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This article will educate readers on the distinct characteristics of bipolar vs PMDD, with information on the causes of symptoms of PMDD vs. bipolar disorder. It will help readers learn more about getting an accurate diagnosis and guide individuals in seeking appropriate treatment and support.
Introduction
Women of childbearing age can face many hormonal changes having to do with menstruation. But this is also a time frame for symptoms of other mental health disorders like bipolar disorder or depression to arise. So, is PMDD a form of bipolar? What is the difference between bipolar and PMDD?
This article will review the signs of PMDD vs. bipolar disorder, the risk factors for PMDD and bipolar, how they differ, and what treatment is available for PMDD or bipolar disorder. Distinguishing between the two is imperative to your successful treatment of either.
Understanding PMDD (Premenstrual Dysphoric Disorder)
If you are experiencing irritability that seems to manifest suddenly for several weeks, with headaches, skin conditions, abdominal issues, moodiness, and confusion, you might wonder if you have signs of PMDD or bipolar.
-Definition and Symptoms of PMDD
PMDD is a severe form of PMD. It tends to happen in women who are of childbearing age. This condition is a legitimate medical condition, one that has severe impacts on daily function. If you or someone close to you exhibits the signs of PMDD, it is important to find professional treatment, such as medication or lifestyle changes, to help.
-How PMDD differs from typical premenstrual syndrome (PMS)
PMDD symptoms differ from traditional PMS in terms of their severity. They usually appear the week prior to PMS and end a few days after a period. The symptoms last longer than traditional PMS and are so severe that they can impede daily function. Moreover, the symptoms take place at different times of the month compared to PMS.
-Causes and risk factors of PMDD
Science does not yet know what causes PMDD yet. It is thought, however, that PMDD is an abnormal reaction to hormonal changes women face during menstruation. Such hormonal changes result in serotonin reductions, and with an abnormal response to such reductions, women can experience poor mood and other symptoms similar to bipolar disorder.
Any woman can develop PMDD, but there are a few risk factors that increase the likelihood of that happening, namely:
- Having a family history of PMDD
- Having a family history of depressive disorders or mood disorders
Understanding Bipolar Disorder
If you experience severe mood swings that often fall under manic or depressive behaviors, either full of energy or completely depleted of energy, full of impulsivity, or full of confusion and depression, you might have questions about whether you have bipolar disorder.
-Definition and Symptoms of Bipolar Disorder
Bipolar and related disorders are a class of mental health disorders between depressive disorders and schizophrenia disorders in terms of the severity of their symptoms and how they manifest.
Individuals with any diagnosis of bipolar disorder will experience severe symptoms of either manic, depressive, or both episodes that can happen without warning, often triggered by stress or trauma. There are several medications and therapies that can be used to help manage symptoms, particularly those of depressive episodes.
-Different types of Bipolar Disorder
There are three main types of disorders under the category of “bipolar:
- Bipolar I
- Bipolar II
- Cyclothymic Disorder
Bipolar I disorder usually comes with symptoms of manic episodes and major depressive episodes, whereas bipolar II is often limited to major depressive episodes but only one hypomanic episode. People with hypomanic and depressive episodes without other criteria who have had symptoms for at least two years can be diagnosed with cyclothymic bipolar disorder.
What a manic episode looks like
Bipolar I disorder is characterized by recurring mood episodes where symptoms remain nearly every day for several weeks. Someone who is experiencing a manic episode might feel excessively cheerful like they are on top of the world. However, this excessive and euphoric mood can lead to risky interpersonal interactions, sexual choices, and occupational functioning.
For example:
Someone might decide to spontaneously start conversations with strangers in public because they are feeling great. However, it’s also common for speech to be pressured, loud, and rapid. They might be talking continuously to that stranger without regard for whether or not that stranger even wants to communicate or without any regard for what is said.
