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I’m a teenager, do I have PMDD?

What’s happening in my body?
PMDD causes changes in my hormones during my menstrual cycle. These shifts can make my brain and body react more strongly than usual, leading to headaches, tiredness, and feeling physically unwell. Sometimes, I feel pain or discomfort that comes and goes each month.

How do I feel?
I might suddenly feel very sad, angry, anxious, or irritable, even if nothing has happened to cause it. My energy drops, and I can find it hard to concentrate or remember things. Sometimes, I feel overwhelmed or like I want to be alone, and it’s hard to explain why.

How does it affect me at school, socially, or at home?
At school, I might struggle to keep up with lessons, forget homework, or find it hard to join in with friends. I may need to miss days or take breaks when I feel unwell. Socially, I can feel left out or misunderstood, especially if my mood changes quickly or I want to avoid people. At home, I might argue more, need extra support, or find it hard to help with chores or family activities. These ups and downs can be confusing for me and those around me.

Navigating School Support

PMDD can make school challenging. Teenagers may experience irritability, tearfulness, “brain fog,” headaches, and fatigue, which can lead to increased absences or difficulties with learning and social interactions. If you notice a pattern of difficulties, start by contacting your child’s form tutor, SENCO (Special Educational Needs Coordinator), or pastoral lead. Bring a symptom diary or chart to show how symptoms link to the menstrual cycle, and be honest about the impact on learning and wellbeing.

Schools can make reasonable adjustments to help your child, such as:

• Flexible timetables or permission to leave lessons if symptoms flare up

• Access to a quiet space for rest or emotional regulation

• Extra time or rest breaks during exams and assessments

• Support with homework deadlines during severe symptom periods

• Permission to use comfort items or take short walks

Support doesn’t always require a formal EHCP. Many schools offer SEN (Special Educational Needs) provision, Individual Health Care Plans, or Pastoral Support Plans tailored to your child’s needs. Regular check-ins with a trusted adult at school can also make a big difference.

EHCPs and the Realities of the Process

Applying for an Education, Health and Care Plan (EHCP) is often described as a marathon rather than a sprint. The process is governed by the Children and Families Act 2014 and SEND Regulations 2014, which set out statutory timeframes—usually 20 weeks from request to final plan—but in practice, delays are common. Each local authority has its own approach, resources, and priorities, so experiences can vary widely.

Starting the Journey

• You can request an EHC needs assessment directly, or the school can do this on your behalf. The local authority must reply within six weeks, but this is just the beginning.

  
  

• Evidence is everything. Symptom diaries, letters from GPs, CAMHS, and school reports showing the impact of PMDD on learning, attendance, and wellbeing are vital.

  
  

• The local authority will seek advice from professionals—education, health, and social care. If advice already exists, they should not duplicate it, but parents can ask for new assessments if circumstances have changed.

Assessment Phase

The local authority gathers information from you, your child, the school, and relevant health professionals. You’ll be given 15 days to comment on a draft plan and suggest a preferred school or setting. If your child is absent from the area for four weeks, or there are exceptional personal circumstances, the process may be delayed. You should be informed if exemptions apply.

Drafting and Reviewing the Plan

The draft EHCP should detail your child’s needs, desired outcomes, and the provision required. It’s your chance to challenge anything that’s missing or unclear. You can request specific therapies, adjustments, or support, but the local authority will weigh these against their resources and policies. Some counties are ambitious and creative, others are stretched and risk-averse.

Common Pitfalls and Delays

• Some local authorities may push back, suggesting SEN support is “enough” or that PMDD is “just puberty.” Persistence is key—refer to statutory guidance and keep records of all communication.

  
  

• Delays can occur if professionals miss appointments, schools are slow to respond, or there’s a lack of understanding about PMDD. If you feel the process is drifting, ask for updates and escalate if necessary.

  
  

• The process can be emotionally draining. Some parents find themselves repeating information, chasing reports, or attending multiple meetings with little progress.

Interim Support

While waiting for an EHCP, ask the school for interim measures: Individual Health Care Plans, flexible timetables, or pastoral support. These can be put in place quickly and reviewed regularly.

