PMDD
Premenstrual dysphoric disorder (PMDD) is a psychological condition which cyclically occurs with the menstruation cycle. Unfortunately, because the symptoms of this condition can mirror many mental health diagnoses, it can be difficult for patients to receive a diagnosis. This qualitative analysis aims to help medical professionals better understand the nuances of this condition through interviews with patients.
Symptoms can occur prior to the first menstruation cycle, however; symptoms at this time still occur cyclically. They are a direct response to the fluctuating levels of progesterone and estrogen in the body. These can include-
- Severe depression
- Severe anxiety
- Episodes of psychosis
PMDD is thought to effect between 3 and 8 percent of all women. It used to be called a severe manifestation of premenstrual syndrome (PMS) but has now received its own separate classification.
Neurobiological differences in this condition include-
- Abnormal expressions of hormone-processing genes
- Abnormal brain sensitivities to allopregnanolone
However, there remains to not to be a clear biological marker for the condition. That means that diagnosis is made simply by cyclical symptoms. However, the above neurobiological differences have convinced scientists this is a legitimate condition which necessitates attention.
Treatment can include ovulation suppression using a GnRH agonist or a hysterectomy (as a last resort).
The Study
This study occurred in the UK in 2018 with 17 diagnosed PMDD patients age 18 and over. The average age of the participants was 37. The average age of symptom onset was 15, and the average age of diagnosis was 35 years. Through their interviews, researchers found twelve different unique subthemes that could be organized into four main themes. These include-
- A Broken Woman – The symptoms, methods of coping, and emotional impact of living with this disease.
- Misdiagnosis and The Lost Decades – Women’s experiences of searching for answers, responses from their healthcare team, and their enduring symptoms without answers.
- A Life Transformed – Women’s understanding of how this condition has impacted their mental health, identity, and lives.
- Negotiating the Aftermath – The residual struggles caused by misdiagnosis and the challenges they still face today.
Looking Forward
The themes found in these interviews clearly show the dangers of misdiagnosis, the need for further research, and the necessity of increased support for patients. It is essential that healthcare professionals are able to recognize the symptoms of this condition, provide their patients an early diagnosis, and offer treatment options.
As of now, the cyclical nature of women’s symptoms is key to their diagnosis. For this reason, it is extremely beneficial for patients to keep a diary of their symptoms and talk openly with their doctor about their experiences.
You can read more about this condition here.