Friday 14 June 2019

What is PMDD?

Your alarm goes off and you reluctantly open your eyes. God, you are so tired. It's an effort to even raise your arm to shut off the annoying alarm. You glance over at your husband who's still sleeping, undisturbed by the alarm. A wave of red-hot anger sweeps over you. How can he still be asleep? And his breathing is fucking annoying. You roughly shove him, bend over and yell into his ear: "Wake up! Sleepy time is over!" He wakes up with a start, looking at you with surprise and hurt in his eyes. You feel a twinge of guilt, but it's quickly replaced by more rage. It's not your fault that he can sleep through an earthquake. If he would behave like an adult it wouldn't always fall on you to make sure that everything goes smoothly in your life. Fuck. This day already sucks.


Have you ever had a morning like this? Where you wake up with rage in your heart, mad at the world? Where you feel completely off-balance, drained, with zero energy, overly sensitive and also feeling like you're 6 months pregnant because you're so bloated? You may have PMDD.

PMDD stands for Premenstrual Dysphoric Disorder. Dysphoria means being "in a state of unease or generalized dissatisfaction with life", and it sums up succinctly what PMDD feels like.

PMDD is a severe form of PMS (premenstrual syndrome). The difference between the two is that PMDD is debilitating and severely affects the mental well-being of women suffering from it. Up to 75% of women experience mild PMS, while only 3-8% of women have symptoms that prevent them from functioning in normal life. I'm one of them.   

There is no clinical test that can diagnose PMDD. The way it's diagnosed is this: 
  • There is a list of 11 symptoms, and you have at least 5 of them.
  • They are limited to the luteal phase of your menstrual cycle (=the second half of your cycle, after ovulation and before your period starts - for me its's exactly 7 days before my period). This is important: no symptoms one week after your period! If you do have them, you may have a generalized depression/anxiety disorder.
  • You have the symptoms for at least 2 cycles in a row.

Here is the list of symptoms:
  1. Severe fatigue
  2. Persistent anger and irritability
  3. Feeling of hopelessness, depression
  4. Anxiety, feeling on edge
  5. Crying and/or emotional sensitivity
  6. Difficulty concentrating
  7. Decreased interest in things you usually enjoy (hobbies, friends, work)
  8. Change in appetite, overeating or food cravings
  9. Sleeping too much or insomnia
  10. Feeling overwhelmed
  11. Physical symptoms: bloating, joint or muscle pain, breast tenderness, weight gain
I have all 11, which is as terrible for the people living with me as it is for myself. The worst part of it was that I wasn't diagnosed for the majority of it. On average it takes 12 years before a woman with PMDD is diagnosed - in my case it was 20. 
That's 240 times feeling like a bitch on wheels, having awful fights with my parents, sister and husband, feeling like I may never be happy again. 

I finally figured it out because a good friend of mine has it and told me about it; I can never thank her enough for doing that. Thank you Christine! 
Awareness is the biggest step towards feeling better. Knowing that there is a real reason for feeling so terrible, knowing that it's not all in your head is huge.

Treating it is tricky, because there isn't a simple pill you can take and poof!, all your problems are gone. However, there are several ways how you can live easier and happier with PMDD. The literature recommends lifestyle changes like eating healthy, taking vitamins, limiting caffeine, sodium and alcohol, and regular exercise. You know, the stuff everybody is supposed to be doing anyway. It also states that therapy can be helpful, anger management classes (anger and irritability are the worst symptoms of PMDD for many), self-help and light therapy.
There are herbal therapies, antidepressants and hormone therapy. 
For a full list of treatment options click here.

Here are the things that help me:
  1. Be gentle with myself. That's number 1. 
  2. I mark down the "danger days" in my calendar so I can prepare myself for the oncoming flood of emotions. My period comes like clockwork, so I know exactly when PMDD will crash into my life. My worst days are days 7+6 before my period, so I take a double-dose of my antidepressants on days 8-6 and I'm very, very careful. I don't make any important decisions on those days.
  3. Take a double-dose of Citalopram, my anti-depressant (see above). 
  4. Avoid people. Yes, even the ones I love. As an introvert I sometimes find people draining even on my best days, and PMDD are my worst days. If I have to work I keep my head down, seek solitude during lunch and don't join in the general banter, because I simply don't have the energy for it. After work I won't socialize, and I try to avoid having house guests if at all possible. 
  5. Rest. I need to hide when I have PMDD, so I go to bed when possible and escape reality by reading and watching Netflix.
  6. Chocolate.
  7. Dog and cat cuddles. 
  8. Gentle stretching.
  9. Being outside in nature. 
  10. Cry. A good cry is cleansing, and as long as I remember that it's my hormones playing havoc with me and I'm okay, I can cry without feeling too sorry for myself. 
  11. Remember that PMDD lies. My life isn't shitty, my husband isn't the worst husband ever, and I'm not an ugly, selfish and worthless person. My mantra is: it will pass, it will pass, it will pass. It always does. Those thoughts aren't real; they are all lies. 
  12. Watch Born Different on Facebook. Seeing what kinda stuff other people have to deal with puts all my own problems into perspective. That show is addictive. 
If you think you may have PMDD, talk about it. Talk to a friend, to your doctor, a counsellor or click here for online peer support
Know that it's not your fault. Know that you are not alone. And know that you can live a full and happy life with PMDD. You may have it, but it doesn't have you. 

For more information check out these resources:


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