PMDD symptoms can look a lot like depressive symptoms of Major Depressive Disorder or Bipolar Disorder, but the mood symptoms are more connected to hormonal changes and the timing of one’s hormonal fluctuations. If you or your loved one are looking for mental health treatment for PMDD, major depressive disorder, or bipolar disorder, contact our friendly admissions team today, or read more about these mental health disorders below.
PMDD is categorized as a depressive disorder, and it is not the same as bipolar disorder, though some PMDD symptoms may be similar to symptoms of bipolar disorder. To be diagnosed with PMDD, according to the DSM-5, you must be experiencing 5 out of the 11 following symptoms, and they must be timed in relation to your menstrual cycle, for at least two consecutive menstrual cycles3:
Currently, the prevalence of PMDD is estimated that 3-8% of women of reproductive age meet strict criteria for PMDD; 13-18% of women of reproductive age may have premenstrual dysphoric symptoms severe enough to induce impairment and distress, though the number of symptoms may not meet the DSM-5 criteria required for accurate diagnosis.4 There are a variety of risk factors, contraceptives, and hormonal fluctuations that can lead to worsening premenstrual exacerbation.
There have been a number of studies conducted surrounding the co-occurrence of bipolar disorder and PMDD. One large community-based epidemiological study found that women with PMDD were 8 times more likely to have a comorbid diagnosis of bipolar disorder. Another two independent studies found higher rates of PMDD among women with BD.5 Their comorbidity appears to be linked to common biological mechanisms and usually results in more severity of mood symptoms and struggles with long-term mental wellness. 6
Understanding the differences between PMDD and Bipolar Disorder can help avoid cases of misdiagnosis. While both are mood disorders, PMDD symptoms must meet the above listed criteria, and must occur in relation to two consecutive menstrual cycles.
Antidepressants are considered the front-line treatment for comorbid premenstrual dysphoric disorder and bipolar disorder. One systemic review found that in using the vitamin B-6 to treat PMDD and bipolar disorder, a proportion of women whose overall premenstrual symptoms showed an improvement over placebo.7 A single-case report on mood stabilizers found significant efficacy of lamotrigine in reducing the follicular phase depressive and luteal phase mood elevation symptoms in a woman affected by a treatment-resistant rapid cycling BD-II was published.8
Secondarily, hormonal agents may be helpful in treating PMDD, due to fluctuations in estrogen and progesterone levels.
AMFM Mental Health Treatment provides comprehensive psychiatric care for bipolar disorder, along with traditional therapeutic modalities. Our on-staff clinicians are equipped to design personalized treatment plans for your continued success. In combination with psychotherapy, psychiatric care is handled safely, to help you or your loved one overcome mental health challenges.
Group therapy sessions can be used to help provide structured times to help you understand that you are not alone in your struggles, that your peers are also walking through these challenges, while also providing guidance, suggestions and communications from psychologists with specialized backgrounds. These groups can span a variety of backgrounds, including but not limited to art therapy, somatic therapy, and narrative therapy.
Hypomania refers to a shorter duration of manic symptoms, with generally milder symptoms. In order to be diagnosed with Bipolar II, an individual must experience at least one episode of hypomania, in addition to an episode of depression (manic depression). According to the DSM-5, hypomanic episodes are common in Bipolar I Disorder as well, but are not required for the diagnosis of Bipolar I.
In order to be diagnosed with Bipolar II, an individual must experience both a hypomanic and a depressive episode. Depressive episodes are characterized by low moods, suicidal thoughts, or other common symptoms of depression like loss of interest, low self-esteem, fatigue, or changes in appetite. If you or a loved one are struggling with suicidal ideation and need immediate medical assistance, please call 911 for emergency medical attention, or 988, the National Suicide and Crisis hotline, which is available 24/7, free of cost.
Therapy for Bipolar Disorder and Comorbid PMDD is a key piece of effective treatment for a greater quality of life and emotional regulation with this lifelong condition, and may help you or your loved one with executive functioning throughout the day. Seeking care from a mental health professional can help regulate extreme mood episodes for a long-term lifestyle change. AMFM Mental Health Treatment offers a combination of holistic mental health services and evidence-based therapies to provide treatment options that meet your individual needs:
Recovery can feel isolating; mental health programming can provide cohesive treatment plans to help you or your loved one as you move forward.
