If pharmaceutical companies have their way, severe PMS will be adopted into the new Diagnostic Manual of Mental Disorders as a mood disorder. They call it Premenstrual Dsyphoric Disorder, or PMDD for short.
PMDD has been listed as a proposed diagnosis in the appendix of the DSM since 1987, but it’s never been officially recognized. The symptoms read like a mix of clinical depression and run of the mill PMS:
The current criteria being proposed for PMDD includes mood swings, marked irritability or anger or increased interpersonal conflicts, feelings of hopelessness, marked anxiety and decreased interest in usual activities. Also: a subjective sense of difficulty in concentration, lethargy, a marked change in appetite, insomnia, a subjective sense of being overwhelmed and other physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” weight gain.
To be diagnosed with PMDD, a woman must have experienced five of the symptoms in the past year, including physical effects. This doesn’t sit right with everyone – Dr. Paula J. Caplan of Harvard University told Salon, “PMDD is an invented ‘mental illness.’” Caplan believes that women suffering from PMDD probably have another mood disorder – depression or anxiety – or they’re experiencing external sources of distress in their lives such as failing relationships or a history of abuse.
The FDA has approved Zoloft, Paxil and Sarafem (a rebranded version of Prozac) to treat PMDD, despite the fact that it’s not recognized as an official illness by the American Psychiatric Association. These antidepressants do actually seem to work in relieving symptoms – but the drugs can have serious side effects and usually aren’t recommended as the first, or only, course of treatment in cases of other mood disorders. No research has really been done on alternative treatments for PMDD, such as psychotherapy or hormones – so nobody knows if throwing antidepressants at women with severe PMS is the best solution to the problem.
On the other hand, there are women out there who seem to have legitimate medical problems which are alleviated by antidepressants. As one woman suffering from PMDD told Salon’s Natasha Vargas-Cooper:
“One of the things I find frustrating about modern feminist critique,” Elise says, “is that I’m expected to be tough no matter what my body deals me, otherwise I’m giving in to patriarchy. What if sometimes, I’m in pain and I can’t do it on my own. What has to happen to make that acceptable?”
And maybe, for the sake of women like Elise, being able to have an official diagnosis is more important than a debate about the distinction between “regular” PMS and PMDD.
Photo credit: Claus Rebler