If you're a woman struggling with painful symptoms before and/or during your period, you're not alone. Meet Britney, a certified women's health practitioner dedicated to helping women manage and reduce their Premenstrual Dysphoric Disorder (PMDD) symptoms. PMDD, a severe form of Premenstrual syndrome (PMS), is characterized by intense mood and physical symptoms that often occur in the luteal phase of the menstrual cycle. Those who suffer from PMDD may also experience comorbid depression and anxiety. In this interview, Britney discusses the impact of PMDD on mental health, highlighting common symptoms, causes, treatment approaches, and coping strategies.

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Can you briefly tell us what Premenstrual Dysphoric Disorder (PMDD) is, and what are the differences between that and Premenstrual Syndrome (PMS)?

Absolutely! PMDD is a severe form of premenstrual syndrome (PMS) characterized by intense mood and physical symptoms that occur in the luteal phase of the menstrual cycle. This can be 1-2 weeks before a period. However, some women with PMDD can have symptoms lasting all the way until the end of their period. Unlike PMS, PMDD symptoms are debilitating and significantly impact daily functioning and can also impact a woman’s quality of life. 

What are some common psychological symptoms that women with PMDD experience, and how do these symptoms impact their daily lives?

Women with PMDD commonly experience psychological symptoms such as severe mood swings, irritability, anxiety, depression, and feelings of hopelessness. These symptoms can interfere with relationships, work, and daily activities, leading to significant distress and impairment in functioning. They can also experience physical symptoms that could include bloating, fatigue, insomnia, headaches and even weight gain. 

Could you share some insights into the relationship between PMDD and mood disorders such as depression and anxiety?

The relationship between PMDD and mood disorders like depression and anxiety is complex. While PMDD is distinct from mood disorders, many women with PMDD also experience comorbid depression and anxiety. PMDD symptoms can exacerbate existing mood disorders or mimic their symptoms, making diagnosis and treatment challenging. This can be known as PME (Premenstrual exacerbation). However women with PMDD, will usually report that at the beginning or end of their period their symptoms disappear and they feel like themselves again. There are many factors that can explain why a woman may experience depression or heightened anxiety during the luteal phase. This could have to do with Allopregnanolone (A metabolite of progesterone), genetics as well as a history of trauma.

How do you approach treating the mental health aspects of PMDD in your practice?

In my practice, I take a holistic and investigative approach to treating the mental health aspects of PMDD. Drawing from my personal experience with PMDD, I understand the profound impact it can have on mental well-being, and I'm passionate about helping others navigate this journey. I believe that the mental health aspects of PMDD are often interconnected with various factors, including trauma, genetics, and brain function. Addressing trauma can be crucial in managing PMDD-related mental health symptoms for example.

It’s important to know that genetics play a significant role in PMDD, with specific gene mutations being linked to the condition. By identifying and addressing these genetic factors, we can potentially mitigate mental health symptoms associated with PMDD. This personalized approach allows for targeted interventions that address the underlying biological mechanisms contributing to PMDD. So, it goes without saying, but understanding the impact of brain structure and function is essential in treating PMDD-related mental health issues.

Overall, my approach to treating the mental health aspects of PMDD involves comprehensive assessment, personalized interventions, and a focus on addressing underlying biological and psychological factors.

In your experience, what are some of the biggest challenges women face when seeking support for PMDD-related mental health issues?

In my experience, one of the most significant challenges women face when seeking support for PMDD-related mental health issues is the dismissal or invalidation of their experiences. All too often, women are met with skepticism or indifference when they try to discuss their symptoms with healthcare providers or loved ones. This dismissal can leave them feeling hopeless, isolated, and misunderstood, exacerbating the emotional toll of PMDD.

Also, the standard treatments offered for PMDD, such as birth control or antidepressants, may not provide adequate relief for many women. While these medications can alleviate some symptoms, they often fail to address the root causes of PMDD or may come with unwanted side effects. This can lead to a sense of defeat and frustration, as women struggle to find effective solutions to manage their condition. There truly is a pressing need for more education and investigation surrounding PMDD to offer better treatment solutions.

Are there any lifestyle changes or coping strategies that you recommend to help manage the mental health effects of PMDD?

Absolutely, there are several lifestyle changes and coping strategies that can help manage the mental health effects of PMDD.

• Diet: Adopting a balanced diet rich in whole foods, fruits, vegetables, and lean proteins can help stabilize blood sugar levels and support overall well-being. Some women find relief by reducing their intake of caffeine, alcohol, sugar, and processed foods, which can exacerbate mood swings and other PMDD symptoms.

• Exercise: Regular physical activity, such as aerobic exercise, yoga, or tai chi, can help alleviate stress, improve mood, and promote better sleep. Aim for at least 30 minutes of moderate-intensity exercise most days of the week to reap the benefits.

• Sleep: Prioritize getting enough restful sleep each night, as sleep disturbances can worsen PMDD symptoms. Establish a consistent sleep schedule, create a relaxing bedtime routine, and create a comfortable sleep environment to promote quality sleep.

• Therapy: Therapeutic approaches like ISTDP (Intensive Short-Term Dynamic Psychotherapy) or EMDR (Eye Movement Desensitization and Reprocessing) can be effective for addressing underlying emotional issues, trauma, or negative thought patterns associated with PMDD. These therapies can help individuals process and resolve past traumas, improve emotional regulation, and develop healthier coping strategies.

What advice would you give to someone who suspects they may be experiencing PMDD-related mental health challenges but hasn't yet sought professional help?

If you suspect you're experiencing PMDD-related mental health challenges but haven't sought professional help, there are steps you can take. Start by educating yourself about PMDD and keeping a symptom journal to track changes. Reach out to supportive friends or join online communities for validation. Seek help from healthcare providers, but don't settle for practitioners who aren't willing to explore your symptoms deeply or use a functional approach to PMDD. Be persistent in finding the right support, and remember, you're not alone, and there are solutions available to help manage your symptoms and improve your well-being.