PMDD or Depression?

[Sunisshining12]

Dr has suggested these as possible reasons for my symptoms. He’s offered either the contraceptive pill or SSRI antidepressants. Not both. I’ve never had mental health issues before so this is alien.

Which would you go for? I’ve tried lifestyle changes but feel like I’m at rock bottom now & just want to feel better.

Has anyone had PMDD (I’d never heard of it). Which treatment worked best for you? Dr said it’s difficult to say whether it is PMDD or depression & that it’s not worth worrying about the diagnosis label?

Tia

Is your mood particularly bad when you're pre menstrual, or does it affect you throughout the month? Can I ask how old you are, is perimenopause a possibility?

I'd try the ADs first because lots of women react badly to the pill, it can have a negative effect on your mental health. Some ADs can make you feel worse at first too, but that period is usually shortlived.

If it is peri or PMS/DD, have a read on this website about treatment options. The gold standard treatment is not the pill or ADs, but hormones tailored to you. Unfortunately it's difficult to get this on the NHS. Prof Studd is an expert in this area.

www.studd.co.uk/

I’m 33. It started after childbirth. My cycles are sometimes irregular & sometimes can be heavy for a couple of days - but others times are fine & like clockwork? For example 3 months of 30 day cycles, but this month has been 50 days.

When I am actually menstruating I’m okay. That’s my ‘favourite’ part of my cycle as I am managing. But id say the next 2-3 weeks after my period has finished my mood gets worse & worse & I hit rock bottom.

Other symptoms are generally feeling low, down, can’t be bothered with anyone or anything, no motivation, tired 24-7, sleeping more, binge eating on sugarary junk, weight gain (a stone) because of my appalling eating habits, anger at my husband over trivial things, just not being myself, not caring about myself or anything really.

Dr has told me to have a think & call back for either pill or anti depressant. He never mentioned hormone. Thanks

PMDD is a hormone imbalance, it's a term for the most severe PMS. It can go on for several weeks. On what you've said, it's very unlikely the GP will offer you more tailored hormonal options beyond the pill, you'd need a gynae referral for that and you'd need to have tried other options first.

I'd go with the AD first as your symptoms are for most of the month, and if you are progesterone intolerant, the pill is going to make you worse. If the AD doesn't help or only helps to an extent you could look at trying the pill as well. If you're still struggling then ask for a gynae referral, or a referral to the mental health team, ideally both.

@ChaChaCha2012 - thanks for clarifying. Just been having a read online. I tick the boxes for PMDD but I also tick the boxes for ‘just’ depression. There seems to be such an overlap, how do you differentiate which one it is?

I’ll avoid the pill for now then. I’ve not taken it for years. (We use condoms & tbh sex is rare because I have no interest whatsoever, luckily my OH is understanding but I don’t want to carry on like this)

How long would you try the AD for?

How long should I expect the AD to have an effect? What does it feel like to take them? I’m worried about it all. Thanks

Another thing that has just occurred to me - I’ve only ever been truly truly happy and free of black clouds, up & down moods when I was pregnant. Not in the sense of happy/excitement about having a baby, but being ‘free’ of sadness if that makes sense? I’ve never really realised it until now. Would that indicate a marker more towards PMDD or more towards depression? Sorry for all the posts, I literally have nobody to speak to about this.

Anyone? Still unsure whether to start the AD

I thought I had it (now not so sure). But usually my moods would go downhill around ovulation and stay that way until I started bleeding.

You sound like me, minus the happy in pregnancy bit...I'm trying sertraline. Its supposed to help with both according to this...www.webmd.com/drugs/2/drug-1/sertraline-oral/details

I hope you feel better soon. Its horrible, I completely understand how you are feeling. My husband and I have been having marriage counselling....but I think I am the biggest part of our issues, I just haven't been the same since the birth of my youngest...possibly undiagnosed PND?!

@BentleyBelly sorry to hear that. It really is horrible. I’ve also put so much weight on & am continuing to do so. I haven’t been ‘right’ since the birth of my youngest (was fine after first). But don’t know if coincidence or not.

I started AD 2 weeks ago. Citalopram. Hoping they help...

Just wanted to let others know I started Citalopram, I feel a little bit better (but not sure if ovulated yet) so will see how the second half of the cycle goes. I’m convinced it’s PMDD now as a couple of days after my period arrived I felt absolutely fine, as if a weight had been lifted off my shoulders. I’m going into 3rd week of the AD so presume they’ll be in my system but then. This only started after second DC so not sure if hormonal or what triggered it!

I have PMDD. I find my symptoms are worst before my period and around the middle of the month around ovulation.

I don't have treatment but I find it helps for me to ensure I'm getting enough sleep, eating properly and exercise helps.

If it could be PMDD it would be a good idea to keep a diary of your symptoms to see if there is a pattern.