Premenstrual Dysphoric Disorder (PMDD) affects only 3-8% of women with devastating cyclic symptoms (Steiner et al, 1995). Current thought is that it is related to post-traumatic stress syndrome, with unusually low cortisol levels along with high epinephrine levels being an indicator of problems related to stress response. Diagnosis requires five of eleven criteria according to American Psychiatric Association. PMDD was added to the list of depressive disorders in the Diagnostic and Statistical Manual of Mental Disorders in 2013.
Criteria for Premenstrual Dysphoric Disorder: