PMDD vs. PMS: When Hormones Disrupt Mental Health
- Alyssa Sekadlo
- Sep 18
- 2 min read
Most people are familiar with PMS — the irritability, bloating, or low energy that creeps in before a period. But if your symptoms feel more like an emotional collapse than a mild annoyance, you may be experiencing PMDD (Premenstrual Dysphoric Disorder) — a condition that often goes undiagnosed and untreated, especially in high-functioning women.
Let’s clarify the difference — and more importantly, what you can do about it.
PMS vs. PMDD: What’s the Difference?
PMDD isn’t caused by a hormone imbalance. Instead, it stems from an abnormal sensitivity to the body’s normal hormonal shifts, particularly to progesterone and estrogen in the luteal phase of the menstrual cycle. This hormone-brain interaction affects serotonin pathways, which help regulate mood, sleep, and emotional resilience.
Common Symptoms of PMDD
Intense irritability or sudden anger
Panic attacks or racing thoughts
Brain fog or difficulty concentrating
Feeling out of control or emotionally unstable
Crying spells or deep sadness
Thoughts of self-harm or suicidal ideation
Physical symptoms: bloating, breast tenderness, fatigue, sleep disturbances
How to Know if It’s PMDD
If your mood tanks cyclically and you feel normal again once your period starts — track your symptoms for two or more cycles. Bring your results to your provider — preferably someone who understands both biological and mental health aspects of care. Below are helpful tools to monitor your symptoms:- Me v PMDD App (https://mevpmdd.com)- Daily mood and symptom journaling- Menstrual cycle tracking tools like Clue or Flo.
Treatment Options: Evidence-Based & Individualized
As a psychiatric mental health nurse practitioner, I work with clients using integrative, personalized approaches. Treatment may include:
SSRIs (like fluoxetine or sertraline), taken continuously or only during the luteal phase
Cognitive Behavioral Therapy (CBT) focused on emotional regulation
Lifestyle interventions: stress management, sleep hygiene, exercise
Nutritional support: magnesium, calcium, B6 (with professional guidance)
Hormonal collaboration with OB/GYNs (e.g., birth control or ovulation suppression)
Mind-body support: yoga, mindfulness, or nervous system work
If you're navigating monthly emotional crashes or wondering whether your cycle is contributing to your mental health symptoms, I invite you to reach out. Compassionate, evidence-informed care is available.
If you’re interested in setting up a 90 minute comprehensive evaluation or a free 15 minute complimentary consultation with our APNP, Alyssa Sekadlo, reach out to our office manager, Carrie, at 262-235-4385 ext. 7 or email info@bestselfcc.com.
You can also browse our website for more information about other mental health services we offer!
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