Circadian Rhythm Disorders - Premenstrual Dysphoric Disorder (PMDD)

PMDD is a short-term depression, which occurs during the latter part of the menstrual cycle. PMDD is usually associated with more severe symptoms of PMS and interferes with your ability to interact socially. Approximately 5-10% of PMS sufferers also have PMDD. Since PMDD sufferers also have PMS, it is a good idea to review the section on PMS.

Since PMDD can easily be mistaken for major depression or another mood disorder, it is best diagnosed with the help of a mood tracker that can show the pattern and severity of symptoms. The difference between PMMD and other disorders is that its symptoms generally appear the week prior to menstruation.

PMDD symptoms

PMDD includes at least one of the following symptoms:

Feeling sad, worthless or hopeless
Feeling tense, anxious or 'on edge'
Mood swings, emotional outbursts or unexplained crying
Irritability, anger, short temper or argumentative
Carbohydrate cravings

PMDD also includes other common symptoms of depression such as sleep problems, changes in appetite or weight, loss of concentration or interest in activities, feeling overwhelmed or thoughts of suicide.

There is a strong connection between PMDD and low serotonin. Serotonin not only acts as a calming hormone, but it acts as the postal service for the body clock. When serotonin levels are restored, many of the more destructive symptoms of PMDD disappear, such as anxiety, irritability, anger, food cravings, etc.

Since light is known to produce serotonin as well as reset the body clock, researchers at UCSD have had success using Apollo's Britewave technology in treating women with PMS and PMDD. Adding light a week before PMS or PMDD started cut symptoms by at least 50%. This was more effective than drugs alone, but relief was even greater when light was used in conjunction with medication, especially for women with severe symptoms. Many women reported complete relief from light alone.

Women who had more severe PMDD also benefited from wake therapy and morning light. For more information on wake therapy, click here .

This discovery that light regulates serotonin and melatonin is significant, because these hormones are linked to these disorders. For example, studies show that women suffering from PMS and PMMD not only have low levels of serotonin, but that their body clocks are running too fast. This releases the withdrawal hormone, melatonin, too early, and that depletes your serotonin reserves and causes sleep problems. Using this special light in the evening will slow the body clock back down and balance your natural serotonin levels.

When researchers used light to slow the body clock back down, symptoms of PMS also dissipated. The discovery that light reduces menstrual problems as well as regulates cycles, is encouraging, particularly for women who are seeking natural alternatives:

"This apparently powerful - yet simple and seemingly safe - methodology should lead to exciting progress in our understanding of human reproductive endocrinology." - Daniel Kripke MD, Head of Chronobiology Research, UCSD.

Wake Therapy

Scientists believe that depression causes the body clock to 'shut down', and wake therapy is just like rebooting a computer. 'Wake therapy' means waking the patient early, from about 2:00am on, when the body clock is most active. Since the body clock doesn't get the sleep feedback it needs, it reboots its system.

Adding morning bright light keeps the circadian system from shutting down again. Several clinical studies now confirm that using bright light with wake therapy produces an immediate and lasting antidepressant response. Research also shows that when wake therapy is combined with traditional medications, the effect is even more pronounced. Apollo's Britewave technology is used in most wake therapy studies.

"It appears that bright light combined with wake therapy and medication might produce a much better antidepressant response much more rapidly than our available antidepressant drugs." - R Loving,D Kripke, "Bright light augments antidepressant effects of medication and wake therapy," Depression and Anxiety, 16: 1-3 (2002)

APOLLO HEALTH TIPS

BRITEWAVE Therapy 15-30 minutes in the evening to extend your active day length. Slowing your body clock down will also allow you to sleep better throughout the night. BRITEWAVE light is specially designed to produce the active hormone, serotonin and suppress melatonin. Melatonin is often called the 'hibernation hormone' and is thought to restrict other hormones that promote a healthy menstrual cycle. Your body produces higher levels of melatonin during the winter, and when you don't get enough bright light. PMDD is also worse in the winter. Since PMDD symptoms are more severe than PMS, you may also need to add 15-30 minutes of morning light.
Wake Therapy has been used successfully with women for stronger symptoms of PMDD. With the guidance of a physician, try waking up early, around 2:00 am (for one morning only) before your period starts, and use BRITEWAVE light each morning through the first week of your next cycle.
Increase Serotonin Levels . Low levels of serotonin are related to depression, mood, irritability, low concentration and pain. Women are more vulnerable to serotonin deficiency than men. In addition to BRITEWAVE therapy, Apollo's Harmony™ works with BRITEWAVE to balance your serotonin levels.
Increase vitamins and minerals . Since PMDD is marked by a deficiency in several vitamins, calcium and magnesium, Apollo has developed a high-quality supplement to restore balance to PMDD sufferers. Studies show that an increase in calcium & magnesium reduce symptoms by as much as 50%. Calcium is also an important factor in preventing osteoporosis, which affects most women as they mature. Apollo's Vitality™ and Neutralize™ work with your circadian rhythm to restore this essential balance of vitamins and minerals.
Healthy lifestyle . Caffeine, alcohol, and tobacco all increase PMDD symptoms such as irritability, stomach problems and insomnia. Salty foods help retain water and contribute to blood pressure problems. Refined sugars and carbohydrates increase insulin, which depletes serotonin.
Exercise moderately . A consistent exercise plan increases energy and mood and cuts down on cramping and body aches. Late afternoon is the best time to exercise; less cortisol is in your system, which means less risk to your heart. Your body burns energy better, and muscles respond quicker in the afternoon & evening. Don't exercise within 4 hours of bedtime, though. This may make it difficult to sleep.
Reduce Stress. PMS & PMDD may often be the cause of stress, because of the discomfort and emotional problems it causes. Make sure to review the main stress section in our web page.
Birth Control Pills level out the hormone shifts that result from ovulation. This in turn may lessen the effect of PMS & PMDD symptoms.