Are Bipolar Disorder and PMDD Cause The Risk Of Misdiagnosis?

People with the problem of bipolar disorder severely suffer from mood swings, with depression being the most common symptom. Since premenstrual dysphoric disorder (PMDD) also leads to mood swings and depression, it often leads physicians and mental health professionals to misdiagnose PMDD as bipolar disorder among women.

Though both disorders affect mood, it is essential to comprehend the difference between PMDD and bipolar disorder. While bipolar disorder is a severe psychiatric disorder, PMDD is a disorder caused due to the fluctuation of reproductive hormones. Both PMDD and bipolar disorder are two different types of medical conditions with very different treatments.

Approximately 3 to 9 percent of women suffer from PMDD, a condition described by strong emotional and physical symptoms that occur between ovulation and menstruation; less severe premenstrual syndrome (PMS) is more common. PMDD is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) as a “mood disorder.” The symptoms of PMDD are quite similar to depression, which causes interference with daily functioning.

Key differences between PMDD and bipolar disorder

Unlike bipolar disorder, the problem of PMDD develops a week prior to the start of the menstrual cycle and ends a week after the completion of the cycle. Therefore, PMDD has a distinct timeline compared to bipolar disorder and other mood-related problems. It is important to realize that PMDD doesn’t comprise the more elevated moods caused due to bipolar disorders I and II: mania and hypomania.

Both the elevated moods inflict the symptoms of sleeplessness, high energy and/or possible distractibility, grandiosity, racing thoughts, and increased activity and speaking. People struggling with such varied moods indulge in financial and sexual recklessness, as well as speeding excesses. They may also experience delusional thoughts or hallucinations. Most women seek treatment for PMS and PMDD only once they are in their 30s. Unfortunately, this is also the time when bipolar disorder hits them. Consequently, it becomes difficult to diagnose PMDD and bipolar disorder due to the overlapping symptoms.

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Scientists indicate that women with bipolar disorder exhibit significant menstruation-related mood alterations, despite receiving effective treatment for their bipolar disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, a woman, in order to be diagnosed with PMDD, must exhibit five of the following symptoms in most menstrual cycles of the previous year:

  • Evidently depressed mood
  • Self-critical thoughts
  • Clear affective lability
  • Noticeable anxiety
  • Diminished interest in typical activities
  • Marked anger
  • Amplified interpersonal conflicts
  • Subjective sense of trouble in being focused
  • Lethargy
  • Fatigability
  • Overeating
  • Specific food craving
  • Being out of control
  • Insomnia
  • Breast tenderness or swelling
  • Headaches
  • Pain in muscle and joints
  • Bloating
  • Weight gain

Besides the problem of diagnostic confusion, bipolar disorder increases the risk of developing PMDD. Though scientists are still unclear about the reasons behind the overlap between both conditions, medical practitioners caution against misdiagnosis of any of them. In case of any doubts, women are recommended to consult an expert without any hesitation and fear.