Most of society is no stranger to mental illness. In America 43.6 million adults suffer with some form of it. Mental illness: what does that mean exactly? A disease of the mind? Postpartum mood disorders are classified by the Diagnostic and Statistical Manual of Mental Disorders as just that — a form of mental disorder.

Like clinical depression, these issues can come and go throughout life. They don’t have to be permanent to be labeled a mental illness.

That being said, there is a great wave of research blooming that suggests postpartum disorders — yes, PMDD can be one — are anything but mental. This is something sufferers of them have known for a long time. Postpartum depression affects the brain, but it doesn’t start in the brain.

The same goes for postpartum anxiety, postpartum psychosis, and another lesser known disorder that can creep up in the postpartum period — PMDD.

PMDD stands for Premenstrual Dysphoric Disorder. It looks quite similar to PPD, PPA and sometimes even PPP. Many women are incorrectly diagnosed with one of those disorders and only realize over time that PMDD is the real issue.

While PMDD can appear to develop as early as the onset of menses or reportedly from other hormonal disruptions — like using birth control — it often rears its head after a woman has had a baby.

This disorder is actually most aligned with autoimmune disease. It often goes into remission during pregnancy, like other autoimmune illnesses do. The root cause: most likely leaky gut.

Each month when the woman enters her luteal phase (the time between ovulation and the onset of menses), her body will have some unpleasant reactions to the hormonal ebbs and flows it’s experiencing.

It’s not PMS. It’s not imbalance, either, but rather an overall intolerance to those ups and downs that causes PMDD to flare. Most women with PMDD are afflicted by MTHFR — short for methylenetetrahydrofolate reductase. This gene mutation is what increases their risk for gut injury and autoimmune illness in the first place.

They also have the Val158Met polymorphism in the COMT gene. So how do you know if you have PMDD? It’ll look a little like this.

14 Extreme Bloating

Sure, women with PMS get bloated at that time of the month. A few days before their period starts, their pants suddenly aren’t as comfy. Women with PMDD wish they were that fortunate. Instead, their bloating starts around ovulation and slowly increases for the next couple of weeks.

By the time aunt flow makes her arrival, the excess water weight might be enough to make the scale jump by ten pounds.

It doesn’t stop there. A PMDD woman knows the struggle of having a small closet. You can’t deal with small storage space with PMDD when you need to keep three or four clothing sizes on hand at all times, because you might be a size 4 on day 7 of your cycle, but you’re a size 10 and living in sweatpants on day 27.

Those old standbys for treating premenstrual bloating like avoiding caffeine increasing water intake or downing some diuretics won’t work for the PMDD woman. In addition, the water retention is so bad that it causes other side effects. The excess fluid presses on nerves that cause migraines.

It gets trapped in joints causing arthritic pain. It makes PMS look like a walk in the park.

13 Overreaction To Stress

Oh my. Understandably, no one likes stress. Alright, a few select people on the planet may thrive under it, but for most of us it’s unbearable. We want to put a stop to it as soon as we can. People resort to substance abuse just to check out from stress. Why? It makes us worry and preoccupies our minds with negative thoughts. It also causes physical tension.

However, for the woman affected by PMDD, stress is the catalyst that will make or break her this month. It might spell the end of her career if she can’t keep it together under a deadline. For the PMDD woman, it doesn’t have to be insurmountable stress, either. Stress releases cortisol and PMDD clashes with cortisol like America and the Middle East.

For the woman with PMDD, she may be preparing to go to a family gathering with her husband and children when a relative calls and asks them to pick up something from the store on their way. This change in plans might be a minor annoyance to most anyone that they quickly bounce back from. But the PMDD woman reacts violently to cortisol and will not be able to calm down until that hormone is back in check. Cortisol is one of the reasons that PMDD is not strictly premenstrual, because PMDD women are intolerant to many hormones, not just the intimate ones.

12 Wild Mood Swings

This is one of the toughest parts of living with this illness. It will make you loathe the ones you love. No joke; those hormones are powerful chemicals. Just as some people can’t eat nuts without an anaphylactic response, some people can’t handle that surge in estrogen at ovulation time or the sharp drop in progesterone a week out from their period.

Think about what it must feel like to essentially be allergic to your own body. There is no escaping it. Some women will resort to drastic measures getting a hysterectomy to try to rid themselves of the cyclical nature of PMDD, but the majority are left with other issues, and often new ones arise as a result of further disrupting the body’s natural cycle.

These women can wake up the day before ovulation feeling energized and excited for date night the next day and by the time it arrives, they hate their partner.

