Wild mood swings, rage, anxiety – what it’s like to live with PMDD

Imagine PMS so bad you can barely function. That’s the reality for women suffering from this crippling disorder – but help is out there and you are not alone.

Cranky, teary, tired – all common tell-tale signs in the lead up to a period.

But for one in 20 women the onset of menstruation causes days of wild mood swings, rage, depression, or intense anxiety.

Premenstrual dysphoric disorder is a little-known, debilitating condition and many women who have it go undiagnosed for years.

What is premenstrual dysphoric disorder or PMDD?

Dr Rosie Worsley, an endocrinologist and clinical advisor for Jean Hailes, says PMDD is similar to PMS but far more severe.

“Women will have symptoms in the week leading up to their period to a degree that significantly impairs their ability to function in the day-to-day,” Dr Worsley says.

Dr Worsley says women suffering from PMDD can experience a range of extreme symptoms.

“These include severe irritability, fatigue to the point of not being able to get out of bed, migraines, mood swings, sadness or despair, panic attacks, anxiety.”

Other symptoms include trouble focussing, insomnia, feeling out of control, and physical symptoms such as bloating, cramping, breast tenderness, and joint or muscle pain.

“Some women get aches and pains they liken to having the flu every month,” Dr Worsley says.

What causes PMDD?

PMDD is believed to be the result of a sensitivity to the spikes in hormones before menstruation.

Recent research suggests there could also be a genetic component.

“Essentially, PMDD is a negative reaction to a by-product of progesterone called allopregnanolone,” Dr Worsley says.

“This sensitivity can change over time, and a lot of women only develop PMDD after pregnancy.”

How is PMDD diagnosed and treated?

PMDD is diagnosed when a woman has five or more PMDD symptoms, including one mood-related symptom.

Consultant psychiatrist at the Royal Women’s Hospital, Dr Yasaman Rezaei Adli, says a range of treatments are available.

Serotonin reuptake inhibitors (SSRIs) are a group of antidepressants that have been proven to be effective,” Dr Rezaei Adli says.

“The other group of medications used in PMDD addresses the body’s hormonal activity, like oral contraceptive pills and ovulation suppression treatments.”

Making healthy choices such as maintaining a balanced diet low in sugar, salt and caffeine, abstaining from alcohol and cigarettes, and getting plenty of sleep can reduce symptoms.

“Psychological treatments such as mindfulness-based exercises and cognitive behavioural therapy may also be helpful,” she says.

Kelly’s story: I thought I might have bipolar

Kelly Hobday, 42, battled PMDD for decades before she was diagnosed.

“I would feel like cement was being pumped through my veins; aches, anxiety, crying all the time; and then that feeling of rage,” Kelly says.

“It’s horrible to feel that way and it made me withdraw from other people just so I could stay in control.”

After the birth of her second child, her symptoms intensified.

“I started to notice something wasn’t right, so I went to the doctor but I was told there was nothing wrong, that it was all in my head,” she says.

“I just didn’t know where to turn – I began to think I might have bipolar.”

Kelly says it wasn’t until she stumbled upon the Australian PMDD Facebook group while doing her own research that she realised what the problem might be.

“I started reading other women’s stories, and I thought ‘Oh my God – that’s me’,” she says.

She then sought a referral to a women’s clinic for treatment, and says seeking help is vital.

“Just to have an answer is such a relief – to know you’re not going crazy,” she says.

If you are struggling, talk to your GP or contact Beyond Blue on 1300 224 636.

Written by Dimity Barber.