What is PMDD?
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Premenstrual dysphoric disorder (PMDD) is a mood disorder that causes significant mental health changes and physical symptoms leading up to each menstrual period.
Unlike premenstrual syndrome (PMS), which affects approximately three out of four menstruating people, only 3 percent to 8 percent of menstruating people have PMDD. However, some researchers believe the condition is underdiagnosed, as it was only recently recognized as a medical diagnosis by the World Health Organization.
Read on to learn more about its symptoms, the difference between PMS and PMDD, treatment options, and more.
What are the symptoms of PMDD?
People with PMDD typically experience both mood changes and physical symptoms during each menstrual cycle’s luteal phase—the time between ovulation and menstruation. These symptoms typically last seven to 14 days and resolve when menstruation begins.
Mood symptoms may include:
- Irritability
- Anxiety and panic attacks
- Extreme or sudden mood shifts
- Difficulty concentrating
- Depression and suicidal ideation
Physical symptoms may include:
- Fatigue
- Insomnia
- Headaches
- Changes in appetite
- Body aches
- Bloating
- Abdominal cramps
- Breast swelling or tenderness
What is the difference between PMS and PMDD?
Both PMS and PMDD cause emotional and physical symptoms before menstruation. Unlike PMS, PMDD causes extreme mood changes that disrupt daily life and may lead to conflict with friends, family, partners, and coworkers. Additionally, symptoms may last longer than PMS symptoms.
In severe cases, PMDD may lead to depression or suicide. More than 70 percent of people with the condition have actively thought about suicide, and 34 percent have attempted it.
What is the history of PMDD?
PMDD wasn’t added to the Diagnostic and Statistical Manual of Mental Disorders until 2013. In 2019, the World Health Organization officially recognized it as a medical diagnosis.
References to PMDD in medical literature date back to the 1960s, but defining it as a mental health and medical condition initially faced pushback from women’s rights groups. These groups were concerned that recognizing the condition could perpetuate stereotypes about women’s mental health and capabilities before and during menstruation.
Today, many women-led organizations are supportive of PMDD being an official diagnosis, as this has helped those living with the condition access care.
What causes PMDD?
Researchers don’t know exactly what causes PMDD. Many speculate that people with the condition have an abnormal response to fluctuations in hormones and serotonin—a brain chemical impacting mood— that occur throughout the menstrual cycle. Symptoms fully resolve after menopause.
People who have a family history of premenstrual symptoms and mood disorders or have a personal history of traumatic life events may be at higher risk of PMDD.
How is PMDD diagnosed?
Health care providers of many types, including mental health providers, can diagnose PMDD. Providers typically ask patients about their premenstrual symptoms and the amount of stress those symptoms are causing. Some providers may ask patients to track their periods and symptoms for one month or longer to determine whether those symptoms are linked to their menstrual cycle.
Some patients may struggle to receive a PMDD diagnosis, as some providers may lack knowledge about the condition. If your provider is unfamiliar with the condition and unwilling to explore treatment options, find a provider who can offer adequate support. The International Association for Premenstrual Disorders offers a directory of providers who treat the condition.
How is PMDD treated?
There is no cure for PMDD, but health care providers can prescribe medication to help manage symptoms. Some medication options include:
- Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that regulate serotonin in the brain and may improve mood when taken daily or during the luteal phase of each menstrual cycle.
- Hormonal birth control to prevent ovulation-related hormonal changes.
- Over-the-counter pain medication like Tylenol, which can ease headaches, breast tenderness, abdominal cramping, and other physical symptoms.
Providers may also encourage patients to make lifestyle changes to improve symptoms. Those lifestyle changes may include:
- Limiting caffeine intake
- Eating meals regularly to balance blood sugar
- Exercising regularly
- Practicing stress management using breathing exercises and meditation
- Having regular therapy sessions and attending peer support groups
For more information, talk to your health care provider.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Four Thousand Weeks – by Oliver Burkeman
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This is not, strictly speaking, a time management book. It’s more a “contemplating mortality and making things count while still doing the necessaries”.
Burkeman’s premise is that we get around 4,000 weeks of life, on average. If we live to 120, it’s more like 6,200. Unlucky souls may have to do the best they can with 1,000 or so.
The book is thought-provoking; consider:
- how was your last week?
- how will your next week be?
- what if it were your last?
Of course, we cannot necessarily liquidate all our assets and spend next week burning out in style, because then the following week comes. So, what’s the solution?
That’s something Burkeman lays out over the course of the book, with key ideas including passion projects and figuring out what can be safely neglected, but there’s far more there than we could sum up here.
Bottom line: if you ever find yourself struggling to balance what is expected of you with what is of value to you, this book can help you get the most out of your choices.
Click here to check out Four Thousand Weeks, and make yours count!
