Living with PMDD is like having the Grim Reaper visit every month

Living with PMDD is like having – Annika Waheed’s life took a dramatic turn one morning after she attempted to end her own life. As the sun rose, her period began, and with it came a profound sense of relief. The despair that had gripped her the previous day faded, leaving her with a newfound clarity. “Did I really do that?” she asked her sister, who had held her tightly while she slept off the overdose. The sister confirmed, “Yes, you did.” For Annika, this monthly cycle is a battle against a condition that haunts her for two weeks each month—premenstrual dysphoric disorder (PMDD).

Annika, now 42, has grappled with PMDD for over eight years. It is a mental health disorder that amplifies emotional and physical distress, often reaching a level that feels overwhelming. Unlike premenstrual syndrome (PMS), which can bring fatigue, irritability, and bloating, PMDD intensifies these symptoms to an extreme. Women with PMDD may experience deep anxiety, depressive episodes, and a sense of losing control, all tied to the luteal phase—the one to two weeks before menstruation. The disorder can strike at any stage of a woman’s life, but it often coincides with pivotal hormonal shifts, such as puberty, childbirth, or menopause.

“PMS can be really hard,” says Annika, who also suffers from physical symptoms like heart palpitations, severe backache, and bloating. “But this? This is something else. It is like the Grim Reaper coming for us every month. You can feel it, and there is nothing you can do about it.”

PMDD is not merely a temporary mood fluctuation. It is a condition that can significantly impair daily functioning. The International Association for Premenstrual Disorders (IAPMD), a global research charity, estimates that over a million women in the UK may live with PMDD, yet only a fraction have been officially diagnosed. This gap in recognition highlights the challenges in identifying and treating the disorder. Suicide, a complex phenomenon, is linked to PMDD in some studies. These suggest that women with PMDD may be more prone to suicidal thoughts and attempts than the general population.

Experts believe PMDD stems from a heightened sensitivity to hormonal changes. Before a period, progesterone levels peak, while oestrogen fluctuates. This combination can trigger intense emotions of despair, loss, and hopelessness. While the exact mechanisms remain unclear, researchers are exploring how these fluctuations interact with individual biology to produce such severe effects. For many women, the cycle is a relentless source of suffering, often mistaken for general mental health issues.

A Groundbreaking Tool for Suicide Prevention

Scotland-based researchers are making strides in addressing this challenge. Dr. Lynsay Matthews, leading the initiative at the University of the West of Scotland, has developed a novel tool to help clinicians recognize PMDD-related suicide risk. “For so long, women have lived with this condition and not had any idea what could be causing it,” she explains. “Even though the menstrual cycle plays such a huge part in a woman’s health, it is often not brought up in doctors’ consultation rooms.” Matthews argues that questioning patients about their menstrual patterns could uncover critical clues about their mental health.

The model, already accessible to healthcare professionals, offers insights into how PMDD affects a woman’s susceptibility to suicidal behavior. It highlights differences in emotional responses compared to the broader population, aiding in more targeted interventions. The next step, according to Matthews, is to evaluate its effectiveness. If successful, the tool could be integrated into NHS services, improving early detection and treatment for PMDD.

Challenges in Diagnosis and Awareness

Dr. Helen Wall, a GP in Bolton specializing in women’s health, echoes these concerns. “Doctors still struggle to relate things to a woman’s periods,” she notes. “We have to listen to women’s stories and understand what is happening in the context of their hormones.” However, the healthcare system often limits this understanding. “We get 10 minutes, 15 minutes maximum with a patient,” Wall explains. “Many women with PMDD will present when they are in crisis, and they have nowhere else to turn. It is difficult to get a full history and understand the complexities in such little time.”

Despite these hurdles, awareness is growing. Social media platforms, particularly TikTok, have become vital spaces for women to share their experiences. The hashtag #PMDD has amassed over 230 million views, offering a sense of community and visibility. Katie Cook, one of those who documented her journey, was diagnosed in 2025 at a young age. Her story, like many others, underscores the need for greater recognition of PMDD as a legitimate health concern.

For Annika, the disorder has been a constant companion. “How can my hormones do this to me?” she questions, reflecting on the deep psychological toll. The monthly onslaught of symptoms can feel like a living entity, one that visits with unwavering regularity. While the physical pain and emotional weight are significant, the struggle lies in the lack of understanding and resources. Many women go through years of suffering without a diagnosis, their symptoms dismissed as temporary or unrelated to their health.

Matthews emphasizes the importance of incorporating menstrual cycles into medical discussions. “Asking women questions about their cycle can help identify patterns and link mental health struggles to hormonal changes,” she says. This approach could lead to more personalized care, allowing for targeted therapies and support. However, it requires a shift in how healthcare professionals perceive and prioritize women’s health issues. The tool developed by Matthews is a step in that direction, but its success depends on broader adoption and awareness.

As the search for solutions continues, stories like Annika’s and Katie’s remind us of the human impact behind the science. The emotional burden of PMDD is not just a monthly inconvenience—it is a profound struggle that can shape a woman’s life. With more research and public discourse, there is hope for better understanding, diagnosis, and treatment. Until then, the Grim Reaper may linger, but awareness could one day turn that shadow into light.