07/17/2025
Neurodivergent folks are far more likely to suffer from PMDD than our neurotypical comrades.
You're not crazy!
You're not alone.
🔴 PMDD is a medical condition. It is not a personality disorder.
A personality disorder is a long-standing pattern of thinking, feeling, and behaving that can make daily life and relationships more difficult. While symptoms in a personality disorder can worsen with hormone fluctuations (aka premenstrual exacerbation or PME), this is not PMDD.
🧠 Premenstrual Dysphoric Disorder (PMDD) is a cyclical, hormone-based mood disorder, a neuroendocrine condition, where symptoms emerge in response to the brain’s abnormal reaction to natural hormonal changes in the menstrual cycle. Diagnostic criteria for PMDD also emphasize that these symptoms are not an exacerbation of an existing condition, like a personality disorder.
Because symptoms like mood swings, rage, anxiety, depression, and suicidal thoughts can resemble those seen in conditions like Borderline Personality Disorder (BPD), PMDD is frequently misdiagnosed, especially when the hormonal timing of symptoms goes unnoticed.
Many people are told they’re “too emotional,” “unstable,” or even given a psychiatric label that doesn’t reflect the true, hormone-driven, time-specific nature of their condition.
🔍 Why does this misdiagnosis happen?
❗ PMDD and personality disorders share some overlapping symptoms
🩸 The cyclical pattern (luteal phase) is often missed
📉 Clinicians often lack training in PMDD
⚠️ Menstrual stigma fuels assumptions and dismissals
🧬 What’s the difference?
Premenstrual Dysphoric Disorder (PMDD)
– Cyclical, tied to hormone shifts
– Symptoms appear and resolve with the menstrual phases
– Medical treatment focuses on hormones and mood regulation
Borderline Personality Disorder (BPD)
– Chronic, not cyclical
– Symptoms are present most days
– Treated with long-term therapy and sometimes medication
Premenstrual Exacerbation (PME)
– Worsening of an existing condition, such as Borderline Personality Disorder (BPD), in the luteal phase or the premenstrual phase
– Symptoms do not go away entirely in the follicular phase
People with PMDD and potentially other comorbid (coexisting) conditions deserve understanding, not a misdiagnosis. Let’s call PMDD what it is: a medical condition that requires evidence-based care and a stigma-free response.
At the same time, it’s important to recognize that diagnostic journeys are rarely straightforward. Hormones can affect many conditions, and it takes careful tracking, the right questions, and hormone-aware providers to tell them apart.
📝 Explore peer-reviewed research on this topic here:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6436806/
https://onlinelibrary.wiley.com/doi/10.1002/ab.21877