The Monthly Monster(PMDD)

The monthly menstrual cycle is a topic less discussed in our circles. Yet it presents a number of issues that affect both female and male. While dysmenorrhea (painful period) is a common topic the emotional and mental health issues are less explored.

Pre-menstrual Syndrome (PMS) is a condition that affects a woman's emotions, physical health, and behavior during certain days of the menstrual cycle, generally just before her menses. Due to its nature PMS also affects the interactions between the patient and those around her. Causes have been linked to reactions due to the change in hormone levels that occurs during this period. The changes may alter the brain chemical composition and affect hormones responsible for emotion regulation. The chief hormones are Serotonin and Cortisol. A decrease in the hormone serotonin (feel good hormone) results in depression and anxiety. A rise in Cortisol (stress hormone) results in negative emotions.

The symptoms of PMS range between mild and severe. While symptoms may be mild in some women, some experience severe symptoms.A severe form of PMS is known as Pre-menstrual dysphoric disorder(PMDD). In the diagnostic manual (DSM iv) PMDD is classified under depressive disorders. This means that it is a clinical mental disorder. However there has been controversy on the inclusion of PMDD in the diagnostic manual.

Just like in any other disorder ,diagnosis is important. While there is no particular test diagnosis depends on an evaluation of symptoms and the time of their occurrence however the following factors are considered:

1.consistency of symptoms and occurrence limited to the menstrual period.

2.severity of symptoms and their effect on the mental, social ,occupational and general function.

3.the association of symptoms to the menstrual cycle in the absence of underlying conditions like major depressive disorder, panic disorder or a personality disorder.

Major Symptoms of PMDD include, significant levels of depression which are usually characterized by feelings of hopelessness,self-deprecation and in some cases suicidal thoughts and suicide, attempts.Marked anxiety, tension anger, irritability and agitation are some mood based symptoms related to PMDD. Behavior changes like insomnia and change in eating patterns may be experienced. other symptoms include,emotional sensitivity, paranoia, severe fatigue, social withdrawal, low interest or participation in usual activities like work, study, hobbies among others.

The Pre-menstrual syndrome has implications in the daily life of individuals.Due to its association with depression and anxiety it can lead to suicidal thoughts and attempts. Hence individuals going through this phase need social support and affirmation. It is important to avoid confrontation and conflicts during this period due to high emotional sensitivity. The patients easily get emotionally worked out with frequent crying spells. Presence is a key aspect of Social support in Pre-menstrual syndrome. Individuals suffering from PMS easily experience feelings of rejection hence the need of being there for them and words of affirmation.

Mood swings and anger bouts experienced during this period may impair relationships. For those living with affected individuals it is critical to guard our words and actions. In cases where individuals prefer social withdrawal their wishes should be respected. In the work-place and school PMS may result in Poor task performance. Due to both physical and mental fatigue , individuals may fail to cope with the pressure of work. Attention may also be affected and this compromises performance.

PMS also poses a threat for Impulsive decision making. Due to the mood swings and mental instability , individuals may make decisions based on their feelings at that particular period. Considering the potential dangers poised by PMS to is important to make sure the causes are addressed and the disorder is treated.

Treatment of the disorder depends on addressing the hormonal level changes. Lifestyle plays an important role in addressing hormonal challenges. It is important to address lifestyle factors. A Healthy , balanced diet encourages good hormone composition. Make sure you

eliminate alcohol, and caffeine,reduce carbohydrates and salt. Increasing intake of foods rich in B vitamins especially B6, calcium and magnesium. Severe cases may require serotonin treatment in form of anti-depressants. Consistent exercise, Good sleeping habits and exposure to Sunshine helps in the production of Serotonin. Sunbath at least before it gets too hot in order to deal with stress it is important for individuals to learn and practice good stress regulation techniques.Reach out to a professional counselor where necessary.

Studies have shown the priceless value of spiritual beliefs on stress reduction. Prayer and study of the bible will promote positive thoughts and reduce depression and anxiety. Remember God is a constant friend reach out to Him through prayer, engage in bible study and trust in His leading.

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