Individual therapy takes place in a one on one setting with a licensed professional, usually consisting of a combination of dialectical and cognitive behavioral therapies, in which a person can talk through his or her individual struggles. Individual therapy and mental health care is one of the most crucial steps for those facing mental health challenges.
Group therapy sessions can be used to help provide structured times to help you understand that you are not alone in your struggles, that your peers are also walking through these challenges, while also providing guidance, suggestions and communications from psychologists with specialized backgrounds. These groups can span a variety of backgrounds, including but not limited to art therapy, somatic therapy, and narrative therapy.
Cognitive-Behavioral Therapy (CBT) is a form of therapy that’s focused on restructuring and reprogramming maladaptive and negative thought processes. Psychologists are trained to help you change your cognitive and emotional processes in order to outgrow coping mechanisms that may no longer be serving you.
Dialectical Behavior Therapy (DBT) is most commonly referred to as “talk therapy,” and is designed to help process emotions. Qualified professionals offer psychological therapy to move forward with healthy ways of engaging in interpersonal relationships and alleviating physical and emotional distress.
TMS Therapy is a type of therapy that uses magnetic pulses to treat depression by stimulating neurotransmitters in the brain. This is a noninvasive method of treatment that some mental health programs offer for treatment of depression, bipolar disorder, and post-traumatic stress disorder.
Family therapy may be used when a loved one’s mental health symptoms are affecting others. This can increase a family members’ understanding of anxiety and talk about how to support each other. Family-focused therapy sessions and support groups can improve communication patterns, focus on problem-solving, address unresolved conflicts, and increase the sense of understanding among one another.
AMFM Mental Health Treatment has extensive experience treating a variety of mental health disorders beyond Bipolar Disorder through evidence-based therapies, including but not limited to the following:
Recovery can feel isolating; mental health programming can provide cohesive treatment plans to help you or your loved one as you move forward.
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Mishra S, Elliott H, Marwaha R. Premenstrual Dysphoric Disorder. [Updated 2023 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532307/
Yonkers KA, Simoni MK. Premenstrual disorders. Am J Obstet Gynecol. 2018 Jan;218(1):68-74. doi: 10.1016/j.ajog.2017.05.045. Epub 2017 May 29. PMID: 28571724.
Halbreich U, Borenstein J, Pearlstein T, Kahn LS. The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology. 2003 Aug;28 Suppl 3:1-23. doi: 10.1016/s0306-4530(03)00098-2. PMID: 12892987.
Smith M, Frey BN. Treating comorbid premenstrual dysphoric disorder in women with bipolar disorder. J Psychiatry Neurosci. 2016 Mar;41(2):E22-3. doi: 10.1503/jpn.150073. PMID: 26898728; PMCID: PMC4764487.
Sepede G, Brunetti M, Di Giannantonio M. Comorbid Premenstrual Dysphoric Disorder in Women with Bipolar Disorder: Management Challenges. Neuropsychiatr Dis Treat. 2020 Feb 10;16:415-426. doi: 10.2147/NDT.S202881. PMID: 32103961; PMCID: PMC7020916.
Wyatt KM, Dimmock PW, Jones PW, Shaughn O’Brien PM. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ. 1999 May 22;318(7195):1375-81. doi: 10.1136/bmj.318.7195.1375. PMID: 10334745; PMCID: PMC27878.
Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Mental Health Services Administration (US); 2016 Jun. Table 12, DSM-IV to DSM-5 Bipolar I Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t8/
Burdick KE, Millett CE, Russo M, Et. al, The association between lithium use and neurocognitive performance in patients with bipolar disorder. Neuropsychopharmacology. 2020 Sep;45(10):1743-1749. doi: 10.1038/s41386-020-0683-2. Epub 2020 Apr 29. PMID: 32349118; PMCID: PMC7419515.
Kusumakar V. Antidepressants and antipsychotics in the long-term treatment of bipolar disorder. J Clin Psychiatry. 2002;63 Suppl 10:23-8. PMID: 12392350.
American Psychological Association. (n.d.-a). American Psychological Association. https://www.apa.org/topics/bipolar-disorder
Novick DM, Swartz HA, Frank E. Suicide attempts in bipolar I and bipolar II disorder: a review and meta-analysis of the evidence. Bipolar Disord. 2010 Feb;12(1):1-9. doi: 10.1111/j.1399-5618.2009.00786.x. PMID: 20148862; PMCID: PMC4536929.
