PMS and PMDD Support

In the book Healing Amelia, we were able to completely heal most of the issues Amelia brought to therapy through the framework of Parts and Memory Therapy. Among those issues were her painful experiences of PMS (Premenstrual Syndrome) and PMDD (Premenstrual Dysphoric Disorder). PMDD is essentially PMS with the added criteria that your problems are great enough that your career or school functioning or your relationship with others is seriously endangered. PMDD is an official mental disorders diagnosis of the American Psychiatric Association.

Amelia’s PMDD was so severe that, in combination with other issues, her therapy took twenty months of once-a-week sessions. The good news is that, now that we know that psychotherapy can heal PMS, we’ve been able to successfully bring permanent relief in as few as five sessions to women with significant PMS, but who do not meet the more extensive criteria of PMDD.

The criteria for diagnosing PMDD include the following 11 sets of symptoms, of which a woman must have five for a diagnosis, including at least one of the first four symptoms listed. The symptoms usually appear during the last three to five days preceding the onset of monthly menstruation. Then they generally quickly lessen beginning with the first day of the period.

Premenstrual Dysphoric Disorder (PMDD) Symptoms

1 Becoming suddenly tearful or sensitive to rejection.

2 Being easily angered or irritated.

3 Feeling hopeless, depressed, or putting yourself down.

4 Feeling anxious or tense.

5 Feeling uninterested in the things you usually like to do.

6 Having difficulty concentrating.

7 Feeling lethargic.

8 Craving particular foods or overeating.

9 Difficulty sleeping or sleeping too much.

10 Feeling overwhelmed or not in control.

11 Feeling joint or muscle pain, tender or swollen breasts, or a sensation of bloating.

Not All PMS Is the Same

Women can experience PMS in different ways. The typical experience is for symptoms to begin three to five days before the beginning of menses, with an increase in intensity until the beginning of menses and a cessation of symptoms on the first or second day of a woman’s period.

Amelia’s pattern was atypical. She would have high intensity PMS symptoms for two to three days at ovulation (roughly Day 14) and, after a relatively calm state, again experience symptoms beginning about three or four days before her period. Unlike other women with this pattern, Amelia didn’t find relief at the beginning of menses but would continue to suffer until the end of her period

A second atypical pattern for some women is the sudden appearance of severe symptoms at ovulation, with these symptoms continuing for a solid two weeks until the beginning of menses. Still another pattern is for symptoms to first appear at about Day 8 of the cycle with a sharp rise in severity until ovulation (Day 14) and then a slower increase in intensity until maximum severity at Day 28. Many women experience slight variations of one or more of these patterns.

How Prevalent is PMS/PMDD?

According to the DSM-5, the official diagnostic manual of the American Psychiatric Association, between three and eight percent of premenopausal women are significantly incapacitated for a few days each month with PMDD, and unable to function socially or professionally. Less severe but still significant PMS affects 20 to 40 percent of premenopausal women, while approximately 75 percent of women experience at least some premenstrual symptoms.

Translating those percentages to actual numbers, using as a base the approximately 60 million women in the United States between the ages of 18 and 45, then there are roughly 4.8 million American women who meet criteria for PMDD. They are included in the roughly 24 million women who meet criteria for PMS. Overall, about 45 million women have at least some significant symptoms of PMS.

Where to Find Help

There are not many therapists trained in Parts and Memory Therapy (see the P&MT Therapists tab). But now that we know that PMS/PMDD can be cured with psychotherapy, you can take this newfound knowledge to a therapist in your area, and ask for the treatment of the painful life experiences that are the foundation for your distress. Be aware that standard talk therapy that ignores your history of painful life experiences will be of little help. You want to find a therapist who is comfortable in working with traumatic and other painful memories, and who has the techniques to neutralize those memories. Four of these therapies are EMDR, Internal Family Systems, Coherence Therapy, and Ego State Therapy. Remember that you will probably have to let your therapist know about the connection between a history of disturbing life experiences and PMS/PMDD. You can also write to us for suggestions or blog responses.

Amelia’s Progress

About halfway through the therapy, this is what Amelia said about her progress:

Oh my! This reminds me of how low-functioning I was. How stressed and overwhelmed I was. It was absolutely overwhelming, physically, mentally, emotionally. I am functioning now. I think back there I just dragged myself to do things I needed to do but I couldn’t do it well—like I was on autopilot, just dragging myself to one thing and then another. But I couldn’t fully enjoy them or be engaged in them. I was just trying to survive. Now I’m capable of functioning at a higher level.”