Types of Depression
Depression in Women
II Depression in Men
Depression in the Elderly
Seasonal Affective Disorder
Postpartum Depression (PPD)
Premenstrual Dysphoric Disorder
Holiday Depression II
PMDD (Premenstrual Dysphoric Disorder).
Premenstrual Dysphoric Disorder or PMDD is a condition
associated with severe emotional and physical problems that are
linked closely to the menstrual cycle. Symptoms occur regularly in
the second half of the cycle and end when menstruation begins or
PMDD can be considered a severe form of Premenstrual Syndrome
(PMS). A woman with PMDD experiences the same ailments as a woman
with PMS, only the woman with PMDD suffers to a far greater
Between 30 and 40 percent of women can be diagnosed as having
Premenstrual Syndrome. Between 3 and 7 percent of those women have
Premenstrual Dysphoric Disorder.
Premenstrual Dysphoric Disorder Symptoms:
- Very depressed mood, feeling hopeless.
- Feeling out of control or overwhelmed.
- Sudden mood shifts (crying easily, extreme sensitivity).
- Marked anxiety, tension, edginess.
- Loss of interest in usual activities work, school, socializing.
- Persistent, marked irritability, anger, increased conflicts.
- Marked appetite change, overeating, food cravings.
- Difficulty concentrating and staying focused.
- Fatigue, tiredness, loss of energy.
- Insomnia (difficulty sleeping) or sleeping too much.
- Physical symptoms such as weight gain, bloating, breast
tenderness or swelling, headache, and muscle or joint aches and
PMDD is often confused not only with PMS, but also with
depression. To separate the disorder from PMS, PMDD symptoms must
exist in such severity as to inhibit the woman's day to day
Premenstrual Dysphoric Disorder consists of symptoms more commonly
associated with chronic depression: sad, anxious, or empty moods;
feelings of pessimism or hopelessness; emotions such as guilt or
worthlessness; insomnia; oversleeping; change in appetite,
resulting in weight gain or loss; suicidal thoughts/attempts;
uncontrollable rage or anger; lack of self control; denial;
anxiety; and frequent tearfulness. What separates PMDD from
depression is a sudden disappearance of most symptoms shortly
after a woman's period begins.
Basic research links the onset of PMDD to neurological and
hormonal differences in some women's bodies. Some women's bodies
cannot effectively handle the hormonal shifts that occur every
week in a menstrual cycle. Routine changes in estrogen and
progesterone associated with menses may, in vulnerable women,
induce a serotonin deficiency that could trigger the symptoms of
Women in their late 30s and 40s are most vulnerable to
experiencing PMDD, further suggesting a hormonal balance. This is
the time in a woman’s life that is often marked by perimenopause,
the time leading up to the end of childbearing years.
The diagnosis of PMDD is based on the regular presence of certain
symptoms for part of each menstrual cycle. A physician can
diagnose PMDD only if the woman has five or more of the symptoms
described above for most menstrual cycles and the symptoms must be
severe enough to interfere with occupational and social
A physician also will need to consider and rule out other possible
causes of the symptoms such as thyroid problems, lupus or other
mental disorders such as depression or an anxiety disorder. The
symptoms of all these conditions may worsen before menstruation
and so could be confused with PMDD.
Three options exist for treatment of PMDD. The first is
conventional medicine; antidepressants, anti-anxiety drugs or
hormones. The FDA approved the antidepressant Sarafem (fluoxetine)
for the treatment of PMDD. Sarafem is Prozac, just renamed for the
treatment of PMDD. Physicians also prescribe other SSRI
antidepressants “off-label” to treat depression — such as
sertraline, citalopram and paroxetine. All of these pharmaceutical
drug options have side effects - some of which are serious or
It is important to note that while antidepressants are often
the first line of treatment, there are safe alternatives to most
types of depression. Discuss natural alternatives like
your health care provider before using prescription medications
with potentially serious and life-threatening side effects.
The woman suffering from PMDD may instead try focusing on the
behavioral aspects of the disorder. This includes stress
management, psychotherapy, and relaxation. The same lifestyle
changes that sometimes help women with PMS may help relieve the
symptoms of PMDD.
The third option is a nutritional modification, including
dietary restrictions, extra vitamins, rigorous exercise, and
herbal remedies. Many doctors have found homeopathic remedies
are most effective, thereby decreasing the validity of
antidepressant drugs. Deprex is a nutritional, herbal and
homeopathic remedy that is safe and highly effective.