# PMDD vs. Bipolar Disorder



## Anti-Citrite (Oct 22, 2008)

PMDD vs. Bipolar

Found a few interesting pieces on the Internet likening PMDD (for those who don't know, that's severe PMS) to Bipolar Disorder.   Some say that PMDD is often misdiagnosed as Bipolar - although, medically treated rather differently.  It affects about 2% of the population (of women obviously...) - similar stat to bipolar.

Anyone have any personal experiences in this?   Is it possible to have both (God love the husbands of these women!).


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## David Baxter PhD (Oct 22, 2008)

Actually, there are several things that can be misdiagnosed as bipolar disorder but it's important to note that any condition involving hormonal dysfunction or swings (including PMDD and thyroid conditions) can influence existing conditions such as anxiety disorders, depression, bipolar disorder, schizophrenia, etc. The reason is that the endocrine (hormonal) system is tightly interwoven with the neurotransmitter system in a rather complex "domino effect" way, so that changes in one element results in changes throughout both systems.


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## Always Changing (Oct 22, 2008)

(God love the husbands of these women!). 
Why?,

 Any woman who has experienced \ is experiencing both is the person to be pitied.?


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## Anti-Citrite (Oct 22, 2008)

Dr. Baxter - that's very interesting.   There isn't much written about the idea of them being interwoven online.   Treatment has to be tricky...  Well - isn't treatment tricky with all mood disorders?

No doubt the woman needs all the support and empathy she can get, but living with the highs and lows of a bipolar woman with PMDD is not easy and can be immensely frustrating for even the kindest and most patient of men.  There is a high rate of divorce in bipolar relationships and a man who supports a wife with both of these conditions will need a lot of support himself.   Add children to the mix and who protects them from the mood that can often be irrational, angry and damaging?   God love the man who is able to do this...there aren't many.


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## Lana (Oct 22, 2008)

Anti-Citrite said:


> Dr. Baxter - that's very interesting. There isn't much written about the idea of them being interwoven online. Treatment has to be tricky... Well - isn't treatment tricky with all mood disorders?
> 
> No doubt the woman needs all the support and empathy she can get, but living with the highs and lows of a bipolar woman with PMDD is not easy and can be immensely frustrating for even the kindest and most patient of men. There is a high rate of divorce in bipolar relationships and a man who supports a wife with both of these conditions will need a lot of support himself. Add children to the mix and who protects them from the mood that can often be irrational, angry and damaging? God love the man who is able to do this...there aren't many.


 
I have been diagnosed with PMDD and I am being treated for depression also. I suspect that during my hormonal fluctuations I am a bit more jumpy then other times. Unlike Bipolar, symptoms of PMDD end as soon as the period starts. Unlike Bipolar, I don't have the highs that they experience...just the down swing when PMDD kicks in. Treatment is anti-depressant.

I have to say that I'm extremely offended by your comments, Anti-Citrite. It's bad enough to have people smirk and scoff at the idea of having bad case of PMS or attributing every emotional reaction to it or female gender, it's worse when men are pitied for it. I have no doubt my husband would find such comments offensive also because I know for a fact that given the choice, he'd choose me with all my "luggage" and "frustrations" that I come with.

I say, God love the people that think the way you do.


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## David Baxter PhD (Oct 23, 2008)

I don't see anything in Anti-Citrite's post that suggests that she is smirking or scoffing at PMS or PMDD or women. She is making the specific observation that living with a partner with bipolar disorder is difficult and that combining that with PMDD is more difficult.

She is correct. It certainly is not easy for the sufferer coping with conditions like major depression, or panic disorder, or bipolar disorder. But it is also hard on spouses, children, and families of the sufferers.

That's not a stigma issue, nor is it diminishing the distress experienced by the person suffering from the condition or illness. It's simply a fact.

It's not uncommon for me when assisting clients with anxiety disorders, or depression, etc., to suggest to the client that the spouse or parent or other famil member come in for a session or two, with the goal of providing information to the significant other about the realities of having a disorder and the realities of trying to support someone who has a disorder.


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## Anti-Citrite (Oct 23, 2008)

David Baxter said:


> I don't see anything in Anti-Citrite's that suggests that she is smirking or scoffing at PMS or PMDD or women. She is making the specific observation that living with a partner with bipolar disorder is difficult and that combining that with PMDD is more difficult.
> 
> *Yep - that is exactly what I was saying.*
> 
> ...



I am simply being sensitive to the fact that the people around me also suffer as a result of these illnesses. I certainly meant no offence and am sorry if my communication lead you to believe I was minimizing the condition in any way, shape or form.


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## Lana (Oct 24, 2008)

Thank you for clearing that up, David and Anti-Citrite. 

And to make one thing perfectly clear, I never see myself as a victim in this situation, nor use it a as a crutch or as an excuse to misbehave. Nor do I play the role of survivor for I feel it's just another term for "victim". I strive to live a good life and I strive to make life pleasant, or at least easier, for those that I come in touch with. I am very much in touch with who I am and what I'm all about. That, of course, is always work in progress and there's always room for improvement. But the ultimate goal is that I am in charge of my feelings, not the other way around.