But that same person might also decide that because they have so much energy, they can start six new projects all at once even though they don’t have a lot of knowledge about any of those topics. The activities in which they engage might be political, religious, occupational, or even sexual. With increased energy levels and a decreased need for sleep, they’ll find themselves working at unusual hours of the day without any normal sleep pattern.
An individual with bipolar disorder, during a manic episode, might decide that they can write a science fiction novel even though they don’t have any expertise or talent when it comes to that particular field. They might believe that they have special relationships with famous people.
What a depressive episode looks like
Depressive episodes for bipolar disorder have several of the same characteristics as a major depressive disorder. Many people are misdiagnosed with depressive disorder because they only seek treatment during a depressive episode and not during a manic episode.
A depressive episode is likely to manifest with feelings of depression most of the day, nearly every day, for several weeks. Individuals might appear to be on the verge of tears at all times. Someone with bipolar disorder experiencing a depressive episode will likely struggle with significant weight loss, representing a noticeable change in body weight because of a decrease in appetite.
That same person might have a diminished interest in activities that they used to do nearly every day, finding it difficult to even get out of bed in the morning. Fatigue and diminished energy levels can make it difficult to complete daily tasks like chores around the house, showering, getting dressed, or even going to work.
Someone struggling with a depressive episode will likely pull away not just from activities but from relationships and social engagements, which can place undue stress and burdens on the rest of their family or friends, who might have to pick up the slack.
Weight increases or decreases are often associated with sleep changes, or an individual sleeps too much or too little, taking naps throughout the day and still feeling a complete loss of energy. During a depressive episode, an individual will find it difficult to focus or make decisions, and they’ll be overwhelmed with feelings of inappropriately placed guilt or worthlessness.
-Causes and risk factors of Bipolar Disorder
The exact causes of bipolar are also not known, but research suggests there are several risk factors that can increase the risk of developing it, such as:
- Having a family history of bipolar disorder
- Experiencing trauma as a child
- Experiencing stressful life events
- Changes to brain chemistry
- Substance abuse
In addition to the several risk factors associated with developing bipolar disorder, there are risk factors for an individual who already has bipolar disorder (diagnosed or not) in triggering mood episodes. In many cases, responses to significant loss can bring about symptoms that look like a depressive episode or are a depressive episode. Things like financial ruin, serious medical illness, bereavement, or losses after a natural disaster can increase the risk of an episode among those who already have bipolar disorder.
PMDD vs Bipolar: The Key Differences
There are far more differences between PMDD and bipolar disorder than there are overlaps.
-Comparing symptoms of PMDD and Bipolar Disorder
When you look at the symptoms of premenstrual dysphoric disorder and bipolar, there are several key differences.
Symptoms of PMDD
The common symptoms of PMDD have many forms:
| Psychological Symptoms | Gastrointestinal Symptoms | Neurologic Symptoms | Other Symptoms |
| Irritability | Abdominal cramps | Headaches | Decreased coordination |
| Trouble sleeping | Bloating | Dizziness | Painful menstruation |
| Moodiness | Constipation | Fainting | Food cravings and appetite changes |
| Crying spells | Vomiting | Numbness or tingling in the arms or legs | Hot flashes |
| Emotional sensitivity | Nausea | Easy bruising | Diminished sex drive |
| Anxiety | Backaches | Heart palpitations | Acne, cold sores, skin inflammation |
| Confusion and difficulty concentrating | Pressure in the pelvis | Muscle spasms | Allergies and infections |
| Severe fatigue | Vision changes | ||
| Paranoia | Eye infections | ||
| Poor self-image | Swelling in the ankles, hands, and feet | ||
| Forgetfulness | Weight gain | ||
| Depression | Diminished urine output | ||
| Anger and agitation | Full and painful breasts |
Symptoms of Bipolar Disorder
The common symptoms of bipolar disorder are a bit different. For starters, bipolar disorder can come in several forms, with either manic episodes, depressive episodes, or both.
