You just found out someone you care about has PMDD. Whether you're hearing the diagnosis along with them from the beginning or they got up the courage to tell you after years, how do you respond?
What not to say
"It's normal! Everyone gets PMS!"
PMDD isn't normal PMS, and saying it's such downplays your teen's struggles. PMDD is a mood disorder (it's a lot more than cramps and bloating), comparing it to PMS is inaccurate and ignores most of the illness.
"It's just a myth!" or "It's all in your head."
Not only is PMDD not a myth (it's in the DSM and numerous studies have found it to exist as a unique mental illness). Even if you aren't convinced it exists or that it's what your teen is going through, she/he has gotten up the courage to come to you with her struggles and you should be respectful instead of invalidating them.
"But you look normal!"
PMDD is a mental illness, so it's not always easy to see. In addition, it's probably been particularly hard to see because -- up until now -- she/he has been doing their best to hide it from you. Don't make your teen regret their decision to stop hiding it from you by assuming that now is the time when they're acting.
"Just snap out of it!""
PMDD, being an illness, is not something that can be gotten rid of by sheer spontaneous willpower. If you act like your teen should be able to do this he/she will become frustrated and lose confidence. Instead, get her them help they needs to learn healthy coping mechanisms that can help them to pull themself part way out of it.
"Stop being so selfish!" or "Stop complaining!"
More than one person can be having a hard time at once. Your teen's struggles are real, and it may be hard for them to worry about someone else's difficulties when they're on the roller coaster of emotions that PMDD brings. Accusing them of selfishness will only fuel that roller coaster with guilt.
Maybe your teen is complaining too much -- or maybe you're being insensitive. Think it through and if your teen is being too negative it's ok to give them a little space for a while. PMDD isn't an excuse to be toxic.
"It's your fault!"
PMDD isn't their fault. Your teen didn't wake up one morning and decide to feel this way. Blaming them will just make them feel guilty that they can't stop it. Instead, help her/him get treatment so they can learn how to better handle their PMDD.
"You just need to..."
Unless what comes next is "...get help," because your teen hasn't yet don't say it. Just don't say it. Even if your teen has asked for advice PMDD is complicated and there is no one simple fix that makes anyone and everyone's PMDD go away completely forever. Helping your teen make changes to her/his lifestyle is great, but be gentle about it and understand that even if lifestyle changes reduce the problem they might not solve it.
"Why can't you just be normal?"
Having PMDD probably makes your teen feel anything but normal, and a lot of the reactions she/he will get to her PMDD will probably suggest that she/he should be ashamed of it. She/he shouldn't be. It might be cliche, but it's still true: lots of people are fighting invisible battles.
"You're just looking for attention."
PMDD isn't a choice and a plea for help isn't a plea for attention. If PMDD is straining your relationship with your teen or she/he is being too demanding then make sure your teen gets the help he/she needs and then give them some space so that you can get a break.
What to say
"This isn't normal PMS, & we need to do something about it."
PMDD isn't normal PMS, and your teen doesn't need to continue to struggle with it alone. If your teen hasn't already gotten help with her/his PMDD they should. Be supportive by helping your teen get help. If you're a friend this might mean finding an adult they feels comfortable talking about it with. If you're her/his parent, then take them to see a medical professional who can help make a plan of action.
"Even though I haven't experienced this, I believe you ."
Affirm your teen's experience. She/he has gotten up the courage to come to you with their struggles not knowing if you'll believe them; trust them so they don't regret their decision to be open with you. Even if you don't think it's PMDD or don't know enough to be sure, she/he is going through a hard time and there's no reason to be skeptical of that.
"You're brave for telling me about this."
Up until now your teen has probably been working very hard to hide this from you. Telling you required courage. Give your teen a chance to associate bravery and strength with what feels to them like a weakness and a liability.
Invite them to do something fun with you. Human contact and keeping busy isn't always what someone with PMDD wants, but sometimes getting out and spending time with friends can be a great distraction. When choosing an activity keep in mind that for some people with PMDD a lot of people, noise, light and movement might be overstimulating.
"I care about you."
Be supportive and understand that your teen is struggling. Your teen probably has never met anyone -- or at least not anyone their age -- going through the same thing to have a positive role model for how to handle PMDD. In addition, PMDD can make your teen feel like he/she doesn't matter and that no one cares about them, they needs reassurance that this isn't true; you do value them and you do care about them. If your teen is receptive to it, show them our section on coping with PMDD.
"It's not your fault."
Be supportive. And to reiterate, be supportive. Not everyone will be and your teen needs to know that there are people on her side if she/he is willing to work with them to get better.
"You can get through this."
In the moment, PMDD can feel insurmountable. Have faith in your teen's ability to get though this even without a magic elixir to fix it.
"You aren't alone."
Show your teen this site or NAPMDD. Even looking through some statistics about PMDD can be powerful; if you look at the numbers your teen probably knows someone else with PMDD, it's just not something people are usually open about. Most figures put the percentage of the females with PMDD to be anywhere from 1-8%.
"Do you want to talk about it?"
If your teen not being toxic and is reaching out for professional help she/he still might like to talk to you about it. PMDD can be scary and isolating, show that you care.
It's important that people with PMDD get the help they need. If your teen seems to be having an especially hard time or something seems off talk to her about it. You might also want to keep an eye out for warning signs of suicide. Talking about suicide isn't putting ideas or dangerous in your teen's head, it's making sure that they aren't there in the first place and that your teen is safe.
No matter what your role in their life is, it's not your job to support the teen you care about alone. In addition to helping her/him get treatment help them build a support network of other people who can help them through this so you're not the only one this teen has to turn to. You need to take a break sometimes and care for yourself. There will be times when you can't be there for them, but that doesn't mean she/he has to go through it alone.