A couple of months ago, I was diagnosed with premenstrual dysphoric disorder, or PMDD. Though PMDD can present a lot of the same symptoms as premenstrual syndrome (PMS), those symptoms and their remedies tend to be a lot more intense. PMDD is also less common, with only three to five percent of menstruators experiencing it as opposed to the nearly 80% of menstruators that experience PMS.

The Symptoms

If you’ve ever gotten a period, you probably know that the week or two before it starts can suck pretty hard. Many people experience PMS experience symptoms like sore muscles and breasts, bloating, sleepiness, cramping, cravings, mild mood swings, and acne flare-ups. Super fun stuff, right?

While these symptoms definitely suck, they’re usually fairly manageable and they go away as soon as your period starts (only to be replaced by even more), but PMDD is different. The symptoms of PMDD are a lot more severe, including intense irritability, fatigue, debilitating cramps and joint pain, and headaches. PMDD can also bring about and irritate mood disorders like depression and anxiety. These symptoms are a lot harder to treat, and often, can only be dulled out as opposed to relieved completely.

I started to realize my symptoms were out of the ordinary when they started affecting my school and work, and when a lot of my friend’s symptoms didn’t quite line up with mine. Everyone around me seemed to be able to pop a few Midol or Tylenol, put on some comfy clothes and move on with their life, but even with medicine, I still found it incredibly hard to make it through my intense fatigue and back pain. I would struggle through a week-and-a-half every month, trying to ward off bouts of anxiety, depression, and irritability napping as often as I could. And when the first two days of my period came around, I would be left glued to my heating pad, not being able to relive my cramps and back pain no matter how much Midol I took. After that though, everything seemed to get back to normal. It took me years to learn that that’s not how periods are supposed to go.

The Treatments

A lot of the symptoms of PMS can be relieved with medicines like Midol, Pamprin, and Tylenol- all readily available on the shelf of your local drugstore. Simple lifestyle remedies like aerobic exercise and eating healthier can also help lessen the symptoms of PMS. But PMDD isn’t that easy. Drugstore medicines often do little to help, and a lot of the time, lifestyle remedies may as well just be thrown out the window. Doctors will often prescribe stronger, over the counter anti-inflammatories for physical symptoms, and prescription anti-depressants for mood symptoms. Sometimes though, even these don’t fully help.

Several years ago, when all of the other anti-inflammatory medications had stopped working, I was prescribed a stronger over the counter one in order to manage my back pain. At the time, neither I or my doctor thought the pain could be related to my menstrual cycle- we thought it was from an old dance injury, and just happened to get irritated near my period due to muscles contracting. However, when I went to the doctors more recently for reasons that I thought were completely unrelated, I was shocked when my doctor handed me a prescription for anti-depressants and very casually stated “oh, and here. This should help with your PMDD”.

All of a sudden, everything made sense. I wasn’t just too sensitive to manage PMS symptoms, I just didn’t have PMS –I had PMDD. Being diagnosed not only helped me find the appropriate treatments for my symptoms, but it helped me feel less alone too. It really helped to know that there were others out there like me and that I wasn’t just the odd-ball out. I encourage anyone out there struggling with severe PMS symptoms to have a chat with your doctor, or gynecologist. There’s help out there, and you’re not alone.