Premenstrual Dysphoric Disorder (PMDD) in DSM-5 is included among the Depressive Disorders
- In the final week before the onset of menses, at least five symptoms among all listed below (which then improve within a few day after the onset of menses)
- Marked affective lability (mood swings, suddenly tearful or sad, etc.)
- Marked irritability or anger or increased interpersonal conflicts
- Marked depressed mood, feelings of hopelessness, etc.
- Marked anxiety, tension, feeling keyed up or on edgeof which at least one or more of the following must be present
- 1. Decreased interest in usual activities of daily life
- 2. Subjective difficulty in concentrating
- 3. Lethargy, easy tiredness, lack of energy
- 4. Marked change in appetite
- 5. Too much sleep/insomnia
- 6. Sense of being overwhelmed or out of control
- 7. Physical symptoms, e.g., breast tenderness, joint or muscle pain, sense of weight gain.
- Distress or interference with work, school, or usual activities
- The symptoms must occur during the majority of menstrual cycles over the course of a year
- Prevalence: roughly ~1.8-5.8% of menstruating women
- Among various treatments, use of SSRIs has shown effectiveness in 60-90% of women with PMDD. Multiple other treatment options exist.
|Treatment: General Issues|
There are at least 400 recognized forms of "therapy" for the treatment of mental disorders. These represent one or more of the following general modalities of treatment
- Insight Therapies: Treatment by thinking
- Psychoanalysis and psychodynamic psychotherapy (a close cousin to psychoanalysis) are only two of many insight therapies
- Cognitive-Behavioral Therapy (which uses both cognitive & behavioral approaches) is the most widely-used "thinking" based therapy in the United States.
- Identify automatic negative thoughts: I always fail tests; I can never do well in school; people don't like me
- Substitute more reasonable thoughts: I'm prepared for this test so that I'll probably do okay; school may be challenging, but most people like me actually do well; while some people might not like me, a whole lot of others do.
- Behavior Therapies: Treatment by doing (learning)
- Grounded in learning theory (classical conditioning, operant conditioning, social learning)
- Focuses upon what people actually do and what happens to them as a result
- Biomedical Therapies: Treatment by affecting the body
- Medications (Drugs)
- Favored by insurance companies
- For some disorders, non-drug treatments are equally effective, e.g., cognitive-behavior therapy for mild-moderate depression
- Electroconvulsive Therapy (ECT) = "Shock Therapy" (mostly used for severe forms of depression)
- Roughly 15% of the US population seeks treatment for mental health issues every year (even though almost 30% experience a disorder).
- Roughly 50% of visits to physicians (medical doctors) involve psychological issues.
Who treats psychological disorders?
- Psychologists: Ph.D. or Psy.D. degree (4-6 years post college which includes 1 year of internship; afterwards, usually at least 1 post-doctoral year of supervised work)
- Clinical Psychologists: Tend to treat more serious or difficult disorders
- Counseling Psychologists: Tend to treat somewhat less serious disorders or difficulties of everyday life
- Psychiatrists: MD = physician who specializes in diagnosing and treating mental disorders. Medical school (4 years) + 1 year internship + 2-4 years psychiatric residency.
- Psychiatric Social Worker: MSW. Social worker has 2+ years post college training which includes both classroom work and supervised clinical experience
- Other professionals: psychiatric nursing, counselors, marriage and family therapists, clergy, drug counselors and others
This page was originally posted on 12/01/03 and last updated on December 7, 2016