For two weeks of the month you’re fine. Then something shifts, and you become someone you don’t recognise. You can see it happening and can’t stop it. Then your period arrives and it lifts. 

If you’ve been told this is just PMS, or that you should try yoga, or that everyone gets a bit down before their period, you already know how badly that lands.

What PMDD is

Premenstrual dysphoric disorder is a severe, cyclical condition tied to the luteal phase of the menstrual cycle; the stretch between ovulation and your period. It’s currently understood not as a hormone imbalance but as an abnormal sensitivity to normal hormonal fluctuation. The hormones are doing what they should. The response to them isn’t.

What separates it from PMS is severity and the nature of the symptoms. PMS is uncomfortable. PMDD dismantles things. Relationships, jobs, your sense of who you are.

Common experiences people bring me:

• Rage that arrives out of nowhere and is out of proportion to what triggered it
• Despair or hopelessness that feels genuinely absolute in the moment
• Suicidal thoughts that appear on schedule and disappear when the period starts
• Feeling like a different person for two weeks, and being aware of it while it happens
• Relationship conflict that follows the cycle so closely you could plot it
• Sensitivity to rejection that makes ordinary interactions feel unbearable
• Complete loss of function. Days you can’t work, can’t parent, can’t leave the house
• Total remission once bleeding starts, and the shame that arrives with the clarity

The part that gets missed

Most of the damage from PMDD isn’t the two weeks. It’s what accumulates around them.

The relationship that’s absorbed years of cyclical conflict. The career that’s been shaped around unpredictable weeks. The self-concept built from a decade of thinking you’re unstable, difficult, or too much.

And the medical dismissal on top of it. Most people I see have raised this with two or three doctors before anyone took it seriously. By the time they arrive, the injury isn’t only the condition. It’s not being believed.

How I work with PMDD

Tracking and pattern work. Before anything else, we establish whether your symptoms genuinely follow your cycle. This matters enormously. It’s what separates PMDD from a mood disorder that happens to worsen premenstrually, and it’s the single most useful thing you can take to a doctor. 

Repairing the self-concept. Years of being told you’re unstable leaves marks. A lot of this work is separating who you are from what your luteal phase does.

Practical planning around the cycle. Not a cure, a way of living with it. What you schedule and what you don’t. What you agree in advance about the hard weeks. How you build in advance rather than repairing after.

Relationship repair. PMDD is hard on partners and families, and the fallout is often what finally brings people in. This work can include your partner. 

Trauma work where it’s needed. PMDD symptoms are often worse for people with trauma histories, and the medical dismissal is itself a kind of injury. I work in a trauma-informed way throughout.

The strongest version of treatment is usually a combination of medical treatment and therapy: the medical side handled by a doctor, and the psychological side here. I’ll work alongside whoever you’re seeing.

Practical details

Sessions are 50 minutes and cost $180. No GP referral is needed and you can book directly from my website.

I offer telehealth across Australia, which matters for this in particular. Some weeks you won’t be able to get to an appointment. Video means you don’t have to cancel.

If you’re in crisis

PMDD can bring suicidal thoughts, and for some people those thoughts are severe. If you’re in that place right now, please contact 000, Lifeline on 13 11 14 or 13YARN on 13 92 76, or go to your nearest emergency department. They’re available around the clock.