Yesterday they loved their job and were motivated to tackle the project their boss has entrusted them with, and today they can’t believe the stress on their plate and are convinced they aren’t good enough for this job. They just know they’re going to fail. Their boss is an ass, end of story.

It doesn’t have to be that major, though. Sometimes it’s as simple as the barista getting your coffee order wrong and before you know it you’re telling him where to stick that latte.

11 Intense Irritability

This goes back to stress a little bit but cortisol isn’t the only problem. Obviously stress doesn’t have to be a factor for something to bother us. Maybe the front door didn’t shut all the way and we have to walk back and close it. On a normal day for your average person, this isn’t a big deal.

But for a woman who is enduring life under the cloud of PMDD, it’s the icing on the cake of every single minor annoyance that has been building in her mind all day.

Getting ready for work that morning, she couldn’t get her makeup right since her skin is dry yet breaking out. Then she burnt herself with the curling iron because PMDD throws off her equilibrium and makes her lose her balance and coordination. Then her pants didn’t fit because it’s day 24 and she’s retaining enough water to fill a Culligan jug.

Her coworkers chewed too loudly at work. Her boss gave her some constructive criticism but it’s her worst week of PMDD this cycle and she couldn’t help but take it to heart. So she’s been telling herself internally all day what a screw-u she is.

By the time she got home to the door that wouldn’t shut, the kids were screaming (playing joyfully) and her husband was complaining about dinner (asking if he should order takeout since it’s day 24). When it’s PMDD, everything is misinterpreted and internalized.

The result, she’ll snap — at her coworkers her boss, her kids, her husband, and herself.

10 Craving More Food

Oh my goodness. This one might sound a little like PMS, but rest assured the 85 percent of women who experience PMS have nothing on the 3 to 9 percent that experience PMDD in this department. I would liken a woman’s appetite while enduring PMDD to one of the octomom when she was pregnant.

When a woman enters the luteal phase of her cycle, magnesium and B vitamins diminish. This imbalance of nutrients causes her to start craving food. Unfortunately, the cravings might miss the mark, because all she wants is ice cream, chocolate, sugar, popcorn, potato chips, sugar, biscuits, and a little more sugar.

Her body is depleted of energy, and feeding it this food only makes for a vicious cycle of low energy, causing it to crave more food. I kid you not; PMDD women can eat their weight in processed treats.

Likewise, food is one of the major catalysts for PMDD. It all goes back to leaky gut. Women with PMDD need to avoid synthetic folic acid, processed foods, non-sprouted grains, inflammatory foods, dairy, and sugar.

These foods cause toxins to leach into the bloodstream through the injured gut, and MTHFR impairs the PMDD woman’s ability to detox from those toxins. This leads to hormones surging and the body and mind going haywire and the cycle just keeps repeating.

9 Deepening Depression

This is often where the incorrect postpartum depression diagnosis comes in. Women often feel sadness after the birth of their babies. It’s a time in their lives when they are overwhelmed by fluctuating hormones. In most cases, it’s just the baby blues, which affects about 70 percent or more of new moms.

This bout of temporary depression tends to come on around one to two weeks postpartum and lift within a week’s time.

Unfortunately, doctors and suffering women often jump the gun and start trying to treat these bouts of sadness with prescription antidepressants before the woman’s body has been able to bounce back from it. In addition, very few doctors even test a woman’s hormones first to make sure the problem isn’t merely imbalance — which it most often is.

For a lot of these ladies, they assume it can’t be PMDD because they just had a baby and their period hasn’t returned. This is again where that premenstrual title is misleading. PMDD is simply intolerance to the fluctuation of hormones.

That means it can present with or without ovulation, and those hormones are certainly going wild after women have babies. Likewise, a woman can ovulate as soon as three weeks after birth.

The depression that PMDD forces upon women is grave. Some won’t make it out of bed for days at a time. They’ll attend social events that they’d looked forward to for months with a cloud above them that prevents them from enjoying it at all. In fact, it’s more of a burden than anything else.

They hate themselves, their families, their jobs, their house, their responsibilities and more. Although this depression lifts after menses start each cycle, they still can’t feel anything but despair.

8 Increased Anxiety

At one point or another, almost all of us experience anxiety. It might not be crippling, but we worry ourselves enough to affect our lives. We waste time thinking about what can go wrong in certain scenarios. We obsess over whether a guy likes us or not, whether a new friend likes us or not.

The PMDD woman worries about whether her husband likes her or not.