During a manic episode, individuals will have noticeable changes from their usual behavior that include things such as:
- Increased self-esteem and feelings of grandiosity
- Decreased demand for sleep, often feeling rested after just 3 hours or so
- Feeling more talkative or feeling pressure to keep talking
- Experiencing racing thoughts and flights of ideas
- Being easily distracted by unimportant or irrelevant stimuli
- An increase in goal-directed activity at work, school, or even sexually, as well as increased psychomotor agitation like non-goal-directed activity
- Increased involvement in activities that have a risk for painful consequences like impulsive spending sprees, foolish investments, or unsafe sex
During a depressive episode, individuals will have noticeable changes from their usual behavior that include things such as:
- Depressed mood most of the time, feeling hopeless and empty
- Noticeable diminished interest in nearly all or all activities
- Significant weight loss or a severe increase in appetite representing a change of more than 5% of body weight in a month
- Noticeable sleep patterns leading to hypersomnia or insomnia
- Feelings of restlessness but slow action and thought, with psychomotor agitation and retardation on daily tasks
- Loss of energy and fatigue throughout the day
- Feelings of excessive worthlessness or inappropriate guilt
- A diminished ability to focus, think, or even make decisions
- Recurrent thoughts of death or even suicide
-Temporal patterns
Manic episodes for bipolar disorder have to last at least one week and persist nearly every day during that time frame, whereas major depressive disorders have symptoms that manifest for at least two weeks nearly every day of that time frame. The length of symptom manifestation is the same when comparing PMDD and bipolar disorder, but when they arise, it is different.
PMDD is linked with the menstrual cycle, while Bipolar disorder has episodic mood changes. This means they manifest at different times, and with PMDD in particular, you have an easier time monitoring the temporal patterns.
-PMDD vs bipolar impact on daily life and relationships
When you compare bipolar vs. PMDD, some of the impacts overlap:
- Individuals with PMDD or bipolar disorder, during an episode when symptoms manifest, might find it difficult to focus and make decisions.
- Individuals are more likely to experience extreme fatigue, which can interfere with daily tasks.
- Moodiness, emotional sensitivity, and irritability can be present in both.
However, PMDD comes with several symptoms outside of psychological, including gastrointestinal, respiratory, neurologic, and vascular, which bipolar disorder does not have.
During a manic episode, the symptoms cause severe impairment to an occupational or social function, with symptoms that interfere with things like productivity, interpersonal relationships, and self-care.
During a depressive episode, individuals struggle with severe distress and impairment in their occupational, social, or other areas of daily function. These symptoms can impede an individual’s ability to take care of themselves, care for their family, go to work, or complete any other responsibilities. They can have a secondary and tertiary impact on friends and family. Moreover, the symptoms related to appetite and sleep can exacerbate other symptoms, increasing the mental health and physical health ramifications.
With PMDD, daily life and relationships can be equally hindered but in different ways. The psychological symptoms of things like depression, insomnia, agitation, a lack of control, and forgetfulness can interfere with daily tasks, taking care of oneself or others, or completing work responsibilities.
The Overlap: PMDD and Bipolar
When you compare premenstrual dysphoric disorder and bipolar disorder, it can be difficult to get the right treatment because there exists overlap with several other conditions.
- PMDD can look very similar to medical issues like a thyroid condition or other mental health disorders like anxiety or depression.
- Bipolar disorder can look very similar to major depressive disorder, generalized anxiety disorder, schizoaffective disorder, ADHD, personality disorder, disruptive mood dysregulation disorder, or substance abuse.
Moreover, there is a high comorbidity with bipolar disorder, where the majority of individuals have a history of three or more disorders, usually anxiety disorders, depressive disorder, or ADHD. There are high rates of co-occurring mental health disorders and high risks of obesity and obesity-related physical health issues for those who do not get treatment for bipolar disorder.
The overlap happens in very specific instances, such as the irritability, insomnia, appetite changes, and fatigue associated with PMDD, which is also associated with a depressive episode for someone with bipolar disorder. Again, the length of time whereby the symptoms remain also has some overlap, usually around one or two weeks.
