"Time will pass... this will pass… I will, eventually, be myself again."
It happens every month… You become a version of yourself that you have come to hate. You feel broken, disconnected from joy and love that you typically feel. You feel tense…so tense. Like your body could literally explode. Frustration, irritability, uncontrollable mood swings, deep sadness to deep rage. These all come flooding towards you at once and of course it is the people you love most that get the worst of it…the worst of you. And then, you get a burst of absolute guilt and shame around your inability to control your emotions and how you treated your loved ones. EVERY MONTH…
Defining PMDD
The International Association For Premenstrual Disorders defines Premenstrual Dysphoric Disorder (PMDD) as: "a cyclical, hormone-based mood disorder with symptoms arising during the luteal phase of the menstrual cycle and lasting until the onset of menstrual flow. It affects an estimated 2-10% of women of reproductive age. While PMDD is directly connected to a woman’s menstrual cycle, it is not a hormone disorder. It is a suspected genetic disorder with symptoms often worsening over time and following reproductive events including menarche, ovulation, pregnancy, birth, miscarriage, and menopause.”
So… to sum that up, PMDD symptoms show up around the 14th day of your cycle (typically a week and a half to two weeks before your period starts). These symptoms build with the hormone levels in your body and typically start to fade and dissipate after you start your period and hormone levels begin to balance out.
THIS IS NOT PMS
PMS is a term that defines “normal” and typical symptoms that occur when women get their periods. PMDD is a much more significant disturbance of mood and emotion that often has a damaging impact on your life and relationships. It is the “evil twin of PMS,” looking very similar and sharing similar core traits, however PMDD having hidden villainous qualities that can cripple the life of the women suffering from it.
What PMDD Looks Like
The lack of suitable medical research makes it hard to identify the exact symptoms of PMDD, and they can vary from woman to woman. Below are the most common symptoms of PMDD. Keep in mind the intensity level of these symptoms is higher than “common” PMS symptoms:
Depression * Sadness * Hopelessness * Anxiety / Panic Attacks * Tension/Restlessness * Extreme Sensitivity / Mood Swings * Irritability * Rage / Anger * Suicidal Ideations * Racing thoughts / Difficulty Concentration * Relational Conflict * Low Self-esteem / Negative self-talk * Fatigue / Insomnia * Self-Harming
A Little History
PMDD was not recognized as a diagnosable disorder until May of 2013. Prior to that it was acknowledged as provisional due to insufficient research and was often treated as a low level depressive disorder that got worse during menstruation. This led many women to feel guilt and shame around their symptoms and be treated incorrectly for their struggles.
What PMDD Feels Like
Women suffering from PMDD have described it as feeling like a completely different person, as though you are living a different life.
Here are some quotes from courageous women who chose to share their experience:
“I felt deep misery and severe panic attacks, and when in the thick of it, I felt as though I would always be this miserable and it wouldn’t go away.” - Marie, 31
“When I am in the worst of it, I feel as if my body could literally explode with the amount of tension I experience. The littlest things will completely overwhelm me to the point of inability to function and do daily tasks.” - Jennifer, 37
“I tend to be a perfectionist naturally but when it is the week before my period I am wholeheartedly convinced I am failing at everything in life, and that EVERYONE feels the same way. I am a complete irrational mess.” - Anita, 29
“I cry for a week… I am wrecked by any and all emotions. Songs, commercials, certain sounds, I’m crying. And not just a few tears shed, a deep, raw, ugly cry!” - Kendra, 40
“My husband was fearful of this time of the month, every month. Before we knew what was happening to me, and before we even knew what PMDD was, we used to fight a lot about how bad I got. It was so hard to explain to him what was happening for me when I didn’t even know myself. I felt GUILT like I’ve never felt about anything else in life.” - Lisa, 39
See what more women say about their experiences with PMDD here.
If you relate to these women, I hope this helps you know, YOU ARE NOT ALONE. You are not broken, you are not crazy.
TREATMENT
There are many different treatments for PMDD, some natural remedies as well as medications. One of the more complicated parts of treating and managing PMDD is that there is no one size fits all remedy. Our bodies are all diverse and respond differently to the vast amount of options there are to navigate this journey. The important thing is to find the unique treatment regimen that fits for YOU.
Medical + Prescription Treatment Options
Most commonly prescribed in the medical field are antidepressants that slow the re-uptake of serotonin (SSRI’s: Prozac, Celexa, Effexor, etc.), which have shown to be an effective treatment of PMDD. These drugs decrease symptoms of PMDD more rapidly than typical depression or major depressive disorder, which means that women don't necessarily have to take them every day. Instead, these drugs are commonly prescribed to be taken as “luteal-phase” doses, beginning approximately 14 days before mensuration starts and ending shortly after.
Other medical and prescription treatment options include HRT (hormone replacement therapy), birth control, or hysterectomy + oophorectomy (removal of uterus + ovaries), all of which have benefits and deficits included within them but have also been shown to help significantly for some women.
Holistic Approaches to Treating PMDD
There are a variety of holistic treatment options and regimens that have been shown to successfully manage and lessen the intensity of PMDD symptoms. Dietary and nutrition changes, vitamins and herbal supplements, mindfulness, meditation, acupuncture, eastern medicine, naturopathic medicine, psychotherapy and coaching, are just some of the approaches to treating PMDD symptoms that have created positive changes. Often times it is finding the right variety of these options that work for you and fit your unique journey with PMDD.
All of these options can be quite overwhelming. The trial and error period is often where disappointment and discouragement can create a sense of hopelessness in overcoming the struggle. That’s where we come in…
How Therapy Can Help
Sessions include the following elements:
A safe place to get intimately familiar with your cycle, your triggers, your saving graces and understand your relationship with PMDD.
Knowing yourself on every level, from what pushes you to the edge to what pulls you back, is key to surviving PMDD.
Conversations on how to lean into PMDD, prepare for its monthly battle, and reach acceptance of its presence in your life, to weaken its hold on you and free you to live fully and wholeheartedly as your true self.
Personalized coping tactics and strategies for how to manage your symptoms, both leading up to and in the eye of the storm.
Finding the tools that work for YOU and your unique monthly journey, this is not a one size fits all method.
A guide to navigating the endless natural treatment remedies that have shown to combat symptoms of PMDD.
This includes homeopathic treatment options, nutrition, body movement, and sleep strategies.
An accountability partner to keep you focused and redirect you when you stray from your path.
We are human and we often step away from the paths we know are guiding us towards fulfillment. Sometimes we need someone to remind us to come back.
A place to understand how your personal relationships affect your PMDD. Therapy can also help heal any damage that PMDD has caused in your relationships as well as help you battle against any residual guilt or shame you may be feeling.
Partners, family, friends, co-workers, all play a role in helping or hindering our success every month. Understanding this can be a tremendous asset as you voyage into PMDD.
PMDD can create shifts in our thoughts that can blind us to reality as well as disconnect us with our own inner strengths. Therapy can help you find ways to create more clarity and ability to address our own damaging thoughts.
Therapy can also help to ground you and connect you to who you are underneath the havoc that PMDD is wreaking on your life.
More than anything, therapy is place to be heard, to be understood, and to NEVER be judged for what you are feeling or experiencing.
Because PMDD is a fairly new diagnosis and less widely known by the general public it can be hard to find people to talk to and connect with.
If you suffer from PMDD, I hope you will reach out for help and know you are not alone.
Find support here and connect with other women that suffer from PMDD: PMDD Facebook Support Group
If you are located in California and think therapy is the right path for you, we can help.