PMDD Care
When the Week Before Isn't Just PMS
When the week before your period reliably takes you somewhere darker than the rest of the month can explain, that is PMDD, and it is treatable.
— CLINICAL CARE · PMDD
Understanding PMDD
If the same dark wave arrives before your period every month, it is not weakness, and it is not in your head.
Premenstrual dysphoric disorder (PMDD) is a severe mood condition tied to your cycle. In the week or two before your period, mood, anxiety, and irritability can change sharply, then ease soon after bleeding starts.
It is more than PMS. It can affect your work, your relationships, and how you feel about yourself, and it is treatable.
What it can look like
It Can Feel Like Two Different People Each Month.
Many women spend years feeling fine, then not fine, then ashamed, without anyone connecting it to the cycle.
Sudden Mood Shifts
Feeling tearful, hopeless, or on edge in the days before your period.
Intense Irritability or Anger
Snapping, conflict, or rage that feels out of proportion and out of character.
Anxiety and Tension
Feeling keyed up, overwhelmed, or unable to settle.
Hopelessness and Self Doubt
Dark thoughts about yourself, your relationships, or whether things will get better.
Fatigue and Brain Fog
Low energy, trouble concentrating, and feeling like you cannot keep up.
Relief Once Your Period Starts
Feeling like yourself again soon after bleeding begins, then dreading the next month.
Why it happens in women
We Look at the Whole Picture, Not Just PMS
PMDD is thought to reflect an unusual sensitivity of the brain to normal hormone shifts across the cycle. Stress, trauma history, and other mood or anxiety conditions can make symptoms worse. Tracking your symptoms is the key to understanding the pattern.
Your hormone levels may be normal. Your brain may simply be more sensitive to the change.
Your Pattern
When symptoms begin, when they lift, and how they affect your life.
Symptom Tracking
Daily notes across at least two cycles to confirm the pattern.
Hormones and Cycle
Your cycle history and other health factors that may play a role.
Mood, Anxiety, Focus
What is happening in your mind, named clearly and without judgment.
How I treat it
Your Plan Starts With You
Treatment for PMDD is individualized. It can include therapy, sleep and lifestyle support, and tracking your cycle together so we understand your pattern.
When medication makes sense for you, I can prescribe and manage it. You will have a say in each decision, and we will adjust as we learn what helps.
When to reach out
You Do Not Have to Wait for It to Get Worse
Your mood or irritability changes sharply before your period every month.
Relationships or work suffer during the same part of your cycle.
You have felt hopeless or had dark thoughts around your period.
You have been told it is just PMS, but it feels like more.
If you are in crisis or thinking about harming yourself, call or text 988 in the U.S., or go to the nearest emergency room.
Meet your psychiatric provider
Christine Archer, MSN, PMHNP-BC
Psychiatric nurse practitioner for women
I have spent over 20 years working with women. I treat PMDD by tracking your pattern with you and building a plan around your cycle, so the weeks before your period stop running your life.
Our visits are by telehealth in Maryland, Washington State, and New York. You see the same provider each time, one who remembers your story.
- PMHNP-BCBoard-Certified Psychiatric Mental Health Nurse Practitioner
- Integrative Health and NutritionPost-Master's Certificate
- EMDR TrainedEye Movement Desensitization and Reprocessing
- PSI TrainedAdvanced Perinatal Mental Health Psychopharmacology (2025)
- Menopause SocietyCertification candidate
- Former competitive bodybuilderWomen's health advocate
Getting started
Three Steps to a Plan That Fits
You decide each step, at your own pace.
Book a free consultation
A 15-minute conversation about what is happening and whether we are a fit.
Complete your evaluation
We look at your history, your body, your hormones, and what you want help with, together.
Build your plan
A plan shaped around your life and your pace, never rushed and never one size fits all.
Questions about PMDD
Before You Book
How is PMDD different from PMS?
PMS is common and usually mild. PMDD is more severe and affects daily life, with mood symptoms that lift soon after your period begins.
How do you diagnose PMDD?
Tracking your symptoms across at least two cycles, along with a full history, is central to the diagnosis.
What if I have dark or suicidal thoughts?
Reach out right away. Call or text 988 or go to the nearest emergency room, and tell me at your visit.
How do visits work?
Visits are by secure video. I see patients in Maryland, Washington, and New York.
A week out of every month is too much of your life to lose.
A free 15-minute consultation, and a real conversation about what is happening. Telehealth across Maryland, Washington, and New York.