PMDD & Me.
Pre-menstrual dysphoric disorder, or PMDD, is something I think few people have actually heard about. But, if I were to say “My PMS is really bad right now” I think the majority of those with a uterus would know what that’s like. PMDD, unscientifically, could be seen as the worst form of PMS (pre-menstrual syndrome). I heard someone recently describe it as wanting to hit the self destruct button for about two weeks every month. Personally, I think that’s the best way I’ve heard it talked about thus far. If I had heard about PMDD back when I was 18, I would have strongly denied to myself and others that that was what I was experiencing; I didn’t want to face up to it. The continual up and down, the erratic nature of it all, it was very much me in ‘self destruct’ mode. It wasn’t until I was 20, that I was not only ready to acknowledge what was happening to me, but actually deal with the problem properly too.
Premenstrual dysphoric disorder causes very severe, emotional, and physical symptoms every month. It typically happens around a week or two before your period. This means, from a cycle perspective, its occurring during the luteal phase, where your oestrogen levels drop and your progesterone levels are high. The problem with PMDD, and perhaps most important for this condition, is it effects your everyday life in the same way depression would. For me, it became incredibly difficult to function even on the most basic of levels. Perhaps its best if I list some of the symptoms that I experience and others who also have PMDD:
First you have the emotional experiences of PMDD
extreme mood swings.
feeling upset, tearful or hopeless.
lack of energy and a lot less interest in activities you normally enjoy.
feeling easily angered, irritable or anxious.
Incredible difficulty in concentrating and a strong sense of overwhelm.
In some cases it can lead to suicidal feelings.
Second is some of the Physical experiences of PMDD
headaches.
feeling bloated and seeing changes in your appetite, such as overeating or having specific food cravings.
sleep problems.
increased anger or conflict with people around you.
becoming very upset if you feel that others are rejecting you.
My Journey
Looking back on my experience with PMDD over the past couple years, I think I can pinpoint quite easily when it started. I had always been someone who suffered with pretty bad moods off the back of my period. Even if it wasn’t obvious to the people around me, unhappiness because of my period happened very time. However, when I hit 18, that took on a whole new meaning.
Me aged 18 (this is about a year into me suffering with PMDD unknowingly, and yes, the mask really should have been over my nose lol)
It was 2020, and as many of us will remember, the covid pandemic was in full swing. In fact, on my 18th birthday, I remember the UK government announced that the third lockdown would be starting that very day. My A levels got cancelled, I was barely seeing my friends, I was stuck inside and it was cold outside. I was not keeping up with the work that year 13 had brought on at all, and I was utterly terrified of failing. I just couldn’t get myself out of what I thought was this this lazy, sluggish mentality. Of course, I would have bursts of energy, of productivity, and of feeling good, but the anxiety and deep sadness, the irritability and ‘I cannot leave my bed right now’ always came back.
However, what made it different from the PMS I had experienced before was that it was taking a toll on my external life, more that it ever had. I was arguing with my friends more because I would blow up over silly things, I would ignore my work for days on end or not even try to complete it (and I definitely felt the repercussions of that in class and my grades). I would spend hours and hours laying in bed or on the sofa pretending I was just taking time out, when in reality I couldn’t bring myself to move. I was hopeless and teary all the time, and to make matters worse, for a large part of it, I was stuck in the same four walls during the dead of winter - all ideas of exercise or mindful walks just didn’t exist.
Because eventually covid ended, and the sun came out, and I was free from the confines of my bedroom, I thought all these repetitive cycles of serious sadness would be over. And, I do think for a time I was a little better. I got back into a few routines that were good for my physical and mental health, and that managed the PMDD symptoms a lot better. But of course, they were always nagging at me. Whether it was my mood or the physical fatigue of it all, I just couldn’t shake the impact of PMDD.
My Dad <3
Fast forward to August 2022, nearing the end of my gap year, and I’m on holiday with my family. Although I wasn’t tracking it properly at the time, I was in my luteal phase. For the whole week I was battling to be happy and positive ,that my family and I were all together, in the sun, and having a really lovely time. In all honesty, I just continually wanted to cry - and I would in private which is just horrible to think back on now. I was so tired of feeling like this, the constant up and down, functional to not functional within weeks, it was exhausting. Nothing had really changed in those two years in terms of the symptoms I was experiencing, and I had kept putting off dealing with it. I made up excuse after excuse as to why I was feeling this way - I was cranky because it was hot/cold weather, or I had too much work to do, or I was irritated by something or someone in the present moment and it would pass. As well as this, during those two years I had also lost my dad unexpectedly which threw so many other parts of my life into a weird chaotic mess. Therefore naturally, I believed that grief was the root cause of a lot of these moods for a long time. But I knew there was more to it than that, I had been experiencing these symptoms before he had passed, and although it may have exacerbated it, it was not why I was suffering the way I was.
