Content warning: This article discusses suicide. Premenstrual Dysphoric Disorder, also known as PMDD, might not be on your radar, but if your monthly cycle starts to feel just a little bit overbearing, it’s time to look deeper. It isn’t just “bad PMS” — it’s a serious condition that can absolutely affect your mood, your ability to concentrate, and even your relationships. Plus, knowing what PMDD is can make all the difference in how you handle both your health and college experiences.
PMDD is a serious, long-term condition that many women experience during the luteal phase of their menstrual cycle (the days between ovulation and your period). “PMDD is much more pronounced on the psycho-emotional level and leads to an intense experience that could be called ‘PMS on steroids,’” Lisa Jara, a women’s female health specialist at the Flourish Institute tells Her Campus. “For anywhere between 2-3 days up to two full weeks before their period, these menstruators enter into a state of existential despair like they’re ‘hit by a truck.’”
According to the National Library of Medicine, about 5% to 8% of menstruating individuals experience PMDD. And in a college environment, where stress is high and sleep is low, those symptoms can seriously be magnified. But recognizing PMDD early on is crucial, because it can be managed, whether that’s through lifestyle changes, medication, or professional help.
For college students, managing classes, social life, and responsibilities can make the emotional and physical challenges of PMDD feel even more overwhelming. “This is extremely taxing on the nervous system, especially since many don’t understand that this could be connected to their menstrual cycle experience,” says Jara. “It is connected to a state of estrogen excess and an increased nerve sensitivity that makes them sensitive to even subtle and normal hormonal changes that occur within a menstrual cycle.”
What are the key symptoms of PMDD that college students should be aware of?
Many of us might be familiar with PMS (Premenstrual Syndrome) and its common symptoms like bloating, fatigue, and mild mood swings. But PMDD takes things to a whole new level. Although they share some physical symptoms, the emotional toll of PMDD is far more intense. “The specific causes of PMDD are still largely unknown, yet it is connected to a state of estrogen excess and an increased nerve sensitivity that makes them sensitive to even subtle and normal hormonal changes that occur within a menstrual cycle,” says Jara.
While PMS might cause irritability and cramps, these symptoms are generally manageable and don’t interfere too much with your daily routine. You might feel a little off, but it’s usually something you can push through. On the other hand, “PMDD is much more pronounced on the psycho-emotional level, so a cocktail of wild mood swings, rage, a dark sense of depression and, in some cases, suicidal ideation,” Jara says. “These symptoms are common, but not normal — as in, it’s not ‘just in their head,’ it’s not a curse, they haven’t done anything wrong and they don’t need to ‘just suffer through it.’”
How does PMDD impact mental health?
Students may feel unusually down, anxious, or on edge, and those with underlying mental health conditions like depression or anxiety may find their symptoms worsen during this time. “The side effect that often happens is that the experience, although happening ‘only’ in a certain phase, will taint the rest of their cyclical experience as well,” Jara says. “Once they have survived one round of PMDD, they might already start fearing the next time it’s going to happen.”
Sometimes this fear makes it difficult to get through everyday tasks like going to class, studying, hanging out with friends, or even getting out of bed. PMDD causes severe mood disturbances in the days leading up to menstruation, such as extreme irritability, anger, anxiety, and even depression, that can disrupt relationships, work, and personal well-being. “When they notice signs of depression or anxiety around their menstrual cycle, I suggest they start charting it, including their symptoms, so they can discern patterns and see if and how it’s connected,” Jara says. “This allows them to at least make preparations, schedule down-time, ask friends for support, etc.”
What treatment options are available for PMDD?
“Unfortunately, treatment options in modern Western medicine are very limited,” Jara says. “They usually encompass antidepressant medication, the birth control pill or Gonadotropin-releasing hormone (GnRH) injections (which puts the body into a temporary menopause-like state, switching off the menstrual cycle completely) or hysterectomy (the complete surgical removal of the uterus).” However, Jara is convinced that there are gentler, less invasive approaches to help the body restore hormonal balance and foster a more comfortable experience.
“So the first thing to look at needs to be whether there’s a pattern to it over the course of their menstrual cycle, with symptoms being worse in the time between ovulation and the next period,” Jara says. “Charting one’s cycle including the symptoms is key.”
If symptoms do become worse, it might be worth talking to a healthcare provider, like a gynecologist or a mental health counselor, to get the support you need, whether it’s hormonal treatments, antidepressants, or even simple lifestyle changes and stress management techniques. “I also suggest finding ways to align their life and their cycle,” says Jara. “Not as in ‘do this sport, or eat that food in [a specific phase of your cycle]”, but through their own experience.” By understanding when they’re likely to feel more energized, they can plan activities that require focus and motivation during those high-energy moments. And when they know they’ll be in a low-energy phase, they can be kinder to themselves, offering self-compassion, and taking the time to recharge without feeling guilty.
So, if you’re feeling like your physical and psycho-emotional symptoms are taking over your life right before your period, you don’t have to manage it alone. Recognizing that PMDD is a valid and treatable condition is the first step toward feeling better.
If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Illness (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.