From crying spells to insomnia: 11 signs it's more than just 'bad PMS'.

Between stabby stomach cramps, achy *everything* and feeling like you want to punch people in the face, PMS can be the absolute pits. But did you know there's a whole ~other~ level of PMS? We didn't. 

While some of us might relate to the above symptoms, others suffer premenstrual symptoms that go far beyond feeling irritable, sensitive and lethargic. 

We're talking about things like wild mood swings, outbursts of rage, depression, anxiety and barely being able to leave bed for days on end. 

Welcome to the crippling period condition that is premenstrual dysphoric disorder (PMDD).

Watch: Here's what your period would be like if it was a person. Post continues below.

Heard of PMDD before? 

It's a serious medical condition that affects a whopping one in 20 women. Yet, many of us have never heard of it. And while they may show symptoms, many women don't even know they have it. Pretty crazy, right?

The symptoms are debilitating and can result in everything from lapsed careers to broken relationships and a negative self-image. It basically makes it hard to get on with your daily life. 

Listen: Here's what no one tells you about the contraceptive pill. Post continues below. 

So, what's the go? Why have so many of us never heard of it? 

Well, similar to many other understudied women's health conditions, the research and understanding around PMDD is murky at best. There's a solid lack of knowledge around symptoms and how they come about, which leads to PMDD being commonly misdiagnosed.

To find out more about PMDD, we spoke to obstetrician and gynaecologist Dr Nicole Stamatopoulos, and asked her about some of the common physical and psychological signs of this misunderstood condition, as well as what kinds of treatment options are out there.

What is PMDD?

PMDD is a much more severe version of its well-known relative, PMS, and is a condition that can have physical, emotional and behavioural implications.

"It is classified as a depressive disorder that is otherwise not specified. It causes severe distress and dysfunction that is worse than PMS," explains Dr Stamatopoulos.

It's basically PMS on steroids - often resulting in extreme emotional distress and days spent in bed. As we said before, it even has the potential to put a pause on education, careers and relationships. 

What are some common signs of PMDD?

While there are many symptoms associated with PMDD, Dr Stamatopoulos said the impact that it has both mentally and emotionally is the most distressing. "These symptoms usually occur in the week prior to menstruation and stop a few days after the period starts," she adds.

As we mentioned before, getting a diagnosis with PMDD can be difficult. If any of these symptoms are familiar and interfere with daily activities, we recommend seeing your doctor or seeking a referral to a gynaecologist with expertise in PMDD.

Some of the most common PMDD symptoms include:

1. Depression.

People with PMDD are at a high risk of suffering from a range of serious mental health issues, including depression. Sometimes those struggling with the condition will experience a "markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts," said Dr Stamatopoulos.

2. Anxiety.

It's also common for women with PMDD to experience "anxiety, tension and feelings of being 'keyed up' or 'on edge'", according to Dr Stamatopoulos.

3. Mood swings.

While it's normal to experience mood swings during PMS, those who suffer from PMDD may experience really out-of-character behaviour - such as suddenly feeling very sad or tearful or having an increased sensitivity to rejection.

4. Irritability.

Feeling irritable during your menstrual cycle is a thing that just happens, but PMDD presents more serious symptoms that are a step up from this, characterised by "persistent and marked anger or increased interpersonal conflicts."

5. Difficulty in concentrating. 

PMDD sufferers might also find that they don't feel like their usual efficient self when it comes to school or work. That's because the condition can make concentration difficult, creating fuzzy thinking, brain fog and tripping up your memory.

6. Fatigue and tiredness.

While it's completely normal to feel tired, or even exhausted before your period, if you often feel like you’re too exhausted or tired to do much of *anything*, you may want to see if there is a monthly pattern to your symptoms. Lethargy, easy fatigability, or a low level of energy are all common signs associated with PMDD.

8. Change in appetite.

There may also be a marked change in appetite, said Dr Stamatopoulos, resulting in overeating, or specific food cravings.

9. Hypersomnia or insomnia.

Women with PMDD often struggle with either sleeping too much or not enough before and during their period. Given how important sleep is to physical and mental health, this can be detrimental.

7. Feeling antisocial.

According to Dr Stamatopoulos, some of these symptoms may lead to a "decreased interest in usual activities" and you may find that you struggle to function in social, work, or other situations. Whether it's missing out on school/work days, experiencing broken relationships or avoiding your usual social engagements or hobbies.

10. Feeling overwhelmed.

PMDD can often make it difficult, if not impossible, to manage stress. "Women who suffer from PMDD often feel a subjective sense of being overwhelmed or out of control," said Dr Stamatopoulos.

11. Breast tenderness or swelling.

Other physical symptoms, such as "breast tenderness or swelling, headaches, joint or muscle pain, a sensation of “bloating,” or weight gain" are also common.

PMDD treatments: What's the best way to treat PMDD?

While there is no exact 'cure' for PMDD, there are many treatments out there that can help manage, reduce and, in some cases, completely diminish the symptoms of this condition.

Dr Stamatopoulos recommends exploring some simple lifestyle changes including: "decreasing caffeine, increasing exercise, quitting smoking and getting regular sleep."

She also recommends exploring herbal remedies such as vitamin B6, magnesium and chase tree (shown to reduce mood swings and irritability). 

"Other unmedicated treatment options include cognitive behaviour therapy (a type of psychotherapy) and stress reduction management," she said.

In terms of medicated options, your GP will most likely look at hormonal medication to stop ovulation, such as oral contraceptives.

Dr Stamatopoulos said hormonal options such as the Mirena and the pill can be used to help control PMDD, while medications like antidepressants may also be prescribed to help tackle mood symptoms.

However, treatment options vary and will depend on the individual case (everyone is different). As mentioned before, if any of the above symptoms sound familiar, it's best to check in with a doctor or specialist and they'll be able to suggest a treatment that works for you.

If you think you may be experiencing depression or another mental health problem, please contact your general practitioner or in Australia, contact Lifeline 13 11 14 for support or  beyondblue 1300 22 4636.

If you, or a young person you know, is struggling with symptoms of mental illness please contact your local headspace centre here or chat to them online, here. If you are over the age of 25 and suffering from symptoms of mental illness please contact your local GP for a Mental Health Assessment Plan or call  Lifeline Australia on 13 11 14.

Do you suffer from PMDD? Do you have any experiences or advice you'd like to share? Let us know in the comment section below.

Feature image: Getty