Also known as PMDD, premenstrual dysphoric disorder is a debilitating mood disorder, related to PMS, that affects about 3 to 5 percent of menstruating women in the United States.

The symptoms of PMDD are characterized by severe monthly mood swings that often adversely affect the woman's dealings with others and her ability to function in her daily life. The symptoms of this disorder can also manifest themselves as physical pain. Women with this disorder have a higher incidence of other reproductive system disorders such as endometriosis, which can account for this pain.

The symptoms usually begin a week before menstruation and end a day or two after the onset of the woman's period begins. The symptoms can include irritability, depression, anxiety, insomnia, uncontrollable crying, and anger. In severe cases psychosis, hallucinations, and suicidal thoughts may occur.

Although the exact cause of PMDD is unknown, it is believed that it is caused by abnormal hormone fluctuations during the menstrual cycle. A drastic drop in hormone levels in the body can affect the levels of serotonin, a neurotransmitter that controls mood, in the brain.

Women with a history of mood disorders, depression, or mental illness are more likely to have PMDD.

The treatment of PMDD includes lifestyle changes, hormone therapy, or the use of anti-depressant drugs such as Prozac or Zoloft.

Herbs that can increase estrogen levels such as cohosh or soy as well as sedative herbs such as valerian and passionflower can also be helpful.

As a sufferer of this disorder, I can attest to the pain and inconvenience that it can be. People often joke about women with PMS and the moodiness involved, however, for people with PMDD, this is no joke.

When I was younger, I would often throw very dangerous temper tantrums right before my period. These tantrums often consisted of me attacking my siblings with scissors or knives. Blacking out due to PMDD was also common for me during this point in my life.

During my later teenage years, I had attempted suicide many times due to this disorder. I was not usually depressed; however, when I had PMS, I would fall into a black hole, and would not be able to think clearly. Irrational thoughts and at times, severe paranoia, had often triggered my attempts.

Now that I am more aware of this disorder, it is easier to control the symptoms. I still get very moody; however, I have found various coping strategies. I have also chosen to self medicate with birth control pills, which help immensely.

This disorder is often scoffed at, and therefore, little "real" treatment or research exists for it. Often, like other disorders such as fibromyalgia or chronic fatigue syndrome, the validity of PMDD itself is questioned. This prevents thousands of suffers from seeking or receiving help for this extremely debilitating disease.

The treatment of PMDD includes lifestyle changes, hormone therapy, or the use of anti-depressant drugs such as Prozac or Zoloft.

Eli Lilly has repackaged Prozac to treat premenstrual dysphoric disorder. This new drug is called Sarafem.

From the Eli Lilly website: "Sarafem (fluoxetine hydrochloride) is the first FDA-approved prescription treatment for both the mood and physical symptoms of Premenstrual Dysphoric Disorder (PMDD). Sarafem helps you be more like the woman you are, every day of the month, even during your most difficult days. "

I have been on Sarafem for one year now and have never felt better. Not only are my mood swings gone, but I feel as if I have emerged from a cloud of darkness that I didn't even know I was enclosed in. About two months after I started taking the drug, I called Scoresby and told him that I suddenly felt interested in life again. I felt like a child, new and happy. Of course this makes me think that I might have just needed Prozac for depression. In fact, some doctors believe that Premenstrual Dysphoric Disorder is really just depression which is amplified during women's periods.

Sarafem has also made me stop eating because I was sad or bored and I have noticed some weight loss due to this.

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