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PMS and PMDD: What’s the difference?

Hot water bottles, paracetamol, warm bubble baths and a chocolate craving. Can you guess what we’re talking about? If you’re a woman, you’ll know exactly! Yep, it’s that time of the month. PMS, or Premenstrual Symptoms are the bane of many women's lives. From stomach cramps and sore breasts to breakouts and mood swings - we go through the works at this time of the month… not to mention the five to seven (if you’re lucky) days of bleeding too! The menstrual cycle as a whole has a significant impact on mental wellbeing as well as physical, and many women experience symptoms of depression during certain points of their cycle. But how do we know the difference between PMS, the more severe form called PMDD (Premenstrual dysphoric disorder) and depression? To find out, read on!

Each woman experiences PMS differently, some women have no symptoms at all (what’s it like to be God’s favourite?) and others experience all the symptoms under the sun… X2! Think of it like a spectrum, all women sit somewhere on the line, and all of their experiences with PMS look different to each other. This fact alone can be frustrating for many women, and can cause problems when it comes to getting a particular diagnosis or treatment for symptoms.

This also makes it hard for us to understand what exactly we’re experiencing during our cycle. Is it just that we feel a bit blue, or are we experiencing an episode of depression? How do we know when it’s time to contact our GP when our cramps are causing us pain?

If symptoms of PMS are interfering with our day-to-day life, whether that's physical, emotional, mental or behavioural, then we should consult a medical professional. Interfering with our daily life looks like struggling to work, sleep, meet our usual demands like cooking or cleaning, taking the dog for a walk, and socialising. Seeking professional help is important to resume our quality of life without having to take a week off each month.

But what’s the difference between PMS and PMDD?

According to the NHS website, the most common symptoms of PMS include:

  • mood swings

  • feeling upset, anxious or irritable

  • tiredness or trouble sleeping

  • bloating or tummy pain

  • breast tenderness

  • headaches

  • spotty skin

  • greasy hair

  • changes in appetite and sex drive

PMS is uncomfortable, annoying and tear-inducing for many of us. But it mostly comes and goes with ease, we mostly feel in control of our mood even if it’s a bad one, and feel able to cope with daily demands despite being grumpy, getting cramps or waking up to a breakout.

It can make interactions with those around more snippy, have us crying at cat videos and even wanting to stay tucked up in bed, but it mostly feels completely manageable.

On the other hand, premenstrual dysphoric disorder (PMDD), is defined as a severe form of PMS. The symptoms of PMDD are more intense and can have a serious impact on your life. It can make it difficult to engage in our usual activities, like working, socialising, taking care of ourselves and environments. But of course those with PMDD will experience symptoms differently.

PMDD can feel very similar to experiencing depression, with overlapping symptoms as well as some experiencing suicidal thoughts. PMDD causes these symptoms to occur in the lead up to starting your period, rather than all the time as with depression. But being able to recognise this during the time can be very difficult, especially if we’re not familiar with our cycle. And both can occur at once so it’s important to speak to your GP if this sounds familiar.

The physical and behavioural symptoms we might experience with PMDD are fairly similar to PMS, breast tenderness, aches and pains, feeling bloated or changes in appetite, and having more volatile interactions with others. But the emotional symptoms, while similar to those of PMS, can feel very different.

The emotional symptoms can be confusing and scary for those who experience it. Strong mood swings, feeling deeply upset or irritable, lacking in energy or interest in enjoyable activities. We may experience feeling hopeless, heightened anxiety, particularly low mood - more than just a bad mood or a bit sad - overwhelmed, tense or out of control.

If you are concerned about experiencing PMDD or think you might, speak to your GP. There are a few things we can do to relieve symptoms of PMDD that require a discussion with a healthcare professional. Keeping a record of symptoms can be helpful in explaining your experience, and can even help you understand a pattern in symptoms around your cycle. Getting a diagnosis is important to prevent a crisis as a result of PMDD, so seek support even if you’re just concerned.

To find out more about depression and its symptoms, head over to this blog. Seek support if you're concerned about your experiences or someone you know, and speak to a healthcare professional about your options for relief.

So how can we ease our symptoms?

Because all of our symptoms and experiences are different, finding treatments and relief for our symptoms will look different for each individual. Some people vow a hot water bottle or bath is the way to go, whilst others swear by birth control, and others prefer a more natural route with herbal remedies. Unfortunately, there’s no one-size-fits-all solution, and so it’s a case of trial and error, just ensure whatever you try comes from a credible source - not just because some influencer swears by it.

Here’s some suggestions from the NHS website to ease symptoms:

  • exercise regularly

  • eat a healthy, balanced diet – you may find that eating frequent smaller meals (every 2-3 hours) suits you better than eating 3 larger meals a day

  • get plenty of sleep – 7 to 8 hours is recommended

  • try reducing your stress by doing yoga or meditation

  • take painkillers such as ibuprofen or paracetamol to ease the pain

  • keep a diary of your symptoms for at least 2 to 3 menstrual cycles – you can take this to a GP appointment

And here’s some things that the Beingwell ladies recommend:

Cara, Social and Media Manager:

“I find heat is my best friend during my period. I get very severe cramps that have me doubled over in pain, so the minute I feel a cramp I get a hot water bottle on my stomach or lower back. I’ll make myself a cup of tea and in the evening will spend some time in a hot bath to relax the muscles in the area. I take painkillers if the pain is particularly bad or I need to go out somewhere and can’t do much relaxing! I try to stay on top of my nutrition, sleep and exercise to prevent pain before and during my period too”.

Grace, Life coach and Copingwell Expert:

“I have endometriosis and adenomyosis, which makes my periods extremely painful and often debilitating. Unfortunately, there isn’t much that relieves my pain - painkillers don’t touch it - and it causes many other symptoms like fatigue, nausea, nerve pain and headaches. I also experience PMDD symptoms, feeling really low in the run up, and often feels like a cloud lifting as my period starts. It feels bizarre and is often difficult to differentiate between real feelings and hormonal ones. During this time I really just try to take care of myself, take it very easy and relax as much as possible. I’ve taken time to understand my cycle so I can spot signs and symptoms. Very slow stretching (if I can) and heat offers the most relief, but mostly I curl up on the sofa and feel sorry for myself and I strongly recommend that - even if it’s only for an hour at a time.”

Martina, Cognitive Scientist and Thinkingwell Expert

Mood swings is what I experienced most in the week before my period. It’s when everything looks dark and hopeless, really the worst time of the month for clear reasoning and decision making. Once I realised it, I stopped taking important decisions during that time, and forced myself to double think about it later. Things were always easier to solve and dramatic decisions not always needed, after the symptoms of PMS ended. During my period I used to suffer from back and stomach pain and fatigue. I started taking contraceptive pills that block period about four years ago and my life significantly changed for the better since then. I don’t have to worry about painful cramps anymore. But remember contraceptive pills are still a drug and as such must be taken only under a recommendation and supervision of a professional gynaecologist. Also, they’re not free from side effects, such as changes in blood flow, weight and mood.”

Final note from us: As you can see, we all experience PMS and the menstrual cycle in general completely differently - but all of those individual experiences are valid. Finding things that work for you and help with your symptoms is the key, whether it’s a hot bath, a prescription, or a box (and a half) of chocolates to yourself, find whatever makes you feel even a little bit better and more equipped to cope during this time. And don’t be afraid to seek out professional help if you feel that you need it, they’re there to help us!




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