Despite the fact that a large proportion of the population experiences premenstrual symptoms, there are a number of differences between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).
On the one hand, PMS includes a range of emotional, behavioral, cognitive and physical symptoms that crop up and continue during the luteal period (one stage of the menstrual cycle) and resolve rapidly within a couple of days at the beginning of menstruation.
With more than 200 premenstrual symptoms around, it is quite difficult to diagnose PMS. Rather than being a solitary condition, further evidence highlights that PMS is a collection of interrelated symptoms with various genotypes, phenotypes, or subtypes, and other pathophysiologic events that occur with ovulation.
On the other hand, premenstrual dysphoric disorder (PMDD) is an extreme type of PMS. One of the primary characteristics of PMDD is premenstrual mood disturbances, particularly reactivity and irritability. Such drastic mood disturbances hamper social or occupational functioning and have severe implications in interpersonal functioning.
Usually, the symptoms of PMDD occur before menstruation and often conclude with its onset. Furthermore, the symptoms can exacerbate over time. Past findings also reported that these premenstrual symptoms tend to intensify among women who are likely to enter their menopause period.
The symptoms like mood swings, social withdrawal, headaches, fatigue, depressed mood, anxiety, lack of concentration, etc. are quite common during PMDD. Due to the overlapping of symptoms and due to the lapses in identifying the underlying mental disorders like anxiety disorder, medical practitioners tend to misdiagnose PMS and PMDD in women.
Though the onset of PMS and PMDD is not very much distinct, researchers, have identified that PMDD invloves comparatively more severe mood-related problems and mental health symptoms. However, there is difference between PMDD and mood disorders due to the cyclical nature of the mood disturbance.
While the symptoms of mood disturbance persist only for a certain period of time in the case of PMDD, they stay constant or variable in the case of mood disorders. However, women suffering from mental health problems like anxiety disorders are comparatively more vulnerable to menstrual triggers.
The abnormal levels of the hormone estrogen and progesterone, associated with premenstrual mood disorder, can affect the central neurotransmission, especially the serotonergic, noradrenergic and dopaminergic pathways. Such fluctuations can trigger symptoms like irritability, depression and craving for carbohydrate.
Therefore, both PMS and PMDD represent a biological phenomenon rather than being completely psychological events. Although the symptoms of PMS and PMDD do not signify the aggravation of an existing disorder like major depression, anxiety and panic disorders, dysthymic disorder or personality disorder, they may, otherwise, overlap with one of the psychiatric disorders.
Over the decades, multiple therapies and treatments have been explored to effectively curb the symptoms of PMS and PMDD. These include:
If symptoms of stress persist or are more significant, psychological counseling that includes cognitive-behavioral therapy (CBT) or group therapy may be helpful. In fact, numerous studies have demonstrated the effectiveness of CBT in treating the PMS symptoms.
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