32-year-old diagnosed with PMDD says condition severely disrupts life

A 32-year-old reader reports she was recently diagnosed with premenstrual dysphoric disorder (PMDD) and says the condition severely affects every area of her life for about 10 days each month. She describes becoming irritable and impatient, experiencing debilitating brain fog, and at her worst feeling depressed with uncontrollable crying and suicidal ideation.

The reader says healthy habits become almost impossible during the luteal phase and that she sometimes wants to leave her job, break up with her partner and ignore friends, but finds it hard to share the experience because PMDD is chronically under-recognised and under-researched.

The columnist consulted Dr Sophie Behrman, a psychiatrist who recently set up an NHS menopause and menstrual health clinic in Oxford. Behrman told her it is estimated that 1–3% of women get PMDD and that it can happen at any time during their menstrual life. She described PMDD as a mental disorder that causes severe psychological (and sometimes physical) symptoms in the luteal phase of the cycle.

Behrman said the issue is not an abnormal balance of hormones but how the brain reacts, specifically to falling progesterone levels before a period, producing irritability, anxiety, depression and impulsivity. She told the columnist the reader is already doing a lot that can help and said there is evidence a good wholefood diet and exercise can be beneficial; supplements can help and cognitive behavioural therapy can be useful.

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