“Nearly 5% of adolescent girls suffer from PMDD, with higher prevalence among those with depression, GAD, and higher perceived stress,” according to research. Premenstrual Dysphoric Disorder (PMDD) is like dealing with a moody dragon while juggling chemistry homework. But fear not, by reading this blog, you will learn what PMDD is, how it affects teens and adolescents, what the symptoms of PMDD are, and about the treatments for PMDD.

What is PMDD?

Premenstrual Dysphoric Disorder (PMDD) is a mood disorder that emerges around the menstrual cycle. Symptoms include mood swings, irritability, anxiety, depression, fatigue, and changes in appetite and sleep. Typically, PMDD symptoms increase during the premenstrual or luteal phase of the menstrual cycle (before your period) and reduce a few days after menstruation begins. It is common for PMDD to be misdiagnosed as major depressive disorder or another type of mental health disorder.

PMDD Symptoms

PMDD can only be diagnosed by tracking symptoms after going to a medical professional. There is not a formal blood, urine or medical test. PMDD symptoms are defined in the DSM-5 (Diagnostic Statistical Manual 5th Edition). There are very specific criteria for PMDD and they must all be met in order to have a formal diagnosis. 

Criteria A: In the majority of menstrual cycles, at least 5 symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses.

Criteria B: One or more of the following symptoms must be present:

1. Mood swings

2. Irritability or anger or increased interpersonal conflicts

3. Depressed mood, feelings of hopelessness, or self-deprecating thoughts

4. Anxiety, tension, and/or feelings of being keyed up or on edge

Criteria C: One (or more) of the following symptoms must additionally be present to reach a total of 5 symptoms when combined with symptoms from criterion B above:

1. Decreased interest in usual activities

2. Difficulty in concentration

3. Lethargy, easy fatigued, or marked lack of energy

4. Marked change in appetite; overeating or specific food cravings

5. Hypersomnia or insomnia

6. A sense of being overwhelmed or out of control

7. Physical symptoms such as breast tenderness or swelling; joint or muscle pain, a sensation of “bloating” or weight gain

PMDD symptoms must be associated with clinical distress or interfere with work, school, relationships, etc. Symptoms also cannot be due to another medical condition, mental health disorder or the effects of a substance. 

How Does PMDD Affect Teens and Adolescents? 

As fun as it can be to be a teenager, it can also be stressful. Your body is changing, your hormones feel out of control and your mood starts to dip. You are trying to figure out who you are and where you belong. Adding a mental health condition makes being a teenager even harder. When you have PMDD, it's common to miss parties, class, sports or other events due to your symptoms. You may not feel comfortable yet sharing with others why you can't come so you begin to feel isolated, alone and misunderstood. This can lead to social anxiety and depression. Suicide rates for teens have doubled in the past 10 years. One of the symptoms of PMDD is hopeless or self-deprecating thoughts, which can lead to suicidal thoughts or behaviors. If you are experiencing thoughts of hurting yourself or someone else, call suicide crisis line at 988 or text help to 741741. Another important aspect to consider is if an individual was born female but identifies as trans or non-binary. Having a menstrual cycle can be very triggering, let alone experiencing PMDD symptoms. 

PMDD Treatment

1. Knowledge is power! Helping young people gain knowledge about menstruation, mental health, and PMDD can help them feel more empowered. 

2. Talk to a trusted friend or family. Opening up can be hard, especially when you might feel embarrassed about what is going on or none of your friends have their periods yet. The good thing is that if you have friends who are born female, they will eventually menstruate! If you can find one person you feel comfortable talking to, that is enough. 

3. Keep a journal. Tracking your symptoms including the first and last day of your menstrual cycle can help you know when to anticipate when they will start and stop. 

4. Self-care, self-care, self-care. When you experience flare ups of PMDD, this is not the time to be hard on yourself! This is the time to treat yourself like the amazing person you are. Take a bath, spend extra time cuddling with your pet, try to get lots of sleep, watch your favorite TV show, or anything else that makes you feel comfortable! 

5. Start therapy. When talking to a friend or family doesn’t feel like enough, therapy might be helpful. Adolescent counseling is confidential and therapists are trained in evidenced based techniques such as DBT and CBT to help you feel better.

Start Teen Counseling in Detroit and Ann Arbor

Whether you think you have PMDD, struggle with anxiety or depression or just want to talk to someone who can’t tell your parents what is going on in your life (unless you are at risk to yourself or others!), we are here to support you. Embodied Wellness, PLLC has online therapy for teens who understand what you are going through.

Follow these steps to get started:

1. Text us to schedule a free 15 minute consultation with one of our teen therapists

2. Start teen or adolescent counseling that is tailored to your needs

3. Feel better today!

Additional Services We Offer via Online Therapy in Michigan

Embodied Wellness, PLLC also provides online therapy in Michigan to adults. Our therapists are trained in EMDR, DBT, Internal Family Systems and the treatment of trauma/PTSD and OCD. Servicios de terapia in Español.

About the Author: 

Sarah Rollins, LMSW, SEP is the founder of Embodied Wellness, PLLC, a group therapy practice providing online therapy in Michigan. She is passionate about expanding awareness of somatic therapy as way to treat and heal trauma. She incorporates other holistic treatments into her practice including EMDR and IFS.