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Yes, blue light from your phone can harm your skin. A dermatologist explains
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Social media is full of claims that everyday habits can harm your skin. It’s also full of recommendations or advertisements for products that can protect you.
Now social media has blue light from our devices in its sights.
So can scrolling on our phones really damage your skin? And will applying creams or lotions help?
Here’s what the evidence says and what we should really be focusing on.
Max kegfire/Shutterstock Remind me, what actually is blue light?
Blue light is part of the visible light spectrum. Sunlight is the strongest source. But our electronic devices – such as our phones, laptops and TVs – also emit it, albeit at levels 100-1,000 times lower.
Seeing as we spend so much time using these devices, there has been some concern about the impact of blue light on our health, including on our eyes and sleep.
Now, we’re learning more about the impact of blue light on our skin.
How does blue light affect the skin?
The evidence for blue light’s impact on skin is still emerging. But there are some interesting findings.
1. Blue light can increase pigmentation
Studies suggest exposure to blue light can stimulate production of melanin, the natural skin pigment that gives skin its colour.
So too much blue light can potentially worsen hyperpigmentation – overproduction of melanin leading to dark spots on the skin – especially in people with darker skin.
Blue light can worsen dark spots on the skin caused by overproduction of melanin. DUANGJAN J/Shutterstock 2. Blue light can give you wrinkles
Some research suggests blue light might damage collagen, a protein essential for skin structure, potentially accelerating the formation of wrinkles.
A laboratory study suggests this can happen if you hold your device one centimetre from your skin for as little as an hour.
However, for most people, if you hold your device more than 10cm away from your skin, that would reduce your exposure 100-fold. So this is much less likely to be significant.
3. Blue light can disrupt your sleep, affecting your skin
If the skin around your eyes looks dull or puffy, it’s easy to blame this directly on blue light. But as we know blue light affects sleep, what you’re probably seeing are some of the visible signs of sleep deprivation.
We know blue light is particularly good at suppressing production of melatonin. This natural hormone normally signals to our bodies when it’s time for sleep and helps regulate our sleep-wake cycle.
By suppressing melatonin, blue light exposure before bed disrupts this natural process, making it harder to fall asleep and potentially reducing the quality of your sleep.
The stimulating nature of screen content further disrupts sleep. Social media feeds, news articles, video games, or even work emails can keep our brains active and alert, hindering the transition into a sleep state.
Long-term sleep problems can also worsen existing skin conditions, such as acne, eczema and rosacea.
Sleep deprivation can elevate cortisol levels, a stress hormone that breaks down collagen, the protein responsible for skin’s firmness. Lack of sleep can also weaken the skin’s natural barrier, making it more susceptible to environmental damage and dryness.
Can skincare protect me?
The beauty industry has capitalised on concerns about blue light and offers a range of protective products such as mists, serums and lip glosses.
From a practical perspective, probably only those with the more troublesome hyperpigmentation known as melasma need to be concerned about blue light from devices.
This condition requires the skin to be well protected from all visible light at all times. The only products that are totally effective are those that block all light, namely mineral-based suncreens or some cosmetics. If you can’t see the skin through them they are going to be effective.
But there is a lack of rigorous testing for non-opaque products outside laboratories. This makes it difficult to assess if they work and if it’s worth adding them to your skincare routine.
What can I do to minimise blue light then?
Here are some simple steps you can take to minimise your exposure to blue light, especially at night when it can disrupt your sleep:
- use the “night mode” setting on your device or use a blue-light filter app to reduce your exposure to blue light in the evening
- minimise screen time before bed and create a relaxing bedtime routine to avoid the types of sleep disturbances that can affect the health of your skin
- hold your phone or device away from your skin to minimise exposure to blue light
- use sunscreen. Mineral and physical sunscreens containing titanium dioxide and iron oxides offer broad protection, including from blue light.
In a nutshell
Blue light exposure has been linked with some skin concerns, particularly pigmentation for people with darker skin. However, research is ongoing.
While skincare to protect against blue light shows promise, more testing is needed to determine if it works.
For now, prioritise good sun protection with a broad-spectrum sunscreen, which not only protects against UV, but also light.
Michael Freeman, Associate Professor of Dermatology, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Overcome Front-Of-Hip Pain
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Dr. Alyssa Kuhn, physiotherapist, demonstrates how:
One, two, three…
One kind of pain affects a lot of related things: hip pain has an impact on everything that’s connected to the pelvis, which is basically the rest of the body, but especially the spine itself. For this reason, it’s critical to keep it in as good condition as possible.
Two primary causes of hip stiffness and pain:
- Anterior pelvic tilt due to posture, weight distribution, or pain. This tightens the front muscles and weakens the back muscles.
