---
title: How can doctors tell the difference between severe PMS and bipolar disorder?
description: Doctors can tell the difference by looking for symptoms that clearly follow the menstrual cycle and improve during pregnancy. These patterns occur in severe P
url: https://niyora.com/research/papers/severe-premenstrual-syndrome-and-bipolar-disorder-a-tragic-confusion-2012/
---

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- How can doctors tell the difference between severe PMS and bipolar disorder?

Case report, 2012

# How can doctors tell the difference between severe PMS and bipolar disorder?

Doctors can tell the difference by looking for symptoms that clearly follow the menstrual cycle and improve during pregnancy. These patterns occur in severe PMS but not in bipolar disorder, and severe PMS doesn't respond to antidepressants or mood-stabilizing medications used for bipolar disorder.

 Early or limited evidence

Young women with symptoms that could be confused with bipolar disorder.

## What they did

Case discussion of how to distinguish between severe PMS and bipolar disorder in young women.

## What they found

Women with severe PMS have symptoms that follow their menstrual cycle and improve during pregnancy. Physical symptoms include breast tenderness, bloating and headaches. Their hormone levels are normal. They do not respond to medications typically prescribed for bipolar disorder.

## What it means for you

Getting the right diagnosis is critical because these conditions need very different treatments. The main limit is that this is a single case discussion, not evidence from a large study.

## About the study

Original title Severe premenstrual syndrome and bipolar disorder: a tragic confusion Authors Studd J Journal Menopause international Year 2012 Study design Case report What was tested None (this is about correct diagnosis). Read the paper [doi.org/10.1258/mi.2012.012018](https://doi.org/10.1258/mi.2012.012018)

## Topics

[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Bloating, breast tenderness and physical symptoms](https://niyora.com/research/topics/symptom-physical-symptoms/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[GnRH agonists and ovarian suppression](https://niyora.com/research/topics/treatment-gnrh/)[Estradiol, progesterone and hormone therapy](https://niyora.com/research/topics/treatment-hormone-therapy/)[Surgical menopause](https://niyora.com/research/topics/treatment-surgery/)[Bipolar disorder](https://niyora.com/research/topics/comorbidity-bipolar/)[Pregnancy and postpartum](https://niyora.com/research/topics/comorbidity-postpartum/)

Research tells you what helps on average. Niyora helps on the day it hits.

Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor.

## Related studies

Review, 2012

Is depression linked to hormonal changes during the menstrual cycle, pregnancy, and menopause?

Case report, 2023

Can stopping ovulation help severe PMDD when other treatments do not work?

Study, 2015

How are hormones related to depression in women?

Non-randomised trial, 2014

Does hormone therapy help women with depression linked to periods and menopause?

Systematic review, 2023

What hormonal treatments have been tested for PMDD, menstrual migraine, and catamenial epilepsy?

Systematic review, 2007

What treatments work for premenstrual syndrome?

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