Severe PMS: premenstrual dysphoric disorder Severe PMS symptoms are rare. A small percentage of women who have severe symptoms have premenstrual dysphoric disorder (PMDD). PMDD affects between 3 to 8 percent of women. The symptoms of PMDD may include: depression thoughts of suicide panic attacks extreme anxiety anger with severe mood swings crying spells a lack of interest in daily activities .insomnia trouble thinking or focusing binge eating painful cramping bloating The symptoms of PMDD may occur due to changes in your estrogen and progesterone levels. A connection between low serotonin levels and PMDD also exists. Your doctor may do the following to rule out other medical problems: a physical exam a gynecological exam a complete blood count Your doctor may also recommend a psychiatric evaluation. A personal or family history of major depression, substance abuse, trauma, or stress can trigger or worsen PMDD symptoms. Treatment for PMDD varies. Your doctor may recommend: daily exercise vitamin supplements, such as calcium, magnesiun and vitamin B-6 a caffeine-free diet individual counseling stress management classes drospirenone and ethinyl estradiol tablet , which is a only birth control pill is also helpfull to treat PMDD symptoms If your PMDD symptoms still do not improve, your doctor may give you a selective serotonin reuptake inhibitor (SSRI) antidepressant. This medication increases serotonin levels in your brain and has many roles in regulating brain chemistry that are not limited to depression. You can’t prevent PMS or PMDD, but the treatments outlined above can help reduce the severity and duration of your symptoms. To be continued...... Dr nandini