Please understand that I am not boasting here for the road to this space and time has not been easy, but I am very proud of my accomplishments and my ability to know when my thoughts are skewed or clear as a whistle. Truth be told, playing a victim or being labelled as one upsets me to no end. My reaction to your post was not a result of some trauma as you have suggested, I just didn't like what was said and spoke my mind.

Having said all that, it was obviously a misread on my part, but after reading your initial and follow up posts, I was left with the impression that men who live with women that suffer from Bipolar and/or PMDD are victims....and I don't see them as such...nor the women they live with.


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## David Baxter PhD (Oct 24, 2008)

I'm not going to try to speak for Anti-Citrite, but I don't see the issue as one of the partner being a victim at all. It's merely an acknowledgement that any mental health condition can be hard on the individual's famil as well as the individual.


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## Anti-Citrite (Oct 27, 2008)

Once again Dr. B - yep.


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## tryindbt (Feb 27, 2011)

Thanks for this thread. It sounds interesting. I didn't know that PMDD was likened to bi-polar and I would then think this was not me since I don't have any manic phases..but, I do get depressed.. what would be the difference of effexor xr and the drugs that are most likely prescribed for pmdd like the following (from an article Steve posted online). I know this is not an all inclusive list, but I have not been prescribed any of the ones listed below. Is effexor xr one prescribed for pmdd? is it different from the ones below? 



> Selective serotonin-reuptake inhibitors (SSRIs) are antidepressant drugs that can treat PMDD. SSRIs include fluoxetine (Prozac, Sarafem), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).


 
---------- Post added at 11:41 PM ---------- Previous post was at 11:39 PM ----------

you know..i might sometimes react like anti-citrite here..that's the way I react when I get moody and feel that i could have pmdd..BUT, I would not think i have pmdd until later when I am not feeling the moodiness and the pms is gone - like today!


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## David Baxter PhD (Feb 27, 2011)

First, it's usually a mistake to self-diagnose and we cannot provide a diagnosis online here. Maybe you meet the criteria for PMDD; maybe you don't. There are several other possibilities...

Wait to see a qualified practitioner who can diagnose you face to face.



> Selective serotonin-reuptake inhibitors (SSRIs) are antidepressant drugs that can treat PMDD. SSRIs include fluoxetine (Prozac, Sarafem), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).


 
Effexor is a dual action medication that directly affects both serotonin and norepniphrine. It's generally considered to be in the same family as the SSRI medications, or at least a related medication. Other dual action medications include Pristiq and Cymbalta.

The other medications you mention in your quote are all SSRI drugs, i.e., they directly affect only serotonin (although the neurotransmitters are highhly intertwined so that changes in the level of one affect the others rather like a domino effect; the neurotransmitters are also affected by and linked to the endocrine system - the hormones - which is another complex "domino effect" system).


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## tryindbt (Feb 27, 2011)

I understand that i and anyone online cannot diagnose me and it is not safe to self-diagnose. I just want to find out more information about it to see if I do fit the profile...and if I do, I can have some reasons as to why I think this when I bring up these things with my doctor..also, I read that it is hard to diagnose and keeping track of things on a calendar along with mood swings etc, can help. and I think eating healthier and keeping notes in a calendar can be helpful even if I don't have pmdd.

This is just something i have always thought I might have, but i never really researched it, other than reading one or two articles. This time, because I got fired and I think it was my moodiness and conflicts two weeks before my menstrual cycle started today! Exactly like what they say online, that it usually happens before your cycle starts..and then it goes away when it starts...BUT, if this is so, I don't know why it might not work like this all the time....at least not for me..it may be worse some months than others..but not always so bad..and maybe if it is something that is suppose to happen like clockwork every month- then maybe that means I don't have it...and I'm just a moody person!

---------- Post added February 27th, 2011 at 12:03 AM ---------- Previous post was February 26th, 2011 at 11:58 PM ----------

Is there a reason why someone would be prescribed a dual action medication vs. those that only affect serotonin levels? 

My doctor has only prescribed effexor xr and recently gave me a few Pristiq samples. I don't remember what I took at the beginning of this when he first tried to figure out what to prescribe to me for my depression because I was so depressed I was just one of the walking dead and didn't really look at what he gave me. I don't remember it either. But it's been several years that I have now been on effexor xr.


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## David Baxter PhD (Feb 27, 2011)

tryindbt said:


> Is there a reason why someone would be prescribed a dual action medication vs. those that only affect serotonin levels?


 
Sometimes because the doctor might think you need a stronger medication (some people find the dual action drugs to be too much). Sometimes it's because other SSRIs haven't worked well for you. Sometimes it's because the medication is prescribed to treat both depression annd anxiety.


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## tryindbt (Feb 27, 2011)

Thank you Dr. B. that's a lot of information. I remember him telling me that he liked effexor xr because it was a new form of anti-depressant that seemed to have less side effects than other older/more common medications.  This I know found to be somewhat true, but not really because when I have tried to get off it in the past I get horrible headaches! And, the weight gain is a HUGE side effect.  

Well, I learned that my body needs the serotonin, which is might be what i am missing. Because I had a really bad reaction to the generic version of WELLBUTRIN XL. And, my doctor told me that it was because the generic WELLBUTRIN XL does not help with the serotonin levels the same way that effexor xr does....and that the serotonin issue in these type of medications is what usually is linked to the people that gain weight on these type of meds.  

So, it's just something to bring up when I can and hopefully I will have benefits soon.


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