- Prolonged sitting, which tightens the hip muscles due to inactivity.
Three exercises are recommended by Dr. Kuhn to relieve pain and stiffness:
- Bridge exercise:
- Lie on a firm surface with your knees bent.
- Push through your feet, engage your hamstrings, and flatten your lower back.
- Hold for 3–5 seconds, relax, and repeat (10–20 reps).
- Wall exercise with arms:
- Stand with your lower back against the wall, feet a step away.
- Tilt your hips backwards, keeping your lower back in contact with the wall.
- Alternate lifting one arm at a time while maintaining back contact with the wall (10–20 reps).
- Wall exercise with legs:
- Same stance as the previous exercise but wider now.
- Lift one heel at a time while keeping your hips stable and your back against the wall.
- Practice for 30–60 seconds, maintaining good form.
As ever, consistency is key for long-term relief. Dr. Kuhn recommends doing these regularly, especially before any expected periods of prolonged sitting (e.g. at desk, or driving, etc). And of course, do try to reduce, or at least break up, those sitting marathons if you can.
For more on all of this plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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Sugar Blues – by William Dufty
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This is a “read it cover to cover” book. It charts the rise of sugar’s place in world diets in general and the American diet in particular, and draws many conclusions about the effect this has had on us.
This book will challenge you. Sometimes, it will change your mind. Sometimes, you’ll go “no, I’m sure that’s not right”, and you’ll go Googling. Either way, you’ll learn something.
And that, for us, is the most important measure of any informational book: did we gain something from it? In Sugar Blues, perhaps the single biggest “gain” for the reader is that it’s an eye-opener and a call-to-arms—the extent to which you heed that is up to you, but it sure is good to at least be familiar with the battlefield.
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Aspirin, CVD Risk, & Potential Counter-Risks
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Aspirin Pros & Cons
In Tuesday’s newsletter, we asked your health-related opinion of aspirin, and got the above-depicted, below-described set of responses:
- About 42% said “Most people can benefit from low-dose daily use to lower CVD risk”
- About 31% said “It’s safe for occasional use as a mild analgesic, but that’s all”
- About 28% said “We should avoid aspirin; it can cause liver and/or kidney damage”
So, what does the science say?
Most people can benefit from low-dose daily aspirin use to lower the risk of cardiovascular disease: True or False?
True or False depending on what we mean by “benefit from”. You see, it works by inhibiting platelet function, which means it simultaneously:
- decreases the risk of atherothrombosis
- increases the risk of bleeding, especially in the gastrointestinal tract
When it comes to balancing these things and deciding whether the benefit merits the risk, you might be asking yourself: “which am I most likely to die from?” and the answer is: neither
While aspirin is associated with a significant improvement in cardiovascular disease outcomes in total, it is not significantly associated with reductions in cardiovascular disease mortality or all-cause mortality.
In other words: speaking in statistical generalizations of course, it may improve your recovery from minor cardiac events but is unlikely to help against fatal ones
The current prevailing professional (amongst cardiologists) consensus is that it may be recommended for secondary prevention of ASCVD (i.e. if you have a history of CVD), but not for primary prevention (i.e. if you have no history of CVD). Note: this means personal history, not family history.
In the words of the Journal of the American College of Cardiology:
❝Low-dose aspirin (75-100 mg orally daily) might be considered for the primary prevention of ASCVD among select adults 40 to 70 years of age who are at higher ASCVD risk but not at increased bleeding risk (S4.6-1–S4.6-8).
Low-dose aspirin (75-100 mg orally daily) should not be administered on a routine basis for the primary prevention of ASCVD among adults >70 years of age (S4.6-9).
Low-dose aspirin (75-100 mg orally daily) should not be administered for the primary prevention of ASCVD among adults of any age who are at increased risk of bleeding (S4.6-10).❞
~ Dr. Donna Arnett et al. (those section references are where you can find this information in the document)
Read in full: Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology
Or if you’d prefer a more pop-science presentation:
Many older adults still use aspirin for CVD prevention, contrary to clinical guidance
Aspirin can cause liver and/or kidney damage: True or False?
True, but that doesn’t mean we must necessarily abstain, so much as exercise caution.
Aspirin is (at recommended doses) not usually hepatotoxic (toxic to the liver), but there is a strong association between aspirin use in children and the development of Reye’s syndrome, a disease involving encephalopathy and a fatty liver. For this reason, most places have an official recommendation that aspirin not be used by children (cut-off age varies from place to place, for example 12 in the US and 16 in the UK, but the key idea is: it’s potentially dangerous for those who are not fully grown).
Aspirin is well-established as nephrotoxic (toxic to the kidneys), however, the toxicity is sufficiently low that this is not expected to be a problem to otherwise healthy adults taking it at no more than the recommended dose.
