Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual illness in which emotional and physical symptoms recur in the luteal phase of the menstrual cycle and can substantially disrupt daily life.
Symptoms may include marked irritability, depression, anxiety, anger, sleep or appetite changes, difficulty concentrating and physical symptoms such as bloating, headache or breast tenderness. The key feature is the cyclical pattern: symptoms appear before menstruation and improve after the period begins.
Diagnosis should not be made from one difficult month. Clinicians may ask people to record symptoms across at least two menstrual cycles to confirm timing and distinguish PMDD from other mental-health or gynaecological conditions.
Treatment is individual and can include antidepressants such as SSRIs, hormonal approaches and psychological support. Persistent symptoms that affect work, relationships or daily functioning should be discussed with a GP or specialist.
PMDD can include severe depression or suicidal thoughts. Anyone in immediate danger or experiencing a mental-health emergency should seek urgent medical help.
Source: NHS guidance on PMS and PMDD.
