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Light Therapy: A ray of hope for Premenstrual Dysphoric Disorder (PMDD) sufferers?
from:Premenstrual Syndrome (PMS) is a combination of physical
discomforts and emotional symptoms, which occur in the latter
half of the menstrual cycle (late luteal phase), and reduce or
diminish during the first few days of menstruation. Symptoms of
PMS are so severe that they impair social and work-related
functions, resulting in Premenstrual Dysphoric Disorder (PMDD).
PMDD differs from PMS in that emotional symptoms in PMDD are
more serious and severe than in PMS, although physical symptoms
are relatively similar. PMDD can lower quality of life to an
extent quite similar to that of major depression, and can also
be associated with an increase in suicidal ideation and suicide
attempts. Approximately 5-10% of PMS sufferers also have PMDD.
It affects 3 to 8% of women in their reproductive years
worldwide, and is a source of huge burden on women and their
families. Women with seasonal affective disorder (SAD) are more
likely to have PMDD than women in the general population.
The exact cause of PMDD is unknown; however, several theories
have been proposed. One of such theories suggests that PMDD is
due to the lack of serotonin (a substance found naturally in the
brain and involved in sleep, depression, memory, and other
neurological processes). Serotonin acts as a calming hormone;
therefore when serotonin levels are low, symptoms such as pain,
irritability, anger, food cravings, and anxiety are
precipitated. Once serotonin levels are restored, many of these
symptoms disappear.
PMDD symptoms include at least one of the following: 1. Feeling
sad, worthless or hopeless. 2. Feeling tense, anxious or 'on
edge'. 3. Feeling overwhelmed or out of control. 4. Mood swings,
emotional outbursts or unexplained crying. 5. Irritability,
anger, or short temper. 6. Increased appetite (carbohydrate
cravings) It also includes other common symptoms of depression
such as sleep problems, changes in appetite or weight,
difficulty in concentrating, lack of interest in activities once
enjoyed, and having suicidal thoughts. Physical symptoms are
similar to that in PMS, breast tenderness, bloating, weight
gain, headaches/backaches, and skin problems such as acne.
The first-line treatment for PMDD has been anti-depressants.
However, these can be intolerable or result in serious adverse
effects, especially in adolescents. Bright Light Therapy has
been proposed as a non-pharmacological treatment, amongst other
such treatments, to help increase serotonin levels and
production, and may represent a safe and attractive alternative.
According to Terman & Terman (2005), patients with both seasonal
and nonseasonal PMDD, or milder PMS have responded favourably to
1 week of bright light therapy, in a series of clinical trials.
The effect of bright light is thought to be mediated through
increased production of melatonin, which subsequently boosts
serotonin levels. For women seeking a non-pharmacological and
safe treatment for PMDD, light therapy is a promising treatment
with great prospects.
Useful links e-Medicine: Premenstrual Dysphoric Disorder
http://www.emedicine.com/med/topic3357.htm
HealthyPlace.com - Depression Community: Premenstrual Dysphoric
Disorder (PMDD)
http://www.healthyplace.com/communities/depression/pmdd.asp
References 1. Light therapy. PMS & Premenstrual Dysphoric
Disorder (PMDD). http://www.lighttherapy.com.au/pms.php.
Accessed: 23/08/2007. 2. Lam RW, Carter D, Misri S, Kuan AJ,
Yatham LN, Zis AP. A controlled study of light therapy in women
with late luteal phase dysphoric disorder. Psych Res 1999; 86:
185-192. 3. Terman M, Terman JS. Light Therapy. In: Principles
and Practice of Sleep Medicine (2005). Ed by Kryger MH, Roth T,
Dement WC. 4th Ed. Elsevier. Philadelphia. Pp 1424-1442. 4.
Krasnik C et al. The effect of bright light therapy on
depression associated with premenstrual dysphoric disorder. Am J
Obstet Gynecol 2005; 193: 658-661. 5. Liang BA et al.
Recognizing and Treating Premenstrual Dysphoric Disorder. Hosp
Physician 2003.
http://www.turner-white.com/pdf/hp_aug03_disorder.pdf. Accessed:
23/08/2007.
About the author: Kunbi Balogun
BSc (Hons) Pharmacology MSc. Pharmaceutical Science with
Management Studies
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