Last year, I found myself in the darkest place I had ever been in life. At first, I attributed my drastic change in mood to be a result of the impending Winter - just a bad bought of seasonal depression. I began seeing a therapist and taking medication in hopes that I would start feeling better. When Spring finally rolled around, though, I was still experiencing cycles of erratic behavior, depression, and angry outbursts. With my therapist's recommendation, I began to record my moods daily to see if I could identify any triggers. It was a simple task, but the story my mood journal told was shocking.
After four months, there was a crystal clear-pattern: the severity of my symptoms happened approximately 10-14 days before my period. I was officially diagnosed with premenstrual dysphoric disorder (PMDD). According to the National Institutes of Health, PMDD is a condition that includes severe, often debilitating depression symptoms, irritability, and tension before menstruation. It can also result in intense pain and heavy blood flow. Since my diagnosis, I've found comfort in connecting with others who are affected by this disorder. Here is what I've learned and what I feel is important for people to understand about PMDD.
1. No, PMDD Is Not Just PMS
Most women experience some physical or emotional symptoms before their periods. Tender breasts, cramps, irritability, bloating, feeling sensitive - all extremely unpleasant, but often expected. With PMDD, those two weeks became a nightmare. Not only did I experience the typical PMS symptoms on overdrive, I also developed new physical symptoms, such as unbearable migraines and night sweats. I was also exhausted. All the time. But it was the extreme changes in my emotional behavior that really scared me. In an instant, I would go from being completely fine to one or more of these three frames of mind: hopeless and in complete despair, irrational and impulsive, or inexplicably filled with rage. Regardless of what other people said to me, I knew this wasn't my norm. This was not "regular" PMS - this was hell.
2. Say Goodbye to Control
Before I was diagnosed and knew what was happening, there was one specific incident that made me feel like I had lost complete control of myself. 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 came out of nowhere. It felt like someone flipped a switch inside of me. Tears welled up in my eyes and I ran to hide in a bathroom stall and proceeded to sob uncontrollably. I couldn't even offer an explanation to anyone because I didn't have one myself. The worst part? I couldn't make it stop. I felt powerless. I felt like my own body was betraying me. I honestly felt suicidal some days because I hated not knowing when it would happen again.
3. You're Not Your PMDD
Feeling like you're losing control is a terrible feeling, but feeling like you're losing your identity is terrifying. The most accurate way I can describe what it feels like to have PMDD is like an alien invasion. OK, OK, so I don't actually know what an alien invasion feels like. What I do know is that PMDD made me become someone I didn't recognize. And my family noticed it, too. One instance, after I'd had an irrational outburst complete with screaming and throwing things, my wife told me that my face actually changed. She said, in almost disbelief, "I don't know how to describe it, but the look in your eyes and your expression - it just wasn't you." She was right. I was angry at everything all of the time. Then I'd get my period, and after a day, I'd be back to my old self. Then, like clockwork, it would start back up again. It was exhausting being two different people every month.
4. Listen to Your Body
According to the Gia Allemand Foundation (which educates on PMDD), out of the 62 million women of reproductive age living in the US, only three to eight percent of women are diagnosed with PMDD. This number does not include the women who are not diagnosed or misdiagnosed. How many more women are suffering from PMDD but don't know 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.
5. Be Patient With Treatment
While it's not yet clear what causes PMDD, some doctors believe it has to do with a response to hormone fluctuations. Currently, there are several treatment options for women who suffer from PMDD including hormone therapy such as birth control or cycling antidepressants (meaning you only take them in the 14 days after ovulation and before menstruation begins). I opted for the cycling option, but unfortunately it wasn't effective. I felt frustrated and defeated and I questioned whether I would have to continue to suffer while PMDD impacted my life. Luckily, I was honest with my doctor, who tried me on two daily medications instead of cycling. This significantly decreased my symptoms.
It didn't happen overnight. I still have some really tough months, but I am leaps and bounds better than I was. It's important to remember is that every woman's body is different. What worked for me may not work for you - but you do have options. Aside from medication, I make sure to treat my body with an extra dose of self-love when I feel the onset of symptoms. I try to stay active (as hard as it is sometimes), nourish my body properly, use essential oils, meditate, and practice other forms of self-care.
Opening up about my diagnosis is challenging, but I feel it's important for me, as someone going through this, to share my experiences. Since my diagnosis, I feel a strange sense of empowerment. Maybe it's because I can finally put a name to what had been a mystery to me for so long. 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 even though PMDD is not visible, it is still a very real handicap that affects women. And for the women out there who are currently suffering with PMDD or for those who think they may be, know this is my message to you. We should never be ashamed for what we are going through. We are not making it up; we are not just crazy, hormonal women. 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.
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