Q. I have the same type of problem as the woman in question #1, except that it is so severe, I really get badly depressed and often miss several days of work and my boyfriend avoids being around me, because I am so hard to get along with!

A. It sounds like you have a more severe form of PMS that is termed Premenstrual Dysphoric Disorder (PMDD). About 5% of fertile woman are affected. Again, we are not sure what causes this disorder, although it is suspected that chemical changes in the brain, and hormonal changes are involved. The symptoms of irritability, anger, and depression surface between ovulation and menstruation, and promptly resolve upon menstruating.

This disorder is more severe than PMS because it does interfere with occupational and or social functioning. The treatment is very similar to PMS with drugs such as Prozac and Celexa being very useful, including just during the luteal phase (between ovulating and menstruation). However, it is probably prudent to involve a psychiatrist as well for this PMDD.

For more info: National Depressive Association 1-800-826-3632.

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