Premenstrual Dysphoric Disorder as Cyclical Ground State Disruption: Neuroactive Steroid Sensitivity, Luteal Phase as Imposed D(ξ), and the Monthly Return Arc

We apply the Displacement Framework to premenstrual dysphoric disorder (PMDD), formalizing the follicular phase as the hormonal ground state S°_hormonal and the luteal phase as a cyclically imposed displacement D(ξ) with four dimensions: mood, cognitive, identity, and somatic. The core mechanism is neuroactive steroid sensitivity: the progesterone metabolite allopregnanolone (ALLO) normally enhances GABA-A receptor function (anxiolytic), but in PMDD paradoxically increases anxiety — a sensitivity reversal that is the cause of luteal-phase displacement rather than abnormal hormone levels per se.

Nine formal propositions are derived covering: S°_hormonal as follicular-phase baseline with four defining properties, the ALLO/GABA-A paradox as the mechanism of cyclically imposed D(ξ), identity discontinuity as the core displacement (the dual-self structure of follicular vs. luteal identity), anticipatory anxiety during the follicular phase as D(ξ) accumulation before the displacement even begins, relationship strain as secondary D(ξ_social) from cyclically imposed D(ξ_self), lifetime Φ accumulation (3–6 months of displacement per year, up to 17 years over a lifespan), avoidance of luteal-phase commitments as secondary wrong attractor, SSRIs and hormonal suppression as return-path interventions targeting different mechanisms, and hormonal suppression as eliminating the cyclically imposed D(ξ) entirely (removing the forcing term rather than traversing the return path).

The diagnostic history of PMDD — dismissed for decades, denied DSM status until 2013 — is analyzed as reflecting landscape factors rather than scientific uncertainty.