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Premenstrual Dysphoric Disorder (PMDD)

This is a diagnosis that is gaining increasing acceptance in the medical world, although in the DSM-IV-TR it is still considered a condition that requires further study before being fully endorsed.  It describes a situation where a woman experiences at least five of the following symptoms, including at least one of the first four listed, exclusively during the week before and the few days during menstruation (last week of the luteal phase and beginning of the follicular phase), and not during the rest of her cycle:

  1. A depressed mood, feelings of hopeless, and/or self-deprecating thoughts.
  2. Feeling anxious or tense
  3. Rapidly shifting moods, feeling perhaps sad one moment, and angry or irritable the next; this may also include becoming very sensitive to feelings of rejection.
  4. Becoming generally more angry and irritable and getting into conflicts with others as a result.
  5. Decreased interests in her usual activities
  6. Difficulty concentrating
  7. Lethargy or fatigue
  8. An increase or decrease in appetite, or specific food cravings
  9. Sleeping too little or too much
  10. A subjective sense of being overwhelmed or out of control
  11. Having particular physical symptoms such as breast tenderness or swelling, headaches, joint or muscle pains, a sensation of bloating, and weight gain. 

In order to make a clear diagnosis of this condition, a women should rate the presence of the above symptoms on a daily basis over the course of two menstrual cycles, while also recording her daily menstrual symptoms.  


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