MHM Magazine

26 | MENTAL HEALTH MATTERS | 2022 | Issue 4 MHM Women are vulnerable to many psychological changes or mental health problems over their lifespan.  Hormone levels fluctuate through women’s different life stages; from the onset of menstruation to the reproductive or childbearing years, to changes during and after pregnancy, childbirth, postpartum through to menopause.  Hormones affect brain function, and this makes women particularly vulnerable to mental health challenges arising from these physical changes.  Premenstrual Dysphoric Disorder is a severe mental health disorder, affecting millions of women worldwide, characterised by physical symptoms (discomfort), affective symptoms (mood and behavioural) and cognitive symptoms.  These impact severely on a woman’s quality of life.  It’s a condition that is very often misunderstood, often misdiagnosed and potentially quite crippling for women.  It’s important to clarify that PMDD is not “just a bad mood”. It’s a biological process. The latest research there is a biological basis for PMDD, that the disorder is related to abnormal metabolism of hormones causing mood disruptions.  Symptoms occur in most menstrual cycles during the past year. At least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week post menses.  One (or more) of the following symptoms must be present: • Marked affective lability (e.g. mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection).  • Marked irritability or anger or increased interpersonal conflicts.  • Marked depressed mood - feelings of hopelessness, or self- deprecating thoughts.  • Marked anxiety, tension and/or feelings of being keyed up or on edge.  • Decreased interest in usual activities (e.g. work, school, friends, hobbies).  • Subjective difficulty in concentration.  • Lethargy, easy fatiguability or marked lack of energy.  • Marked change in appetite, overeating or specific food cravings.  • Hypersomnia or insomnia.  • A sense of being overwhelmed or out of control.  • Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of bloating or weight gain.  By Dr Marshinee Naidoo Specialist psychiatrist at Akeso Psychiatric Clinics – Parktown/Alberton Gauteng PREMENSTRUAL DYSPHORIC DISORDER