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:
1) Markedly depressed mood, feelings of hopelessness, or self-depreciating thoughts.
2) Marked anxiety, tension, and feelings of being "keyed up" or "on edge".
3) Marked affective liability (e.g., feeling suddenly sad or tearful or feeling increased sensitivity to rejection.
4) Persistent and marked anger or irritability or increased in interpersonal conflicts.
5) Decreased interest in usual activities (e.g., work, school, friends, hobbies)
6) Subjective sense of difficulty in concentrating.
7) Lethargy, easy fatigability, or marked lack of energy.
8) Marked change in appetite, overeating, or specific food cravings.
9) Hypersomnia or insomnia
10) A subjective sense of being overwhelmed or out of control.
11) Other physical symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, weight gain.
Key terms: Dysphoria: excessive disquiet, agitation, restlessness
Source: American Psychiatric Association (2000)
Page updated 2/2013
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