Severe depression while PMS-ing? You might have PMDD

There was a tweet that went around this week that emphasized how mental health awareness shouldn’t just be limited to depression and anxiety. To loosely quote it: We should be giving the same energy to “lesser-known” illnesses and break the stigma around them as well.

One mental health concern you might’ve not heard about is premenstrual dysphoric disorder (PMDD), which affects two to five percent of women of childbearing age. This is a severe form of premenstrual syndrome (PMS) that can greatly affect a woman’s psychological health.

Healthline enumerates symptoms like extreme mood swings, panic attacks, and sudden bursts of anger. Other symptoms are similar to what women experience regularly like headaches, cramps, having low energy, and bloating. So it’s possible that they ignore the red flags and just think what they’re feeling is normal.

For freelancer Karen Sison, she suspected something wasn’t right in 2017 when her PMS symptoms were affecting her energy and focus during the luteal phase, which occurs one to two weeks before a woman’s period.

“My energy levels were extremely low: I could barely stay awake during the work day. I would be napping for several hours on the office couch. Not even coffee could make a significant difference, at first. I also had a difficult time concentrating: I always felt overwhelmed, sometimes for no particular reason. It was also as if my brain was in a fog,” she tells us. “At the same time though, I couldn’t stop thinking: Often, I would fixate on one small thing, think that it ruined everything, and I would have very self-deprecating thoughts. Sometimes, I would also have thoughts on self-harm and suicidal ideation.”

She says a Twitter discussion from mental health organization, MentalHealthPH (fka, Silakbo PH), enlightened her about PMDD. This encouraged her to visit a psychiatrist in 2018 to get a diagnosis.

PMDD and the period stigma

In order to understand the effect PMDD has, we must also tackle the stigma surrounding periods. Women are often told they’re overreacting when they have health concerns caused by their periods, the most common being dysmenorrhea or menstrual cramps.

As we reported before, menstrual cramps were officially ruled as a medical condition that feels similar to having a heart attack. Not that it’s any surprise to us women how bad periods can get. But society has also dismissed our troubles as something women normally experience, never something that needs medical attention. (We don’t take painkillers just for the heck of it, okay?)

There’s also the sexist stereotype that women are “on their period” when we are expressing negative emotions. This can be especially troublesome for people who have or may have PMDD because people might not take their experiences seriously.

Karen admits she would occasionally receive comments about being “OA” (over-acting), but the bigger concern for her is feeling isolated because “no one can truly and fully and understand the difficulty.” Although she’s fortunate enough to have progressive friends and co-workers who empathize with her situation.

Resources about PMDD are still lacking worldwide. It was just added to the International Classification of Diseases (ICD-11) earlier this year. Because of this, Karen says this can be a disadvantage for working women as some companies and even healthcare professionals may not be aware of its existence yet.

“We live in a society where you have to prove that you’re worthy of receiving your basic needs and that’s by working, often long and hard and even in toxic working environments, especially at an entry-level job, and that if you can’t work, it’s completely your fault. This mindset doesn’t take into account circumstances out of a person’s control, whether it’s a condition as debilitating as PMDD,emotional trauma, or a mere lack of financial resources.”

What to do if you suspect that you have PMDD?

Do you think your PMS is keeping you from doing everyday tasks? Then don’t hesitate to go to a medical professional—be it your OB-GYN or a psychiatrist—to know if you have PMDD or not.

For Karen, what helped her significantly before going to the doctor is keeping a journal to track her symptoms. “It helps to see if there’s a pattern, whether it’s the symptoms you experience or the time of month you experience it. It also gives you something to show your doctor when you do see him or her.” She adds that this method still works even after getting diagnosed.

Mind, a UK-based mental health charity, also recommends keeping a journal for at least two months before visiting your doctor.

It’s possible that doctors might not diagnose you with PMDD right away. According to Cleveland Clinic, at least five symptoms (full list here) occurring within seven to 10 days should be identified first, which is why keeping a journal is important. If you do get a PMDD diagnosis, you can be prescribed antidepressants (e.g. Escitalopram) or birth control pills.

If you’re hesitant about going to the doctor, we’re not going to rush you into doing so. You should go when you’re ready or once you have the resources for an appointment. You also read up on PMDD and its symptoms first, or to talk to people who are going through the same thing.

Remember: Just like with any mental illness, people need to know more about PMDD and its effects. If you or someone you know was diagnosed with it, we’re reminding you you’re not alone in this.

For additional assistance, you can contact the hotlines below.

HOPELINE: (02) 804-4673, (0917) 558-4673

National Center for Mental Health (NCMH): (0917) 899-8727, (02) 989-8727


Art by Tricia Guevara

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