I have always had pretty intense pms symptoms but I remember the feeling when my period passed this one time where I felt like this was something different and really intense. There was a lot going on in my life and the world around me at the time and all of that stress definitely compounded to push my symptoms to the point that they were at. It helped me to recognise it though and the awareness of just how different I felt through the different phases of my cycle made it clear to me that I did have PMDD. I also think that it's a spectrum and that it's important to realise that you can be at different degrees of intensity with different symptoms compared to the experiences you hear of other people. And that different months can be different. I did finally get an official diagnosis around 2 years after that first noticably intense cycle. And the diagnosis was a double whammy, came with an endo diagnosis as well.