The reason this story is important is because the way I discovered the term PMDD was on this family holiday. It was totally random, while I was strolling through instagram by the pool. So groundbreaking I know. It was an interview with a woman just describing the symptoms of PMDD, how it only effected part of her month, that she battled with depressive thoughts and behaviours, and it had impacted her social and familial life also. Basically, everything that I had been fighting against for years.
To be completely candid, I was utterly terrified. Mental health issues have very much plagued my generation. I had grown up with friends experiencing severe anxiety, depression, tangled up in unrelenting relationships with self harm or EDs. I had grown up with rhetoric around the importance of caring for your mental health and the dangers of these behaviours in the long term, the last thing I wanted was to be told I was that I was another depressed teenager who was struggling to manage her symptoms. I had suffered (by this time at 19) at least 2 incredibly bad bouts of anxiety, that had led to me being sick every day, and homebound with nerves. I had gone to therapy, I had learn to manage my anxiety, by this time I thought I was over my ‘blip with mental health’. All this lady’s interview had said to me was that it wasn’t over, and that this time it was going to happen every month.
Cambridge Fresher’s week taking me by storm :)
At this point, I had two choices. Continue ignoring the destructive, depressive behaviours I had been battling with these past two years, or try and solve the issue. I had spoken to a couple friends and my mum about it all, and came to the conclusion that if I kept living like this, I was just going to collapse. The first thing I needed to do was track my mood alongside my cycle which, to get a proper diagnosis, I needed to do for around 6 months to be sure. So, that’s what I did. The only problem was I was starting university that September, which meant managing my ‘potential PMDD’ while going through Freshers. Not only that, I was heading to a university with a reputation of hardcore workloads and intensive study. It wasn’t exactly the best combination for someone who knew they want to press self-destruct button for two weeks each month.
Suffice to say, my first term at Cambridge was incredibly difficult. I honestly did try my best to manage it all, but this point was definitely the worst my PMDD ever got. By Christmas, I was so physically anxious about going back to Cambridge and having to deal with it all, I checked myself back into therapy - something I hadn’t done in over a year. I’m incredibly thankful for my therapist, as visiting her convinced me to stop prolonging the process of getting medical help just to ‘prove to myself’ this was actually happening and a real issue. I was initially offered the contraceptive pill, something I personally wasn’t comfortable with, so I opted for sertraline (an anti-depressant with the lowest levels of withdrawal symptoms). I took about a week for me to adjust to it, the nausea was a little insane but overall it was so worth it.
I find it kind of crazy now to think at how much PMDD affected my life, now that it is something I don’t have to struggle with everyday. I still get a low before my periods, and have had one case of bad PMDD since starting sertraline, but nothing has been even close to what it used to be. I’m healthier and happier than I have ever been while taking this medication, and its opened up so many more opportunities that I didn’t think I could even vaguely manage before, including starting Galene and helping other women care for themselves. I actually get to be myself, instead of constantly hanging over the self destruct button.
Happy Healthy Col <3
PMDD is not something that is discussed when those who menstruate learn about periods. We get tidbits about PMS and how cramps might effect us, but nowhere in our educational system is it acknowledged that sometimes your PMS is a bit more than just a bad mood. I wouldn’t be surprised that now this is starting to be spoken about in the media, women start to realise this is something they have been battling with for a long time. You should be able to function on your period, you should be able to get out of bed on your period, but its okay if you can’t because there is always an answer as to why.
Galene, for me, was a way of understanding not only why it’s so important for women to know about their sexual and reproductive health, but also explore my personal relationship with it. When your daily life is suffering, and it’s to do with your period, it should never be brushed off with ‘Oh, it’s just PMS’. You deserve to know what’s truly happening to your body. I hope if you take anything from my story, I hope that its the fact its easy to pretend your bad mood is just something else; but if you take the time to understand yourself, and care for yourself through that, it’s the best way you can prove to yourself that you deserve to be happy and healthy.
