What Is PMDD?
Premenstrual Dysphoric Disorder affects roughly 3-8% of women during their reproductive years. It is often confused with PMS, but PMDD is in a different category entirely. Where PMS might mean feeling a little moody or bloated, PMDD brings severe depression, intense irritability, overwhelming anxiety, or a sense of hopelessness in the week or two before your period. These symptoms are bad enough to affect your relationships, your work, and your ability to function -- and then they lift once your period starts, almost like a switch flipped.
PMDD is not about being "overly emotional." It is a neurobiological condition where your brain reacts differently to normal hormone changes during your cycle. Many women go years without a diagnosis because they assume what they experience is normal or because providers dismiss their symptoms.
How We Treat PMDD
The good news is that PMDD responds very well to treatment. SSRIs -- the same class of medication used for depression -- work differently for PMDD. They can start relieving symptoms within a day or two instead of the weeks they take for depression. You have two options: take the SSRI every day of the month, or only during the luteal phase (the two weeks before your period). Both approaches are effective, and we help you choose based on your symptoms and how you feel about daily medication.
If SSRIs alone are not enough, we can coordinate with your OB/GYN to explore hormonal treatments that reduce the cyclical fluctuations triggering your symptoms.
What to Expect at Your First Visit
Tracking your symptoms across your cycle is the most helpful thing you can bring to your first appointment. A period tracking app, a mood journal, or even notes on your phone showing when the bad days hit each month all help us confirm the pattern. We will talk through your history, rule out other conditions, and discuss treatment options.
Insurance and Payment
PMDD treatment is covered by most insurance plans. SSRI medications are available as affordable generics. Contact us to check your coverage before your visit.
When to Seek Help
If you dread the second half of every menstrual cycle, if your partner or family notices a drastic personality shift before your period, or if you have thoughts of harming yourself during those days -- these are signs of PMDD, not "normal PMS." It is treatable, and you do not have to power through it every month.