PMDD: When You Learn to Dread Your Period
PMDD, otherwise known as Pre-Menstrual Dysphoric Disorder is often described as a much more severe form of PMS (Pre-Menstrual Syndrome). Having recently received this diagnosis myself, and therefore talking from experience, personally, I think Perfectly Miserable Depressed Days is a far more helpful acronym to sum the condition up in a nutshell.
Not being medically qualified in any way, this article is written purely as a recount of my experiences which may help someone else understand what they may be going through.
What It Is
PMS can be rubbish as many of us will know. There’s the physical symptoms of cramps, sore boobs, backaches and headaches as well as the often joked about mental/emotional symptoms of mood swings, irritability and food cravings to name but a few.
PMDD though – that’s a cat of a different breed! Not only is it medically classified as an endocrine (hormonal) disorder but, because of the symptoms of depression, anxiety and thoughts of suicide, it is also now classed as a mental health condition too. Generally, although not always, the symptoms are less physical and more mood based.
For details as to typical symptoms, take a look at What is PMDD? | Mind
For me though, prior to diagnosis and treatment, usually around 10 days before my period, there was a noticeable and steady drop in mood until I no longer recognised myself. I could be happy and laughing one minute and then feel on the edge of a nervous breakdown, completely overwhelmed, in tears and shouting or screaming at those around me in a way that was massively out of proportion to whatever was going on.
I was also completely shattered for those 10 days with my energy depleting more and more until I could just about drag myself to work and back but by then I was running on empty. I would crawl into bed as soon as I could, convinced that I had Chronic Fatigue Syndrome or Adrenal Fatigue, feeling incredibly guilty that I wasn’t spending enough time with my family and knowing that even when I did, I wasn’t pleasant to be around.
There were still some physical symptoms to contend with though – I frequently had headaches that no amount of painkillers would shift and could not stand to be around bright lights or noise. The worst for me though was the insomnia. I would fall asleep as usual around 10:30 p.m. but, within 30 minutes or so, the slightest noise would disturb me and I would be up until the early hours of the morning.
Insomnia and fatigue do not a good mix make! However, it was the insomnia that finally forced me to acknowledge that this problem was not something I could continue to try to fix on my own with lifestyle improvements. I was already no longer smoking, drinking, eating less takeaways and processed foods, taking vitamins, exercising and practising yoga, meditating, drinking more water and less caffeine. There really was not much more I felt I could do on my own so I reluctantly booked a doctor’s appointment.
The first doctor was more concerned, quite rightly I think, with dealing with the immediate issue of the insomnia. He prescribed me sleeping tablets which I took for 2 weeks. The hope was that my mood would lift once I started sleeping. It did of course improve, but only very slightly. I was prescribed another 2 week course and told that this was the maximum recommended course as they tend to lose their effectiveness and people can become dependent on them. I was told by this male doctor that he thought I was bipolar and would need a mood stabiliser.
On my next visit, I had a female doctor who straightaway told me that she thought my symptoms sounded very much like PMDD rather than CFS, bipolar or anything else as, very shortly after my period arrived, my symptoms would improve and I’d feel back to normal – until the next time. She took me off the sleeping tablets and together we decided to try anti-depressants. The first course I tried for a month but I felt were not for me – I could not stop eating! She then suggested Sertraline, an anti-depressant I’ve used before and tolerated well after a week or so of unpleasant symptoms. Within a month or two, I slowly started to see an improvement.
I was no longer shouting and screaming at my friends and family. I started getting back into some of my old hobbies and interests. My energy levels began to increase so that I started walking more and sitting less. The unexplained aches and pains all but vanished.
Having said that, some symptoms remain – it has not been a cure all. I still cannot get through some days without a lie down and good sleep no matter how good my sleep the night before. But instead of it being 10 days like that, it’s now down to the first one or two days of my actual period, when I’d expect to be tired and fatigued, and not 10 days every month. Or put another way, a third of every year.
Other possible medications include birth control pills. I’ve decided that, at the moment, that’s not a road I want to do down. I’ve used them before and almost ended up having a stroke and know other young girls who actually did. Of course I know many others that have been fine but it’s just not something that I think is good for my body, based on past experience.
Apart from anti-depressants and birth control, along with lifestyle improvements, basic treatments available are pretty limited at the moment. The understanding of PMDD currently seems to be that it is the body’s abnormal reaction to a normal bodily function (e.g. fluctuations in hormones during the menstrual cycle), a bit like an allergic reaction I guess.
I am actually very happy that I now have a diagnosis, a treatment plan and can see improvement after about 12 months of trying to fix this by myself. I still don’t know why I did that! I suppose with Covid and everything else going on, I didn’t feel it was serious enough to bother my doctor with. If you think you might be suffering with PMDD, or any other condition for that matter, my best advice would be to go along and see your doctor. They’re the experts and although it may take some time to figure out exactly what is going on, it felt good to finally start doing something about it.
I’d also say that although anti-depressants aren’t for everybody and they often come with side effects, usually these side-effects do pass within a few weeks or you can try a different anti-depressant that you can tolerate better. The first week of being on Sertraline, I wasn’t sure I could do it but I am 100% glad I stuck it out because my body did adjust to the medication and it was well worth it to do so.