Help Pmdd

PMDD differs from PMS in the emotional symptoms in PMDD are more severe and more severe than in PMS, although physical symptoms are relatively similar. PMDD can lower quality of life to an extent quite similar to that of major depression, and may also be associated with increased suicidal ideation and suicide attempts. Approximately 5-10% of PMS sufferers also have PMDD. It affects 3-8% of women of childbearing age worldwide, and is a source of huge burden on women and their families. Women with Seasonal Affective Disorder (SAD) are more likely to have PMDD than women in the general population.

The exact cause of PMDD is unknown, but several theories have been proposed. One theory suggests that PMDD is caused by the absence of serotonin (a naturally occurring substance in the brain involved in sleep, depression, memory and other neurological processes). Serotonin acts as a calming hormone, therefore, when serotonin levels are low, symptoms such as pain, irritability, anger, cravings, and anxiety are precipitated. When serotonin levels are restored, many of these symptoms disappear.

Symptoms of PMDD include at least one of the following:
1. Feeling sad, worthless or hopeless.
2. Feeling tense, anxious or "on the edge.
3. Feeling overwhelmed or out of control.
4. Mood swings, emotional outbursts or unexplained crying.
5. Irritability, anger, or irritable.
6. Increased appetite (carbohydrate cravings)
It also includes other common symptoms of depression, sleep disturbances, changes in appetite or weight, difficulty concentrating, lack of interest in activities once enjoyed, and having suicidal thoughts. Physical symptoms are similar to those of PMS, breast tenderness, bloating, weight gain, headaches / back pain and skin problems like acne.

The first line treatment for PMDD has been anti-depressants. However, they may be intolerable or serious side effects, especially among adolescents. Light therapy has been proposed as a non-pharmacological treatment, among other such treatments to increase levels of serotonin and production, and may represent an attractive and safe alternative. According to Terman & Terman (2005), patients with both seasonal and nonseasonal premenstrual dysphoric disorder, or milder PMS responded positively to one week of light therapy in a series of clinical trials. The effect of light is thought to be mediated by increased production of melatonin, which increases serotonin levels follow. For women seeking a safe and non-pharmacological treatment for TDP, light therapy is a promising treatment with great prospects.

Links
e-Medicine: Premenstrual Dysphoric Disorder
http://www.emedicine.com/med/topic3357.htm

HealthyPlace.com Depression Community -: premenstrual dysphoric disorder (PMDD)
http://www.healthyplace.com/communities/depression/pmdd.asp
References
1. Light therapy. PMS and premenstrual dysphoric disorder (PMDD). http://www.lighttherapy.com.au/pms.php. Accessed 23/08/2007.
2. Lam RW, Carter D, Misri S, Kuan AJ, Yatham LN, Zis AP. A controlled study of light therapy in women with late luteal phase dysphoric disorder. Psych Res 1999 86: 185-192.
3. Terman M, Terman JS. Therapy. In: Principles and Practice of Sleep Medicine (2005). By Ed Kryger MH, Roth T, Dement WC. 4th Ed. Elsevier. Philadelphia. Pp 1424-1442.
4. Krasnik C et al. The effect of light therapy on depression associated with premenstrual dysphoric disorder. Am J Obstet Gynecol 2005 193: 658-661.
5. Liang BA et al. Recognizing and treating premenstrual dysphoric disorder. Hosp Physician 2003. http://www.turner-white.com/pdf/hp_aug03_disorder.pdf. Accessed 23/08/2007.

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