Q: Is it possible someone can have PMDD & have it be confused with
Bipolar disorder. Does it mean if a person tried a suicide attempt that it
strictly classifies he or she as Bipolar? Do people with PMDD attempt suicide?
Dear Mia --
Well, this is one of those "there is a long answer, and a short answer" things.
I'm going to try for the short answer. For the long answer, I would recommend
that you learn a lot about the idea of the "bipolar spectrum". My
website on bipolar II might be a good start there.
The short answer, in my personal opinion -- as there is very little research
directly on this question, to my knowledge -- is contained in the following
picture (from my separate page on
hormones and mood):
The picture is intended to illustrate that there is a continuum from "PMS"
(premenstrual syndrome) through "PMDD" (premenstrual dysphoric disorder, the
somewhat more official name for severe PMS), to bipolar disorder (shifts of mood
and energy severe enough to warrant both treatment and a label, which occurred
not just prior to menses but throughout the month).
Considering suicide, or making an attempt, probably probably indicates a
condition which is "severe enough to warrant both treatment and a label",
wouldn't you say? I think most people would say yes.
Technically, if a woman has major depression, she
should not be diagnosed as having PM DD. The former "trumps" the latter,
diagnostically, in an official terms. Bipolar disorder includes episodes
of major depression. It is differentiated from major depression by also
having other symptoms suggestive of "maniac". This is getting into the
long answer. Again, I would refer you to a page on my website.
In real life, it is clearly obvious that women can have both: they can have
an underlying mood disorder (either major depression or bipolar mood cycling)
and also have severe exacerbations of their mood problem just prior to menses.
In this case, technically, they do not have "PMS" or "PMDD", they just have a
worsening of their illness that is associated with their reproductive cycles.
We know that people can be suicidal in association with major depression and
bipolar disorder. But can a woman become suicidal from PMDD alone? In other
words, can she have no other symptoms throughout the month, except the last 10
days prior to menses, and then become suicidal during that premenstrual phase?
That's an interesting question. Not knowing if anyone has even studied
this,I've put the words PMDD suicide in the search engine at the national
Library medicine (pub
med). two articles appear. They both might be of interest to you, although
they both are rather technical -- and the bottom line of each contradicts the
other! One says that suicide is associated with PMS, and the other finds the
Baca-Garcia Or so I would interpret from reading the abstract alone,
which is always a little tricky. If you are really interested in this, you
might want to dig up those articles.
Thank you for an interesting question.
Published April, 2008