Melissa Watts has paid an unnaturally high price for being a woman. Every month, for the fortnight leading up to her period, Melissa has gone through personality changes she didn't understand, and couldn't control.

For more than a decade, family life and relationships have been strained, as this young mum endured physical symptoms - migraines, sinus troubles, aches and pains, coupled with the monthly emotional turmoil.

Melissa has been diagnosed with Premenstrual Dysphoric Disorder or PMDD - an extreme version of PMT. It could affect up to seven hundred thousand Australian women. Yet most don't know they've got it, and suffer in silence.

Husband Brad has borne the brunt of the mood swings, admitting it's pushed their relationship to the edge. The slightest thing would set Melissa off - home life became hell. Melissa had no idea what was rally happening. And neither did her doctors. More than a dozen told her she suffered from depression. They were wrong. A consult with GP Dr Shashi Patel for sinusitis led to Melissa being diagnosed with PMDD. Dr Patel put the puzzle together, after studying ALL of Melissa's symptoms. It was the combination of physical and emotional problems that gave him his best clue. The diagnosis came as a huge relief for Melissa.

Head of Psychological Medicine at Perth's King Edward Memorial Hospital, Dr John Rampono says PMDD is a serious and the impact on women can be debilitating. Internationally, there are cases where it's been used as a medical defence in criminal cases where the rage rendered women insane.

So what exactly is PMDD?

Hormones released from the pituitary gland, trigger ovulation. The change in hormones also triggers symptoms through the brain's neurotransmitters, affecting levels of serotonin, the chemical that helps moderate mood, sleep, aggression, even appetite. Doctors believe these changes trigger PMDD.

Researchers found in the lead up to getting a period, there was more brain activity in the frontal regions of the brain, which control emotions. Once the period started, the extra brain activity disappeared.

She's not depressed, but it's a depression medication that's now Melissa's treatment. For two weeks a month she now takes a serotonin boosting anti depressant, the drug licenced in Australia for PMDD.

Dr Rampono says women who think they have PMDD need to keep a diary for two months, rating their mood from 0- 3 every day, noting also when their period falls. If there are significant mood changes in the week or fortnight before, see your doctor.

Melissa Watts isn't out of the woods yet, but she now knows how to manage her condition. She's gone public hoping other daughters, wives and mums will also get help and avoid the years of misery she's endured.


PMDD - Premenstrual Dysphoric Disorder

Treatment options include:

- Adequate regular hours of s leep in the second half of the Menstrual Cycle

- Reduce caffeine, salt, alcohol and nicotine

- Regular exercise in the Aerobic range

- Relaxation strategies

- Vitamin B6 - up to 50 mg/day ONLY

- Medications that increase the efficacy of Serotonin in practical terms

- the new generation Antidepressants - from day 14 to the commencement of Menstruation. These are generally known by the trade names of Lovan, Lexapro, Zoloft, Cipramil etc

Women who think they might have PMDD, should keep a diary for two months, rating their daily mood (on a 0-3 scale), and noting when their period occurs. I

In the case of PMDD, physical and emotional changes occur in the 7-14 days preceeding their period. If you have these symptoms, see your doctor. GP's who state "an interest in Women's Health" are more likely to be informed about PMDD

Source: Dr Jonathan Rampono Head of Psychological Medicine King Edward Memorial Hospital Perth.