PMDD Diagnosis and Treatment in South Florida

What is Premenstrual Dysphoric Disorder (PMDD)?

Premenstrual dysphoric disorder (PMDD) is a mood disorder in which significant emotional and physical symptoms appear in the week or so before a period and ease within a few days after it begins. It is more than just a difficult case of PMS. For people with PMDD, the change can feel like becoming a different person for part of each month, with mood swings, irritability, sadness, anxiety, or a sense of being overwhelmed that strains work, relationships, and self-confidence. Physical symptoms such as fatigue, changes in sleep or appetite, bloating, and breast tenderness often come along with the emotional ones.

PMDD affects an estimated 5% of women of reproductive age, and many people live with it for years before it is recognized. Rather than being caused by abnormal hormone levels, PMDD appears to reflect a heightened sensitivity in the brain to the normal hormonal changes of the menstrual cycle. The good news is that PMDD is very treatable, and putting a name to the pattern is often a relief in itself.

How is PMDD diagnosed?

PMDD is diagnosed by confirming that symptoms follow the menstrual cycle. Because memory of past months can be unreliable, guidelines recommend tracking symptoms daily for at least two cycles, using a simple tool such as the Daily Record of Severity of Problems. Many phones now include built-in mood and cycle trackers, such as Apple Health, which work well for this too. Your psychiatrist also looks carefully at other conditions, such as depression, anxiety, bipolar disorder, or thyroid problems, which can be worsened by the cycle without being PMDD. If you have already been tracking, we are happy to review it with you; if not, we can start together.

Our approach to treatment of PMDD

At Tranquility Psychiatry, we pay careful attention to times of hormonal change, and PMDD is a natural part of our work in reproductive mental health. Treatment is individualized to your symptoms, your goals, and where you are in life, including whether you are planning a pregnancy. Medications called SSRIs are the most studied treatment for PMDD and can be taken every day or only during the second half of the cycle; for many people they begin helping more quickly than they do in depression. Certain hormonal birth control options can also help, and we are glad to coordinate with your OB/GYN or primary care clinician. Therapeutic strategies, such as cognitive behavioral tools, along with regular exercise and attention to sleep and stress, round out a plan that treats the whole person rather than a single symptom.

Our telehealth visits make care accessible from the comfort of your home anywhere in Florida, and in person appointments in Delray Beach are available upon request.

Cost and insurance

A new patient evaluation is $400 for up to 60 minutes, and follow-up medication management visits are $200 for up to 30 minutes. Tranquility Psychiatry is not in network with insurance, but we can provide a superbill that you may submit to your insurance for out-of-network reimbursement.

Frequently asked questions

How is PMDD different from PMS?

PMS is common and usually mild. PMDD is less common and more severe, with mood symptoms that significantly disrupt work, relationships, or daily life in the days before a period.

Can PMDD be treated by telehealth?

Yes. Adults located anywhere in Florida can be evaluated and treated by secure video, and in person visits in Delray Beach are available upon request.

Do I need to track my symptoms before my first visit?

It helps, but it is not required. If you have not been tracking, we will start together and use the next two cycles to confirm the pattern.

Will I need to take medication every day?

Not necessarily. Some people with PMDD take an SSRI only during the second half of their cycle. We will talk through the options and choose what fits you.

If you are having thoughts of harming yourself, call or text 988 or go to the nearest emergency room.

Where treatment begins

If the same difficult days return month after month, you do not have to keep pushing through them alone. Schedule a free 10-minute phone consultation, or click here to get connected to one of our psychiatrists.