I am the 74-year-old father of a 36-year-old daughter who suffers monthly from the most acute symptoms of PMDD that would light up any tracking chart. The observations and opinions offered here are made from a distance as my daughter becomes very argumentative and hostile toward me during her PMDD episodes. On a positive note, recently my daughter has agreed to see a new psychiatrist and gynecologist who offers treatment options for PMDD.

It is only recently, upon her return to our home state, that my wife and I have made the connection between our daughter’s psychotic episodes and her monthly premenstrual cycles. During the many years that my daughter lived in the south, no linkage was ever made between her episodes of abnormal behavior and her monthly menstrual cycles by the institutions she attended, or her psychiatrists and psychotherapists. It became obvious to me only two months after my daughter’s return home that there was a likely physiological connection between her psychotic episodes and her monthly menstrual cycles.

Our daughter suffers from a recurring pattern of psychosis with acute irritability prior to her monthly period. This psychosis is usually preceded by a day or two of hyperactivity. During this time she barely sleeps, talks to herself, loses track of time, roams the streets and becomes somewhat paranoid. These psychotic episodes last for 3 to 5 days after which her behavior returns to normal. However, because of the resulting trauma and physical exhaustion caused by this ordeal, it takes her an additional 2 to 4 days of rest to once again become fully functional. It is my opinion that this level of premenstrual abnormality has been growing within her since her early teenage years.

I approach each PMDD resource I discover with both guarded optimism and some skepticism. I’m determined to find relief for my precious daughter’s monthly traumatic suffering before my last breath; even then I will find a way. I hope to educate myself as much as I can regarding PMDD for the purpose of guiding my daughter to the degree possible.

I share my daughter’s burning desire to, once again, live independently. However, we must first, at best, eliminate the causes (hormonal or otherwise) for her monthly episodes of acute abnormal behavior; at a minimum, manage them to a point that allows normal functionality.

PMDD causes various symptoms to occur in the luteal phase of the menstrual cycle. While ‘psychosis’ is not a symptom of PMDD included in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), scientists and clinicians are continually refining these criteria to better reflect the lived experience of people with PMDD. Premenstrual exacerbation (PME) of other disorders is also common and could account for symptoms that aren’t included in the diagnostic criteria for PMDD.