Will PMS Be In The DSM?

Scientists have found a gene that may cause the extreme form of PMS known as premenstrual dysphoric disorder (sometimes treated with Prozac, pictured). But should the disorder be considered a mental illness?

According to Barbara Kantrowitz and Pat Wingert of Newsweek, a study at the Rockefeller University showed that female mice with a gene variant called "brain-derived neurotropic factor Met" had memory problems and anxiety at certain points in their menstrual cycle."Women aren't mice," Kantrowitz and Wingert note, but 20-30% of women have the same gene variant, and PMDD sufferers experience some of the same symptoms as the mice. Lead study author Joanna Spencer says, "On a broader scale, I think that this kind of research shows that hormones do affect the brain, and they do affect behavior."

So if hormones affect the brain, do those most profoundly affected suffer from a mental disorder? That's what the American Psychiatric Association will decide when it determines whether to include PMDD in the DSM-5. Kantrowitz and Wingert write, "The American Psychiatric Association first considered adding PMDD to an earlier edition of the manual 20 years ago, but women's health advocates protested, claiming that making PMDD an official disorder would pathologize female biology and incorrectly label women as mentally ill." But as with so many disorders, that "label" might convince insurance companies to pay for treatment. And for some women, scientific recognition of their premenstrual problems might be comforting.

The debate over PMDD shows how difficult it can be to separate mind from body, and how artificial these separations sometimes are. The term "mental illness" can still be stigmatizing, but it shouldn't be — at least in part because there's often no real distinction between a mental illness and a physical one. If we truly understood how reproductive hormones affect mood, then we might gain a greater appreciation for the interconnections between brain and body, and thus build support for parity between mental health and physical health treatments. We might also end the blame, stereotype, and second-guessing that currently attend PMS and mental illness alike, and replace these with a more holistic view of health that recognizes the influence of mind on body and body on mind.

Is There A PMS Gene? [Newsweek]