A growing number of women, healthcare professionals and advocates are calling for greater awareness and research into Premenstrual Dysphoric Disorder (PMDD), a severe hormone-related condition that can have profound effects on mental health, family relationships and quality of life but remains widely underdiagnosed and poorly understood.

Current research indicates that PMDD affects up to one in 20 women of reproductive age. Despite its prevalence, only about 1.6% of affected individuals receive a formal diagnosis. The consequences can be severe. Research cited in the source material indicates that approximately one-third of those diagnosed with PMDD have attempted suicide, underscoring the condition’s significant mental health burden.

PMDD is characterized by severe emotional, psychological and physical symptoms that occur during the luteal phase of the menstrual cycle, typically in the days before menstruation. However, many patients report years of confusion, misdiagnosis and ineffective treatment before receiving appropriate care.

Limited awareness within the medical community has contributed to delayed diagnosis and treatment, according to patients and healthcare professionals interviewed about their experiences. The condition remains unfamiliar to many clinicians despite its potentially debilitating effects.

The lack of understanding extends beyond clinical diagnosis. Relatively little is known about how PMDD affects family dynamics, particularly relationships between mothers and their children. In response to these gaps, the United Kingdom has recently seen the establishment of its first charity dedicated exclusively to supporting individuals with PMDD and their families.

For families living with the condition, the impact can extend far beyond the individual experiencing symptoms.Daly, now 37, recalls growing up in a household affected by her mother’s undiagnosed PMDD. She remembers frequent and intense arguments between her parents before treatment became available.

“I’d feel sad because she’d be crying – I hated seeing her so upset,” Daly said.Reflecting on her childhood, Daly described periods when her mother’s behavior was difficult to understand.“Mum was hard work at points. I’d sometimes overhear her shouting at Dad and think, this is unfair,” she said.

For many women diagnosed later in life, understanding the source of recurring emotional distress can bring both relief and regret. Barker, another woman living with PMDD, described years of struggling with symptoms that affected her relationships and self-perception.“I’d say nasty things, and felt unable to stop, then afterwards think: that was awful,” Barker said.

She described a recurring cycle in which episodes of anger and emotional instability were followed by periods of remorse, depression and repeated apologies.“Then the tears and depression came, I’d spend a week apologising – then it’d start all over,” she said.

Barker’s experience also highlights the connection between PMDD and serious mental health challenges. Visible reminders of that period remain part of her daily life.

Tattoos now cover self-harm scars from some of the most difficult years of her illness.A significant turning point came when consultant gynecologist Professor John Studd introduced her to treatment involving oestrogen implants. According to Barker, the results were immediate and transformative.“It was the only thing that worked – my symptoms disappeared,” she said.

However, access to treatment proved challenging. Barker said the National Health Service declined to fund the therapy because PMDD was classified as a syndrome rather than a disease, affecting eligibility for coverage.Determined to continue treatment, she contacted physicians, elected officials and healthcare providers while relocating from Hampshire to Edinburgh.

The process ultimately required substantial personal financial investment.“I ended up paying £600 every six months to travel to London and get a new implant fitted at my own expense,” Barker said.Despite the costs, she described the treatment as indispensable.“Life on the oestrogen implant was heaven,” she said.

At one point, Barker said her daughter loaned her £1,000 to help finance continued treatment after her own financial resources became strained.Even after finding an effective medical intervention, Barker said she remained concerned about the effect PMDD had already had on her children.

“I worried I’d ruined my relationship with my kids,” she said.She believes receiving treatment before her children reached adolescence helped prevent further difficulties, but she remains conscious of the years lost to managing symptoms.“I was lucky to get treatment before their teens.

But as younger kids, they grew up around me, not with me,” she said. “I was on the outside looking in, trying to manage and hide my symptoms. They bore the brunt.”According to Barker, successful treatment allowed her to reconnect emotionally with her family in ways that had previously been difficult.She said it enabled her “to feel the love and joy from spending time with the kids which PMDD had stolen.”The lack of awareness surrounding PMDD is not limited to patients.

Healthcare professionals themselves can experience the condition without recognizing it.Dr. Milli Raizada, a general practitioner and specialist in women’s health, said she had never heard of PMDD before being diagnosed with it six years ago, despite years of medical training and clinical experience.Now 40, Raizada said the diagnosis exposed significant shortcomings in professional education regarding women’s health conditions.

