Premenstrual dysphoric disorder, or PMDD, is a severe pattern of mood and body symptoms tied to the menstrual cycle. It is more than ordinary premenstrual discomfort. Symptoms usually begin in the week or two before a period. They ease within a few days after bleeding starts. The pattern needs to show up across most cycles, not just one hard month. Notes from two cycles help the conversation. Dr. Ijeoma Mbionwu, DNP, PMHNP-BC, listens before any plan is discussed.
Mood can swing quickly from sadness to anger. The shift often clusters in the days before a period.
Irritability may feel out of proportion. Small comments can spark conflict that later feels unlike you.
A heavy, hopeless mood may arrive before bleeding starts and lift once the period is underway.
Tension or feeling on edge may build in the late cycle, even when nothing else has changed.
Reading, work, or a simple decision can take more effort in the days before a period.
Bloating, breast tenderness, headaches, or joint aches may arrive with the mood change before bleeding.
Deadlines, classes, and meetings may feel harder in the late cycle, then easier once bleeding has started.
Sharp reactions can strain talks at home. The conflict may ease after the period begins.
Sleep may turn light or broken in the days before bleeding, with fatigue close behind.
Meals, errands, and plans may slip during that window and feel more manageable afterward.
A calendar makes the pattern easier to see. Mark mood, sleep, irritability, and the first day of bleeding for at least two cycles. Bring those notes to the visit. Symptoms that cluster before the period and lift afterward point toward PMDD. Low mood or worry that stays all month may fit depression or an anxiety disorder instead. An OB-GYN or primary care provider can review cycle health alongside this visit. Those conversations can sit together.
Care looks at the whole person: sleep, stress, relationships, physical health, other conditions, and goals. The plan is personalized and evidence-based, from a board-certified PMHNP, in Orlando or by telehealth across Florida.
A visit reviews cycle timing, mood, sleep, health, and how the hard days affect life.
Medicine may be discussed when it fits the cycle pattern. Side effects are reviewed over time.
Talking through stress and relationships may support care alongside other parts of the plan.
Later visits compare notes across cycles and leave room for questions about the plan.
The visit starts with your cycle notes, sleep, health, medicines, and what feels hardest.
From there, you and your provider discuss options that fit your needs and daily responsibilities.
Follow-up visits leave room for questions, side effects, and changes across the next cycles.
If mood changes before your period are disrupting daily life, Schedule Your Appointment or Call 407-616-1691. Visits are in Orlando or by telehealth across Florida. If you are in crisis, call or text 988 or call 911.
Getting started with StarMaris is simple. Please complete the forms below before your first appointment to help us provide timely, personalized psychiatric care. Referring providers can submit patient referrals securely online. For questions, call us at 407-616-1691.