After years of sitting on the fence, the American Psychiatric Association's updated Diagnostic and Statistical Manual (DSM-5), used by doctors across the country to categorize mental illnesses, has recognized the more severe and rare premenstrual dysphoric disorder (PMDD) as a serious and medically treatable condition. However, an NPR report reveals that not all women are happy about its new classification.
Women with PMDD experience far more serious symptoms than those with common PMS. Doctors who treat PMDD say women who suffer from it tend to experience depression, anxiety, and tension during the two-week span beginning at the luteal phase of the cycle.
The inclusion of PMDD in DSM-5 has created a lively debate: To opponents, it pathologizes atypical but not unhealthy behavior; to supporters, it medically validates the symptoms, which could provide the afflicted with a sense of community.
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A sufferer of PMDD, Megan Olney, tells NPR, "There comes a point where you need to realize there's a name for what you're going through. It helps you to realize you're not alone in your struggles."
Online communities and support groups have grown around PMDD to help women guide each other, share treatment options, and feel less isolated. This last feature is extra important, considering that less than one percent of women are believed to suffer from PMDD.
Unfortunately, PMDD's recognition in DSM-5 could serve to bolster stereotypes about women being crazy due to their menstrual cycles, prime comedy fodder of obnoxious chauvinists.
There's a long history of jokes about how women are irrational because they have menstrual cycles. Ever hear this one: "Why do women call it PMS? Because Mad Cow disease was already taken?" Hysterical!
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And while irritating jokes can be laughed off, the stereotype can have concrete negative effects on women. Lest you think I exaggerate, even the Iron Lady was accused (by a U.N. diplomat no less) of engaging in the Falkland War as a result of "the glandular system of women."
The repercussions for women diagnosed with PMDD could be even worse. Sarah Gelhart of Washington University in St. Louis worries that the diagnosis could be used against women and undermine their rights and claims. Gelhart tells NPR:
Say a poor woman was in court, trying to see whether she could keep the custody of her child. Her partner's attorney might say, "Yes, your honor, but she has a mental disorder." And she might not get custody. [NPR]
There's also the concern that PMDD is just a big cash-cow for pharmaceuticals. When Eli Lilly was about to see Prozac's patent expire, the company renamed it Sarafem, colored it pink, and marketed it as a PMDD treatment, all while raising the price from 25 cents a pill to $10.
At the very least, it is suspect that women are given pink pills to calm their emotions, but men are given pretty much nothing for intermittent mood swings. That's not exactly fair considering that "women aren't the only ones driven to act unfavorably by hormone fluctuations," writes Erin Gloria Ryan at Jezebel.
Imagine the massive disorder diagnosis upswing if only testosterone poisoning were A Thing. Every time a guy punches a wall because he missed a layup? Road rage, chair throwings, gang skirmishes? All sad symptoms of the as-yet unrecognized by the DSM Duding The Fuck Out Disease. [Jezebel]
But who knows? Duding The Fuck Out could be the next diagnosis if Eli Lilly decides to dye Prozac blue.
Emily Shire is chief researcher for The Week magazine. She has written about pop culture, religion, and women and gender issues at publications including Slate, The Forward, and Jewcy.
