PMDD Depression & Anxiety

PMDD Depression & Anxiety - Ask the Doctor Q & A

Question

My premenstrual depression is extreme, to the point where I feel my symptoms have hindered my process of being a human being—my children don't want to be around me, and I don't want to be around them. It's hard to function because I don't feel right. I like to feel good. I want to feel confident when I go into situations. I want to feel confident about myself, and if I feel like I'm crap because of the emotional issues I start to spiral down. I get depressed, extremely depressed. I can't function. Just getting up in the morning is extremely hard because I can't sleep. So I'm tired, I'm not sleeping very well. I'm antsy, I'm anxious. I have panic attacks, anxiety attacks, and this is all right after I ovulate or a couple days before I ovulate and it starts to spiral down and then I go into crazy week. I either don't have an appetite, or I have a huge appetite. It feels like PMS keeps me from being me. I know that I'm better than this. I feel there are two people in me: the sane and the insane. Sometimes I feel I've got this split personality, and at PMS time this insane person comes in and takes over. I can handle the physical symptoms a lot better than I can handle the emotional ones. I would rather not have to take medication for this.

~ Julie

Answer

Julie, it's possible you have the most severe form of PMS, called PMDD (Premenstrual Dysphoric Disorder) which usually causes severe depression-like symptoms, before the period. Whether or not a doctor would actually diagnose that condition, I think you are right that your premenstrual symptoms are extremely severe. I recommend you take our self-assessment if you haven't done so already. It will help give you a sense of the severity of your symptoms.

It's hard to know exactly how much of what you are feeling is related to hormones, how much is related to the kind of mood chemistry (neurotransmitter) imbalance that is typical of PMDD and severe PMS, and how much might be related to deep-seated emotion- and thought-patterns. In most women, a combination of all three determines how symptoms manifest. I often recommend talking to a professional counselor, or a clergyperson trained in counseling, in addition to pursuing a PMS Comfort Natural Relief Program.

In fact, many women are convinced they want to try prescription medications for PMDD symptoms, and I believe this may be an appropriate choice, as long as you understand the potential side effects of the drug treatment. My professional preference is for a natural approach that attempts to address the cause of the problem rather than just covering up the symptoms.