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We explore premenstrual dysphoric disorder (PMDD), a frequently misunderstood and misdiagnosed condition that therapists should understand for their licensing exams. PMDD is characterized as a severe form of PMS that significantly disrupts daily functioning with symptoms emerging during the luteal phase and improving shortly after menstruation begins.

• PMDD must be distinguished from other mood disorders by its cyclical pattern
• DSM criteria require at least five symptoms present in the week before menses, improving within days after onset
• Symptoms include marked affective lability, irritability, depression, anxiety, decreased interest in activities, and physical symptoms
• PMDD typically emerges after puberty with peak incidence in late 20s to early 30s
• Symptoms abate during pregnancy but typically return after delivery
• Common comorbidities include mood disorders, anxiety disorders, borderline personality disorder, and eating disorders
• First-line treatments include SSRIs and hormonal contraceptives
• Cognitive behavioral therapy shows strong outcomes for managing symptoms
• Assessment tools like the Daily Record of Severity of Problems help track symptoms over multiple cycles
• A multimodal approach combining medication, therapy, and lifestyle modifications is most effective

Remember that PMDD is in the DSM and represents a severe condition with significant functional impairment that distinguishes it from more common premenstrual symptoms.

If you need to study for your national licensing exam, try the free samplers at: LicensureExams


This podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.