The menstrual mood disorder that makes you feel like 'Jekyll and Hyde'

Women afflicted by a severe menstrual mood disorder describe feeling like "Jekyll and Hyde," according to a Scotland-based researcher.

Premenstrual dysphoric disorder - or PMDD - affects around one in 20 women and people assigned female at birth and can cause debilitating emotional, cognitive and sometimes physical symptoms.

Lecturer in Public Health at the University of the West of Scotland, Lynsay Matthews told Nine to Noon the disorder was different from PMS (premenstrual syndrome).

"With PMDD there's very debilitating changes in mood that come at quite a severe and frightening level such as changes in anger, irritability, anxiety, low mood and it has a much higher rate of suicidal thoughts and suicidal behaviour."

Matthews said those with the disorder had a brain that reacted negatively to normal hormonal fluctuations, with symptoms appearing and vanishing with a rapidity that was disorienting.

"It has a very specific timing, so PMDD is in the luteal phase of the monthly menstrual cycle. So for one or two weeks every month people will have symptoms and then when they start their period the symptoms can very, very quickly disappear.

"So they have this cyclical pattern of where they describe themselves as living a double-life or a dual personality or a Jekyll and Hyde-type personality, which can be quite frightening and quite confusing for them.

"They may have heightened sensitivity to rejection, a lot of relationship conflict with their loved-ones or colleagues around them. They may have big changes in their cognition such as how they make decisions or their attention span, and in some cases, some people may have physical symptoms."

Matthews said research showed the majority of women with the disorder experienced suicidal thoughts and one in three would make an attempt.

More than half of those with the condition self-harmed, she said.

Matthews said the disorder was recognised in 2013, but despite its severity remained relatively unknown resulting in under-diagnosis and misdiagnosis, sometimes mistaken for bipolar or borderline personality disorder.

She said the majority of women experienced symptoms for 12 to 20 years - usually at a time when they were pursuing higher education, careers, or a family - before learning they had PMDD.

She hoped a tool, based on a suicidal behavioural model and developed with a team of colleagues, would improve rates of diagnosis by zeroing in on key differences between those with PMDD and the general population.

Matthews said women with PMDD were more likely to be neurodivergent and experience suicidal ideation at specific phases of the menstrual cycle be post-partum or peri-menopausal.

She said the model could be used by a range of frontline healthcare professionals such as general practitioners, mental health crisis teams or clinical psychologists.

She said the aim was to help those in healthcare understand the types of questions to ask patients.

Matthews said once there'd been a diagnosis, treatment options ranged from "very specific anti-depressants" taken during the luteal phase of menstruation, to hormonal contraceptives to prevent fluctuations and in severe cases inducing menopause either chemically or surgically.