There’s a major difference between PMS and PMDD — here’s what you should know

Every living human being who has ever had a period is familiar with premenstrual syndrome (PMS). We get moody and irritable, we battle persistent cramps, and we sometimes feel like eating the whole fridge in one fell swoop. We’ve learned over the years how to manage these symptoms, but that doesn’t exactly mean we like it when they come banging on our door every month.

If you know your way around PMS, you may have heard of something called premenstrual dysphoria disorder (PMDD). It sounds vaguely similar to PMS, but it’s a different beast entirely. HelloGiggles spoke with Alyssa Dweck, M.D., gynecologist in New York and author of The Complete A To Z For Your V: Everything You Ever Wanted to Know About Your Vagina, who explained the difference between PMS and PMDD. Take notes.

"PMS is a conglomeration of symptoms that we all know too well," Dr. Dweck says. "PMDD is all of these symptoms on steroids."

Women who suffer from PMDD will battle all the basics a several days before their period —menstrual cramps, breast tenderness, fatigue, mood swings — but everything is amplified to the point where they can’t function properly. We’re talking cramps so bad, you’re curled up in the fetal position, have headaches that make you super sensitive to light, and suffer from acute anxiety that prevent you from entering social situations.

“These symptoms need to cause significant stress or interference with day to day activities or relationships,” Dr. Dweck explains. So the irritability you may experience when you’re PMSing isn’t the same as the severe mood swings someone with PMDD suffers from. They won’t be able to communicate in a healthy way with their friends or their partner when their period is around the corner. Furthermore, people with PMDD harbor intense feelings of sadness, anger, or hopelessness. In fact, these feelings may be so extreme that they can’t get out of bed.

PMS is a monthly syndrome, but PMDD “is actually a psychiatric diagnosis,” according to Dr. Dweck. There are very specific ways to define it, and she says you have to have at least five of the extreme symptoms in order to qualify for PMDD. The most common PMDD symptoms include:

1. Severe mood swings that affect your personal relationships

2. A change in appetite

3. Fatigue

4. Depression or feelings of hopelessness

5. Intense menstrual cramps

6. Acute anxiety

7. Feeling out of control

8. Difficulty going about your everyday tasks

Generally, PMDD begins to show up when women are in their 20s. Between 3 and 10 percent of women suffer from this disorder, but at this point we don’t know what the causes of PMDD are. Although there are some speculations that low serotonin levels in the brain may be linked to PMDD, nothing has been proven in the world of science as of yet.

Dr. Dweck says if you're wondering whether you have PMDD, keep in mind the symptoms in question have to be related to your menstrual cycle. "If the symptoms are every single day, it's not PMS or PMDD," she explains.

“They have to be during the second phase of the cycle and have to be relieved a few days after the period starts,” she tells HG. Also, the symptoms have to be present in your life for at least a year or more. If your PMS is especially bad for a couple months in a row because you were stressed, that doesn’t equal PMDD.

There’s talk floating around that PMDD is linked to people who are predisposed to mental illness, such as depression or anxiety. After all, some symptoms of PMDD are shared symptoms of clinical depression. We asked Dr. Dweck if this is true.

“I will speak anecdotally and in my practice,” she says. “I would say most likely, but I’m really not sure whether this has been scientifically proven and it’s probably difficult to tease out the symptoms of one versus the other. But it wouldn’t surprise me.”

Luckily for the people who do live with PMDD, there are treatment options. Anti-depressants such as selective serotonin reuptake inhibitors (SSRIs) are sometimes prescribed. Dr. Dweck says these are meant “to enhance the amount of serotonin” in your brain. Birth control pills are also a good way to manage PMDD, since they smooth out the hormonal changes you go through each month.

"PMDD is a significant diagnosis, so I don't want people to walk away thinking they have PMDD," says Dr. Dweck.

She reminds us that the big distinction to watch out for is that the symptoms “need to be overwhelming and disruptive to your personal life, your relationships, or your day to day activities.” People with PMDD can’t easily go to work or school, get out of bed, or converse with their S.O. right before their period. It truly is a debilitating disorder.

If any of this sounds familiar, the first thing to do is speak to your doctor. It might help to keep a journal of all your symptoms, so you can bring a bulk of relevant information to your OBGYN. In the meantime, maintain a balanced diet and exercise regularly. Whether or not you have PMDD, keeping a healthy lifestyle will make your period easier to live with.

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