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Premenstrual dysphoric disorder causes debilitating periods. Here’s what we know about how to treat it.

For people with premenstrual dysphoric disorder (PMDD), every month involves a struggle: feeling low and hopeless, navigating a minefield of intrusive thoughts and emotions, feeling so tired and overwhelmed that they are reduced to tears. The symptoms — which can also include depressed mood, anxiety, mood swings, irritability, sleep disturbances, difficulty concentrating and appetite changes — lift when their period starts, only to return again the next month.