If you’ve ever felt like your ADHD symptoms take on a life of their own right before your period, you’re not imagining it. That overlapping chaos might not be “just hormones” or “just your ADHD acting up”—it could be the result of PMDD (Premenstrual Dysphoric Disorder) and ADHD intersecting in a very real (and very frustrating) way.
Let’s break it down.
First, What Is PMDD?
PMDD is like PMS on steroids—an intense, often debilitating condition that affects 1–7% of menstruating individuals. While PMS might bring some cramping and crankiness, PMDD can lead to severe mood shifts, depression, irritability, exhaustion, and difficulty concentrating. These symptoms show up in the luteal phase (the week or two before your period), and they can be so disruptive that they interfere with work, relationships, and daily functioning.
And here’s the kicker: for folks with ADHD, PMDD doesn’t just layer on top of existing challenges. It can turn the volume way up.
ADHD + PMDD = A Perfect Storm
ADHD already comes with its own set of hurdles: executive dysfunction, emotional dysregulation, difficulty with focus, and time blindness, just to name a few. But during the luteal phase? These issues can become more intense. Emotional reactivity spikes. Concentration tanks. Irritability flares. And the usual coping strategies? They might not cut it.
According to a study by Dorani et al. (2021), women with ADHD were more than ten times as likely to experience PMDD symptoms compared to the general population (45.5% vs. 3.8%). That’s a staggering stat—and it shows how common this combo actually is.
Even more frustrating? Stimulant medications, which are commonly used to treat ADHD, may become less effective during this time of the cycle (de Jong et al., 2023). So just when you need them most, they might let you down.
Why Does This Happen?
Researchers suggest this link is partially due to hormonal sensitivity. ADHD is associated with altered dopamine function—and dopamine fluctuates with hormonal shifts across the menstrual cycle. Combine that with PMDD’s impact on serotonin and GABA systems, and you’ve got a hormonal-neurochemical cocktail that’s hard to manage (Van der Weyden & Peters, 2024; Carlini & Deligiannidis, 2020).
Plus, if you’re already prone to emotional ups and downs with ADHD, PMDD can further destabilize your mood, attention, and regulation.
So… What Can You Do?
The good news: there are things you can do to support yourself if you’re dealing with both PMDD and ADHD. But it might take some experimentation and a supportive team.
Here are a few suggestions:
🩸 Track Your Cycle (Even if Imperfectly)
Knowing when your luteal phase starts can help you prepare for the symptom surge. Apps can help, but even jotting down symptoms in your notes app or calendar is a great start. (We know this can be hard with ADHD—be kind to yourself about it!)
💊 Talk to Your Doctor About Meds
For some people, increasing their stimulant dose during the luteal phase helps manage premenstrual ADHD symptoms (de Jong et al., 2023). Others find SSRIs or hormonal birth control useful for PMDD. But—and this is important—SSRIs can worsen symptoms for some folks with ADHD, so it’s crucial to have an individualized treatment plan (Dorani et al., 2021). A psychiatrist familiar with both conditions can help you navigate this.
🧠 Use Psychotherapy to Build Coping Tools
Therapies like CBT or DBT can be incredibly helpful in managing emotional dysregulation, impulsivity, and PMDD-related mood swings. Mindfulness-based CBT is gaining attention as a way to help women with this comorbidity manage the cyclical nature of symptoms and regulate emotional responses (Carlini et al., 2022).
🧘 Adjust Your Expectations
You might need to build more rest into your schedule, say no more often, or simplify your to-do list in the week before your period. This isn’t lazy—it’s strategic. Being proactive about supporting your nervous system during high-symptom times is a smart way to protect your mental health.
🤝 Find Community and Advocacy
You’re not alone in this. PMDD and ADHD are both under-researched and under-discussed, especially in combination. But more people are talking about it—and pushing for better treatment. Sharing your experience (if it feels safe) can be a powerful way to feel less isolated.
Final Thoughts
Navigating either PMDD or ADHD is challenging on its own. Managing both? That’s a whole other ballgame. But just because it’s complex doesn’t mean you’re broken. These are real conditions with real neurobiological roots—and you deserve real support.
If you’re struggling with this combo and aren’t sure where to start, therapy can help. Whether it’s learning how to manage the overwhelm, advocating for better care, or simply finding language to describe your experience—there’s space for that here.
Reach out to Strong Counselling to book a consultation. You don’t have to navigate this alone.
References:
Carlini, S. V., & Deligiannidis, K. M. (2020). Evidence-based treatment of premenstrual dysphoric disorder. Turkish Journal of Clinical Psychiatry, 81(2). https://doi.org/10.4088/JCP.19ac13071
de Jong, M., Wynchank, D. S. M. R., van Andel, E., Beekman, A. T. F., & Kooij, J. J. S. (2023). Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage. Frontiers in Psychiatry., 14. https://doi.org/10.3389/fpsyt.2023.1306194
Dorani, F., Bijlenga, D., Beekman, A. T., van Someren, E. J., & Kooij, J. S. (2021). Prevalence of hormone-related mood disorder symptoms in women with ADHD. Journal of Psychiatric Research, 133, 10-15. https://doi.org/10.1016/j.jpsychires.2020.12.005
Van der Weyden, C., & Peters, S. (2024). Hormonal influences on adult Attention Deficit Hyperactivity Disorder (ADHD): A scoping review. The Australian Journal of Herbal and Naturopathic Medicine, 36(2), 82-86. https://doi.org/10.33235/ajhnm.36.2.82-86