PMDD / Bipolar Disorder

There is evidence to suggest that women and AFAB individuals with PMDD are commonly misdiagnosed with bipolar disorder. Bipolar disorder is characterized by episodes of depression and mania, and like PMDD, is a cyclic disorder. In bipolar disorder, depression includes low mood or loss of interest in activities lasting at least two weeks, while mania is a period of abnormally and persistently elevated, expansive, or irritable mood and energy, lasting at least one week.

While PMDD and bipolar disorder are both associated with mood lability and extreme mood states, the two disorders can be differentiated by the pattern of mood cycles. In PMDD, mood swings are synchronized with the menstrual cycle. In contrast, the mood swings associated with bipolar disorder are not linked with the menstrual cycle, and do not follow a predictable pattern.

If an individual does not track their menstrual cycle or is not advised to track their menstrual cycle, they are at an increased risk to be misdiagnosed and treated with heavy antipsychotic drugs that may have potential long-term risks. 1,2,3

 

 
 

Symptoms of Bipolar Disorder

  • Feelings of sadness or despair or even thoughts of suicide

  • Mood swings or frequent crying

  • Lasting irritability or anger that affects other people

  • Lack of interest in daily activities and relationships

  • Trouble thinking or focusing

  • Tiredness or low energy

  • Trouble sleeping / decreased need for sleep

  • Increased energy, hyperactivity

  • Impulsivity, engagement in risky behaviors

  • Elevated, expansive mood

  • Inflated self-esteem or grandiosity

  • Feeling out of control

  • Rapid, pressured speech

  • Racing thoughts

  • And more 

 

Symptoms of PMDD

  • Feelings of sadness or despair or even thoughts of suicide

  • Feelings of tension or anxiety

  • Panic attacks, mood swings or frequent crying

  • Lasting irritability or anger that affects other people

  • Lack of interest in daily activities and relationships

  • Trouble thinking or focusing

  • Tiredness or low-energy

  • Food cravings or binge eating

  • Trouble sleeping

  • Feeling out of control

  • Physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain

  • And more

 
 

 

It is clear there are many similarities between Bipolar Disorder and PMDD. They have similar symptoms, and are both cyclic disorders. It is critical, however, to distinguish between the two, as bipolar disorder is a severe psychiatric disorder and PMDD is a disorder of the endocrine system (i.e. hormone related). While PMDD and bipolar disorder are both associated with mood lability and extreme mood states, the two disorders can be differentiated by the synchronization of PMDD mood swings with the menstrual cycle. In contrast, the mood swings associated with bipolar disorder are not tightly linked to any regular body cycle.

Tracking Symptoms

The first step to a correct diagnosis is to track your symptoms with your cycle. Download this free printable symptom tracker form or a free tracking app for iPhone or Android. You may also contact a peer-support volunteer for more information.


 

Updated February 20, 2019
Dr. Liisa Hantsoo

1. Bipolar Disorder in Adults. (2012). Retrieved October 19, 2015, from http://www.nimh.nih.gov/health/publications/bipolar-disorder-in-adults/index.shtml.
2. Pearlstein, T., & Steiner, M. (2008, July 1). Premenstrual dysphoric disorder: Burden of illness and treatment update. Retrieved November 15, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440788/.
3. Nimh.nih.gov,. 2015. 'NIMH » Mental Health Medications'. Retrieved November 15, 2015. http://www.nimh.nih.gov/health/topics/mental-health-medications/mental-health-medications.shtml.
4. J, Studd. 2015. 'Severe Premenstrual Syndrome And Bipolar Disorder: A Tragic Confusion. - Pubmed - NCBI '. Ncbi.Nlm.Nih.Gov. Accessed November 15, 2015. http://www.ncbi.nlm.nih.gov/pubmed/22611228.
5. Amhc.org,. 2015. 'Bipolar Disorder Versus Major Depression And Premenstrual Dysphoric Disorder - Bipolar Disorder'. Accessed November, 15 2015. http://www.amhc.org/4-bipolar-disorder/article/11199-bipolar-disorder-versus-major-depression-and-premenstrual-dysphoric-disorder.