PMDD: Learning to Weather the Storm
Guest post by Terri Harris, Menstrual Health Educational Trainer and PMDD Advocate
Every cycle begins the same for me, a giant pimple on the right hand side of my chin, tender breasts, and crippling depression.
For many, a slight change in mood will come hand-in-hand the two weeks before their period. For me and my experiences living with PMDD over the past fifteen years, the two weeks before my period have been accompanied by deeply negative thoughts and excruciating anxiety.
That’s because I am one of the 2% of people who menstruate who suffer from Premenstrual Dysphoric Disorder, or PMDD.
Early days
I was eleven when I got my first period. My mother celebrated by baking me a cake and telling everyone, everywhere that I had finally become a woman. Unlike many, my introduction into periods was overwhelmingly positive.
However, from that point onwards what I experienced has been overwhelmingly negative. From age eleven until now, each month has brought crippling pain, calamitous fights and insuppressible tears. According to everyone around me — including medical professionals — what I was experiencing was just normal hormonal changes happening due to puberty.
In my late teens, I began to practise self-harming (cutting) every month at about the same time. It seemed to bore away, for a moment, the ongoing self-loathing chatter in my head. My first doctor told my mother this was classic attention-seeking behaviour of someone my age. I was told to go home and reflect on my actions.
By my early twenties the self-harm had been replaced by risky behaviours. Drugs, sex and alcohol became a normal occurrence to black out the emotions that overtook me in the two weeks before my period. I visited multiple healthcare professionals who prescribed anti-depressants, many of which numbed the pain slightly but didn’t reduce the undulating emotions I would experience every month.
Throughout this time, my romantic life was defined by dysfunctional and emotionally abusive relationships. In the weeks leading up to my period my personality would change completely — I would rage at my partners for every little mistake, I would become paranoid about their friendships and would even convince myself that our relationship was doomed to fail. My whole body would become completely disgusted by their touch and appearance. The effects of this emotional fluctuation was detrimental, with every partner finally growing tired of my ever-changing moods and eventually ending the relationship with me.
Similarly in my friendships, I lost many of my trusted confidants because of outbursts that would happen during my 2-week pre-menstrual phase. During these two weeks, my mind would tell me these friends were judging me and never liked me anyway. In these moments I chose to isolate myself so that these friends wouldn’t see the real me — the horrible and selfish person my mind continually told me I was. So, I would suffer in silence, distance myself from them and finally the friendship would fizzle out. Me. Alone. Again.
In seeking out help, I saw a therapist and undertook Cognitive Behavioral Therapy (CBT) for a few years, took numerous anti-depressants and anti-anxiety medications, all of which seemed to have made my symptoms worse or had no effect at all. I wasn’t formally diagnosed with PMDD until I was 21 when I visited a private gynaecologist in a wealthy area of London. I paid around £300 for the diagnosis (which made little difference), as my state-funded treatment remained the same as the way doctors saw my mental health did not change, as they did not recognise the condition.
From that point on I felt hopeless, and continued to suffer in silence.
The Big Change
The final straw was a conversation I had with my mother, who is my greatest love in life. After having an Intrauterine Device (IUD) put in as a contraceptive method, the hormonal changes to my body completely caught me off-guard. I was close to suicide. As my mother tried to soothe me on the phone and remind me that I was not the person my mind was telling me — I snarled at her and put the phone down. My mind went into overdrive and convinced me that she was in fact the issue, that she didn’t really love me and I had ruined her life. I distanced myself from my mother, for the first time in my life and completely isolated myself. When my period came, and my mood lifted, I realised enough was enough. I promptly went to my doctor.
The doctor listened carefully to my difficulties with my changing moods, he drew diagrams and got books to explain to me the different parts of my brain. He was one of the first medical professionals who really listened to me. He prescribed me a daily mood stabiliser.
The first two weeks on the medication were horrendous, but in the last six months I have noticed a life-changing difference, and so has everyone around me.
The change is most evident in the way I have coped with the turbulence of Covid-19 and being locked-down in my home. Unlike before, the uncertainty of the situation hasn’t left me anxious, panicking and irritable. I have managed to see the positives of this ‘new normal’ and, when naturally feeling anxious, have been able to rationalise my thoughts and calm myself.
This disorder is not linear. I am constantly battling and readjusting to its ever-changing nature.
Taking medication certainly has helped, but I can still feel my mood change during those two weeks. However, for the first time in my life, I am grateful that those two weeks are no longer defined by an overwhelming chatter in my brain telling me what a dreadful and undeserving person I am.
Managing my PMDD
Through my experiences throughout the last years, I spent time researching PMDD and became fascinated about how intertwined the menstrual cycle and other parts of the body are. From this exploration grew an extreme frustration that I was never taught about menstrual health being cyclical, or that the sex hormones that regulated the menstrual cycle can affect the entire body, including the brain. I felt a duty to spread the knowledge I had learned, to help support others, which, in turn led me to become an educational trainer in menstrual health.
Here are the main ways in which I have learned to manage my condition:
- I track both my physical and mental menstrual cycle and symptoms every day; I have come to look out for and understand the tell-tale signs of “the dark spell”; the spot on my chin and my cervical fluid changing to that sticky egg-white consistency
- I control my eating habits; I drink lots of water, I have reduced intake of dairy and sugar, removed processed foods, all of which have the potential to impact hormone levels
- I have informed myself about the sexual biological hormones (i.e. estrogen and progesterone), when they are high and low during different parts of my cycle and what foods, exercise or environments can affect those
- I follow mindfulness techniques including finding a technique to bring me back to the world around me when I feel myself falling into the “dark spell”
- I engage in regular exercise; I personally do not love the gym but aerial skills and yoga allow me to boost my heart rate, which is great for improving my mood and grounding techniques
- I am honest with friends and family about my disorder; I reach out when I’m having a bad period and share my cycle with my partner so he knows when I need more support.
Managing my PMDD really involves being in-tune with how my body changes throughout the month. By knowing when “the dark spell” is coming, I can implement my management techniques and help reduce the downward spiral. The most difficult part of this disorder is how easily you can lose yourself and get wrapped up in the intense emotional undercurrents of the dark spells, like a hurricane picking you up and dropping you once your period begins.
If you can find the techniques that work best for you to calm the storm, there’s a good chance you might be able to lessen the impact that those dark spells have on your life. It’s important to find those techniques in your calmest moments so you have the tools necessary to weather the storm when the hurricane inevitably comes back.
But, seriously folks
This disorder is mind-altering. For me, PMDD has been a continual fluctuation between self-love and self-loathing that leaves me completely exhausted. As I continue to live with PMDD, I allow these different fluctuations to teach me new things about the intelligent beauty of my body and my cycle. Some days it’s harder to see that beauty than others; I can only take it day to day, cycle to cycle.
