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How Psychotherapy Can Help with PMDD

Premenstrual Dysphoric Disorder (PMDD) is a severe, cyclical mood condition linked to hormonal changes in the luteal phase (the week or two before your period).

If you live with PMDD, you might recognise:

  • Sudden mood drops
  • Intense irritability or rage
  • Relationship conflict that feels uncharacteristic
  • Hopeless or self-critical thoughts
  • A sense of becoming “a different person” each month

PMDD is biological — it reflects sensitivity to normal hormonal shifts. But the experience of it is deeply psychological and relational.

And that’s where therapy can help.

Therapy Cannot Stop Your Hormones — But It Can Change How You Experience Them

Psychotherapy can help you:

  • Track your cycle so symptoms become predictable, not chaotic
  • Separate hormonal mood shifts from your core identity
  • Reduce the shame that often follows each episode
  • Strengthen relationships that feel strained by cyclical changes
  • Build nervous system regulation skills for high-reactivity days

Many women describe the worst part of PMDD not as the mood shift itself, but the aftermath — the guilt, the relational repair, the self-doubt.

Therapy offers a steady place to explore that.

Why PMDD Often Feels Worse If You Have a Trauma or Attachment History

Hormonal shifts can amplify:

  • Rejection sensitivity
  • Fear of abandonment
  • Anger that feels disproportionate
  • Emotional flashbacks

If you grew up feeling unseen, criticised, or unsafe, the luteal phase can intensify those old wounds.

Attachment-focused psychotherapy can help you:

  • Develop an internal sense of safety
  • Understand what is hormonal activation vs developmental pain
  • Explore relationship ruptures and challenges for close relationships
  • Increase self-compassion across cycles

Therapy Works Often Works Best as a Complement to Medical therapies

As a psychotherapist, I do not provide medical treatment. PMDD often requires:

  • GP assessment
  • Possible SSRI treatment
  • Hormonal consultation

Therapy complements this by supporting emotional stability, identity integration, and relational repair.

You are not “too much.”
You are not broken.
Your nervous system may simply be more hormonally sensitive.

And that sensitivity deserves understanding — not shame.

My experience

Alongside my professional training as a counsellor and psychotherapist, I also bring lived experience of PMDD. Having experienced the rollercoaster of symptoms for over 25 years, I understand personally how disorientating it can feel when your mood shifts in ways that don’t seem to reflect who you are — and how heavy the shame can be afterwards. That experience informs my work gently and ethically; not by centring my story, but by deepening my empathy, nuance and respect for the cyclical nature of this condition. If you are living with PMDD and would like thoughtful, attachment-informed support, I offer in-person psychotherapy in Altrincham and South Manchester and online sessions for women across the UK. You do not have to navigate the monthly shift alone — it can be understood, contained and supported. Please contact me to book a consultation call.