mental Disorder?

Dec 22

Most women have dealt with premenstrual syndrome (PMS) to some degree at some point in their lives. It may come in the form of irritability, mood swings, food cravings or a depressed mood, but a small percentage of women experience premenstrual symptoms that are much more severe than your typical bout with PMS. These women suffer from something called premenstrual dysphoric disorder (PMDD), a severe and sometimes debilitating extension of premenstrual symptoms that cause significant problems in the sufferer’s life.

Experts estimate that approximately 1-5% of women suffer from PMDD (Standen, 2013), compared to about 75% of menstruating women who suffer from PMS (Mayo Clinic, 2012). PMDD is not very common, but it’s a major issue for those women who have to deal with it each month. So much so that it has gotten the attention of the American Psychological Association (APA), who have recently moved it from being categorized under "depressive disorder not otherwise specified," to having its own separate disorder in the new Diagnostic and Statistical Manual (DSM V). There is a very specific criteria laid out by the APA in order for a person to be diagnosed with PMDD. The symptoms include things like:

marked affective liability (e.g., mood swings; feeling suddenly sad or tearful or increased sensitivity to rejection)
marked irritability or anger or increased interpersonal conflicts
markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts
marked anxiety, tension, feelings of being "keyed up" or "on edge"

These are just a few of the 11 possible symptoms associated with PMDD. A person must have 5 to be considered for diagnosis. Symptoms present sometime after ovulation and subside shortly after the woman has started her period. On top of that, the symptoms have a clinically significant effect on the person’s work, school, social life, and/or relationships with others. The symptoms must not be explained by another mental disorder, such as Major Depressive Disorder (Saedi, 2012).

Getting PMDD in the DSM V should be considered a big success for women’s health issues, but some women say “not so fast…” With our country and society’s history of sexism, there are many people with some legitimate concerns about a woman-specific mental disorder. They are concerned that a disorder such as PMDD could be used against women to deem them incapable or unfit in a variety of different situations. Another concern is that this disorder could be over-diagnosed, and by result, pathologize healthy women and healthy hormonal patterns. As with any kind of disorder or illness, there is money to be made with PMDD. The company that patented Prozac has revamped the Prozac pill, given it a new name, and put in on the market as a PMDD drug, charing $10 per pill versus the generic Prozac that has the same ingredients and goes for $0.25 per pill. If their first attempts at advertising the drug were any indication, the drug company has no intention of properly educating the public about this disorder. The first round of commercials said nothing to define PMDD nor differentiate PMDD from PMS. In the end, the company was told to stop broadcasting their commercials by the FDA because they were so misleading (Standen, 2013). Their ads both trivialized a serious issue and made it seem as though every grumpy woman should be given a little pink pill. No wonder people are concerned.

Then, on the other side, now that PMDD has finally been recognized as a disorder, women who have been suffering with this very real problem have finally been able to receive information, support, and treatment. Women who have PMDD have reported feeling better just knowing there is a name for what they’re going through. It helps to feel they aren’t alone. Through raised awareness around the topic, supportive communities have popped up online which help women share their own experiences and what has helped them deal with their PMDD. For some that has been diet and exercise, and for others it has been birth control pills or antidepressants (Standen, 2013).

In the end, PMDD is a very real disorder that has a very detrimental effect on the women who suffer from it. More research needs to be done to find out why some women suffer from PMDD and others don’t. Perhaps the recognition from the APA and the disorder’s presence in the DSM V will help researchers gain funding to do just that. While diagnosis of the disorder will have to be well regulated and education surrounding the condition will be key, raising awareness should help women with PMDD get the support and treatment they need.

References

Mayo Clinic. (2012). Premenstrual Syndrome. Retrieved December 12, 2013 from http://www.mayoclinic.com/health/premenstrual-syndrome/DS00134

Saedi, G.A. (2012). The Inclusion of PMDD in DSM-5. Retrieved December 12, 2013, from http://www.psychologytoday.com/blog/millennial-media/201202/the-inclusion-pmdd-in-dsm-5

Standen, A. (2013). Should Severe Premenstrual Symptoms Be A Mental Disorder? Retrieved December 10, 2013, from <a data-cke-saved-href="http://www.npr.org/blogs/health/2013/10/22/223805027/should-disabling-premenstrual-symptoms-be-a-mental-disorder" href="http://www.npr.org/blogs/health/2013/10/22/223805027/should-disabling-premenstrual-symptoms-be-a-mental-disorder">http://www.npr.org/blogs/health/2013/10/22/223805027/should-disabling-premenstrual-symptoms-be-a-mental-disorder</a>