The DSM-IV criteria for diagnosing PMDD are dependent upon symptoms being present for most of the woman’s menstrual cycles throughout the last year, documented through the use of prospective daily ratings. Symptoms must markedly interfere with work, school, or usual social activities and in relationships with others. The most typical pattern seems to be that of dysfunction during the week prior to menses that ends mid-menses.

Five or more of the following symptoms must have been present most of the time during the week prior to a patient’s period, remitting within a few days after the onset of the patient’s period. At least one of the symptoms must be one of the first four:

1. Feeling sad, hopeless, or self-deprecating

2. Feeling tense, anxious, or "on edge"

3. Marked lability of mood interspersed with frequent tearfulness

4. Persistent irritability, anger, and increased interpersonal conflicts

5. Decreased interest in usual activities, which may be associated with withdrawal from social relationships

6. Difficulty concentrating

7. Feeling fatigued, lethargic, or lacking in energy

8. Marked changes in appetite, which may be associated with binge eating or craving certain foods

9. Hypersomnia or insomnia

10. A subjective feeling of being overwhelmed or out of control

11. Other physical symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, weight gain

Source: DSM-IV, American Psychiatric Association, 1994.