PMDD vs Bipolar Disorder: Understanding the Difference

Mood swings can be disruptive no matter their cause. At Next Step Psychiatry in Lilburn, we help women throughout metro Atlanta distinguish between PMDD (premenstrual dysphoric disorder) and bipolar disorder—two conditions that can look similar but require different treatments.

What Is PMDD?

PMDD is a severe form of PMS affecting up to 10% of menstruating women. Symptoms occur in the week or two before your period and include extreme mood shifts, irritability, anxiety, depression, and physical symptoms like bloating and fatigue. Symptoms resolve shortly after menstruation begins.

What Is Bipolar Disorder?

Bipolar disorder involves distinct episodes of mania (or hypomania) and depression that can last days, weeks, or longer. These episodes occur independently of the menstrual cycle and involve more extreme mood states—euphoric highs with decreased sleep and increased energy, followed by depressive lows.

Key Differences

• Timing: PMDD follows the menstrual cycle; bipolar episodes occur independently
• Duration: PMDD symptoms last about 1-2 weeks monthly; bipolar episodes can last much longer
• Mania: PMDD doesn't include manic or hypomanic episodes
• Treatment: PMDD often responds to SSRIs and hormonal treatments; bipolar requires mood stabilizers

Can You Have Both?

Yes. Women with bipolar disorder may also have PMDD, which can worsen bipolar symptoms premenstrually. Accurate diagnosis requires careful tracking and professional evaluation.

Getting the Right Diagnosis

Track your symptoms and their timing. Note when mood changes occur relative to your menstrual cycle. This information helps our team distinguish between these conditions and create an effective treatment plan.