New In The Psychiatric Diagnostic Manual: Premenstrual Dysphoric Disorder

The revised psychiatric diagnostic manual, the DSM-5, has an interesting addition: Premenstrual Dysphoric Disorder (PMDD).

So ladies, if you go to your doctor and complain about certain types of distress occurring the week before your period begins, you might find yourself diagnosed with this mental disorder.

Some of us may welcome this diagnostic addition, while others will be appalled, though there is no doubt that many women experience difficult physical, emotional and mental changes prior to each menses. The question has been whether this should be considered a mental health disorder. Now, it officially is one.

The Diagnosis

You can be given the PMDD diagnosis if you experience at least five of the 11 listed criteria or symptoms. The symptoms must not be owed to any other mental illness, need to cause “significant stress” or distress for the individual, and be experienced several months over the course of a year.

PMDD Criteria

• Mood swings, sudden sadness, increased sensitivity to rejection
• Anger, irritability, increased interpersonal conflict
• Problems concentrating
• Having a depressed mood, negative/critical thoughts about the self or sense of hopelessness
• Tension, anxiety, being “on edge”
• Alteration in appetite, overeating, or specific food craving
• Sleeping too much or not sleeping
• Feeling overwhelmed or not in control
• Tender breasts, pain, bloating, swelling, weight increase
• Fatigue, lethargy, lack of energy
• Reduced interest in usual activities such as school, work, friends or hobbies

Stated Benefits of Having the PMDD Diagnosis

Whether the PMDD diagnosis will benefit women or stigmatize them remains to be seen; maybe it will be a little of both.

Proponents of the diagnosis state that there are some benefits of having PMDD in the DSM-5:

• It will stimulate research and data collection, leading to a better understanding of the disorder and more effective treatments, including medications.
• The diagnosis will represent individuals who are not well-represented in other diagnostic categories.
• Women with PMDD who experience functioning impairments in various areas show improvement when they are treated. Having clear diagnostic boundaries will prevent some women with treatable symptoms from being dismissed by healthcare providers.
• Having clear PMDD diagnostic criteria means women with this disorder are less likely to be misdiagnosed with, for instance, depression.

Those who champion the inclusion of PMDD in the DSM-5 say that women who will fit the diagnosis are a small minority. Therefore, fears that women as a whole will be stigmatized by this diagnosis are unfounded.

The proponents may be right, but at least one woman, mental health counselor, and thoughtful human being find the stated benefits of this diagnosis have the flavor of rationalizations. What do you think?

Source: National Institutes of Health
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