It’s fair to say that we’re not always our best selves around that particular time of the month.

Anything can set us off – soppy films, a flippant comment or a sad looking kitten. But, wth a little bit of help (ice-cream) we can usually hold it together. For most, premenstrual syndrome (PMS) is just a small fact of life and though irritating, it is mostly manageable. But for some, a period is accompanied by extreme mood swings, bouts of depression, anxiety and panic attacks. If this is the case, chances are you’re suffering from premenstrual dysphoric disorder (PMDD). It is thought that 3-8% of women actually suffer from the condition but the actual figure may be much higher given that sufferers may not be aware of the condition and assume that their symptoms are related to PMS. PMDD is “a more severe form of PMS,” Dr Jamil Abdur-Rahman tells SELF. And while PMS can present with a mix of physical and emotional symptoms like painful cramping, mood issues, and tender breasts PMDD ups the ante with far more intense, painful versions of the above. Sufferers tend to have angry out bursts, and often find their relationships are being affected, or they have trouble motivating themselves to go to work. While there is no medical test available to establish PMDD, patients who suffer from more than 5 of 11 symptoms are likely to receive a diagnosis. Some of these symptoms include excessive anger/irritability, bloating, lethargy, difficulty concentrating, and decreased interest in activities. Of these symptoms, the biggest indication is a mood-related symptom like anger or disinterest. "Mood is most concerning,” says Dr William Schweizer. “If there are psychological issues, a marked increase in anger or feeling more volatile.” Doctors believe the condition is caused by the way a woman’s body reacts to hormonal changes. While those suffering from PMDD may not experience higher or lower hormonal levels, what is thought to differ is a heightened response to normal changes of the menstrual hormones estrogen and progesterone. Some methods of birth control are expected to alleviate the impact of the condition. “We use a class called monophasic birth control pills—the amounts of estrogen and progesterone stay the same, so there are no fluctuations,” says Abdur-Rahman. In some cases, antidepressants may also help.