Premenstrual syndrome is being added to the Diagnostic and
Statistical Manual of Mental Disorders-IV, the latest edition of the
mental health bible. But not without a fight.
At an American Psychological Association conference on women's
health, the voice of Australian psychologist Elizabeth Harding, Ph.D.,
rose above the din to call the disorder's very existence into
Harding asked 101 University of Melbourne employees to fill out
daily diaries on stress and health for 10 weeks. Not one reported mood
changes meeting the diagnostic criteria for PMS for two consecutive
cycles. Yet 40 percent of the participants said they suffered from the
"When I looked at the actual patterns of the women who said they
had PMS, there was no association with mood and cycle," Harding reports.
They were as likely to say they thought they had PMS whether they showed
postmenstrual change, occasional menstrual change, or no change at all.
"It's as if this label allows them a socially sanctioned time of month to
About 18 percent of the women she studied occasionally showed
marked premenstrual mood change. But emotional change was really not very
different among women who, because of age or hysterectomy, were not
Harding says that billions of dollars are wasted yearly in lost
wages because of PMS. "These are incredible claims based on shoddy
research, with inflated estimates of PMS." She found that cyclic mood
change had no correlation with work performance.
She contends that emotional swings and poor job performance
attributed to PMS are really the result of poor social interactions with
The real issue, she asserts, is that many women feel bad most of
the time. A quarter of the women she studied showed signs of chronic
negative affect--a perpetual state of unhappiness. These women believed
that their life was controlled by chance, felt that they had little
social support, and had few coping skills. They consistently reported
high stress, poor health, and problems at work.
"These women need to learn coping skills and the basics like
relaxation, stress management, and assertiveness training," says Harding.
It's a matter of letting women know it's okay to express themselves at
any time of the month.
But in a country where it is difficult to get insurance
reimbursement for a nondiagnosable disorder, free-floating anxiety and
chronic sadness have to be labeled to be addressed.
PHOTO: Red rose