Experiencing PMDD with BPD

Having a mental health condition influences how you experience life. For people with borderline personality disorder (BPD), this can mean frequent mood swings, impulsive behaviors, and a distorted sense of self. It’s also common for people with  BPD to experience  co-occurring mental health conditions, like depression and anxiety. 

Some people with BPD have a depressive disorder called premenstrual dysphoric disorder (PMDD). A more severe form of premenstrual syndrome (PMS), PMDD causes physical and emotional symptoms during the luteal phase of the menstrual cycle, which is the time between ovulation and the start of menstruation..

If you have BPD and have noticed that your symptoms get more severe at certain times of the month, here’s what you need to know about PMDD and how to cope with the symptoms of both conditions. 

Key differences between BPD and PMDD

BPD is a mental health condition that influences how you think about yourself and other people. It’s characterized by intense emotions, mood swings, and impulsive behavior. PMDD can also influence your mood, causing feelings of sadness, hopelessness, and tension around your menstrual cycle.  

Both BPD and PMDD can cause issues with emotional regulation and interpersonal relationships. People with BPD may experience intense mood swings that last anywhere from several hours to several days. They may find it difficult to maintain stable relationships and are quick to change how they feel about others. With PMDD, it’s common to experience anger and irritability, which can lead to conflict and strained relationships.

Here are some key differences between PMDD and BPD:

• Symptoms: Common symptoms of PMDD include anxiety, fatigue, sleep issues, and difficulty concentrating. PMDD can also cause physical symptoms, like headaches, bloating, and joint or muscle aches. While BPD doesn’t typically include these symptoms, it is associated with impulsivity, paranoia, and fear of abandonment.
• Timing and duration: PMDD is a cyclical mood disorder. Symptoms typically last for one to two weeks per month and resolve within a few days of starting your period. BPD symptoms are more persistent and pervasive, though the frequency and duration may vary based on the type of BPD. 

What’s it like to have both BPD and PMDD? 

Less than 2% of the U.S. adult population has BPD, and most people diagnosed with the condition are people who were assigned female at birth. For this reason, it’s important to understand how a person’s menstrual cycle may affect their BPD symptoms. Some research suggests that BPD symptoms may become worse right before or during a person’s menstrual cycle, likely due to changes to hormones, like estrogen and progesterone. 

Having co-occurring BPD and PMDD can influence how you connect and interact with others. Many people with BPD struggle with the idea of being abandoned, and these fears can become worse during the luteal phase of the menstrual cycle. People with PMDD may also have extreme emotional reactions to criticism, which may become heightened when they’re already feeling more vulnerable or sensitive.

It’s common for people with BPD to engage in self-harm* and other destructive behaviors. And since women with PMDD are more likely to attempt suicide* than women without the condition, it’s especially important to be aware of any urges to self-harm.

*The 988 Suicide and Crisis Lifeline offers 24/7 confidential support through trained crisis counselors. If you or someone you care about is experiencing emotional distress, self-harm, or a suicidal crisis, please call or text 988. For life-threatening emergencies or immediate assistance, call 911.

Coping with heightened BPD symptoms around your cycle

If you’re living with BPD or BPD with co-occurring PMDD, it’s important to be mindful of how your menstrual cycle affects your feelings and behaviors. For people with PMDD, their BPD symptoms may get worse during certain times of the month. 

If this sounds familiar, here are four self-help strategies to help you cope:

• Track your symptoms. Keeping a journal is a great way to identify and monitor BPD symptoms. If you notice that your symptoms tend to worsen at certain times each month, it may be due to PMDD or other hormonal reasons. Mental health journaling can also reduce stress, increase self-awareness, and change the way you think about your relationships. 
• Calm your mind. If you notice that your symptoms are getting worse, take a moment to pause and calm your mind. Meditation and mindfulness exercises can reduce overthinking and encourage you to focus on the present moment. You can also try deep breathing exercises, like inhaling for a count of four, holding for four, and exhaling for four, to help regulate your emotions and create a sense of calm.
• Connect with your support network. BPD can make it difficult to maintain healthy relationships, but make a point to lean on trusted family and friends during vulnerable moments.
• Prioritize rest. When people with BPD don’t get adequate rest, they may be more likely to struggle with their memory, managing their feelings, and social situations. To help prioritize rest, try going to bed and waking up at the same time each day. 

Comprehensive care for co-occurring PMDD and BPD

If you’ve noticed changes in your mood, consider meeting with a mental health professional to discuss your health history, current concerns, and ongoing symptoms. BPD is often difficult to diagnose, but a professional evaluation and treatment plan can help people improve daily functioning and overall quality of life.

Managing BPD, PMDD, or co-occurring conditions usually involves some type of talk therapy, like cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT). Some people may also benefit from medication management and lifestyle changes. It’s important to work with your provider to determine if medication is right for your unique needs.

Find care with Rula

Having a mental health condition like borderline personality disorder (BPD) or premenstrual dysphoric disorder (PMDD) can affect how you view yourself, others, and the world around you. Symptoms vary by person but can often feel overwhelming and unmanageable without professional support. 

Rula specializes in connecting people with affordable, accessible mental healthcare. Our therapist-matching platform makes it easy to find specialized support for PMDD, BPD, and many other mental health concerns. In just a few seconds, we can help you find a therapist who’s accepting new clients and takes your insurance so you can begin treatment via live video calls as soon as tomorrow.

Find care with Rula