Do You Feel Out of Control Every Month? It Could Be PMDD
Understanding the difference between PMS and PMDD — and how a holistic approach can help.
If you feel like a completely different person in the lead-up to your period — anxious, depressed, angry, or totally despairing — you’re not alone. But you might be dealing with more than just PMS.
For many women, the emotional and physical changes they experience each month are far more intense than what’s commonly considered “normal.” If your symptoms feel overwhelming or out of control, it could be Premenstrual Dysphoric Disorder (PMDD) — a serious but often misunderstood condition affecting up to 1 in 20 menstruating people.
Natural Treatment for PMDD: What’s the Difference Between PMS and PMDD?
Both PMS (Premenstrual Syndrome) and PMDD (Premenstrual Dysphoric Disorder) occur in the luteal phase of the menstrual cycle — the weeks before menstruation begins. While PMS is common and typically includes mild mood shifts, bloating, or fatigue, PMDD is more severe, disruptive, and emotionally distressing.
Symptoms of PMDD may include:
Sudden and intense irritability or rage
Crushing anxiety or panic attacks
Deep sadness or hopelessness, sometimes with suicidal thoughts
Extreme fatigue or sleep disturbance
Brain fog or difficulty concentrating
Feeling overwhelmed, out of control, or unlike yourself
Cramps
The difference is not just one of degree. PMDD is a cyclical hormone sensitivity affecting the brain’s response to natural hormonal fluctuations. For those affected, it is not “just hormonal” — it’s neurological, physiological, and deeply emotional.
Introduction to Premenstrual Conditions
Premenstrual conditions, including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), are significant mental health concerns that affect women during their menstrual cycle. While PMS is relatively common and involves mild to moderate physical and emotional symptoms, PMDD is a severe form of PMS that can be debilitating. Women with PMDD experience intense emotional and physical symptoms that can severely impact their daily functioning. According to the Diagnostic and Statistical Manual of Mental Disorders, PMDD is recognised as a mental health condition that requires a proper diagnosis and treatment by a healthcare professional. Understanding the differences between PMS and PMDD is crucial for effective diagnosis and treatment, ensuring that women receive the appropriate care and support they need.
Why PMDD Is Often Misdiagnosed
Because it mimics mood disorders like anxiety and depression, PMDD is frequently overlooked or misdiagnosed. It is crucial to consult a doctor who can provide a proper diagnosis and recommend appropriate treatment options. Many women spend years being offered antidepressants, the birth control pill, or being told “it’s just PMS” without anyone taking their symptoms more seriously, or looking into the cause of this devastating condition.
What makes PMDD particularly cruel is its predictability. For two weeks of the month, you may feel “fine” — even joyful. Then, as if a switch has flipped, darkness descends. You feel like a completely different person. This cyclical nature is one of its key diagnostic features and also one of the most distressing.
A Holistic Path to Healing
While conventional treatments for PMDD often involve antidepressants or hormonal birth control, many women are now turning to a more integrated and holistic approach — one that seeks not just to suppress symptoms, but to heal the root causes.
Many women find significant benefit from integrating these holistic approaches into their treatment plan.
This includes:
1. Trauma Processing
Many women with PMDD have a history of unresolved trauma. The nervous system becomes more sensitive to hormonal changes when underlying stress or emotional wounds are unaddressed. Techniques such as somatic therapy, Family Constellations, EMI (Emotional Mind Integration), or other trauma-informed approaches can create lasting shifts in how the body responds to its hormonal rhythm.
2. Nutritional Therapy
A nutrient-dense, anti-inflammatory diet supports hormone clearance, balances blood sugar, and fuels neurotransmitter production. In addition to a nutrient-dense diet, certain supplements can also support hormone balance and mood stability. Key nutrients like magnesium, B6, calcium, and zinc are crucial for mood stability. A whole food, plant-based diet can be incredibly supportive, especially when tailored to menstrual health.
3. Natural Medicine
Herbs such as Vitex agnus-castus (chaste tree berry), ashwagandha, and rhodiola can help modulate stress hormones and support progesterone sensitivity. These need to be used thoughtfully and ideally under the guidance of a naturopath or herbalist with experience in women’s health. While natural remedies can be effective, some women may also require medication to manage their symptoms effectively.