Is PMDD a form of bipolar disorder?
No. However, PMDD and bipolar disorder are both severe and chronic conditions that require help.
Bipolar disorder does not have a cure, which means the therapy and medication you use as part of your treatment plan will be individualized to the type of bipolar disorder you have and any other co-occurring mental health disorders. It will focus exclusively on controlling acute symptoms for things like depressive disorders or hallucinations while also giving you coping skills that manage the severity of triggers and subsequent symptoms for episodes throughout the rest of your life.
PMDD treatment will focus on medication for very specific symptoms like depressive symptoms or mood changes, but the rest will fall more toward lifestyle changes that you can implement that have a direct impact on your hormonal balance and your overall health. When you work with a medical professional, you can monitor the efficacy of these changes over the course of several months to verify which things like exercise changes di, dietary changes, or even vitamin supplements are better at balancing the hormones associated with your menstrual cycle.
Diagnosis and Treatment Approaches
The diagnostic criteria differ for both PMDD and bipolar disorder, and the treatment approaches are equally different.
-Diagnostic criteria for PMDD and Bipolar Disorder
With PMDD, there are very few diagnostic tests that can be done apart from physical exams and complete medical history. Evaluation of mental health concerns is important as it can help address the mental health symptoms associated with the condition.
You might be asked to keep a journal for several months in order to diagnose the presence of at least five or more of the following symptoms over the course of a year:
- Difficulty concentrating
- insomnia or hypersomnia
- Moodiness
- Depression
- irritability and anger
- feeling out of control or overwhelmed
- physical symptoms like breast tenderness, bloating, and headaches
- a loss of interest in activities that you once enjoyed
It’s important to note that these symptoms must not be related to any other medical condition, something that is generally ruled out with a physical exam. They must also be so severe that they interfere with your ability to function at work, at home, or in social situations.
For bipolar disorder, you have to be evaluated by a mental health professional who will ask you a series of questions about your symptoms and their severity. The diagnostic criteria are slightly different for a diagnosis of bipolar I or bipolar II, particularly when it comes to criteria for a manic episode preceded by or followed by a major depressive episode.
A mental health professional will review the diagnostic criteria with you, asking questions about which symptoms you experienced during your mood disturbances, whether they were severe enough to have significant impairment in your social or occupational functioning, and whether they can be ruled out by any other mental health issue or physical health concern.
-Treatment options for PMDD
This is a chronic and serious condition that requires treatment. Treatment is focused on decreasing or relieving your symptoms and can involve medication like SSRIs or anti-inflammatory medication to help with specific symptoms.
Beyond medication, you can work with a medical professional to determine what lifestyle changes might be best in managing for reducing your symptoms like:
- Stress management techniques
- Changes in diet
- Vitamin supplements
- Birth control pills
- Regular exercise
-Treatment options for Bipolar Disorder
Treatment for bipolar disorder is best done with the help of a professional. A mental health professional can provide you with the structure and support you need to learn how to manage your conditions at home by way of therapy or medication.
Medication
Medication for bipolar disorder might include mood stabilizers for manic symptoms, antidepressants for depressive symptoms, or antipsychotics for hallucinations and delusions associated with your episodes.
Therapy
Medication is always more effective when used in conjunction with therapy. In most cases, Psychotherapy or talk therapy is used to treat bipolar disorders. Talk therapy can be individual or group-centered and, in most cases, involves things like cognitive behavioral therapy, where you can learn to improve your social skills, boost your communication, and work through identifying triggers so that you know when an episode is pending and can prepare to manage it with coping skills.
Summing up
Getting help starts with getting an accurate diagnosis from a mental health professional. Do not try to self-diagnose. It’s important to remain aware and educated about PMDD vs. bipolar disorder, but if you notice symptoms and yourself or someone close to you, reach out to your medical professional to start the process of an evaluation. This will help you find the right type of treatment and the right way to manage your symptoms.
