27 June 2010

PMDD is not a mental disorder - it is just severe PMS

Vincent Van Gogh - Sorrow
 The condition PMDD (pre-menstrual dysphoric disorder) is a type of PMS which is much worse than regular PMS symptoms, especially in terms of the emotional symptoms.

According to a peer reviewed article reprinted by the American Academy of Physicians, they describe PMDD as:

In the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV), PMDD is classified as “depressive disorder not otherwise specified” and emphasizes emotional and cognitive-behavioral symptoms.2  At least five of the 11 specified symptoms must be present for a diagnosis of PMDD (Table 1).1  These symptoms should be limited to the luteal phase and should not represent amplification of preexisting depression, anxiety, or personality disorder. In addition, they must be confirmed prospectively by daily rating for at least two consecutive menstrual cycles. A symptom-free period during the follicular phase of the menstrual cycle is essential in differentiating PMDD from preexisting anxiety and mood disorders.

This means, PMDD has been given status as a serious mental disorder in the vein of major depression and bipolar disorder and in fact, some scientists believe that some women who experience PMDD are depressed, which is why anti-depressants are prescribed.

There are a number of experts who find fault with this diagnosis of PMDD as a mental disorder, notwithstanding that mental disorders have never been proved to exist (other than major mental illness) and that anti-depressants have been shown to do nothing for people with mild to moderate depression.

The problem as I see it with classifying PMDD as a mental disorder, is that it isnt. It is due to a number of factors being misaligned in the body (nutritional deficiencies, too much stress, no exercise, bad circulation) and these factors together can contribute to worsening of PMDD, yet when these issues are sorted out, the PMDD is completely reduced to manageable levels.

A recent study showed that 20% of women who did the diagnostic survey, met the criteria for PMDD, whereas 4.1% of men met the criteria for PMDD too. The authors of the study then suggested:
Therefore, these data suggest that PMDD may not be a premenstrual disorder per se. PMDD may instead reflect general cyclical changes in mood, and in women sometimes these changes occur during or near menstruation.
A number of other studies have criticised the assessment that PMDD is severe mental disorder, when it is clearly not.

If you have severe PMS-like symptoms that could be thought to be PMDD, check out my articles about what needs to be done and work with your natural health care practitioner to find a better way to manage your symptoms. You are not alone and you do not have to suffer with this problem. Just check with your doctor to make sure there is no underlying disorder (a real one).

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, D.C.: American Psychiatric Association, 1994:715–8.
  2. Bhatia SC and Bhatia S.  Diagnosis and Treatment of Premenstrual Dysphoric Disorder. Am Fam Physician. 2002 Oct 1;66(7):1239-1249.  Accessed 27 June 2010
  3. Callaghana GM, Chacona C, Colesa C, Bottsa J, Larawaya S. An Empirical Evaluation of the Diagnostic Criteria for Premenstrual Dysphoric Disorder: Problems with Sex Specificity and Validity. Women & Therapy, Volume 32, Issue 1 January 2009 , pages 1 - 21 
  4. Daw, J. Is PMDD Real? Monitor on Psychology, October 2002, Vol 33, No. 9 . Accessed 27 June 2010
  5. Kissling, E. Women, Men and PMDD. Society for Menstrual Cycle Research, 15 October 2009.  Accessed 27 June 2010
  6. Nash H, Chrisler JC. IS A LITTLE (PSYCHIATRIC) KNOWLEDGE A DANGEROUS THING? Psychology of Women Quarterly, Volume 21 Issue 2, Pages 315 - 322

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