Premenstrual (premenstrual) dysphoric disorder is a picture in which premenstrual syndrome is more severe (Doruk et al, 2009). It is characterized by a marked depressive mood, anxiety and decreased interest one week before the menstrual period (Gönül, Müderris, 1995).
While referring to the premenstrual (premenstrual) dysphoria disorder DSm-5 diagnostic criteria, criterion A must have at least five symptoms specified in criteria B and C in most of the previous year’s menstrual cycles. The start of menstruation continues for a few days, the week after the end of menstruation, the symptoms decrease a lot. At least one of the B criteria for emotional change, anxiety, depressed mood, hopelessness or self-deprecating thoughts, and restlessness should be present. At least one of the C criteria should include loss of interest in usual activities, decreased energy, inability to focus, changes in appetite, distress, and physical symptoms.
The symptoms lead to marked distress and impairment in functioning. It is not better explained by another mood disorder, such as an anxiety disorder or a personality disorder. To make a diagnosis, symptoms must be present during two menstrual cycles (Kring and Johnson, 2017).
While bloating, headache, weakness and change in appetite can be counted as physiological symptoms of premenstrual dysphoric disorder; depressive mood, irritability, tension and emotional confusion can be counted as mental symptoms (Yıldız et al., 2021).
In epidemiological studies using different methods, the incidence of premenstrual (premenstrual) dysphoric disorder is between 2% and 10% (Türkçapar and Türkçapar, 2011).
Premenstrual (premenstrual) dysphoric disorder symptom frequency is as follows. Hopelessness, depressive mood, self-blame 90%, Change in emotion 89%, Anger 81%, Easy fatigue and physical complaints 78%, Anxiety 67%, Loss of interest 63% (Türkçapar & Türkçapar, 2011)
The risk factors for premenstrual (premenstrual) dysphoric disorder can be counted as depression, stress, anxiety, traumatic events, and the presence of premenstrual syndrome in the family history (Türkçapar & Türkçapar, 2011)
Hormonal changes, genetic factors and psychosocial events are effective in the etiology of premenstrual dysphoric disorder.
Effective neurotransmitters are serotonin and gaba . Serotonin is the most effective neurotransmitter in its emergence. Serotonin level decreases and serotonergic activity decreases in the blood of patients with premenstrual dysphoric disorder (Türkçapar and Türkçapar, 2011). Gaba level decreases in patients with premenstrual dysphoric disorder. This situation causes symptoms of anxiety and depression (Yıldız et al., 2021).
As psychosocial events that play a role in the emergence of premenstrual (premenstrual) dysphoric disorder; stress, the connection of the cause of the distressed mood to the menstrual cycle, negative life events and relationship problems can be counted (Türkçapar and Türkçapar 2011).
Medications, stress reduction, cognitive behavioral therapy and psychoeducation are effective in its treatment. Pharmacological treatments and cognitive behavioral therapies are effective in the treatment of premenstrual dysphoric disorder. While lifestyle regulation and psychoeducation are sufficient in mild cases, pharmacological treatment and cognitive behavioral therapy should be taken in more severe cases (Türkçapar & Türkçapar, 2011). Pharmacological treatments effective on serotonin and gaba may be beneficial in premenstrual dysphoric disorder (Gönül and Müderris, 1995).
Specialist Clinical Psychologist Damla KANKAYA SÜNTEROĞLU
Posted by Psychologist Ezgi ŞAHİN