She described feeling disappointed that a condition affecting so many women remained largely absent from medical training.“Too many doctors, myself included, don’t have the knowledge to help women who suffer in silence,” she said.Raizada argues that improvements in medical education and research are essential if diagnosis and treatment rates are to improve.“Better training. More research.

Stop sidelining women’s health,” she said.Her own symptoms emerged after discontinuing oral contraceptive medication. According to Raizada, changes became apparent during the luteal phase of her menstrual cycle, when emotional and psychological symptoms intensified.“In the luteal phase, I’d be arguing lots with him and he said, ‘This isn’t normal’,” she said, referring to observations made by her husband.

Raizada described a sharp contrast between her usual personality and the symptoms she experienced during affected periods.“I’m usually resilient and a multitasker but I suddenly had impostor syndrome, felt overwhelmed and worthless, and was hypersensitive and apathetic for two weeks of the month,” she said.

The turning point came after an unusually intense reaction to a routine family interaction.“After flying off the handle at my mother-in-law over a throwaway comment, I knew it was time to act,” Raizada said.For advocates and patients, such experiences illustrate the urgent need for greater recognition of PMDD within healthcare systems.

Despite affecting millions of women globally, the condition continues to be characterized by delayed diagnoses, inconsistent treatment access and limited research, leaving many patients to navigate years of symptoms before obtaining effective care.

Actor Hannah Murray has offered a deeply personal account of psychosis, involuntary psychiatric treatment and the breakdown of her sense of reality in a forthcoming memoir, describing a period in which she believed she possessed supernatural abilities and played a central role in humanity’s salvation.

In an extract from her memoir, The Make-Believe: A Memoir of Magic and Madness, Murray recounts her experiences while undergoing a severe mental health crisis that ultimately led to her being detained under the UK’s Mental Health Act.

The actor, widely known for portraying Gilly in the television series Game of Thrones, describes a state in which ordinary events were interpreted through an elaborate belief system involving magic, destiny and spiritual transformation.

According to the memoir extract, Murray believed she had become a “Ritual Master” and viewed routine interactions within a hospital setting as part of a larger supernatural narrative. Medical staff, patients and family members were assigned symbolic roles within a reality she perceived as fundamentally altered.

She recounts being brought food and drink by a healthcare worker but refusing to eat, believing instead that she no longer required conventional nourishment. During this period, she writes that she considered herself entirely self-sufficient and capable of surviving through spiritual energy rather than physical needs.

As her condition intensified, Murray describes wandering hospital corridors while waiting for what she believed would be the arrival of an important figure connected to her perceived mission. She interpreted events around her through the lens of a complex belief system that blended personal experiences, spirituality, popular culture and fantasy.

One of the most emotionally significant moments in the account involves a phone call from her mother. Murray writes that when she first heard her mother’s distressed voice, she viewed the conversation not as a family member trying to reach her, but as part of a test designed to pull her back into ordinary reality.

She recalls ending the first call before answering again when her mother phoned back. During the second conversation, Murray attempted to reassure her that she was safe and believed she was in a positive place despite the growing concerns of those around her.

The memoir describes how medical professionals informed her that she was being sectioned under the Mental Health Act, a legal process that allows individuals experiencing severe mental illness to be detained and assessed when they may pose risks to themselves or are unable to recognise their condition.

At the time, however, Murray writes that the information had little impact because it did not fit within the reality she believed she was experiencing. References to legal procedures, assessment periods and patient rights appeared disconnected from the worldview that had taken hold during her psychosis.

Instead, she says she remained focused on what she perceived as powerful energies moving through her body and voices that reinforced her convictions. Throughout the episode, Murray believed she possessed extraordinary abilities and unlimited creative powers.

The actor describes pacing hospital corridors while delivering what she considered a profound performance, convinced she was simultaneously a magician, actor, writer and spiritual guide.

She believed she could perform any conceivable action and viewed herself as possessing superhuman capabilities.The memoir further details grandiose beliefs commonly associated with psychotic episodes. Murray writes that she became convinced she had prevented an apocalypse and served as a central figure in humanity’s future.

She interpreted cultural references, films and professional experiences as evidence supporting those conclusions.Among those interpretations was her belief that a 2016 film, The Girl with All the Gifts, contained messages connected to her perceived role in world events.

