The Cycle

November 15, 2023
A well-informed look at a misunderstood disorder. Journalist Gupta, who suffers from premenstrual dysphoric disorder, offers a close look at the medical, social, and psychological issues surrounding the diagnosis and treatment of menstrual disorders, with the hope that her findings will help the "3 to 8 percent of menstruators" who meet the criteria for this severe syndrome. Too often, she reports, "the never-ending loop of social stigma against menstruation" means that such disorders go untreated. Cultural prejudices and sexism within the medical system have led some women with PMDD--and even Gupta, at times--to doubt their experiences. Her own suffering--which included depression so severe that she became suicidal, as well as angry, violent fights with her boyfriends--persisted for over a decade before she received a diagnosis, and then she spent a year trying to find the proper medications that would alleviate the symptoms. Gupta provides an overview of the menstrual cycle and its effects on many women. Premenstrual syndrome, experienced by about 48% of women, is characterized by physical symptoms such as bloating and insomnia, as well as psychological symptoms such as mood swings and premenstrual mood exacerbation, in which preexisting psychological symptoms, such as depression, get worse during menstruation. Beginning in the 1980s, when little research on PMDD was available and it was often conflated with PMS, debate swirled over whether to include PMDD in the Diagnostic and Statistical Manual of Mental Disorders. Some medical practitioners were opposed, fearing that the diagnosis would victimize women by turning "a regular biological event into a mental disorder." In 2013, it was finally included, and in 2019, the World Health Organization recognized PMDD as a diagnosis in its International Classification of Diseases. With ample evidence from her own life, Gupta ably depicts the reality and intensity of an affliction that rages into a monthly "emotional storm." An informative melding of memoir and research.

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