Symptoms must include ≥ 1 of the following: Marked mood swings (eg, sudden sadness) Marked irritability or anger or increased interpersonal conflicts Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts Marked anxiety, tension, or an on-edge feeling In addition, ≥ 1 of the following must be present: Decreased interest in usual activities, possibly causing withdrawal Difficulty concentrating Low energy or fatigue Marked changes in appetite, overeating, or specific food cravings Insomnia or hyperinsomnia Feelings of being overwhelmed or out of control Physical symptoms associated with PMS (eg, breast tenderness, edema) Also, the symptom pattern must have occurred for most of the previous 12 months, and symptoms must be severe enough to interfere with daily activities and function.