Mood disorders are a group of mental health conditions that primarily affect a person’s emotional state. These disorders can lead to significant changes in mood, which may impact daily functioning, relationships, and overall quality of life. Among these disorders, Premenstrual Dysphoric Disorder (PMDD) stands out due to its specific timing and severity, particularly in relation to the menstrual cycle. This blog aims to explore various types of mood disorders, with a focus on PMDD, and what parents and teachers should look out for in their teens.

Types of Mood Disorders

Mood disorders can be broadly classified into several categories, including:

1. Major Depressive Disorder (MDD): Characterized by persistent sadness and a lack of interest in activities once enjoyed. Symptoms must last for at least two weeks.
2. Bipolar Disorder: Involves alternating episodes of depression and mania, which is a state of heightened energy, mood, and activity.
3. Persistent Depressive Disorder (Dysthymia): A chronic form of depression lasting for at least two years, with symptoms that are less severe than those of MDD but can still impact daily life.
4. Seasonal Affective Disorder (SAD): A type of depression that occurs at specific times of the year, often in winter when sunlight exposure is limited.
5. Premenstrual Dysphoric Disorder (PMDD): A severe form of premenstrual syndrome (PMS) that affects mood, emotions, and behavior during the luteal phase of the menstrual cycle.

“You say you’re ‘depressed’ – all I see is resilience. You are allowed to feel messed up and inside out. It doesn’t mean you’re defective – it just means you’re human.”

David Mitchell, Cloud Atlas

What is Premenstrual Dysphoric Disorder (PMDD)?

PMDD is a severe and debilitating form of PMS that affects approximately 3-8% of women of reproductive age. It is characterized by significant emotional and physical symptoms that disrupt daily functioning and quality of life. While PMS can cause discomfort, PMDD manifests with a set of symptoms that can severely impair a person’s ability to cope with daily tasks and responsibilities.

Common Symptoms of PMDD:

• Emotional Symptoms:
  • Intense mood swings
  • Irritability or anger
  • Anxiety or tension
  • Depression or feelings of hopelessness
  • Difficulty concentrating
• Physical Symptoms:
  • Fatigue
  • Sleep disturbances (insomnia or hypersomnia)
  • Changes in appetite (cravings or aversions)
  • Body aches or joint pain
  • Breast tenderness or bloating

PMDD is a severe form of premenstrual syndrome, affecting approximately 3-8% of women of reproductive age. Women with PMDD experience intense mood swings, irritability, depression, anxiety, and physical symptoms such as bloating, breast tenderness, and fatigue in the days leading up to menstruation. 

Bansal et al

Recognizing PMDD in Teens

As a parent or teacher, recognizing the signs of PMDD in teenage girls can be crucial for providing support and understanding. Teenagers may experience emotional and physical symptoms during their menstrual cycles, and these can escalate to PMDD. Here are some specific markers to look out for:

1. Severe Emotional Changes: If a teen experiences extreme mood swings, irritability, or depressive episodes that seem to coincide with their menstrual cycle, it may indicate PMDD.
2. Disrupted Daily Life: Look for signs that their symptoms are affecting school performance, relationships with peers and family, or participation in extracurricular activities.
3. Physical Discomfort: Complaints of significant physical pain, fatigue, or changes in sleep and eating patterns around their menstrual period could signal PMDD.
4. Social Withdrawal: If a previously active teen becomes isolated or disengaged during certain times of the month, this could indicate emotional distress.
5. Expressing Feelings of Hopelessness: Pay attention to any statements about feeling overwhelmed, hopeless, or questioning their self-worth, especially if these feelings seem to spike around their period.

Statistics and Published Studies on PMDD

• A study published in the American Journal of Psychiatry found that PMDD affects 3-8% of women in their reproductive years, with a significant impact on daily functioning.
• Research published in Psychoneuroendocrinology indicated that PMDD is linked to hormonal changes that affect neurotransmitter function, particularly serotonin, which plays a crucial role in mood regulation.
• According to a study in the Journal of Affective Disorders, women with PMDD are at a higher risk of developing major depressive disorder later in life, emphasizing the need for early intervention and treatment.
• A comprehensive review published in the Journal of Women’s Health highlighted that many women with PMDD do not seek help due to stigma or lack of awareness about their condition, indicating a need for better education and support.

How to Support Teens with PMDD

1. Open Communication: Encourage open and honest discussions about their feelings and experiences related to their menstrual cycle. Creating a safe space for dialogue can help them feel validated.
2. Education: Provide education about PMDD, menstrual health, and emotional wellbeing. Understanding what they are going through can help alleviate feelings of isolation.
3. Encourage Professional Help: If symptoms are severe, encourage seeking help from a mental health professional. Therapy, medication, and lifestyle changes can significantly alleviate PMDD symptoms.
4. Promote Healthy Lifestyle Choices: Encourage a balanced diet, regular exercise, and good sleep hygiene to help manage symptoms.

Monitor Changes: Keep track of any patterns in their mood and behavior relative to their menstrual cycle. This can provide valuable insights when discussing their experiences with a healthcare provider.

Conclusion

Mood disorders, especially PMDD, can significantly impact the lives of teens. As parents and educators, being aware of the signs and symptoms can help provide the necessary support and interventions needed to manage these conditions effectively. By fostering open dialogue and encouraging professional help when needed, we can help teens navigate their emotional and physical health challenges more effectively.

Call To Action

If you suspect that a teenager in your life may be struggling with PMDD or any mood disorder, don’t hesitate to reach out for help. Educate yourself, engage in conversations, and consider seeking support from healthcare professionals. 

Remember, early intervention is key to managing mood disorders and promoting overall well-being. Share your thoughts and experiences in the comments below!

References

Heidi Eccles, Verinder Sharma, The association between premenstrual dysphoric disorder and depression: A systematic review,
Journal of Affective Disorders Reports, Volume 12, 2023, https://doi.org/10.1016/j.jadr.2023.100504 (https://www.sciencedirect.com/science/article/pii/S2666915323000422)

Hantsoo L, Epperson CN. Premenstrual Dysphoric Disorder: Epidemiology and Treatment. Curr Psychiatry Rep. 2015 Nov;17(11):87. doi: 10.1007/s11920-015-0628-3. PMID: 26377947; PMCID: PMC4890701.

Mishra S, Elliott H, Marwaha R. Premenstrual Dysphoric Disorder. [Updated 2023 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532307/

Osborn E, Wittkowski A, Brooks J, Briggs PE, O’Brien PMS. Women’s experiences of receiving a diagnosis of premenstrual dysphoric disorder: a qualitative investigation. BMC Womens Health. 2020 Oct 28;20(1):242. doi: 10.1186/s12905-020-01100-8. PMID: 33115437; PMCID: PMC7594422.

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