Premenstrual dysphoric disorder (PMDD), often rejected as part of being a woman or simply ignored as “PMS only,” is at the intersection of two deeply labeled problems in India – menstruation and mental health.
“If the whole world is uncertain about its future, then why are we here? What’s the point? ”
Namrata Menon, a 24-year-old journalist, was conquered by existential fear during a nationwide lock to fight coronavirus in 2020. They were scared — the lock had increased the feelings of paranoia and anxiety that caused Premenstrual Dysphoric Disorder (PMDD).
PMDD can have a global impact One in 20 women. But few are aware of its existence, and few continue to be diagnosed. Although there have been discourse the effects of the pandemic on women and people with an explosive increase in menstruation irregular episodes and stress-induced PMS symptoms, For people like Namrata who live with PMDD, the pandemic brought with it an extra calculation of their physical and mental well-being. The second wave of the virus is destroying India, so it is imperative to address it impact on mental health and therefore how disorders such as PMDD – which can be exacerbated by stress – may occur in the coming months.
Often, PMDD is distinguished as “part of being a woman” or simply ignored as “PMS only.” PMDD is at the intersection of two deeply labeled problems in India – menstruation and mental health. Diagnosis of PMDD remains a privilege because there is not very much information in the country. Mayo Clinic describes PMDD as a “severe, sometimes debilitating, sequelae of premenstrual syndrome (PMS)” and blurred line between these disturbances is often mentioned as a key factor that prevents accurate and timely diagnosis.
This explanation, although simple, omits the more serious elements of what makes the disturbance so debilitating. PMDD can occur through both physical and mood disorders, ranging from breast tenderness, swelling, and extreme cramps to depression, anxiety, and even suicidal thoughts. In fact, there is a clear difference between the disorder and PMS: as M *, who has lived with PMDD since 2016, described it, “” dysphoria “- a deep accident or restlessness – is what really stands out, and it’s important to shed light on what [PMDD] can do for your self-image and worldview. “
Different Manifestations of PMDD can be as diverse as intense: many people may experience fatigue, physical pain, and brain fog early in their period. They are often unable to think clearly and are exposed to strong doubts and anger. “I don’t think PMS makes you feel 10 times heavier than your own weight, or makes you feel so uncontrollable and furious that you don’t want to believe it’s you,” M explained. This is complicated by the fact that these premenstrual symptoms also usually disappear at the beginning of the season itself. “You feel like an alter ego or some other version of yourself,” M added, emphasizing the constant flow that is characteristic of this disorder.
The stress and anxiety caused by the ongoing pandemic have been significantly detrimental to menstrual bleeding. Dr. Kiran Coelho, director of gynecology at Lilavat Hospital in Mumbai, highlighted the scale of the problem: “Nearly 10 percent of my patients now have PMDD. Those with PMS symptoms in the past [the pandemic] have now developed PMDD as a result of the external stressors they face, “he said. Dr. Coelho also shared that PMDD has been common among those recovering from COVID and that despite ongoing research coronavirus
The fact that these stressors have disproportionate sexual effects is not surprising as they face unpaid nursing work in their homes. The outbreak of the pandemic also proved cases of domestic violence and exploitation reported at the Office of the National Advice Center for Women. These stressors, combined with the uncertainty and hopelessness caused by the pandemic, are likely to have exacerbated the prevalence of PMDD across the country.
While the nation continues to struggle a mental health crisis in addition to a pandemic, the identification and diagnosis of disorders such as PMDD is critical, given how often injury to its symptoms can be. Anuhya Korrapati, founder BeyondBlood, a non – profit organization that provides evidence – based health information to support menstruation, highlighted the anonymity of PMDD in the medical community. “I was indeed diagnosed in the UK,” he said. “I couldn’t get a diagnosis here because my Indian doctor just rejected it as PMS or gave me contraception.”
Lockout has also made the management of PMDD more challenging as it is highly dependent on lifestyle changes as well as medical and psychotherapeutic interventions. Physical activity and social interactions, which are known to help control the disorder, have been severely disrupted since the introduction of India’s first lock in March 2020. Movement restrictions and future uncertainty have significantly increased symptoms for some. “Controlling this has been so difficult during locking. Fresh air and walking are usually helpful, but when you can’t leave the house, a lot of coping tools are taken away from you, ”M.
However, the lock has also encouraged people living with PMDD to take responsibility for their own mental and spiritual well-being. Anuhya’s lock allowed her to focus on exercise and healthier eating. “I think PMDD varied during quarantine, but I was able to build the resources needed to manage it.” Similarly, M was able to restart therapy by working to rebuild the tools needed to cope with the disorder. “The lock has been an opportunity to be truly present with myself,” he said. “One of the hardest things with PMDD is just showing up. It made showing up [for meetings and university] easier than before. “
Despite the myriad challenges that PMDD patients have faced over the past year, there is reason to be hopeful. The PMDD community is growing both in India and abroad. Kolkata-based Therapist Saniya Sidhu explains the importance of this solidarity: “The main supporting factor is to recognize and reinforce the anxiety associated with PMDD. To combat isolation, it is also important to get information from skilled professionals and find a community to share experiences. to help people like them feel supported and seen. “Getting a strong support system is so important to make it easier to manage [the disorder]Said Anuhya, who is with Namrata IAPMDtrained peer service provider. Pages like @ pmdd.india have provided a refuge for those trying to understand their experiences and navigate their own health journeys.
Similarly, more and more attention is being paid to sexual and reproductive health as well as mental health. Proactive for him, a digital health platform, began arranging treatment districts during the pandemic. The purpose of these districts was to build a support system for menstruators and to help those living with them better understand their own bodies. Especially during lock isolation, these groups can be catalytic, leaving PMDD patients a safe space to share their experiences.
However, access to both information and support remains limited. Saniya highlights this critical challenge: “I notice more discussions about PMDD. However, they all happen on social media, which means that this information only reaches a specific population group that has an Internet connection. “Building this access is therefore crucial to ensure that resources are available to achieve during these turbulent times. For example, BeyondBlood has a revised list of medical and mental health professionals who are well versed in PMDD treatment and management. Similarly, Anuhya aims to ensure that resources for the disorder are translated into regional languages, which increases accessibility and minimizes scientific jargon.
Discussion among younger physicians about the disorder has increased. According to Dr. Coelho, raising awareness is a cornerstone for the advancement of more compassionate drug therapy. “We need to understand how these stressors affect PMDD patients, and therefore how to be more empathetic,” he said. He sees men playing a key role, especially in ensuring that the periods around them are able to manage PMDD and get the treatment they need. This can range from sharing the care burden of households to doing research to better understand the disorder and, most importantly, empathic and compassionate.
The journey forward is still complicated. Namrata has admitted that access to a psychiatrist aware of PMDD is still rare. While the pandemic has pushed the debate even further, it is not yet far from what attention it needs to respond adequately. Concerns about PMDD emerge scarcely from those living with it because they, too, may not be aware of what it is. There is still little data to estimate how many people live with PMDD in India – or how dramatically this number has changed since the pandemic broke out.
Tackling a disorder for which there is no cure requires the constant defense and support not only of the people who live with it, but also of the people and systems around them. PMDD can only be addressed through a community-based reproductive and mental health system and well-researched public policies aimed at combating social stigma rather than further strengthening it. Finally, there is still an urgent unmet need to give patients a voice and reinforce their experience. Getting this safe space can make all the difference in the future, Namrata remarked, “I have to be loud about my experiences to get people to believe in me and what I’m going through. If I get them to do that, maybe they’ll be kinder to me or someone else in the future.”