If the week (or two) before your period feels like a totally different version of you shows up, you're not the only one! Premenstrual symptoms are real, common, and often minimised.
But there’s an important distinction that can change what support you deserve (and what treatment actually works):
PMS (Premenstrual Syndrome) = common, can be uncomfortable, usually manageable
PMDD (Premenstrual Dysphoric Disorder) = much more severe, mood-led and can seriously impact daily life
Let’s break it down clearly with practical ways to spot the difference.
First: What PMS Actually Is
PMS is a group of physical and emotional symptoms that happen in the luteal phase (after ovulation, before your period) and ease once your period arrives.
Common PMS symptoms include:
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Bloating, breast tenderness, cramps
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Headaches
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Irritability, mood swings
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Sleep changes, fatigue
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Food cravings
For many people, PMS is annoying and can be disruptive to their normal routine, but it should not be life-derailing.
What PMDD Is (And Why It’s Different)
PMDD is a severe, clinical form of premenstrual disorder where mood symptoms are front and centre and the impact on functioning normally is highly impacted.
People with PMDD often describe it as:
“I don’t feel like myself.”
“I can’t cope normally.”
“It affects my relationships/work/self-esteem every month.”
PMDD symptoms typically improve shortly after bleeding starts, and there’s usually a “clear” window in the cycle where symptoms lift.
PMS vs PMDD: The simplest way to tell
Here’s a clear comparison:
PMS
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Symptoms: physical + emotional
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Severity: uncomfortable, disruptive
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Impact: you can usually still function (even if you're feeling a tad miserable)
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Mood: can be irritable/teary but you still feel like “you”
PMDD
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Symptoms: primarily mood/mental health (plus physical symptoms too)
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Severity: intense
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Impact: work, school, relationships and daily life may feel unmanageable
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Mood: can include depression, rage, panic, hopelessness, feeling out of control
How to Spot the Difference Between PMS and PMDD
1) Look at how much it interferes with your life
Ask yourself:
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Am I cancelling plans every month?
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Do I dread that part of my cycle because I feel mentally unsafe/unsteady?
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Is my work performance or relationships consistently affected?
Functional impairment is a major flag for PMDD.
2) Track timing: does it follow a repeatable cycle pattern?
Both PMS and PMDD typically:
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start in the 1–2 weeks before your period
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improve once bleeding begins (or within a few days)
Clinicians often recommend daily symptom tracking for at least 2 cycles to confirm patterns, especially for PMDD.
3) Check whether mood symptoms feel bigger than “PMS moodiness”
PMDD often includes symptoms like:
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intense irritability or anger
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marked anxiety or tension
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low mood, hopelessness, tearfulness
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feeling overwhelmed or unable to cope
4) Make sure it’s not something else wearing a “PMS mask”
PMDD can overlap with (or amplify) anxiety and depression.
The key clue is cyclical timing and a symptom-free window mid-cycle.
Why It’s So Often Missed
Because “period problems” are still brushed off as normal and because a lot of people are only asked about physical symptoms, not mental ones.
Also: many people don’t realise PMDD is a recognised condition with evidence-based treatments (and that you don’t have to just “power through”).
What Helps: Support + Treatment Options That Actually Work
For PMS (often a mix-and-match approach and highly personal to your cycle and preferences)
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sleep, movement, stress support
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reducing alcohol and caffeine (especially in the luteal phase)
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symptom-targeting (for example: pain relief, heat, gentle exercise)
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sometimes hormonal contraception
For PMDD (you deserve proper care here)
Evidence-based options include:
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medication (only on the advice of medical professionals)
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hormonal contraception (can help some people; this is highly personal and differs based on the individual)
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CBT (Cognitive Behavioural Therapy) can help to equip you with coping tools and pattern awareness
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other specialist options for individual cases
If symptoms include thoughts of self-harm or feeling unsafe, that’s an urgent “you should seek support now” moment, not a “wait and see.”
A Gentle Note (Because This Part Matters)
If you suspect PMDD, you are not “too sensitive” or “dramatic.” Cyclical mental health symptoms are real and treatable.
A good next step is tracking:
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Mood (0–10)
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Anxiety (0–10)
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Irritability/rage (0–10)
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Sleep
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Energy
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Appetite/cravings
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Physical symptoms
…for a minimum of 2 cycles and bringing it to your GP.