She viewed the title itself as a reflection of her identity during the episode.Murray also writes that her acting career took on symbolic significance within the delusional framework. Professional collaborations and casting decisions were reimagined as part of a larger cosmic narrative.

She came to believe that her work in television and film had been preparing her for a destiny connected to the survival and transformation of the world.The account illustrates how psychosis can fundamentally alter a person’s perception of reality, leading ordinary experiences to acquire extraordinary meanings.

Mental health specialists often describe psychosis as a condition in which individuals may experience delusions, hallucinations or disordered thinking that make it difficult to distinguish between subjective beliefs and external reality.Murray’s memoir presents those experiences from her own perspective, allowing readers to follow the internal logic that shaped her thinking during the crisis.

Rather than reflecting on the events solely through hindsight, the narrative recreates the certainty with which she held those beliefs at the time.The extract forms part of a broader memoir examining Murray’s experiences with mental illness, recovery and identity.

By documenting her psychotic episode in detail, she offers an account of how severe mental health conditions can affect perception, relationships and decision-making.The book is scheduled for publication by Cornerstone and explores both the onset of Murray’s illness and the process of understanding what happened after the crisis ended.

The actor is also due to discuss the memoir publicly during an event in London alongside Jessie Cave.For Murray, the memoir represents an effort to chronicle a period in which reality itself became unstable, transforming familiar people, places and experiences into elements of a narrative that felt entirely real at the time but was ultimately shaped by psychosis.

For years, she wanted a child. After a decade of waiting, hope and uncertainty, pregnancy finally arrived carrying both joy and fear in equal measure. What followed, however, was not the soft, instinctive transition into motherhood that culture often promises, but a physically traumatic birth, emotional numbness and a long struggle to recognise herself in her new life.

During pregnancy, she found herself largely alone. Her husband, though supportive and loving, was frequently absent, consumed by the demands of a startup consultancy he had recently founded with two academic partners.

Medical appointments, including an amniocentesis prompted by concerns over possible chromosomal abnormalities, were often faced without him because he was abroad for work.

She attended prenatal classes, but support systems felt limited. Only one person in her close circle had children, and her relationship with her own mother, who lived in Italy, was strained. The isolation deepened her anxiety, particularly because childbirth itself frightened her.

When she raised those fears with her general practitioner, she recalls receiving a familiar reassurance that did little to ease them.“Don’t worry, birth isn’t an illness,” her male GP told her. “It’s all perfectly natural.”She felt the dismissal ignored her lived reality. She was asthmatic and suffering from undiagnosed endometriosis that caused severe pain every few weeks.

Pregnancy did not feel simple or natural. It felt uncertain and medically significant.Still, she felt deeply connected to the child growing inside her. She recognised her daughter through movement alone—the shape of limbs pressing against skin, strong kicks in response to passing sirens, a physical presence both strange and intimate.

She imagined a temperament already forming: long legs like her father, a temper like her own.She expected love to be immediate. After waiting so long, how could it not be?Her due date passed. Then another week.

Then another. At more than 44 weeks pregnant, she says she had to insist repeatedly before her GP agreed to induction. Only when hospital monitoring showed signs of fetal distress did medical staff finally intervene and break her waters.

Labour lasted 20 hours.

She describes induced labour not as a gradual progression but as a sudden collapse into nausea, pain and exhaustion. Hours passed with no progress. She was unable to receive an epidural at first because she was not dilating. The pain became all-consuming.

At one point, fearing the worst, she asked her husband to make a promise: if doctors had to choose between saving her life and their child’s, he should choose the baby.“I am not going to lose either of you,” he replied.

She remembers University College Hospital at the time as a place that inspired little confidence—a crumbling Victorian building with filthy bathrooms, blood on the floors and junior doctors exhausted by punishing shifts. Around her, the maternity ward echoed with the sounds of women in labour: groans, cries, gasps and fear.Eventually she received an epidural, but the baby remained stuck.

Just before midnight, an emergency forceps delivery and episiotomy were performed. Her husband later told her there were 13 people in the room.Then their daughter arrived.She weighed just under 4.5 kilograms—almost 10 pounds.

The mother had lost so much blood that the experience felt, in her words, like surviving a car crash. Her husband, standing in blood-soaked jeans, was overwhelmed with joy.“Isn’t she wonderful?” he said.She felt nothing.

