Classifying Severe PMS as a Mental Disorder Screws Women Over

Illustration for article titled Classifying Severe PMS as a Mental Disorder Screws Women Over

If tired CBS sitcoms and hacky comedians are to be believed, ladies on they periods be crazy (chocolate & cats & wine & crying & Lifetime Original Movies & blanket clutching!). Now, thanks to the publication of the fifth edition of the Diagnostic and Statistics Manuel (the DSM V, for those of us who hate typing/pronouncing syllables), that trope is backed by mainstream psychology; premenstrual dysphoric disorder — or PMDD, again, for the syllabically averse — is now officially classified as a mental disorder. And while that might seem like a positive development for women who suffer emotionally debilitating hormonal states in the lead up to their monthly bloodletting, something about this change in PMDD's status seems... off.


PMDD goes beyond regular PMS, according to NPR's Amy Standen's story on the controversy surrounding the disorder's reclassification. In order for a woman's premenstrual symptoms to "count" as PMDD, Standen explains, they must only happen in the 2 weeks leading up to her period and they must be so severe that they interfere with a woman's ability to perform her regular daily activities. According to researchers, this is only about 1% of menstruating women.

Still, skeptics of PMDD in the DSM V fear that the disorder's relative rareness won't stop the "PERIODS MAKE LADIES CRAZY!" trope from gaining new steam from the pathologizing of PMS. And the minor annoyance that comes from dudebros at the office quietly thinking that every angry or forceful reaction from a female colleague must be due to the demon influence of her monthly bloodbaby is nothing compared to what one researcher Standen interviewed fears might happen to mothers seeking custody of their children.

"Say a poor woman was in court, trying to see whether she could keep custody of her child," [Washington University Researcher Sarah] Gehlert says. "Her partner's or spouse's attorney might say, 'Yes, your honor, but she has a mental disorder.' And she might not get custody of her children."

So that's not good. Also not good: how much this smells like a moneymaking scheme by and for the benefit of drug manufacturers, not women.

One textbook example is the prescription drug Sarafem, which was approved by the Food and Drug Administration in 2000 as a treatment for PMDD. In reality, Sarafem is identical to the widely prescribed SSRI antidepressant Prozac, or fluoxetine. The patent on Prozac was about to expire, and manufacturer Eli Lilly faced losing market share to generic versions.

So Lilly gave Prozac a new name, Sarafem, and painted it pink. What had been a generic drug that cost 25 cents a pill was marketed as a PMDD-specific drug for $10 a pill.

Women are the ideal drug manufacturers' customers, if the very act of being female is turned into a treatable disorder that never gets better but always needs expensive drugs. Treat forever; cure never.

As you might have predicted, the marketing campaign for Sarafem (embedded above, and, again, via NPR) was exactly the sort of sexist garbage nobody needs, featuring a woman at a grocery store ramming carts around. AH WATCH OUT FOR THE PERIOD! IT TURNS LADIES INTO UNSTOPPABLE RAGE MACHINES! Another spot featured a woman freaking out about being unable to find her keys, which elicited a raised eyebrow look from my boyfriend; the other week, I lost my keys in his apartment, and as we were looking for them, I sunk to the floor and broke down in hopeless, hot tears like an overtired child who doesn't want to go to church. Yes, I was about to get my period, but I was also exhausted and stressed out and my blood sugar was out of whack. My premenstrual lower bullshit thresholds aren't something that should be treated with medication; they should be treated by going to bed at a reasonable hour and eating a lunch that consists of more than black coffee and jelly beans.


Furthermore, women aren't the only ones driven to act unfavorably by hormone fluctuations. Imagine the massive disorder diagnosis upswing if only testosterone poisoning were A Thing. Every time a guy punches a wall because he missed a layup? Road rage, chair throwings, gang skirmishes, fraternity hazing gone tragic? Every war, ever? All sad symptoms of the as-yet unrecognized by the DSM Duding The Fuck Out Disease. One possible prescription is called Eaze-otin, a precision engineered plant grown in labs by GlaxoSmithKline typically ingested via rolling into a blunt and "smoking." Soon available orally, via dick-shaped brownies. Medicinal dicks, for men! Who can't stop acting like dicks!

Imagine the drugs you could sell. Instead of lighting shit on fire in anger or celebration after important sporting events, DTFO-suffering dudes would just sit in the park and draw elaborate pictures of their own hands. Think of the Aqua Teen Hunger Force style stoner cartoons that could be produced. We could end subway gropings tomorrow if we only recognized the challenge of living in a world soaked in testosterone.


Get on it, DSM V.




I think it's important to note that this isn't about classifying PMS as a mental disorder but a very specific, much more rare, dehabilitating form of PMS. If classifying it as a mental disorder means that insurance covers treatment and meds, doctors take it seriously, etc., I have to say that I support it.