Is It Just PMS? Or A Full-Blown Mood Disorder?


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.


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Photo credit: Claus Rebler


Kenneth L.
Kenneth L5 years ago

"Since PMDD ('premenstrual dysphoric disorder') first was mentioned in the DSM, people have received the mistaken impression that it's real and that it's a mental illness".
Dr. Paula Caplan, Psychologist

"When the Prozac patent came up (about to end) they (Eli-Lilly drug company) realized they needed something new to keep the money rolling in, and they came up with a new 'disorder', they just made it out of thin air---the 'Premenstrual Dysphoric Disorder', PMDD, and the new wonder drug which is Sarafem, which if you look at Sarafem on the back of the label it just says 'this is Prozac'. And they were able to keep that patent so nobody else could make it, so they could keep that money rolling in" Dr. Toby Watson, Clinical Psychologist

"It should not be surprising, then, that the psychiatric field is riddled with diagnoses that are used to demean and pathologize women"
Dr. Paula Caplan, Psychologist

"The American Psychiatric Association (APA) is in danger of losing the little credibility it still enjoys. The organization is chasing medical insurance company reimbursement money by empowering “working groups” to invent whole new diagnoses by committee."
Dr. Keith Ablow, Psychiatrist

Carolanne Powell
C Powell5 years ago

Hmmm....unfortunetly I suffer from most of these symptoms but am reluctant to pathologicalise!

Past Member 5 years ago

@Kendra R . . .THANK YOU! I could not have said it better myself.

Patricia H.
Patricia H.5 years ago

We need more medical help

Lena T.
Lena T5 years ago

It's such a subjective issue, that I'm afraid I can't judge about it since I'm lucky not to experience any of the described symptoms. But neither do I know anyone who would call it a mental disorder. Usually it's more about physical pain, as far as I know.

Jane Barton
Jane Barton5 years ago

I had terrible pain when I was young too. I had to stay in bed in a fetal position, it was horrible.
It didn't affect my mood or anything like that, it just disabled me with pain. Men never experience this so they have no idea how incapacitating this can be and they aren't empathetic whatsoever. These Bishops are only interested in forcing women to breed and pump out babies so they are trying to use that old, tired "hysterical" PMS crap on us.

Kendra Richards
Kendra richards5 years ago

It's actually true that some women have such debilitating cycles! I've suffered immensely for years and I'm only 22! I also have endometriosis though as well as suffered from a stomach issue. Mental disorder? WTF? No! Debilitating menstrual issues (whatever you wanna name it) is very real to some of us and quite frankly, I was disgusted and disappointed to read that other WOMEN here wuold be so ignorant and insensitive. Maybe it's just "life" to you, but YOU are not the one suffering like hell every month are you now? Not being able to actually get out of bed due to PAIN, real life pain, is a problem. A person who has a "suck it up" attitude about this, knows nothing about having the actual pain and problems. It's uncontrollable. You don't wake up sick from your menstrual cycles. THere's very little that can be done about these things, the pain. Depo is about as relieving as it gets and I'm a nice example of how bad those side effects alone are! YOU try dealing with something truly awful before you run off with insensitive, nasty remarks. It only makes you look terrible.

janet T.
janet t5 years ago

Sounds to me those could be the symptoms of living in this world. I would love to see things implemented that would make it all go away but I doubt we will ever live to see that.

Mercedes Lackey
Mercedes Lackey5 years ago

"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."

That sounds to me like: being required to work 50-60-70 hour weeks ( for no extra pay) by bosses who remind you that there are 30 people who would be happy to have your job, and watching the Repiglicans chipping away at your rights until you are rated as slightly less valuable than a good breeding cow.

Jane Barton
Jane Barton5 years ago

Mood disorder? PMS is NOTHING! What is the GOP Republicans suffering from, BAT @^#