Premenstrual Disorders

physicians.) Another five to six percent are affected so much by their PMS symptoms that their daily lives are severely disrupted during this time. These women suffer from premenstrual dysphoric dis- order (PMDD), a less prevalent but more distressful form of PMS recognized by the American Psychiatric Association (APA) as a “de- pressive disorder.” Although PMDD shares the same symptoms as PMS, it differs in the severity of the symptoms and the necessity of specific treatment to control them. Premenstrual Dysphoric Disorder According to the fourth edition of the American Psychiatric Associa- tion’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), a diagnosis of PMDD can be made when five or more of the following symptoms are consistently present during the first week of the luteal phase, with at least one symptom being among the first four listings: 1. feeling sad, hopeless, or down on yourself 2. feeling tense, anxious or “on edge” 3. marked instability of mood interspersed with frequent tear- fulness 4. persistent irritability, anger, and increased interpersonal con- flicts 5. decreased interest in usual activities, which may be associ- ated with withdrawal from social relationships 6. difficulty concentrating 7. feeling fatigued, lethargic, or lacking in energy 8. marked changes in appetite, including binge eating or food cravings 9. hypersomnia (excessive sleeping) or insomnia (lack of sleep) 10. feeling overwhelmed or out of control 11. physical symptoms such as breast tenderness, headaches, bloating, weight gain, or muscle or joint pain

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DeFining Premenstrual Syndrome