ADHD and PMDD: Why Your Symptoms May Worsen at Certain Times of the Month

Have you ever noticed your ADHD symptoms popping off to a more intense level about a week before your period? It could be PMDD.

PMDD is Premenstrual Dysphoric Disorder, a mood disorder linked to hormonal changes that can also trigger ADHD symptoms. People with ADHD may be particularly vulnerable to premenstrual mood and symptom changes. With ADHD, there’s less dopamine available to begin with, but dopamine and estrogen have a strong relationship. So, when estrogen starts to check out during the luteal phase, dopamine levels can tank with it, leaving you more burnt out, more reactive, and more executively dysfunctional. Dopamine keeps you motivated and that motivation that is already so difficult to harness becomes even more inaccessible during the luteal phase, but starts to pick back up once estrogen reenters the chat.

If you’re a woman navigating an ADHD diagnosis, you have likely been told your entire life that your feelings are too intense and at certain times of the month, you might agree with those people. With the social stigma around emotions flying nearing your menstrual cycle and society’s dismissal of women’s emotions as simply “PMS-ing,” you may have never paid much attention to your symptoms. You might have fallen into the trap of gaslighting yourself. You might have believed the narrative and strove to shrink yourself and your emotions to the standards of everyone around you. This is your sign to stop masking your emotions and pretending its okay, to stop accepting the label of PMS, and to stop dismissing yourself. Let’s start validating these emotions and taking them seriously, because PMDD is not just PMS. It is a significant mood disorder that significantly impacts women’s lives.

Symptoms of PMDD include:

·       Anger or rage

·       Irritability

·       Depressive thoughts

·       Anhedonia

·       Increased anxiety

·       Panic attacks

·       Difficulty focusing

·       Brain fog

·       Severe fatigue

·       Lack of motivation

·       Sleep disturbance

·       Increase sensory sensitivity

·       Increased executive dysfunction

·       Physical symptoms of bloating, breast tenderness, headaches, and joint pain

·       Suicidal thoughts*

*If you or a loved one are experiencing thoughts of self-harm or suicide, seek crisis support immediately. Call 911 for emergency medical attention or call/text 988 (Suicide & Crisis Lifeline) for free, confidential, 24/7 crisis support. If possible, stay with someone you trust and move away from anything you could use to harm yourself. This website and its content are not a substitute for emergency or crisis care.

PMDD has caused conflict in relationships, shaken identities, and even claimed lives. It’s a condition that is too often dismissed and should be taken seriously. If you feel as though you may have PMDD, talk to a provider as soon as possible. Your PMDD care team could include a mental health therapist, a psychiatric prescriber, and an OB/GYN. Treatment options include cycle tracking, lifestyle changes, DBT to improve emotion regulation and reduce suicidality, anti-depressants, and/or hormonal birth control. Start tracking your mood and your menstrual cycle through notes or apps to have a reference point to share with your providers.

Your symptoms deserve curiosity, compassion, and the appropriate support—not shame or gaslighting. You don’t have to navigate this alone.