PMS or SOS?

FEELING BAD

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 question.

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 disorder.

"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 be irritable."

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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 menstruating.

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 others.

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.

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