What Is PMDD and How Is It Different From PMS?
If you've ever googled "Am I just hormonal or is something actually wrong with me?" — you're in the right place.
We live in a world where women are expected to “ride the wave” of their hormones with a smile and a hot water bottle. But for some, the days before a period aren’t just uncomfortable — they’re completely destabilising.
This is where PMDD comes in.
While PMS is common and manageable for many, Premenstrual Dysphoric Disorder (PMDD) is something else entirely — and understanding the difference can be the first step toward reclaiming your mental and emotional health.
Let’s break it down simply, clearly, and without any medical gaslighting.
So, What Is PMDD?
PMDD stands for Premenstrual Dysphoric Disorder. It’s a hormone-related condition that affects around 1 in 20 women and people assigned female at birth. Unlike PMS, PMDD isn’t just about bloating and a bad mood.
It’s a severe, cyclical disorder that causes intense emotional, mental, and sometimes physical symptoms in the second half of the menstrual cycle — typically between ovulation and the onset of bleeding.
It’s not a hormone imbalance per se — your hormones might be perfectly “normal” on paper. The issue lies in how your brain and nervous system respond to those hormone fluctuations, especially progesterone.
This means your period doesn’t cause PMDD… it reveals what’s going on beneath the surface.
The Key Differences: PMS vs. PMDD
Let’s get clear on the distinction. If PMS is a drizzle, PMDD is a thunderstorm with a side of existential dread.
Emotional symptoms:
PMS might cause mild moodiness or irritability.
PMDD can bring intense depression, rage, anxiety, or hopelessness that feels overwhelming.
Impact on daily life:
With PMS, most people can carry on with their usual routines.
With PMDD, symptoms often interfere with work, relationships, and daily functioning.
Timing:
PMS usually shows up a few days before your period.
PMDD tends to begin after ovulation and can last 10–14 days until bleeding starts.
Response to lifestyle changes:
PMS often improves with rest, better food choices, and gentle movement.
PMDD may not shift with these alone — deeper support is usually needed.
Diagnosis:
PMS doesn’t have formal diagnostic criteria.
PMDD is recognised in the DSM-5 and requires symptom tracking over at least two cycles for diagnosis.
Treatment approach:
PMS is often managed with over-the-counter remedies or lifestyle changes.
PMDD may require a more integrative approach — including trauma healing, nervous system support, and sometimes medication.
What Does PMDD Feel Like?
Women with PMDD often describe it like this:
“I feel possessed.”
“It’s like a switch flips, and I become someone I don’t recognise.”
“The week before my period, I want to end my relationship, quit my job, and disappear.”
“And then… the bleeding starts, and I feel normal again — like nothing ever happened.”
If that sounds familiar, please hear this: you’re not dramatic, broken, or weak. You’re likely dealing with a very real condition that deserves attention and proper care.
Why Do So Many Women With PMDD Get Misdiagnosed?
Because PMDD mimics — and overlaps with — anxiety, depression, ADHD, trauma responses, and even borderline personality traits. But the key difference is the timing and predictability of symptoms.
If you feel totally fine for part of the month and then fall apart like clockwork, it’s not a personality flaw. It’s PMDD’s calling card.
Many women go years — even decades — misdiagnosed, medicated, or dismissed by practitioners who haven’t been trained to spot the pattern. And meanwhile, they live in survival mode.
Natural Approaches to Support PMDD (Beyond the Pill)
While medication can help some, it’s not the only option — and for many, it’s not the preferred one.
As a naturopath who specialises in natural PMDD support, I take a whole-person approach that includes:
Nervous system support (because it’s not just your hormones, it’s how your brain responds to them)
Nutritional therapy and herbal medicine to reduce inflammation and support mood regulation
Trauma-informed emotional support, including Rapid Core Healing and Family Constellations
Functional testing, when needed, to identify nutrient deficiencies or hidden imbalances
And most importantly — compassionate, non-judgmental support from someone who truly, personally, gets it
The Bigger Picture: It’s Not Just Hormones — It’s the System
PMDD is more than a hormonal issue. It often reveals nervous system dysregulation, past emotional trauma, poor methylation or liver clearance, and patterns of suppression — like not feeling safe to express anger, or constantly people-pleasing to avoid rejection.
In other words, PMDD is the body saying: “I’ve been holding this for too long. I can’t keep doing it.”
So, What Can You Do?
If you’re starting to suspect you have PMDD, or you’ve already been diagnosed but want a more integrative way to manage it, here are your next steps:
🌿 1. Track Your Symptoms
Use a period tracker app or journal. Look for patterns that repeat in the luteal phase (after ovulation).
🌿 2. Book a Strategy Session
In this 1:1 session, we’ll review your symptoms, history, and goals — and I’ll help you map out a path to feeling like you again.
👉 Book your PMDD Strategy Session here
🌿 3. Explore the PMDD Transformation Journey
This is my signature program for natural, trauma-informed healing — no quick fixes, just real support for deep change.
Final Thoughts: You’re Not Alone, and You’re Not “Too Much”
If you take away one thing from this, let it be this: PMDD is real. And there is hope.
You are not too emotional, too dramatic, or too sensitive. You are responding to very real physiological and emotional triggers — and those responses can change with the right support.
You deserve to feel calm, grounded, and safe in your own body — all month long.
Let’s work together to make that your new normal.
About Camilla Brinkworth
Camilla is a naturopath, nutritionist, and trauma-informed PMDD specialist. After healing her own cycle through an integrative natural and holistic approach, she now helps women worldwide stabilise their moods, restore emotional balance, and feel safe in their bodies again—naturally. Explore support options →