Appeals and Mediation

If the local authority refuses to assess or issue a plan, you have the right to appeal to the SEND Tribunal. Mediation is available and sometimes helps resolve disputes without formal hearings. Keep all evidence—emails, meeting notes, medical letters—as this will support your case if you need to challenge decisions.

Transition Points

• Timing is critical. If your teenager girl is approaching GCSEs or leaving school, push for urgency. EHCPs can continue into further education, but delays may mean support arrives too late for secondary school.

Parent Experience

• Some parents describe the process as “ambitious but messy”—full of hope, setbacks, and small victories. Others find it slow and bureaucratic, with progress depending on the knowledge and attitude of individual caseworkers.

Key Tips

• Be persistent, patient, and prepared to repeat yourself.

• Use statutory guidance to back up your requests.

• Don’t be afraid to escalate concerns or seek advice from SENDIASS or advocacy services.

• Remember, you are your child’s best advocate.

Working with CAMHS and the Local Authority

Navigating mental health services for a child with PMDD can feel overwhelming, especially when symptoms are severe, unpredictable, or misunderstood. CAMHS (Child and Adolescent Mental Health Services) is the main NHS service for children’s mental health, but access and support can vary depending on your area and the professionals involved.

Getting a Referral to CAMHS

• Referrals can be made by your GP, school, or sometimes directly by parents. If your child’s mood swings, anxiety, or distress are affecting daily life, don’t wait—ask for a referral and bring a clear symptom diary showing the cyclical nature of PMDD.

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• Schools can support referrals by providing attendance records, behaviour logs, and evidence of impact on learning. The more detailed your evidence, the easier it is for CAMHS to understand the severity and pattern of symptoms.

What to Expect from CAMHS

Initial assessment may involve interviews with your child and family, questionnaires, and review of school reports. Be prepared to explain how PMDD differs from typical puberty or general anxiety. CAMHS can offer psychological therapies such as CBT, family therapy, or counselling. For PMDD, they may focus on emotional regulation, coping strategies, and crisis planning.

If your child is at risk of self-harm or severe distress, CAMHS can provide crisis intervention, safety planning, and sometimes medication review. CAMHS can liaise with school staff, SENCO, and other professionals to ensure a joined-up approach. This might include advice on reasonable adjustments, attendance support, or strategies for managing symptoms in the classroom.

Challenges and Realities

Waiting times for CAMHS can be long, and not all clinicians are familiar with PMDD. You may need to advocate for your child, explain the cyclical nature of symptoms, and request specialist input if needed. Some families find that CAMHS focus on general mental health, so it’s important to keep highlighting the link between symptoms and the menstrual cycle.

Local Authority Support

• If PMDD leads to frequent absences or your child is unable to attend school, the local authority may offer alternative provision such as home tuition, online learning, or access to a learning centre.

  
  

• Education Welfare Officers can help with attendance issues, and may work with the school to develop a reintegration plan.

  
  

• If there are safeguarding concerns—such as self-harm, suicidal thoughts, or family stress—social care may become involved. Their role is to assess risk, offer support, and ensure your child’s safety.

Advocacy and Navigating the System

Advocacy services can help you prepare for meetings, understand your rights, and challenge decisions if you feel your child’s needs are not being met. Keep all correspondence, meeting notes, and written summaries of agreed support. This helps track progress and ensures accountability. If support is slow or ineffective, request urgent reviews, escalate concerns, or contact your local authority’s SEND team for advice.

Crisis Planning

Recognise signs of severe distress: withdrawal, self-harm, suicidal thoughts, or sudden changes in behaviour. Know who to contact in a crisis: your GP, CAMHS crisis team, or emergency services. Many areas have 24-hour crisis lines for young people. Make sure your child knows who they can talk to at home, school, and outside of school. Build a safety plan together, including trusted adults and coping strategies.

Disclaimer:
This article is for general information only and is written to help parents and carers understand PMDD in teenagers. It is not medical or legal advice. If you are worried that a child or teenager is in immediate danger, or at risk of harm, contact emergency services by dialling 999, or visit your nearest Accident and Emergency department. Always seek professional help if you have concerns about a young person’s safety or wellbeing.