Piece of Mind podcast: The hidden link between hormones and mental health

PMDD is a mood disorder that typically occurs two weeks before the onset of menstrual bleeding and ends within the first few days of the period, also known as the luteal phase. PMDD symptoms are severe and greatly impact the psychological wellbeing of those affected and commonly include suicidal ideation.

Whilst it is estimated that around 5% of the population experience PMDD, this number could be much higher as there is still little known about what causes the condition and how exactly it can be effectively diagnosed and treated.

Becci experienced this confusion first-hand as she received a delayed diagnosis in 2019, after eighteen years of experiencing mental ill-health. This included receiving multiple misdiagnoses, including bipolar and postnatal depression.

“It wasn’t until my daughter was born in 2019 that I reached crisis point, and I told my husband that I wasn’t sure if I would make it to the next month.”

Becci’s GP first alerted her to PMDD after mentioning that the only time she hadn’t experienced symptoms was when she was pregnant.

“I realised that you shouldn’t be feeling suicidal in the lead-up to your period.”

Since her diagnosis Becci has raised awareness of PMDD through television, radio, social media, and local news by calling for more education in both medical and university settings, as well as ensuring GPs are adequately supported.

Becci also discussed the reality of living with PMDD and its impact on parental and family relationships.

“I have to say this to everyone, having PMDD does not make me a bad parent or a bad mum.”

Searching for answers – what has the research told us?

PMDD research has led to an increased awareness of the condition and how it can impact on people’s lives. However, the debate is ongoing as to whether it should be treated as a psychological or gynaecological condition.

Becci adds: “There’s a lot more to be captured about PMDD. A lot of the research is objective and doesn’t consider internal struggles and just how severe the disorder is.”

This is something that researchers at the NCMH are challenging by inviting people to take part in our research. We are interested in hearing from anyone with any experience of premenstrual syndrome (PMS) even if they don’t have a PMDD diagnosis or haven’t yet spoken to a healthcare professional about it.

This research also utilises genetic data by collecting saliva samples, which means that participants who have previously experienced symptoms of PMDD can still take part, as genetic data doesn’t change.

Chloe, an NCMH researcher involved in the study, discussed the implications of analysing genetic data, where researchers might be able to identify similarities in between the genetics of PMDD and other mood disorders, such as bipolar whilst establishing PMDD as its own, separate diagnosis.

Chloe said: “We have taken a very public engagement centred approach to our research. eople who have lived experience of PMDD are often greater experts than the researchers looking at a standard diagnostic criteria.”

A lot of current PMDD research also asks participants about their symptoms retrospectively, despite the diagnostic criteria for the disorder specifying that patients need to have filled out a daily mood monitoring diary for two or more months.

The PreDDICT project is challenging this by asking participants to fill out a daily mood monitoring diary to capture more information about how the symptoms of PMDD may look on a day-to-day basis.