PMS vs PMDD: How to Tell the Difference

It started with a phone charger. Your younger sister borrowed it without asking, again, and something in you snapped. You shouted. She cried. Later, in the office washroom, you cried too, and you could not fully explain why.

Three days later, your period came. And just like that, the heaviness lifted. You felt like yourself again. You even said sorry to your sister with her favourite chocolate.

Then a quiet thought arrives: is this normal? Is it just me? This is where the question of PMS vs PMDD comes in. They sound similar. They are not the same.

PMS is a monsoon drizzle. PMDD is a flood warning. Both are real, and neither is your fault.

PMS is the monsoon drizzle

Premenstrual syndrome, or PMS, covers the physical and emotional changes many women notice in the week or two before their period. Bloating, tender breasts, cravings, tiredness and a shorter fuse are all common. Like a monsoon drizzle, PMS is annoying and sometimes gloomy, but you can still get to work, meet friends and get on with your day.

PMDD is the flood warning

Premenstrual dysphoric disorder, or PMDD, is far less common, affecting roughly 3 to 8 women in every 100. The timing is the same, but the weather is not: PMDD brings intense sadness, hopelessness, anxiety, anger or mood swings that disrupt relationships, work and daily life.

Here is something that surprises many people: women with PMDD usually have normal hormone levels. Their brains simply react more strongly to the ordinary rise and fall of hormones each month. Think of two people listening to the same song. For one, the volume is comfortable. For the other, the volume knob is turned right up. Same song, very different experience. That is why PMDD is nobody's fault.

The key differences between PMS and PMDD

Doctors look at three things:

• Severity: for PMDD, at least five symptoms are present, and at least one is a strong mood symptom, such as low mood, anxiety, irritability or mood swings
• Impact: PMDD gets in the way of work, studies or relationships, while PMS usually does not
• Pattern: the symptoms switch on in the days before your period and switch off within a few days after it starts, in most cycles

Remember that phone charger? One snappy evening is PMS territory. Feeling out of control every month, to the point that it hurts your relationships, may be PMDD.

How to track your PMS symptoms

The most useful tool is a simple daily log. Doctors often use a chart where you rate each symptom from one to six, every day, for at least two cycles. A notebook or a period app works well: note your mood, sleep, energy and cravings, and how much each day was affected. Patterns you cannot see in memory become obvious on paper.

When to seek help

Please see a doctor if premenstrual symptoms are affecting your work or relationships, or if they carry on well after your period starts. Low mood that lasts more than two weeks also needs a doctor's attention.

Women with PMDD have a higher risk of suicidal thoughts. If you ever feel hopeless or think about harming yourself, reach out straight away: in India, you can call Tele-MANAS, the government's free mental health helpline, on 14416, at any hour.

The good news is that PMDD responds to care. Options include lifestyle changes, talking therapy and medicines your doctor can prescribe.

What you feel is real, it has a name, and help exists.

If you have spent years believing you are "too sensitive" or "dramatic", please hear this: you are neither.

Everyday support for PMS

For milder PMS, regular sleep, movement and less caffeine in the second half of your cycle can help. Some plant ingredients have been studied too:

• Chasteberry: researched for PMS symptoms in several trials
• Ginger: studied for how strong PMS symptoms feel

Balance in you includes both, as part of a wider strawberry-flavoured daily formula. For PMDD, though, a doctor's plan comes first.

Next month

When the charger goes missing again, you notice the irritation rising, and this time you know what it is. You breathe, check your log, and laugh it off with your sister.

Your one step today: start a two-cycle symptom diary. One line a day is enough.

Written by: Dr. Indraneel

Disclaimer: This article is for general information only and is not a substitute for medical advice. Balance in you is a nutraceutical supplement and is not intended to diagnose, treat, cure or prevent any disease. Speak to your doctor before starting any supplement, especially if you have a medical condition, kidney disease or take regular medication, or if you are pregnant, planning a pregnancy or breastfeeding. Individual results may vary.

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