For numbers, symptoms, and treatment, see this very clear and helpful resource:
An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose
Take care!
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Families including someone with mental illness can experience deep despair. They need support
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In the aftermath of the tragic Bondi knife attack, Joel Cauchi’s parents have spoken about their son’s long history of mental illness, having been diagnosed with schizophrenia at age 17. They said they were “devastated and horrified” by their son’s actions. “To you he’s a monster,” said his father. “But to me he was a very sick boy.”
Globally, one out of every eight people report a mental illness. In Australia, one in five people experience a mental illness in their lifetime.
Mental illness and distress affects not only the person living with the condition, but family members and communities. As the prevalence of mental health problems grows, the flow-on effect to family members, including caregivers, and the impact on families as a unit, is also rising.
While every family is different, the words of the Cauchis draw attention to how families can experience distress, stress, fear, powerlessness, and still love, despite the challenges and trauma. How can they help a loved one? And who can they turn to for support?
The role of caregivers
Informal caregivers help others within the context of an existing relationship, such as a family member. The care they provide goes beyond the usual expectations or demands of such relationships.
Around 2.7 million Australians provide informal care. For almost a third of these the person’s primary medical diagnosis is psychological or psychiatric.
It has long been acknowledged that those supporting a family member with ongoing mental illness need support themselves.
In the 1980s, interest grew in caregiving dynamics within families of people grappling with mental health issues. Subsequent research recognised chronic health conditions not only affect the quality of life and wellbeing of the people experiencing them, but also impose burdens that reverberate within relationships, caregiving roles, and family dynamics over time.
Past studies have shown families of those diagnosed with chronic mental illness are increasingly forced to manage their own depression, experience elevated levels of emotional stress, negative states of mind and decreased overall mental health.
Conditions such as depression, anxiety disorders, bipolar disorder, and schizophrenia can severely impact daily functioning, relationships, and overall quality of life. Living with mental illness is often accompanied by a myriad of challenges. From stigma and discrimination to difficulty accessing adequate health care and support services. Patients and their families navigate a complex and often isolating journey.
The family is a system
The concept of family health acknowledges the physical and psychological wellbeing of a person is significantly affected by the family.
Amid these challenges, family support emerges as a beacon of hope. Research consistently demonstrates strong familial relationships and support systems play a pivotal role in mitigating the adverse effects of mental illness. Families provide emotional support, practical assistance, and a sense of belonging that are vital for people struggling with mental illness.
My recent research highlights the profound impact of mental illness on family dynamics, emphasising the resilience and endurance shown by participants. Families struggling with mental illness often experience heightened emotional fluctuations, with extreme highs and lows. The enduring nature of family caregiving entails both stress and adaptation over an extended period. Stress associated with caregiving and the demands on personal resources and coping mechanisms builds and builds.
Yet families I’ve interviewed find ways to live “a good life”. They prepare for the peaks and troughs, and show endurance and persistence. They make space for mental illness in their daily lives, describing how it spurs adaptation, acceptance and inner strength within the family unit.
When treating a person with mental illness, health practitioners need to consider the entire family’s needs and engage with family members. By fostering open and early dialogue and providing comprehensive support, health-care professionals can empower families to navigate the complexities of mental illness while fostering resilience and hope for the future. Family members express stories of an inner struggle, isolation and exhaustion.
Family bonds can be a cornerstone of wellbeing. Gorodenkoff/Shutterstock Shifting the focus
There is a pressing need for a shift in research priorities, from illness-centered perspectives to a strengths-based focus when considering families “managing” mental illness.
There is transformative potential in harnessing strengths to respond to challenges posed by mental illnesses, while also supporting family members.
For people facing mental health challenges, having loved ones who listen without judgement and offer empathy can alleviate feelings of despair. Beyond emotional support, families often serve as crucial caregivers, assisting with daily tasks, medication management and navigating the health-care system.
As the Cauchi family so painfully articulated, providing support for a family member with mental illness is intensely challenging. Research shows caregiver burnout, financial strain and strained relationships are common.
Health-care professionals should prioritise support for family members at an early stage. In Australia, there are various support options available for families living with mental illness. Carer Gateway provides information, support and access to services. Headspace offers mental health services and supports to young people and their families.
Beyond these national services, GPs, nurses, nurse practitioners and local community health centres are key to early conversations. Mental health clinics and hospitals often target family involvement in treatment plans.
While Australia has made strides in recognising the importance of family support, challenges persist. Access to services can vary based on geographic location and demand, leaving some families under-served or facing long wait times. And the level of funding and resources allocated to family-oriented mental health support often does not align with the demand or complexity of need.
In the realm of mental illness, family support serves as a lifeline for people navigating the complexities of their conditions.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Amanda Cole, Lead, Mental Health, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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