Therapy for PMDD
Premenstrual Dysphoric Disorder is a severe and disabling form of PMS that goes way beyond just being moody or crampy. It’s like a switch flips in the second half of your cycle and suddenly you’re not yourself.
The good news is that it can be managed with therapy.
The most important thing I want you to know is that I believe your symptoms are real, debilitating, and incredibly disruptive.
I understand how invalidating it is when people (even well-meaning ones) minimize your experience or chalk it up to “just PMS.” I know how painful it is to reflect on a meltdown, conflict, or moment of despair and feel a flicker of relief, thinking, “Oh… I was in my luteal phase,” knowing it wasn’t really you—only to be met with silence or skepticism when you share that insight with someone else.
What makes my approach different is that I take your cyclical symptoms seriously and we work with your nervous system, not against it. My approach is grounded in compassion, collaboration, and education. We’ll get curious together. We’ll get curious about your symptoms, your history, your cycles, your needs, and your strengths.
Therapy for PMDD supports you in navigating the emotional intensity, inner critic flare-ups, and identity disruptions that can surface during the luteal phase. It’s about building tools, self-trust, and compassion, so you don’t feel lost in it every month.
As a trauma-informed therapist, I integrate:
Parts Work (IFS)
Parts work helps you understand and care for the different inner voices that show up in each phase of your cycle
Self-compassion practices
These soften the shame and self-judgment that PMDD often amplifies
Person-Centered Foundations
I’m a relational, person-centered therapist, so that you always feel seen & heard
Polyvagal Theory
Supports nervous system regulation and a felt sense of safety
EMDR
Through resourcing and—when appropriate—reprocessing, EMDR helps develop internal tools and address past wounds that may be contributing to current distress
How can PMDD be managed by therapy?
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Cycle Awareness
plus tracking so you feel less blindsided each month
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Emotional Regulation
tailored to your nervous system state
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Self-Compassion
tools for days when you feel unrecognizable to yourself
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Boundary-Setting
for protecting your energy and relationships
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Grief and Identity Work
if PMDD has disrupted your life plans, self-trust, or relationships
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Reclaiming Your Voice and Power
in both your inner world and your outer one
Have a hunch you’ve got PMDD, but don’t have a formal diagnosis?
First things first: You’re not too sensitive, and you’re definitely not alone. PMDD is real—and you deserve support. It’s a serious and often misunderstood condition that can profoundly affect your emotions, relationships, and overall quality of life.
A great place to start is by tracking your symptoms daily for at least two menstrual cycles. PMDD symptoms typically:
Occur only in the luteal phase (roughly 1–2 weeks before your period),
Resolve within a few days after your period starts, and
Cause significant disruption in your daily functioning, work or relationships.
That said, you don’t have to pursue medical evaluation right away (or at all) to start getting support. You don’t even need an official diagnosis to begin healing. In therapy, we can begin exploring what you're noticing and how it's affecting you emotionally, relationally, and physically.
What’s the difference between PMDD (Premenstrual Dysphoric Disorder), severe PMS, and PME (Premenstrual Exacerbation)?
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Most people with periods experience some level of PMS. It includes physical symptoms (like bloating, fatigue, cramps) and emotional changes (like irritability or sadness) that occur in the luteal phase, which is the week or two before your period. These symptoms can be uncomfortable, but they don’t usually cause major disruption to your daily life.
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This is a more intense version of PMS. The physical and emotional symptoms are stronger and may affect your mood and daily functioning a bit more, but they don’t typically meet the criteria for PMDD. You might feel “off” or more sensitive, but still generally feel like yourself.
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Have you ever fallen into a heap of tears on the floor when you misplaced your phone?
Felt like your life was falling apart and felt like leaving both your job and your relationship at the same time, only to wake up a few days later wondering what happened?
Had thoughts of not wanting to be alive that felt terrifyingly real in the moment, but then faded once your period started?
These are real experiences I’ve seen in my work with clients who struggle with PMDD.
PMDD is a severe and disabling form of PMS that goes way beyond just being moody or crampy. It’s like a switch flips in the second half of your cycle and suddenly you’re not yourself. Common symptoms include:
Intense irritability or rage
Depression or hopelessness
Feeling out of control or unlike yourself
Crying spells, shame spirals, or relationship conflict
Severe fatigue, anxiety, or suicidal thoughts
These symptoms only occur in the luteal phase (after ovulation and before your period starts) and go away once your period begins or shortly after. That pattern is key.
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PME is when an existing condition—like anxiety, depression, ADHD, bipolar disorder, OCD—gets significantly worse during the luteal phase. The symptoms aren’t new or exclusive to this phase, but they become way more intense and harder to manage right before your period.
Example: If you have depression all month but find yourself spiraling deeper every month before your period, that might be PME, not PMDD.
