Premenstrual dysphoric disorder (PMDD) diagnosis relies heavily on reported symptoms of PMDD. No physical tests exist to prove the presence of premenstrual dysphoric disorder, and symptoms can mimic other health disorders.
Despite symptoms similar to PMS, PMDD is considered a mental health disorder, and classified as a “depressive disorder not otherwise specified” in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. The DSM-IV details eleven possible PMDD symptoms, five of which must be present for a PMDD diagnosis.
Symptoms of PMDD and Diagnosis
PMDD/PMS symptoms occur in the luteal phase of a woman’s menstrual cycle, between ovulation and menses. To be considered PMDD, symptoms must be present during the last week of the luteal phase, with relief beginning within a week of menses.
Of the 11 symptoms of PMDD listed in the DMV, four are considered the most significant. At least one of these four symptoms must be present for a PMDD diagnosis:
- anger, irritability, or a marked increase of interpersonal conflicts
- markedly depressed mood, sense of hopelessness of self-denigrating thoughts
- significant anxiety or tension
- sudden feelings of sadness, tearfulness or heightened sensitivity to rejection.
In addition, a further seven symptoms are indicative of PMDD. All told, at least five symptoms must be present to warrant a PMDD diagnosis. The remaining five symptoms include:
- change in appetite
- difficulty concentrating
- either insomnia or increased need for sleep
- fatigue
- feeling “out of control”
- loss of interest in activities
- physical PMS symptoms (breast tenderness, headaches, muscle pain, weight gain, bloating).
Symptoms Frequency and Other Mental Health Disorders
To be considered premenstrual dysphoric disorder, the presence of symptoms must significantly impair a person’s ability to function. For instance, a person with PMDD may avoid social activities and responsibilities. Productivity and efficiency at work or school drops when symptoms are present.
Additionally, PMDD symptoms must be persistent, and must be present for at least five menstrual cycles over a 12-month period. If the menstruation cycle aggravates symptoms of other mental health disorders, such as depression or anxiety disorders, then PMDD is not considered as a possible cause.
If premenstrual dysphoric disorder is suspected, women may be asked to keep a symptom diary for at least two menstrual cycles. The severity of symptoms is rated on a daily basis in the dairy, which helps determine if possible PMDD symptoms occur only during the luteal phase of menstruation. If so, a PMDD diagnosis is considered. If not, other mental health disorders may be the source of symptoms.
While premenstrual dysphoric disorder symptoms can be serious, PMDD help and treatment options can greatly reduce, or even alleviate, symptoms of PMDD.
Resources:
All About Depression. (n.d.). Premenstrual Dysphoric Disorder.
American Family Physician. (1 October, 2002). Diagnosis and Treatment of Premenstrual Dysphoric Disorder.
Disclaimer
The information contained within this article is for informational purposes only, and is not intended to be a substitute in any way for care and treatment by a qualified health professional.
Michael McGrath - Michael McGrath began providing web content shortly after finishing his graduate degree in English at the University of Alberta. His broad ...
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