Supporting Pre-Menstrual Dysphoric Disorder

Written by Sam Wilde

Premenstrual dysphoric disorder (PMDD) is a much more severe form of premenstrual
syndrome (PMS) that can occur among people who menstruate. It includes emotional, physical, and behavioral symptoms that usually resolve with the onset of menstruation. Symptoms include significant shifts in mood (sadness/tearfulness, hopelessness, suicidality, irritability, anger) that disrupt interpersonal relationships and impact the individual’s ability to work and engage in hobbies as well as physical symptoms of breast tenderness, bloating, fatigue, cravings, and more. Behavioral symptoms include increased impulsivity, lack of interest in usual activities, and difficulty concentrating (Mishra et al., 2025).

Research has shown that exposure to American culture increases the likelihood of PMDD symptoms in ethnic minority women (Pilver et. al, 2012). This is one example of how racism, pressure to assimilate, and restricted access to resources, impacts the physical health of people of color in the United States. Research has also shown that neurodivergent people are significantly more likely to experience PMDD (Dorani et al., 2021 and Obaydi and Puri, 2008). Though the cause of PMDD is still being researched, it may be correlated with sensitivity to the hormonal changes that occur during the menstrual cycle. Given that neurodivergent people often have more sensitive nervous systems than those of a more “typical” neurotype, it makes (unfortunate) sense that they may experience harsher symptoms during their menstrual cycle.

Treatment of PMDD currently includes birth control, selective serotonin reuptake inhibitors (SSRIs), or surgery (oophorectomy or hysterectomy). Lifestyle adjustments such as reducing caffeine, alcohol, sodium, and sugar can help alleviate symptoms. Regular physical activity and maintaining a good sleep schedule are beneficial.

If you or someone you know experiences PMDD, be gentle with yourself (and/or them). Treat yourself with all five of your senses - perhaps a candle or a bubble bath of your favorite scent, watch a comfort show or observe nature outdoors (if accessible), eat your favorite snack, listen to your favorite music, snuggle up in your softest blanket, and allow yourself the time and space to simply exist without doing. Know that the pain will pass and you WILL feel better. Reach out to a trusted friend, make art, journal, or record a voice memo. Move your body in whatever way is accessible to you. Allow yourself to feel the emotions and then release them. Honor your experience as you move through this cycle.