Demystifying the DSM: Premenstrual Dysphoric Disorder (PMDD)

Dr. B here with our series on Demystifying the DSM and today I'm talking about PMDD, and if there's men listening, this is a real disorder, and it should be treated. Oftentimes many, many women experience PMS symptoms. But PMDD is to a point of really needing treatment. And even PMS, I want to empower women that even PMS can be treated. I personally take birth control pills on a constant to stop ovulation so that I do not experience those PMS symptoms. That is one of the treatments that we use for PMDD. But oftentimes we also have to add in an antidepressant, sometimes just in those two weeks prior to menses. But oftentimes we have to do it all the time. It's very important that we distinguish PMDD from bipolar type mood, right? It's very specific around the hormone level one week prior to menses. The individual needs to be documenting when they start their menses and where they are in their cycle. Because if there's fluctuations in different times in the cycle, it's likely not PMDD. It's likely more in that bipolar type of mood disorder or mood disorder unspecified. For PMDD it's very specifically in that week prior to the menses is the most severe and actually upon starting menses and the week following menses, the symptoms are improving slowly. It’s very important. You cannot diagnose PMDD without having a clear record of those cycles. And they must have at least five of these symptoms in a dysfunctional manner. Mood swings, suddenly tearful. Severe irritability or anger. Depressed mood or anxiety. A decrease in interests of usual activities. Difficulty concentrating. Severely fatigued. Changes in appetite. Hypersomnia or insomnia. Feeling out of control, and oftentimes they also have physical symptoms. You know, their breasts hurt, they feel inflamed, bloated, and so there's a clear physical component to this hormonal physical component that we often do recommend birth control and again you know we have to look at the history of the person and there are certain kinds of breast cancers and female cancers that can worsen with birth control. So, this is a choice that's made with your doctor. But super important, if you meet criteria for PMDD that you don't just shrug it off as you know this is something we have to deal with as a woman, right? You don't have to. Again, my whole thing is like you deserve to be happy. You deserve to not have to do this half of your life. I remember before myself getting on birth control, I don't have PMDD, but I have PMS, and two weeks out of my month I'm not feeling well, right? I'm having these symptoms of PMS. That's half of my life and as I got older, my cycle shortened. So instead of having a 28-to-36-day menses cycle, I was going to 20-24 day cycle so I'm almost always feeling the symptoms of PMS. I want to empower women that there are safe and effective ways to treat this and that we don't have to endure it just because we're women, right? Because you deserve to be happy.
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Dr. Cristi Bundukamara, Ed.D, PMHNP-BC --- A Psychiatric Mental Health Nurse Practitioner and a Doctor of Healthcare Education has experienced unimaginable trials that have caused many feelings such as depression, anxiety, anger, & overwhelming stress. 
However, she has developed a new pathway to becoming Mentally Strong & Choosing to be Happy.  With purpose, Dr. B has developed the phases that were refined within the Mentally STRONG Method that she created and wants to share with you.

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