Premenstrual Dysphoric Disorder in a Patient With Traumatic Brain Injury: A Case Presentation

We present a case of a 17-year-old girl who developed premenstrual dysphoric disorder (PMDD) after sustaining a severe traumatic brain injury (TBI), and we review the diagnosis of PMDD. The patient developed symptoms of severe depression surrounding her menses months after sustaining severe TBI and was diagnosed with PMDD by a psychiatrist. She ultimately required antipsychotics for optimal symptom resolution. PMDD is a severe form of premenstrual syndrome with symptoms including irritability, anxiety, and nonfatal suicidal behavior. We discuss other potential causes of mood disturbance that are important to screen for after TBI, including depression, anxiety, and hypothalamic-pituitary axis disorders. Rehabilitation medicine providers need to be aware of PMDD in postpubertal female patients with TBI because it can lead to nonfatal suicidal behaviors.

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