PMDD: When You Learn to Dread Your Period

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

Dark Days

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.

Getting Treatment

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.

Progress

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.

What’s in Your Mental Health Toolkit?

How Stable is Your Mental Health?

On 15 February 2020, as I scrolled through my Facebook news feed, it soon became apparent that the TV and radio presenter, Caroline Flack, had unfortunately taken her own life at the relatively young age of 40. What soon became even more apparent, was just how many of my own family, friends and associates had been affected by this sad news.

As someone who doesn’t watch much TV, especially reality TV, the name Caroline Flack didn’t really mean much to me. When I saw her picture, I did recognise her as a TV personality, but even so I was somewhat surprised by just how many people were shaken by her untimely death. Not just my family, friends and associates, or even Caroline’s, but many celebrities who knew her or had worked with her too. I guess Caroline doesn’t fit the bill for what many of us imagine mental health issues to “look” like.

Whilst I wasn’t really familiar with Caroline’s work, I do recall feeling a similar level of grief and shock when Chester Bennington of Linkin Park took his own life back in July 2017. Whilst I obviously didn’t know him personally either, his music had been in the background of my life for 20 years or so such that it hit me a lot harder than I expected at the time. I think it’s the thought of what these people must have been going through mentally to think that suicide was their only way out that hits most of us so much harder than, say, a tragic but unexpected accidental death.

At the moment there does seem to be a bit of a witch-hunt against the media in the stories printed about Caroline following a domestic incident between her and her boyfriend back in December, which no doubt added to the mental torment and stress she was already clearly under that night, and which only got worse with her arrest and looming court date. Whilst I fully agree that if the media played a part in her death by publishing untrue and unfounded stories about Caroline and what really happened that night, without at least first checking the accuracy of the stories they published this needs to be addressed, by blaming the media I think we’re all missing an important opportunity to look at our own mental health stability here.

Caroline Flack’s family have recently released Caroline’s own final unpublished Instagram post as a way of helping her to have her voice heard in the aftermath of her death, and a lot of what Caroline says here warrants a good hard look at just how well any of us would cope with a major life change. It’s a stark reminder as to just how quickly things can turn on a dime: https://www.bbc.co.uk/news/entertainment-arts-51557180

Speaking as someone who had a mild, but long-lasting, depression for several years and who is only now getting to the stage where I feel able to taper off the anti-depressants completely, I know well how quickly one’s mental health can have a “wobble”, and just how very much longer it can take to feel fully recovered. There is a lot of great advice out there on the internet from reputable sources like the NHS, Mind and even other bloggers who’ve been there themselves too. The difficulty is that for many people already mired in a depressive episode, following that advice can feel like climbing a mountain.

For those already feeling depressed, the starting point has to be to reach out to your healthcare provider and if even that feels too hard, speak to a close friend/family member and ask for their help. That too can feel an impossible task, so reaching out to a service like The Samaritans or even talking to others in a (healthy and supportive) internet chat environment where recovery is promoted, can be other excellent alternatives when those first important steps feel just too hard to take.

It’s also important to remember that depression takes many forms – it isn’t always crying and sadness. For me it was a constant, lingering apathy, weariness and fatigue with life, work, family, friends, hobbies – everything! It was only after suffering in silence for months that I eventually went to the doctor to find out just why I was so tired all the darn time that I even began to entertain the thought that I could be depressed, at the doctor’s suggestion, and it all started slotting into place – slowly!

A key part of my recovery has been accepting just how fragile our mental health is, as well as my absolute responsibility in preserving it. There was no huge life event that led to my depression – just quite simply a lot of little stressors that became so unmanageable that I eventually snapped. Looking back, it’s quite amazing that it held out as long as it did!

The real key for me going forward will be to plan to protect my mental health as much as possible so that I never find myself in that situation again, or, if I do, I already have the tools to manoeuvre myself back to mental health wellness via the most straightforward route. It’s the same “prevention is better than cure” message that we’ve heard about our physical health for years that we now urgently need to incorporate into our mental health wellness and well-being toolkit too, if we’re to reduce the sheer volume of these sad instances of suicide, regardless of celebrity status. Incorporating these tools only once somebody is already depressed is, sadly, sometimes too much of an ask.

My Wellbeing and Wellness Toolkit currently includes:

  • Staying active – walking the dog once a day and yoga at least 4-5 times per week might not sound a lot but it adds up to a big difference!
  • Getting a pet – game-changer! We’ve had fish and rabbits and guinea pigs but, firstly, you don’t really get to walk them so that doesn’t help in staying active, but having a reason to get up out of bed some mornings and someone to look after and yes, even talk to, can help a body stay positive and feel connected.
  • Care for others – a good alternative if you don’t want to commit to a pet is to do something for others. Volunteering might be a great place to start.
  • Talking about it – I used to hate reading that being more social was all that I needed to fix my depression. I knew that it wasn’t. But it doesn’t have to mean going to see a friend or even going out. There are of course professionals, many of whom you can self-refer to and have telephone appointments with, or see getting a pet above – they’re great listeners! Another option I see a lot of, being a blogger, is to start a blog or comment on someone else’s blog. Talking about it with someone who has been there, done that, can be great reassurance that you’re not alone. Just be sure that you come away from the interaction feeling more, not less, positive about yourself.
  • Keep in touch – I’m seeing a lot at the moment on social media that we should all check up on our friends more and whilst that may be great advice for some people, I think it shows a lack of understanding at just how well those suffering with mental health issues are at hiding their problems from their loved ones. I also think it puts an unfair burden on loved ones, most of whom are not qualified mental health professionals, to be able to recognise a mental health condition in their nearest and dearest. Talk about a guilt trip! Having said that, if you are feeling down but up to keeping in touch with your loved ones, do try to find a way to do so. I love a good meme myself – has a nice personal touch and tend to be funny as well and we all know that laughter really is the best medicine.
  • Drink in moderation – many of us like drowning our sorrows when we’re on a downer but, as I’m sure we all know, that’s just adding fuel to the fire and we’ll likely end up feeling worse. When I massively reduced my alcohol intake to no more than once or twice a month at the most from several times a week, my life improved. Not overnight but it stabilised. There’s even such a thing as alcohol-induced depression. Now I’m no doctor, so I can’t say with any certainty, but interesting that once I sorted out my drinking levels, my depression lifted…
  • Eat well – follows on from the point above really. If you’re just chowing down on processed foods and/or on a blood sugar roller-coaster on a daily basis, you’re not going to feel great. Food is medicine. Learn how to heal yourself from within – there’s an abundance of information out there whether on the web, book store or even library. Educate then heal yourself with food.
  • Take a break/ask for help – I used to think that I was Wonder Woman and that I could, or should, be able to do it all. What awful pressure to put myself under?! I now recognise my limits and believe me it’s a wonderful thing. A great way to risk your mental health and sanity is to expect far too much from yourself. Tip: if you’re feeling like you’re doing too much, you probably are. How could you reduce the stress you’re under now before it breaks you? And then how will it all get done? Trust me, time well spent!
  • Re-connect with hobbies/interests – what do you like doing that genuinely makes you feel good about yourself? Do more of that!

What’s in your Mental Health Wellness and Wellbeing Toolkit that you couldn’t be without? Let me know in the comments.

And if there’s anyone at all you think would benefit from anything written here, please do share this post with them 🙂