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That monthly syndrome

Pre-menstrual syndrome doesn’t just affect the mood and performance of women in those difficult days, it can lead to crime. A recent High Court judgement even accepted it as a precipitating factor for crime

Anita has lost all hope of normalcy. It has been five years since she started suffering this syndrome.

Every month, one or two weeks prior to her periods, she goes through a phase where she turns into a completely different person. In those days, she can hardly get out of bed and function properly, with a ‘sane’ mind. Call it depression or anxiety or aggression — it was like a ‘mystery’ killer, devouring her every month, driving her insane.

Not a myth
Majority of women in the world suffer from Premenstrual Syndrome (PMS) — a combination of symptoms that affects them every month, prior to their menstruation. The symptoms typically are cramps, headache, irritability, depression, mood swings, change of appetite and anxiety. But in our society, PMS is often considered a ‘myth’. Despite how largely it affects lives of every woman, often we come across ignorant people saying, ‘There is nothing like PMS, it is just an illusion!’

“During my periods, I feel extremely emotional. Little things can make me lose my calm,” says 22-year-old Ritika Das. Parita Dey, 23, seconds her view. She says, apart from body aches and cramps, she goes through a tough time mentally. “I get irritated very easily and it affects my work,” she adds. “There have been times when I feel like I am losing my mind. I argue with my family and friends at the slightest provocation,” says 21-year-old Rishika. She further adds that PMS hits her so bad that she often thought she might be suffering from depression. “I feel like a zombie. I cry without any reason. I feel lost and I even take some wrong decisions because of the emotional turmoil I am going through. It is a mess during PMS,” she elaborates.

Lack of awareness
Unfortunately, PMS is not taken seriously and thus remains untreated, unidentified and ignored. “The person must first accept that she is suffering from PMS. Most women don’t realise. So first a woman has to understand,” says Tripti Sharan, a Delhi-based gynaecologist. She further adds, “The way PMS affects each woman is different for each. Some suffer only from bloating, breast tenderness, irritability; while for others it’s much more. When it starts affecting your normal life, then it becomes a psychiatric problem which requires treatment.”

Sharan says that sometimes no medicine is needed for those suffering from PMS. “All you need is to make a woman understand that it is a natural thing and nothing is wrong with her. It will go away once the periods start. The treatment is not very difficult, but sometimes it is, when women do not accept or recognise. It is a normal thing that happens. And should be treated normally.”

Furthermore, many are unaware of Premenstrual Dysphoric Disorder (PMDD) –an extreme version of PMS. A study revealed that 15% of PMDD sufferers of commit suicide. Those who are suffering from PMDD are often unaware, and are mostly kept untreated due to the lack of knowledge about it. There have also been cases where women having PMDD were told they were suffering from ‘chronic depression’ and were subjected to wrong treatment.

“PMDD is a full-blown psychiatric disorder, an extreme form of PMS. It is a psychiatric manifestation of PMS which needs to be treated by the psychiatrists. Because in that case, a woman is in a state of dysphoria. Thus, those suffering from PMDD need medication.”

“For physical symptoms of PMS — multivitamins, anti-oxidants — such simple medicines are needed. They all help,”she adds. “But the second group —those who are suffering from PMDD — they need psychiatric treatment and medicines.”

In India, we have few specialists who deal solely with PMS or PMDD, nor are there any special centres to treat these kinds of cases exclusively. In UK, there is National Association of Premenstrual Syndrome which is an organisation which supports PMS sufferers, and believes in creating awareness regarding PMS and its treatment. Moreover, research needs to be done to know more about the causes and treatments of PMS.

When PMS kills
Recently, this month, Rajasthan High Court in a 37-year-old case verdict acquitted a woman of murdering a child on the ground that she was suffering from “insanity triggered by PMS.” The accused was able to give testimony of three witness — three doctors who treated her on three different occasions.

This was a first of its kind in India. “It has not been held by the Supreme Court as a valid defence. In this judgement, what the Court has stated is that an accused has to prove some of the reasons that propel the commission of the offence. And the prosecution has to prove its case beyond reasonable doubt. If you are able to create an iota of doubt in the mind of a judge by putting something like this, then the Court has to consider it and the Court may acquit. But the court has not held yet that this is the kind of jurisprudence which is there in the country,” says Mohit Kumar Gupta, a Delhi-based lawyer.

Countries like France and UK recognise PMS as a form of legal insanity. In various countries, there has been a debate regarding this issue. “In India, we are not holding it as kind of valid defence. But yes, in some circumstances, it may be justified to put a reasonable doubt. It is not a valid defence, but it could be used to create doubt in the mind of the judge,” says Gupta.

He further adds, “Someone can claim they were under severe depression, and using that they might be able to convince the judge that every evening they felt depressed, so during that time they committed a crime. Again, the judge has to consider this under medical jurisprudence. But that does not mean everyone will use that as a defence. It is a particular case. So, I do not think that the court has held any kind of medical jurisprudence applicable in India in this case. It has not conclusively spoken about this.”

Gupta believes it should not be used as a valid defence for a crime. “Then many women would start misusing this, and getting a woman convicted will become hard. Ultimately the law throughout the country has to be declared by the SC. Even if it renders applicable in Rajasthan HC, Delhi High Court might take a different view. I don’t think it will go a long way because at this stage to approach the honourable SC of India,” he concludes.