She describes the absence of emotion not as rejection, but as total numbness, as though the epidural that had numbed her body had also severed access to feeling. She spent the night awake in the recovery ward waiting for the expected rush of maternal love that never came, listening to other women crying as anaesthesia wore off.

Instead, she felt transported back to boarding school dormitories, where she had learned early to suppress everything except anger.“Rage has served me quite often as a stimulant against exhaustion,” she writes. “Every woman who goes through childbirth has, I believe, been through the equivalent of war.

”She compares childbirth to trauma rather than celebration, arguing that many women leave the experience carrying symptoms closer to post-traumatic stress than to joy.

She believes poor maternity care intensified that reality.Her experience took place during years of severe strain on Britain’s National Health Service, when long-term underfunding and overstretched staff affected standards of care.

But she also sees a broader cultural issue: motherhood itself, she argues, is often insufficiently respected.At the time, general practice and obstetrics were still dominated by men.

She does not argue that male doctors cannot provide excellent care, but believes many failed to understand how dangerous childbirth could still be, or how often women’s pain was normalised rather than addressed.She was discharged the next day after a blood transfusion and severe physical trauma. She could barely walk.

Her husband worried about her physical recovery, but neither of them recognised the mental damage taking shape beneath it.When the baby began crying—night after night, almost without pause motherhood became a contest between exhaustion and fury.

“Once our baby began to cry relentlessly every night, all night, it felt like a battle between my rage and hers,” she recalls.Then one day, something changed.Her daughter, whose eyes had until then seemed distant and unfocused, suddenly looked directly at her. Then came a smile—clear, unmistakable and full.It was not simply recognition. It felt like acceptance.

“She seemed not only to recognise me, but to greet me with unconditional love and delight,” she writes.She understood intellectually that infant smiles are biological survival mechanisms, but the emotional impact was overwhelming.

The joy felt so sharp it was almost painful.“Oh!” she remembers saying. “It’s you. It’s you.”That first smile altered everything.The sleepless nights did not disappear. The crying continued. But something fundamental shifted in her understanding of motherhood, of love and even of her own mother.

Her relationship with her mother, long marked by pain and distance, softened. She began to understand her mother’s own unresolved grief and emotional absences not simply as cruelty, but as the result of childhood bereavement and wounds never healed.Motherhood brought not only responsibility, but perspective.

As a writer, she found that literature had offered little preparation for the reality of childbirth. Victorian novels she loved moved quickly past pregnancy and motherhood, treating them as narrative transitions rather than lived experiences.

Even contemporary women writers often avoided describing the devastation of birth itself.When she included the physical brutality of childbirth in her 1996 novel A Vicious Circle, critics attacked what one reviewer called “revolting details.”

Yet she says she had still softened the truth, giving her fictional heroine an instant maternal bond she herself had not felt.Years later, much changed. Hospitals improved. Her GP practice became staffed by younger, mostly women doctors. She had a second child, a son, whose birth was entirely different and with whom she bonded immediately.

Her daughter, Leon, grew into a novelist herself—healthy, loving and brilliant.Looking back, she says motherhood brought both unimaginable suffering and extraordinary love.

Public conversation often reduces it to either sentimental joy or unbearable hardship. The truth, she argues, is both.And if the early days felt like darkness, what remained was not the trauma alone, but the light that followed.

Toupees, long associated with poor aesthetics and social stigma, are re-emerging in the form of modern “hair systems”, driven by advances in design, changing attitudes toward male grooming, and the influence of social media.

Industry data and practitioner accounts indicate rising demand for these non-surgical hair replacement options, particularly among men experiencing pattern baldness.Hairpieces have existed for millennia, with evidence of their use traced to ancient Egypt. Toupees, which differ from full wigs by covering only part of the scalp, originated in 18th-century Europe.

The term derives from the French word “toupet”, meaning a tuft of hair. Their popularity peaked in the mid-20th century, with Time magazine estimating that more than 2.5 million men in the United States wore toupees by 1970.

However, their use declined as cultural perceptions shifted, influenced in part by ridicule in popular media and the growing social acceptance of shaved heads.Despiethat decline, hair loss remains widespread.

Estimates cited in clinical practice suggest that male pattern baldness affects between 30% and 50% of men by age 50 and up to 80% over a lifetime. Fabian Martinez, a trichologist and manager at the London Hair Clinic, said that emotional responses to hair loss remain significant.

