How is PMDD Diagnosed?

 Do you ever get the feeling of hopelessness days before you are expecting your menstruation? Are you often irritable and get angry so quickly during your premenstrual days? How about the feeling of hating yourself to the point of thinking of suicide?  Ever wonder why these feelings plague you before you have your monthly and then they just disappear like nothing even happened after a few days during your menstruation?

If you said yes to all questions above then you may be experiencing PMDD. Premenstrual dysphoric disorder, or PMDD, is a severe form of premenstrual syndrome (PMS). 

The physical symptom list of PMDD is identical with PMS. However, the emotional symptoms for PMDD are more serious. In PMDD, the criteria focus on the mood rather than the physical symptoms. With PMS, sadness or mild depression is not uncommon. With PMDD, however, significant depression and hopelessness may occur; in extreme cases, women may feel like killing themselves or others. Attributing suicidal or homicidal feelings to “it’s just PMS” is inappropriate; these feelings must be taken as seriously as they are in anyone else and should be promptly brought to the attention of health professionals.

You should go and see your doctor if you think you are experiencing PMDD. Before your doctor makes a diagnosis of PMDD, he or she will rule out other emotional problems, such as depression or panic disorder, as the cause of the symptoms. In addition, underlying medical or gynecological conditions, such as endometriosis, fibroids, menopause, and hormonal problems that could account for symptoms, also must be ruled out.

Aside from a complete medical history and physical and pelvic examination, diagnostic procedures for PMDD are currently very limited. Your physician may consider recommending a psychiatric evaluation to, more or less; provide a differential diagnosis (to rule out other possible conditions). In addition, he/she may ask that you keep a journal or diary of your symptoms for several months, to better assess the timing, severity, onset, and duration of symptoms. In general, in order for a PMDD diagnosis to be made, the following symptoms must be present:

Over the course of a year, during most menstrual cycles, five or more of the following symptoms must be present:

•  depressed mood, feelings of hopelessness, or self-deprecating thoughts
• Marked anxiety, tension, feelings of being "keyed up" or "on edge"
• Feeling suddenly sad or tearful or increased sensitivity to rejection
• Persistent and marked anger or irritability or increased interpersonal conflicts
• Decreased interest in usual activities (eg, work, school, friends, hobbies)
• Subjective sense of difficulty in concentrating
• Lethargy, easy fatigability, or marked lack of energy
• Marked change in appetite, overeating, or specific food cravings
• Hypersomnia or insomnia
• A subjective sense of being overwhelmed or out of control
• Other physical symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, or weight gain