Back to Healthcare
PMDD Treatment for Psychiatrists

PMDD Treatment for Psychiatrists

Integrated approach for severe psychiatric symptoms

PMDD is often only recognized in your consultation after women have been treated for depression or anxiety disorder for years without lasting effect. The cyclical nature, the severity of symptoms (including suicidal ideation in 30% of women) and the risk of misdiagnosis as bipolar disorder make PMDD a complex but treatable condition. The PMDD Resilience Program offers evidence-based lifestyle support alongside your medication and/or psychotherapeutic treatment, with specific attention to crisis prevention and emotion regulation.

Impact in numbers

30%
Of women with PMDD have suicidal thoughts during luteal phase
70%
Improvement in symptoms with combined SSRI + lifestyle approach
50%
Reduction in hospitalizations and crisis interventions

Common challenges in your practice

These situations probably sound familiar. The PMDD Resilience Program offers a solution.

Misdiagnosis as bipolar disorder

The rapid mood swings of PMDD resemble bipolar disorder, but the cyclical pattern (linked to menstrual cycle) distinguishes PMDD. Wrong diagnosis leads to ineffective treatment with mood stabilizers.

Suicidality during luteal phase

Women can go from stable to acutely suicidal within days. Traditional safety plans are often inadequate because the risk period recurs cyclically.

Comorbidity with other conditions

PMDD often occurs alongside PTSD, ADHD, or a history of depression. Treatment must take both conditions into account.

Treatment resistance

Some women respond insufficiently to SSRIs. Hormonal treatment or ovarian suppression may be necessary, but not all psychiatrists are familiar with this.

Benefits for your patients

Direct benefits for your patients and your practice

  • Differential diagnosis support: Cycle tracking helps distinguish PMDD from bipolar disorder, depression and borderline
  • SSRI optimization: Education on intermittent vs. continuous SSRI administration, including uptitration protocol
  • Crisis prevention: Safety plan specific to luteal phase with crisis line integration and emergency contacts
  • DBT skills for emotion regulation: Radical acceptance, distress tolerance and mindfulness adapted to PMDD
  • Cognitive restructuring: CBT techniques to recognize and adjust negative thoughts during luteal phase
  • Comorbidity management: Strategies for women with PMDD + PTSD, ADHD or trauma history
  • Medication adherence: AI reminders and motivation to use SSRI consistently, also during follicular phase
  • Strengthen social network: Communication training for partner and family to improve support during luteal phase

What makes the program effective?

Evidence-based psychotherapy: DBT and CBT protocols specifically adapted for cyclical symptoms

Crisis management tools: Safety plan, emergency contacts, crisis line integration for acute suicidality

Neurobiological education: Explanation of role of allopregnanolone, GABA and serotonin in PMDD

Tracking and monitoring: DRSP questionnaire, mood diary and suicidality screening per cycle

Lifestyle as medication: Omega-3, vitamin B6, calcium, magnesium to support SSRI effectiveness

Sleep optimization: Protocols for sleep hygiene, dealing with luteal phase insomnia

Case examples

Practice examples from our pilot

1

Case: 29-year-old previously diagnosed with bipolar disorder type II

Patient had used lithium for 5 years without effect. Mood swings turned out to be 100% cyclical (14 days stable, 14 days depressed/irritable). PMDD diagnosis made, lithium tapered and sertraline 100mg continuous started. Referred to program for DBT skills. After 4 months: symptoms 80% reduced, no more admissions needed. "I am not bipolar, I have PMDD."

2

Case: 35-year-old with recurrent suicidal crises

Patient had extreme suicidal thoughts 3-4 days every month, leading to 2 admissions per year. After PMDD diagnosis: escitalopram 20mg continuous + luteal phase safety plan made in program. Early warning signs identified (day 21-23 cycle). After 6 months: no admissions, 1 crisis consultation. Patient can now predict when risk increases.

How it works

Easy referral in 5 steps. No additional administrative burden for your practice.

  1. 1

    Differential diagnosis: Use prospective cycle tracking (2+ cycles DRSP) to distinguish PMDD from bipolar disorder, depression or borderline

  2. 2

    Start medication: Start SSRI (sertraline 50-150mg, fluoxetine 20-60mg or escitalopram 10-20mg) intermittent (luteal phase) or continuous

  3. 3

    Safety plan: Create together with patient a crisis plan specific to luteal phase, including warning signs and emergency contacts

  4. 4

    Program referral: Refer to PMDD Resilience Program for DBT skills, CBT techniques and lifestyle interventions

  5. 5

    Monitoring and adjustment: Evaluate monthly symptoms, suicidality and medication response. With treatment resistance: consider referral gynecologist for hormonal suppression

Ready to start?

Start referring

Schedule a no-obligation introduction call to discuss how the program aligns with your treatment approach.