She might worry every month about the quality of the work she is submitting to her boss having noticed that his critical commentary always follows her bouts of depression. She knows she can’t work as well during PMDD weeks, but what is she supposed to do — only work one or two weeks each month?

When worry creeps up, adrenaline is released and these women often end up in fight or flight mode and reacting violently. Keep in mind, it’s not the worry that is causing her to freak out, it’s the adrenaline.

Listen up, ladies. Anxiety is not a normal part of PMS. When you enter your luteal phase, you should not suddenly be afflicted with concern about whether or not your spouse is cheating, if your in-laws like you, whether the neighbors can hear you arguing, or if you coworkers are all talking about you behind you back.

Likewise, if you’ve recently had a baby, it’s normal to worry about the baby. It’s not normal to sit up all night, every night, watching them to make sure they’re breathing.

7 Rage And Anger

Thy self, or, everyone else. As soon as I think about the rage that PMDD brings with it, I can’t help but feel bad for the poor family members that have to endure this wrath. The PMDD woman might get a little snarky and snippety when ovulation hits, but the rage is usually reserved for closer to that time of the month when progesterone is dropping further and there is no oestrogen to speak of to cheer a lady up.

I’m not talking about your typical bitchy griping about your husband not helping out enough or the kids not listening. I’m talking about full blown rage fests where you’re throwing his work shirts on the lawn and telling him it’s over.

When you’re not in luteal (or recovering from pregnancy), your relationship is a pretty solid one, but come time for those hormones to flex all bets are off.

Some women are so deeply driven into a place of anger and resentment that they turn inward and take it out on themselves. Cutting is quite common among women with PMDD, as is substance abuse.

Likewise, the self-doubt and inner hatred that they spew in their minds all day as they shame themselves and feel endless guilt for their harsh words and irrational behavior is enough to send anyone over the edge.

6 Suicidal Ideation

Over the edge some will go. Sadly, women do lose their lives to this condition. When the going gets tough, some of these women are just plain worn out. They can’t do it any longer. Month after month, year after year with the illnesses seemingly getting worse — as it’s known to do with age — they give up.

They’ve usually tried the antidepressants that take the edge off for roughly half of PMDD women and don’t work at all for the rest. They’ve tried the birth control and that makes many of them worse off because of progesterone intolerance and just doesn’t work for a lot of others.

Natural supplements didn’t help, usually because they didn’t know about the importance of healing leaky gut. So they look for an out.

It doesn’t really matter how it happens. Suicide leaves so many questions for those who are left behind. It leaves heartache that doesn’t fully heal because there is never any kind of resolution or purpose. It will never make sense why a woman is tortured with this illness — one that could lead her to her death.

Women like Gia Allemand deserve recognition of the illness that stole their lives, both while they were alive and in death. Organizations like the Gia Allemand Foundation seek to make this possible.

5 Paranoia

Some people think anxiety is the same as paranoia. PMDD makes it quite clear that they are not, though they often accompany each other. Anxiety is perpetual worry with no real purpose.

It’s the reasoning behind the mothers who are so worried about SIDS that they can’t sleep, even though they have a healthy baby peacefully sleeping next to them. It’s the reason women with PMDD can’t stop worrying that they’re going to get fired from their job when they’ve done nothing wrong.

Paranoia is much more intense. As a part of illness, it’s far more serious than the connotation we usually lend to this word. We might call someone paranoid, but actually suffering from paranoia as a condition is a whole other story. These women may suffer from delusions. They might actually believe they’ve seen things happen that didn’t happen.

The PMDD woman might misinterpret everything her husband says. When he remarks that an actress on television is attractive, she might then become obsessed with the notion that he no longer finds her appealing and would rather be with this other women.

It’s severe enough that she’s shudder every time she sees that actress again for the rest of her life, and there’s nothing she can do about it. Realistically, there was never any concern that her husband was going to leave her for a Hollywood starlet, but her hormones cause her to feel something entirely separate of what logic portrays.

4 Trouble Concentrating

Women and men alike have this problem throughout life. In an age where we are being beckoned by DVRs, iPhones, toddlers, work, market lists, and the nap we wish we had time for, it’s hard to focus on one thing at a time. Besides, aren’t women supposed to be multitaskers?

Throw PMDD into the mix and the result is likely to be cataclysmic. This is where that constant self-doubt about being a career woman comes in. Staying on task becomes almost impossible if those hormones are on shaky ground. It’s been compared to having a sudden onset of Attention Deficit Hyperactivity Disorder.

