A new study published in a recent issue of Women & Therapy finds problems with the diagnostic criteria for PMDD. No surprise – feminist psychologists, researchers within the Society for Menstrual Cycle Research, and many others have repeatedly criticized the concept of PMDD as a mental illness related to menstruation for these and other reasons.
Supposedly, PMDD occurs in 3% to 8% of menstruating women. There is a host of problems with how this is determined, including varying means of defining and applying the DSM-IV criteria for PMDD across studies, but I’ll spare you that litany here. If PMDD is truly an illness related to the menstrual cycle, the criteria should be sex-specific; that is, only those capable of menstruating should meet the diagnosic criteria (the research implicitly assumes everyone is cissexual and that all non-pregnant women of reproductive age menstruate and no men do – let’s set that aside for now).
To test the sex-specificity of the criteria for PMDD, the researchers created two versions of the assessment tools they used to determine its presence: one version included sex-specific terms like menstruation, menstrual cycle, and premenstrual symptoms, while the other version substituted sex-neutral terms such as experiences and symptoms.
Lo and behold, women who completed the sex-specific diagnostic tools met the provisional criteria for PMDD at a significantly higher rate (20%) than women who completed the sex-neutral diagnostic assessment (8%). And 4.1% of men completing the sex-neutral assessment also met the criteria for PMDD. There was no statistically significant difference in the number of women and number of men meeting the criteria when sex-neutral language was used. The researchers tentatively conclude,
Therefore, these data suggest that PMDD may not be a premenstrual disorder per se. PMDD may instead reflect general cyclical changes in mood, and in women sometimes these changes occur during or near menstruation.
So this little study is far from being the last nail in the coffin PMDD deserves. But it’s a start.
But what can they do with all the leftover Prozac if women, by the thousands, no longer need Serafem to treat their non-existent PMDD? Who can they pathologize next?
You try feeling suicidal once every 4-8 weeks for 16 years–(/since
puberty hit) try to reconcile these episodes with an otherwise happy life, to your
friends and family who you’ve sobbed in front of telling them you want to die, when
the next day you feel fine. Try the panic attacks and the fear that seems to always happen around the same time every month. Having tried it all myself, I’ve come to the conclusion that I’m not going to let anyone’s self-satisfied distaste for western medicine, or beef with the pharmaceutical industry keep me from living the life I deserve to lead. I waited years before I was willing to try any prescription drugs–I tried alternative therapies, and vitamins, and I still include those things as a part of a larger approach. But they really weren’t doing much for me. And the prescription drugs I’ve been given (never for PMDD by the way, I was only given that diagnosis this summer and it was the first time I’d ever heard of it) for depressive symptoms that doctors were never comfortable calling ‘depression’ proper (because it didn’t last long enough) and anxiety disorder–they haven’t been fully effective either. PMDD is the first thing that’s ever been suggested to me that fits both the symptoms and the frequency. So if someone studying PMDD (and I don’t give a shit if it’s a big capitalist western pharmaceutical company or a cheapo vitamin supplement) can find something that will help me, then I’m in! Periods are natural, sure. I have no problem with my period–except when it makes me want to kill myself. You may insist that that’s natural, but natural or not, I don’t deserve to live that way. To me it’s not a political issue or one of gender politics, but a life and death issue.
Just wanted to say that I don’t think the post is trying to invalidate the very real experiences people like you have, but simple to point out work around over-diagnoses in ways that can be unhelpful toward some women.