Severe Mood Disorder Is Not Major Depression

By Devaki

Thursday, April 1, 2010, 14:05

The premenstrual dysphoric disorder (PMDD), also known as severe mood disorder, is biologically different from major depression, says the experts. PMDD is often misdiagnosed as major depression or other mood disorder. They also inform that the history of depression affects how the women with PMDD respond to stress and pain.

“PMDD causes severe impairment in the quality of life, which can be equivalent to post-traumatic stress disorder, major depressive disorder and panic disorder. This continually cycles on a monthly basis. Some women spend half their lives suffering from this disorder," says the doctors. They reiterate that PMDD is not garden-variety premenstrual symptoms.

“This new finding give physicians more reason to search for a more specific diagnosis. It could also lead to more precise treatments, of which there are currently few good choices," thinks Dr. Susan Girdler, professor of psychiatry at the University of North Carolina at Chapel Hill School of Medicine who led the study.

In the study, the researchers measured biological responses to stress and pain.

Previous studies demonstrated that women with chronic major depression have a heightened biological response to stress and release more stress hormones, such as cortisol. The women with PMDD respond conversely, with blunted stress responses. Only the PMDD women with prior depression had lower cortisol and greater sensitivity to pain compared to non-PMDD women with prior depression. The current study is the first known head-to-head comparison of the two groups and confirmed the earlier findings. So PMDD and major depression are really two distinct entities in terms of biological response to stress and with respect to pain sensitivity and pain mechanisms.

These differences between PMDD and non-PMDD women were not seen in women who had no depression history. So the history of depression may have special relevance for women with PMDD with respect to stress hormones and pain response.

The Current treatments for PMDD are effective in only about half of women.

Gathering more biological clues about PMDD could expand the treatment options, think the experts.

The study has been published in the journal Biological Psychology.