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Journal of Bioethical Inquiry

, Volume 12, Issue 2, pp 313–330 | Cite as

Is Premenstrual Dysphoric Disorder Really a Disorder?

  • Tamara Kayali Browne
Original Research

Abstract

Premenstrual dysphoric disorder (PMDD) was recently moved to a full category in the DSM-5 (the latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders). It also appears set for inclusion as a separate disorder in the ICD-11 (the upcoming edition of the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems). This paper argues that PMDD should not be listed in the DSM or the ICD at all, adding to the call to recognise PMDD as a socially constructed disorder. I first present the argument that PMDD pathologises understandable anger/distress and that to do so is potentially dangerous. I then present evidence that PMDD is a culture-bound phenomenon, not a universal one. I also argue that even if (1) medication produces a desired effect, (2) there are biological correlates with premenstrual anger/distress, (3) such anger/distress seems to occur monthly, and (4) women are more likely than men to be diagnosed with affective disorders, none of these factors substantiates that premenstrual anger/distress is caused by a mental disorder. I argue that to assume they do is to ignore the now accepted role that one’s environment and psychology play in illness development, as well as arguments concerning the social construction of mental illness. In doing so, I do not claim that there are no women who experience premenstrual distress or that their distress is not a lived experience. My point is that such distress can be recognised and considered significant without being pathologised and that it is unethical to describe premenstrual anger/distress as a mental disorder. Further, if the credibility of women’s suffering is subject to doubt without a clinical diagnosis, then the way to address this problem is to change societal attitudes towards women’s suffering, not to label women as mentally ill. The paper concludes with some broader implications for women and society of the change in status of PMDD in the DSM-5 as well as a sketch of critical policy suggestions to address these implications.

Keywords

Premenstrual Dysphoric Disorder (PMDD) Mental illness DSM Feminist bioethics Psychiatry Neuroethics 

Notes

Acknowledgments

Thanks to Francoise Baylis, the Novel Tech Ethics team at Dalhousie University, and two anonymous reviewers for their helpful feedback on earlier drafts of this paper. This research has been partially funded through Canadian Institute of Health Research (CIHR) grant NNF: 80045 States of Mind: Emerging Issues in Neuroethics.

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Copyright information

© Journal of Bioethical Inquiry Pty Ltd 2014

Authors and Affiliations

  1. 1.Biology Teaching and Learning Centre, Research School of BiologyThe Australian National UniversityCanberraAustralia
  2. 2.Novel Tech EthicsDalhousie UniversityHalifaxCanada

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