Interestingly enough, ADHD is also linked to leaky gut, which allows candida to take over. Candida overgrowth causes the brain fog and inattention, and it’s worsened by estrogen. Leaky gut allows candida to fester, which influences estrogen dominance, and estrogen fuels candida growth, and the vicious cycle repeats itself.

3 Increased Sensitivity To Pain

PMDD women are definitely notorious for being labeled as too sensitive, and that label might not be too far off. Taking the negative connotation out of it, it’s not their fault that their body is overly sensitive to their natural hormones. They aren’t trying to act of character and usually don’t mean the things they say and do, but they’re in pain.

On one hand, the emotional pain these ladies feel is extremely heightened. What wouldn’t have bothered her last week has her gritting her teeth this week. What delighted her about her partner just the other day is now the most annoying thing he’s ever done.

If there was a better name for Premenstrual Dysphoric Disorder, it would be Jekyll/Hyde Disease.

On the other hand, physical pain is also more severe for the PMDD sufferer. It’s not that she necessarily feels pain more strongly than someone else — though that is likely. It’s that she’s feeling things much more strongly than even she is used to.

When that off kilter balance strikes and causes her to hit her head, it might actually throb for hours and cause a headache. Speaking of headaches, expect more of those when you’re dealing with PMDD, too. Fabrics seem more abrasive. Temperatures seem to fluctuate more. Physically, her senses just go through the roof.

2 Inflammation And Swelling

Here’s where the autoimmune part plays a strong factor. Women with PMDD are known to be suffering from some type of chronic inflammation. For reasons we still don’t fully understand, their hormones exacerbate this inflammation.

There have been multiple theories surrounding where this inflammation occurs. It is likely throughout the whole body.

Many women have sought hysterectomies in an attempt to remove the uterus and ovaries. The belief has been that the uterus may be inflamed and removing it would remove PMDD. Likewise, they believe that removing the ovaries would remove the gender hormones and that the disorder would then dissolve. This isn’t exactly true, though.

While some women do improve following the surgery, others worsen. Some will also develop new problems as a result, like fibromyalgia — another disorder that is thought of as a mental illness yet we now know may be autoimmune. PMDD is always present.

It is an over-sensitivity to many hormones, not just progesterone and estrogen. Removing the ovaries may lessen some symptoms, but those same hormones are made in other areas throughout the body so there is no way to be completely free of them.

The inflammation is a result of histamine — another hormone PMDD women are intolerant to. It wreaks havoc on the body and is released in copious amounts from — you guessed it — the brain. Histamine also causes more estrogen to be produced.

Progesterone acts as a natural anti-histamine. So when it stops in the last week of a woman’s cycle, all that histamine floods the body and causes mayhem and inflammation. Hello, cramps!

1 Fighting With Their Partner

Through my time in running the PMDD Support Red Tent group on Facebook, I’ve met and spoke with many sufferers of this illness. Often, newcomers enter just trying to figure out if that’s what’s going on with them.

Sometimes it’s been going on for so long they can’t remember when it started. Other times they came off of birth control and found themselves forever changed, and some women have a baby and end up trapped in this cycle of hormonal hell.

I asked them all the same question when they start routinely listing their PMS-type symptoms, “Are you fighting with your partner?”, or past tense for those whose relationships didn’t survive the battle. When they say “OMG yes!!!” you can almost bet it’s PMDD.

They break up with their partners and regret it moments later. The next day, they break up with them again, and regret it again. Look for the cyclical nature of this disorder, but don’t rule it out just because it doesn’t go away exactly on day 1. Most women don’t find relief until day 3 to 6 of their next cycle.

If a relationship or marriage can withstand what PMDD puts it through, I’m willing to bet you’re right where you’re supposed to be. Finding a partner that understands enough to stand by you and not blame you is not a common occurrence.

Consider yourself lucky, but don’t discount yourself and believe that you aren’t worthy of their patience and loyalty.

We are all behaving in accordance with what our hormones are telling us to do. They’re why you fall in love and why you’re attracted to your partner. You might be able to resist knockin the boots, but can you turn off your natural attraction to someone? Oxytocin makes you fall in love.

The big 'O' makes you release oxytocin. Why don’t you try to have one, but prevent your body from releasing that hormone? Or force yourself to hate someone you love. That is what the world asks of women with PMDD in a sense.

It asks them not to respond to the natural cues their hormones impose upon them. How would it feel to police yourself all day? Get it?

Sources: National Institute of Mental Health, Women’s Health, Fit Pregnancy