Many women experience mood changes, bloating, and irritability in the days leading up to their period. These symptoms are commonly known as PMS (Premenstrual Syndrome). But for some, those symptoms become intense—disrupting work, relationships, and day-to-day life. If this sounds familiar, you may be experiencing Premenstrual Dysphoric Disorder, or PMDD.
At Transformation Counselling, we work with many women who feel confused, overwhelmed, or misunderstood by their monthly emotional struggles. In this article, we’ll break down what PMDD is, how it differs from PMS, and how therapy can offer real relief and support.
What Is PMDD?
Premenstrual Dysphoric Disorder (PMDD) is a severe form of PMS that causes significant emotional and physical symptoms in the week or two before menstruation. These symptoms usually improve within a few days after your period starts and are gone in the week after.
Unlike regular PMS, PMDD symptoms can feel debilitating, sometimes affecting your mental health and ability to function. It’s recognized as a legitimate health condition in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).
PMDD vs PMS – What’s the Difference?
While both PMDD and PMS are connected to the menstrual cycle and share some symptoms, the intensity, duration, and impact of PMDD are much more severe. PMS may involve mild mood swings, some irritability, or physical discomfort that’s manageable and doesn’t significantly interfere with daily life. In contrast, PMDD can cause extreme emotional symptoms like sudden mood swings, intense anger, anxiety, panic attacks, deep sadness, and even feelings of hopelessness. These symptoms don’t just cause discomfort—they can deeply disrupt work, school, relationships, and daily functioning. If you find yourself feeling like a completely different person in the days before your period, and it’s interfering with your ability to cope, it may be more than PMS—it could be PMDD.
Common Symptoms of PMDD
PMDD symptoms usually appear 7–10 days before your period and can include:
Emotional Symptoms:
Sudden mood swings
Intense irritability or anger
Crying easily or feeling overwhelmed
Anxiety or panic attacks
Depression or hopelessness
Feeling out of control
Physical Symptoms:
Bloating
Breast tenderness
Fatigue or low energy
Joint or muscle pain
Headaches
Sleep problems
Changes in appetite or food cravings
Many women describe PMDD as a rollercoaster—feeling like a different person before their period, and then "returning to normal" afterward.
What Causes PMDD?
The exact cause of PMDD isn’t fully understood, but it’s believed to be related to abnormal responses to hormonal fluctuations, particularly estrogen and progesterone. Women with PMDD may be more sensitive to these changes, which affect the brain chemicals that regulate mood—like serotonin.
PMDD is not a sign of emotional weakness or exaggeration. It’s a biological and neurological response, often with genetic, environmental, and lifestyle influences.
Who Is at Risk for PMDD?
PMDD can affect any menstruating person, but you may be at greater risk if you:
Have a family or personal history of depression or anxiety
Experienced trauma or chronic stress
Have a history of postpartum depression or PMS
Are in your 20s, 30s, or 40s (though it can affect teens too)
It’s estimated that up to 8% of menstruating individuals experience PMDD, though many remain undiagnosed or misdiagnosed.
How Is PMDD Diagnosed?
To be diagnosed with PMDD, symptoms must:
Be present during most menstrual cycles over the past year
Disrupt daily functioning (work, relationships, self-care)
Improve a few days after menstruation begins
Not be better explained by another condition (like major depression)
Many doctors recommend tracking your symptoms over two menstrual cycles using a mood and symptom journal. This helps distinguish PMDD from other conditions and confirm the pattern.
Treatment for PMDD – What Can Help?
There’s no one-size-fits-all solution for PMDD, but there are many ways to manage and reduce symptoms.
🧠 Counselling and Therapy
Talking to a trained therapist can help you:
Cope with intense emotions
Build self-awareness and coping skills
Address underlying anxiety or trauma
Improve communication with loved ones
Create a wellness plan around your cycle
Online counselling makes this support more accessible, so you can get help without leaving home.
💊 Medical Options
Some women find relief with:
Antidepressants (SSRIs), often taken during the luteal phase
Birth control pills to stabilize hormone fluctuations
Nutritional supplements like calcium or magnesium
Anti-inflammatory medications (like ibuprofen)
Always speak to your doctor before beginning any medication.
🌿 Lifestyle Changes
Simple changes can make a big difference:
Regular exercise (even gentle movement)
A balanced diet with reduced caffeine and sugar
Mindfulness, yoga, or meditation
Limiting alcohol and processed foods
Prioritizing sleep and stress management
You’re Not Overreacting—You’re Not Alone
Living with PMDD can feel isolating. It’s frustrating when others dismiss your symptoms or when you feel like you’re trapped in a monthly cycle of chaos. But you are not broken, weak, or “too sensitive.”
With the right support, you can learn to manage PMDD, reduce its impact, and regain control over your life.
Get Help for PMDD with Online Counselling
At Transformation Counselling, we support individuals living with PMDD through compassionate, personalized online therapy. Whether you’re newly exploring your symptoms or looking for a long-term coping plan, we’re here to help.
Click the button below to connect with a therapist today. Let’s work together to bring more calm, clarity, and balance into your monthly cycle.