4. Lifestyle and Rhythm
Cycle-tracking, gentle movement, prioritising sleep, and honouring your inner emotional life can all make a profound difference. Emotional support from friends, family, or support groups can also play a crucial role in managing PMDD. PMDD invites us to develop deep self-awareness and cyclical wisdom — a shift from battling the cycle to working with it.
“The body keeps the score,” says trauma expert Bessel van der Kolk — and with PMDD, that score is often played through the rhythms of the menstrual cycle.
Physical Symptoms Comparison
The physical symptoms of PMS and PMDD can often overlap, but the severity of PMDD symptoms sets it apart. Common symptoms for both conditions include bloating, breast tenderness, and headaches. However, women with PMDD may experience more severe symptoms such as debilitating migraines, night sweats, and extreme fatigue. In addition to these physical symptoms, PMDD is also characterized by severe emotional symptoms, including depression, anxiety, and irritability. A thorough understanding of these symptoms is essential for healthcare professionals to provide an accurate diagnosis and effective treatment plan. Recognizing the heightened severity of PMDD symptoms can help in distinguishing it from PMS and ensuring that women receive the necessary support and care.
Diagnosis and Treatment Options
Diagnosing PMDD can be particularly challenging due to its symptom overlap with other mental health conditions. Healthcare professionals typically use a combination of medical history, physical examinations, and diagnostic tests to rule out other conditions and confirm a PMDD diagnosis. Treatment options for PMDD are varied and may include hormone therapy, antidepressants, and lifestyle changes such as regular exercise and stress management. In some cases, other treatments like cognitive-behavioral therapy may also be recommended. It is essential for women to work closely with a healthcare professional to develop a personalized treatment plan that addresses their unique needs. By exploring various treatment options, women can find the most effective strategies to manage their symptoms and improve their overall health and well-being.
Impact on Daily Life
PMDD can have a profound impact on daily life, affecting relationships, work, and overall well-being. Women with PMDD may experience severe mood swings, irritability, and anxiety, making it challenging to manage daily responsibilities and maintain healthy relationships. Physical symptoms such as bloating and fatigue can further complicate daily life, reducing energy levels and overall productivity. Implementing lifestyle changes, such as regular exercise, healthy eating, and effective stress management techniques, can help alleviate symptoms and improve the quality of life. It is crucial for women with PMDD to seek support from healthcare professionals, family, and friends to manage their symptoms effectively. By understanding the impact of PMDD on daily life, women can take proactive steps towards seeking help and managing their symptoms, ultimately improving their overall well-being.
You’re Not Broken — You’re Sensitive
One of the hardest things about PMDD is how alone and ashamed it can make you feel. PMDD is a severe mental illness that requires understanding and support from both healthcare professionals and loved ones. But you are not broken — you are deeply sensitive. And that sensitivity, when understood and supported, can become a profound strength.
Healing PMDD is not about “fixing” your hormones. It’s about creating safety in your body, nourishment in your life, and clarity around what your emotions are trying to tell you. With the right support, many women find that their cycles no longer feel like a curse, but a guide.
Final Thoughts
If you feel like you lose yourself every month — if anxiety, rage, or despair take over in ways that disrupt your life — it’s time to explore the possibility that you’re experiencing more than just PMS. It is important to seek help from health professionals who can provide a proper diagnosis and treatment plan. PMDD is real. And it is treatable.
The most lasting healing happens when we address the whole woman — not just her hormones, but her story, her nervous system, and her inner ecology. A holistic, trauma-informed approach offers not just symptom relief — but deep emotional liberation.
Because you deserve to feel whole, all month long.
I’m a naturopath, nutritionist and holistic health practitioner seeing patients online from the UK, Australia, New Zealand, Europe and beyond. If you’re navigating the highs and lows of PMDD, I invite you to download my free eBook “The PMDD Solution”. It offers a compassionate, mind-body roadmap that goes beyond symptom management — drawing on my personal healing journey and nearly 15 years of experience in the wellness industry. You’ll learn how nutrition, naturopathy, nervous system support, and emotional healing can work together to bring lasting relief. I also offer a 12-week integrative programme designed to help you reclaim stability, clarity, and confidence all month long.