PMS or PMDD? How to Tell the Difference and Why It Matters
Introduction: When “PMS” Feels Like Too Much
If you’ve ever been told “It’s just PMS” while feeling like your entire world is crashing down, I want you to know something important: you are not imagining it, and you are not weak.
When I was 32 I developed PMDD. Every month, in the two weeks before my period, I was overcome with symptoms that felt nothing like the “mild PMS” people around me described. I wasn’t just irritable — I was in tears, overwhelmed by rage, unable to focus, exhausted, and at times, truly hopeless.
That’s when I began looking deeper and discovered that what I was experiencing wasn’t PMS at all — it was PMDD: Premenstrual Dysphoric Disorder. Understanding that difference changed everything for me, because suddenly, my suffering had a name, and I realised I wasn’t alone.
What Is PMS?
Premenstrual Syndrome (PMS) is something many women are familiar with — in fact, up to 75% of women experience it at some point in their lives. PMS is caused by the normal rise and fall of estrogen and progesterone in the second half of the menstrual cycle, and while it can be uncomfortable, it usually doesn’t stop women from living their day-to-day lives.
Common PMS symptoms include:
Mild irritability or moodiness
Temporary bloating or water retention
Breast tenderness
Headaches or mild cramps
Changes in sleep or appetite
Food cravings (often for sweet or salty snacks)
PMS usually begins a few days before your period and tends to ease once bleeding starts. It can be frustrating, but it doesn’t typically cause severe disruption to work, relationships, or emotional wellbeing.
What Is PMDD?
Premenstrual Dysphoric Disorder (PMDD) is much more than PMS. Around 1 in 20 women of reproductive age experience PMDD, yet it is still under-recognised and often misdiagnosed.
PMDD happens when your body is extremely sensitive to the natural hormonal fluctuations of the menstrual cycle. The changes in estrogen and progesterone interact with the brain’s serotonin and GABA systems, as well as the stress response (HPA axis). The result isn’t just discomfort — it’s a cascade of severe mental, emotional, and physical symptoms that return cyclically before every period.
Common PMDD symptoms include:
Severe mood swings — sudden anger, rage, or tearfulness
Debilitating anxiety or panic attacks
Intense feelings of sadness, hopelessness, or even suicidal thoughts
Overwhelming fatigue, brain fog, or difficulty concentrating
Heightened sensitivity to rejection or conflict in relationships
Physical symptoms: bloating, headaches, muscle or joint pain, digestive upset
Feeling like a completely different person for 1–2 weeks of every cycle
For many women, PMDD means losing half their month to emotional and physical distress — leaving little time to actually feel like themselves.
PMS vs PMDD: The Key Differences
It’s easy to assume PMS and PMDD are just different points on the same spectrum, but the differences are significant:
Severity
PMS: Mild to moderate discomfort.
PMDD: Severe, often life-altering symptoms.
Emotional Symptoms
PMS: Irritability, mood changes.
PMDD: Rage, extreme anxiety, deep depression, or suicidal thoughts.
Impact on Life
PMS: Symptoms may be unpleasant, but most women can still function.
PMDD: Can impair work, relationships, social life, and overall quality of life.
Duration
PMS: A few days before menstruation, resolving at onset of bleeding.
PMDD: Symptoms often last 1–2 weeks before a period, meaning only a short window of symptom-free days each cycle.
A real-life contrast:
Imagine one woman who gets a bit more tired, craves chocolate, and feels snappy for a day or two before her period — that’s PMS. Now imagine another woman who spends half the month fighting panic attacks, struggling to get out of bed, and feeling like she might ruin her relationships because of uncontrollable anger — that’s PMDD.
Why Understanding the Difference Matters
Too often, women with PMDD are dismissed or misdiagnosed. They’re told they’re just “too emotional” or need to toughen up. Some are prescribed antidepressants without ever being told that PMDD even exists.
The danger of this misunderstanding is twofold:
Lack of support — Women don’t get the specific help they need.
Self-blame — Many feel broken, weak, or guilty for not coping, when in truth, their bodies are reacting to hormonal changes in a very real, very challenging way.
Naming PMDD is validating. It gives language to the experience and opens the door to tailored, holistic support.
Natural Approaches to Supporting PMDD
While there is no single “magic fix,” naturopathy offers a powerful framework for managing PMDD by addressing both the physical and emotional roots of the condition. Here are some key areas I focus on in my practice:
1. Nourishing Plant-Rich Nutrition
Whole, unprocessed foods reduce inflammation and stabilise blood sugar, which supports hormonal balance.
Key nutrients to prioritise:
Magnesium – calms the nervous system and helps ease cramps.
Vitamin B6 – supports neurotransmitter balance for mood regulation.
Omega-3 fatty acids – especially from Ahiflower oil, a sustainable and highly effective plant-based source.
2. Herbal Remedies
Vitex (Chaste Tree Berry): Helps regulate progesterone and ease mood swings.
Saffron: Shown in research to improve mood, reduce anxiety, and lift premenstrual low mood.
Kava: Supports relaxation and reduces anxiety, particularly useful in the luteal phase.
3. Nervous System Regulation
PMDD symptoms are often intensified by stress and nervous system dysregulation. Supportive practices include:
Breathwork to move from fight-or-flight into calm.
Yoga Nidra for deep restoration and better sleep.
TRE (Tension & Trauma Release Exercises) to release stored stress from the body.
Mindfulness and meditation to create space between you and your emotions.
4. Emotional & Ancestral Healing
PMDD often brings old wounds to the surface. Many women notice unresolved trauma or family patterns re-emerge during their luteal phase. Approaches such as Family Constellations and Rapid Core Healing can help safely uncover and release these deeper blocks, supporting both emotional regulation and physical wellbeing.
You Are Not Alone
If you’re reading this and wondering whether what you’ve been calling “PMS” might actually be PMDD, I want you to know you’re not alone. PMDD is real. It’s not just being “overly sensitive,” and it’s not your fault.
Understanding the difference between PMS and PMDD is empowering — it gives you clarity, helps you advocate for yourself, and opens up new possibilities for healing.
💚 If you’d like compassionate, holistic support for PMDD, I’d love to guide you. Together we can explore nutrition, herbal medicine, nervous system support, and emotional healing to help you find balance and reclaim your life from PMDD.
About Camilla Brinkworth
Camilla Brinkworth is a naturopath, clinical nutritionist, and trauma-informed practitioner specialising in plant-based health, gut restoration, and emotional well-being. With a focus on conditions like SIBO, IBS, and PMDD, Camilla helps clients uncover root causes and create practical, personalised strategies for lasting digestive and hormonal balance. She works globally online so that you can receive the support you need from the comfort of your own home.
Learn more about Camilla’s naturopathy consultations and gut health programmes at www.camillaclare.com.