Premenstrual Dysphoric Disorder: Embarrassing DSM 5 Mistake?

The DSM 5 is no stranger to controversy, and the new “Premenstrual Dysphoric Disorder” diagnosis is on the list of new diagnoses that has critics either raising an eyebrow, or throwing a fit.

DSM 5 isn’t the first DSM to have controversy. No, that began as early as the DSM I, which included a diagnosis of “Female Hysteria.” The problem with “Female Hysteria” is that the definition was embarrassingly broad: “Women expressing emotions in an inappropriate fashion.” Different times, sure, but people knew the diagnosis was a bad one, even in the 1950s.

Female Hysteria was finally removed in the DSM III, replaced by a more accepted disorder with more realistic diagnostic criteria: “Histrionic Personality Disorder.” The diagnosis that still exists in the DSM 5.

However, the DSM 5 now also includes “Premenstrual Dysphoric Disorder,” a mental disorder under the classification of depressive disorders.

Critics are not happy. Some feel that the diagnosis is ludicrous, and the condition is nothing more than a normal depressive reaction to the general medical condition of menstruation (not a depressive disorder).

However, 85% of the DSM 5 task force was male! And men, in general, don’t have a clue about female psychology. So PDD became a medical condition.

This diagnosis reminds me of a situation where a family brought in their mother for care, claiming “Mom’s gone crazy!” The mother was acting very oddly, but she didn’t have a psychological disorder, she had an aggressive urinary tract infection. 3 days later, after a dose of antibiotics, the family had its mom back! Mom was not schizophrenic. She didn’t have a mental disorder. She had a cognitive and emotional response to a medical condition.

In the same vein, “Premenstrual Dysphoric Disorder” should not be a mental disorder.

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