Warning: This article contains discussion of suicide
The morning after Annika Waheed tried to end her life, her period started. The despair lifted like a fog burning off - prompting her to ask her sister, "Did I really do that?" The 42-year-old has lived with premenstrual dysphoric disorder (PMDD) for over eight years, spending two weeks of every month haunted by suicidal thoughts until, like a hormonal light switch, menstruation would flip things back to "able to see and function again."
PMDD is essentially PMS's evil twin - same timing (the luteal phase, one to two weeks before a period), but instead of tiredness and bloating, it brings severe anxiety, depression, and intense psychological distress. The International Association for Premenstrual Disorders (IAPMD) estimates over a million women in the UK may be affected, though only a fraction have been diagnosed. "It is like the Grim Reaper coming for us every month," Annika says. "You can feel it, and there is nothing you can do about it."
The condition appears to be a severe negative reaction to natural hormonal fluctuations - mainly changes in progesterone and oestrogen - triggering feelings of despair, loss, and lack of control. While science still can't fully explain why some women get it and others don't, researchers at the University of the West of Scotland have developed a groundbreaking suicide prevention tool to help clinicians spot the signs. Dr Lynsay Matthews, who led the research, notes that "even though the menstrual cycle plays such a huge part in a woman's health, it is often not brought up in doctors' consultation rooms." The model is available now, with hopes of NHS-wide rollout pending effectiveness studies.
Dr Helen Wall, a GP in Bolton specialising in women's health, says doctors "still struggle to relate things to a woman's periods" and that the healthcare system's 10-to-15-minute appointments make it nearly impossible to get a full history. Meanwhile, women are taking matters into their own hands: #PMDD posts have been viewed over 230 million times on TikTok. Katie Cook, diagnosed at 21 in 2025 after a decade of struggling, describes it as being "Jekyll and Hyde." She started tracking her symptoms in university and finally got answers when a GP asked if she'd heard of PMDD - "everything started to make sense."
Treatments range from antidepressants and the contraceptive pill to the Mirena coil, chemical menopause, and even ovary removal. Annika is on hormone-blocking injections to stop her cycle, though she can feel the anger and despair creeping back within minutes of the medication wearing off. The treatment has also made pregnancy impossible - "PMDD has snatched that from me," she says. Lily Rose Winter, 31, is considering chemical menopause after years of trying treatments with little success. "I tell myself it's OK that I don't feel grateful to be alive today, and it will pass," she says. "I have to be patient."
The government acknowledges women with PMDD "have been failed for far too long," with a Department of Health and Social Care spokesperson promising that the renewed Women's Health Strategy will ensure women are "listened to and taken seriously from their very first appointment." Annika says earlier recognition could have saved her from being "gaslit by doctors" and might have allowed her to "safeguard me from myself." As she puts it: "If doctors understand, then patients understand."