He reported that clients across professions, including law and entertainment, have expressed distress over balding and reluctance to adopt a shaved appearance. According to Martinez, there remains a “misconception” that men should accept baldness without seeking alternatives.

Recent developments in hairpiece manufacturing have altered the market. Modern hair systems are typically constructed from human or synthetic hair attached to lace or polymer-based membranes designed to replicate the appearance of scalp skin. These systems are adhered using medical-grade adhesives and can be tailored to match an individual’s natural hair colour, density and style.

Practitioners say the improved realism and durability distinguish them from earlier products, which were often criticised for their artificial appearance.Market indicators point to renewed consumer interest. Google search trends show a marked increase in queries for “hair systems” since 2025.

Aderans, a manufacturer whose subsidiary Trendco has produced hairpieces since 1965, reported a 43% year-on-year increase in male customers purchasing such systems in 2025. The company attributed this growth partly to the visibility of hair transformation content on social media platforms.

Online content has played a measurable role in shaping consumer behaviour. Posts tagged with “#toupee” on Instagram number in the hundreds of thousands, with some videos attracting millions of views. Emily Alexis Ann Cheney, a California-based stylist known online as the “Toupee Queen”, produces videos documenting client transformations from partial or advanced baldness to full hair coverage.

Viewer responses to these videos are predominantly positive, often focusing on perceived natural appearance and aesthetic improvement.Consumers cite these visual demonstrations as influential. Jon McSherry, a 46-year-old from Lincoln, said he decided to adopt a hair system after watching before-and-after videos online.

He described a mismatch between his physical appearance and how he felt, noting that his hair loss had become more pronounced in his forties. His experience reflects a broader trend of individuals seeking immediate, non-invasive solutions.Barbers and clinics have begun incorporating hair systems into their services.

Thomas Robinson, owner of Tom’s Barbers in Lincoln, said he introduced the offering two years ago after observing demand among clients with thinning hair. He currently serves around 40 customers, each paying more than £600 for a system. Robinson said improvements in product quality and affordability had contributed to uptake, describing the results as immediate and predictable.

Hair systems compete with other hair restoration methods, particularly surgical transplantation. Hair transplant procedures involve relocating follicles from one part of the scalp to another and are typically performed under local anaesthetic.

The UK’s National Health Service states that such procedures are generally safe when conducted by qualified practitioners in regulated settings, though it notes risks including infection, bleeding and allergic reactions. Costs vary widely, ranging from £1,000 to £30,000, with private sector averages reported at approximately £4,820.

Lower-cost procedures are available abroad, particularly in Turkey, where state media reports typical prices around $2,000.Greg Williams, a surgeon and spokesperson for the British Association of Aesthetic Plastic Surgeons, said that while complications from transplantation are uncommon, the procedure often requires repeat interventions due to the progressive nature of hair loss.

He noted that scarring, temporary numbness and infection can occur, though serious complications are rare. Williams added that patients are typically advised to use medication long-term to preserve existing hair.He also highlighted differences in outcomes between surgical and non-surgical approaches.

According to Williams, hair transplants may not achieve the same density as hair systems, particularly in cases of advanced hair loss. As a result, he said hairpieces are often discussed as part of the informed consent process, especially for patients seeking fuller coverage.Some users cite flexibility as an advantage of hair systems.

Unlike surgical interventions, they are not permanent and can be replaced or removed. Paul McCafferty, a 51-year-old from Edinburgh, said he initially adopted a hair system as a short-term solution but continued using it after achieving satisfactory results. He reported that improved products allowed longer use, with some systems lasting up to a year under proper maintenance.

Maintenance requirements include periodic cleaning, rebonding and replacement. Practitioners advise gentle washing and adherence to care guidelines to ensure durability. Robinson said his clients include individuals with active lifestyles, including those who swim, exercise regularly or participate in water sports, suggesting that properly maintained systems can withstand physical activity.

However, hair systems are not without limitations. In January, during a boxing match between Jarrell Miller and Kingsley Ibeh, Miller’s hairpiece became dislodged and was removed mid-fight. Industry practitioners attributed the incident to possible application issues or insufficient time for adhesive bonding prior to intense activity.

Despite such cases, users report growing confidence in the reliability of modern systems. McSherry said initial concerns about detachment diminished with use, adding that the system felt secure and indistinguishable from natural hair.

He attends monthly maintenance sessions, though frequency varies depending on individual needs and lifestyle.