So What is Premenstrual Dysphoric Disorder?

The National Health Service (NHS) defines Premenstrual Dysphoric Disorder (PMDD) is a severe, more intense form of Premenstrual Syndrome (PMS) with severe, often debilitating physiological and psychological symptoms occurring 10-14 days prior to menstruation. While it is common for women to experience some physical and emotional symptoms during their menstrual cycle, the symptoms of PMDD are more severe and have a negative impact on daily life and personal relationships. Symptoms of PMDD differ among individuals; however, common features include severe mood swings, feelings of hopelessness, feeling upset or tearful, lack of energy, suicidal thoughts, feeling overwhelmed, overeating or specific food cravings, headaches, breast tenderness, and difficulty concentrating. PMDD is thought to affect roughly 800,000 UK residents. Unfortunately, diagnosis can be difficult and PMDD only became formally recognized as a discreet psychological disorder in 2013. Diagnosis involves symptom tracking and journaling. If you believe your pre-menstrual symptoms are extreme and are beginning to impact you, keeping a diary of symptoms for 2-3 months and sharing it with your doctor is the most effective way.  

Jen’s Experience

In this article, I share my own experience with PMDD. Over a year ago, I was at a point in my life where I felt a complete and boundless sense of hopelessness. I had been experiencing these inexplicable mood swings for months—going from completely fine to uncontrollable crying, depressed mood, and anxiety. The onset of these symptoms usually came out of nowhere, which only added to my frustration. At first, I attributed my drastic change in mood to be a result of the impending winter—just a bad bought of seasonal depression which was something I had experienced in the past. I began seeing a therapist and taking medication in hopes I would start feeling better. When spring finally rolled around though, I was still experiencing these cycles of erratic behavior, depression and anger outbursts. My therapist suggested I begin recording my moods to identify any triggers, which I had done diligently, but never took the time to actually read and decipher the story this tracker was telling me. In June of 2017, there was one specific incident that led ultimately led to my PMDD diagnosis. I was sitting at my desk at work answering emails and all of a sudden I felt this overwhelming wave of sadness. Nothing triggered me. I wasn't thinking of anything. I wasn't speaking to anyone. It felt like someone flipped a switch inside my brain from “stable” to “unhinged”—because that’s exactly how I felt. I felt like I was unraveling for no reason at all. I had to run to the bathroom and hid in the stall for an hour because I literally could not stop crying. I couldn’t even ask anyone for help or offer an explanation to anyone one because I didn’t have one myself. But the worst part was not being able to make any of it stop. I felt powerless. I hated my brain—I hate my whole body for betraying me. I wanted it to end and that scared the shit out of me. I admitted myself to a week long day program at a US psychiatric facility to get help for my depression. When I was there, I had mentioned the diary my therapist asked me to keep in regards to my moods and mentioned I did notice I tended to feel more depressed during the time I would normally have PMS. My tracker, however, painted a crystal clear picture. The onset of my symptoms came like clockwork, they always occurred two weeks prior to my period. I was diagnosed with PMDD and began a course of treatment.

Since my diagnosis, I’ve felt an obligation to talk about what I went through because I know how alone I felt. Finding a community of other people who are going through what I am has provided me with hope, empowerment, and encouragement to share my story. Specifically as a woman, I feel like I’ve been conditioned to avoid talking about things that are less than delicate, such as menstruation and what comes along with it. But let’s face it—we can’t avoid reality and for me, PMDD is my reality. Maybe it's because I feel a like I am finally taking back my control. Whatever it is, I feel I have an obligation to educate those who don’t understand that just because PMDD is not visible it is still a very real handicap. We should never be ashamed for what we are going through. We are not making it up, we are not just crazy individuals with raging hormones we can’t control.  We are warriors. We do not have to suffer in silence and we do not have to do it alone. We are in this together.  

So What Can I Do if I Think I Am Affected?

The most valuable piece of advice I can offer up to anyone who suffers from PMDD or believes they may be suffering is: Do not ignore your body! It is estimated that at least 1 in every 20 people of menstruating age (which includes women, transgender and non-binary) in the UK is diagnosable of PMDD. How many more people are suffering but don’t even realize it? No one knows your body the way you do. If you feel like something is different in those two weeks before your period, start writing everything down. Keep a journal. Use an app. Mark your mood on your calendar. Be your own advocate. If you are diagnosed and a treatment option such as medication or hormone therapy isn’t working, speak up. Tell your doctor you want to try something else. Look for alternative methods. Do your research. What works for one person may not work for another and it’s imperative to know and understand that you do not need to settle for something that isn’t working.  

Resources

https://viciouscyclepmdd.wordpress.com/

https://giaallemandfoundation.org/

https://www.nhs.uk/conditions/pre-menstrual-syndrome/symptoms/#premenstrual-dysphoric-disorder-pmdd  

By Jen Porcelli

© 2018 Jen Porcelli. All Rights Reserved.  

Author Bio Jen Porcelli is a US-based freelance mental health writer and corporate recruiter. Jen is a regular writer for PopSugar and has her own mental health blog, SoulOnTheMend.com. Jen lives Johnston, Rhode Island with her wife, dog, and three cats.