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~Seek first to understand, then be understood~
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I have a "friend" who shows up once a month. She turns my world upside down, over and over again.
I am a good person, caring and sweet, but when she comes to visit, I could rip off your head.
She takes no prisoners, foul words she does spout, I try to keep the words in, she lets them come out.
People don't understand me, or what this is about, to have this creature inside my head.
I despise who I am, half of the time, I feel sorry for my daughter, family and friends.
There's no way to describe it, for those who don't know, it's a living nightmare, she really needs to go.
~Neysia Manor, Rest in Peace

Thursday, December 30, 2010

Relationships - Choosing Your Family

Families are…hard to deal with, any way you look at it. They consist of the people who are supposed to love you the most, care more about your welfare than anyone else, treat you more kindly than strangers, and keep you safe from the world’s evils.

But they don’t. In fact, they quite often do the opposite. Which leaves all of us feeling pretty damn confused. If my family is supposed to love me and nurture me, provide for my needs and keep me safe…but doesn’t…then how can I expect anyone else to love and encourage me, provide for my needs, and keep me safe?

That’s a question I don’t have an answer to. So I spent yesterday morning researching articles on families and the holidays, hoping to offer some sage words of wisdom in my post on family relationships, and researching took so long I used up the time I would have used writing the post. The worst part was the best advice I could come up with was…

Just say no.

That’s right…just say no. If your family is toxic…then just don’t go to those holiday events, reunions, and family affairs. Article after article after article said the same thing.
Being the kind of person who much prefers to see everyone get along, this message was rather disappointing to me. But it trumped the message boards, hands down.

And I have to admit, that if you follow the advice in my previous posts, about making friends with yourself first, before you make friends with others, and about choosing your friends wisely, and choosing to spend time only with those people who exhibit the qualities you would most like to develop in yourself—how many of us would choose our own families?

Some of us have families that are truly supportive, encouraging us to be the best person we can possibly be. Others, unfortunately, are pits of dysfunctional hell. If you have PMDD, due to the correlation between childhood abuse and PMDD, chances are your family falls more firmly into the second category. Which also means the relationship you’re in right now is probably unhealthy. Which only adds to your problems with PMDD. Like attracts like, (even if you’re opposites—you’re the same in your ability to have a healthy relationship), and if you were abused as a child, the chances are good you will end up in a relationship that is abusive in one way or another. Which will only make your PMDD symptoms worse.

I’m jumping ahead of myself here, because my next post will be about dealing with your immediate family…but the facts can not be denied…studies have shown there is a strong correlation between abusive relationships of any kind, and PMDD.

So…if you have PMDD, chances are your extended family relationships are strained, and holiday gatherings are not pleasant. Taking us back to the first relationship post, where I said relationships begin with you, the best thing you can do for yourself is to learn to listen to yourself, to your intuition and your body, to become more aware of your feelings about everything, and let them guide you.

Emotions are just that, emotions, and they will pass. But feelings, true feelings, will resonate in your body. If the thought of going somewhere and spending time with people you don’t like and who don’t like you fills your body with dread, churns your stomach, gives you a stress headache, puts you on edge, or makes you reach for substances that dull your pain, then yes, you need to stop and think twice about why you are doing this to yourself. Remember, if you don’t look out for yourself, nobody is going to do it for you.

If you don’t set the boundaries of what you will and won’t accept from other people in the way of behavior, be they family or strangers, nobody is going to do it for you. People with abusive personalities don’t recognize or observe boundaries—they will push and push and push as much as you let them. You can either 1) push back—which benefits no one—2) set your boundaries and quietly but firmly enforce them—which abusers will then call abuse, since you are no longer letting them have their way—3) simply refuse to engage, by not answering (unfortunately, this method has its own drawbacks) or 4) not attend any event in which you are likely to be treated with any form of disrespect.

In the end, it all comes down to you again, and how healthy you want to be. PMDD and stress are like the chicken and the egg. Nobody knows which comes first. But they do have a strong correlating relationship, and one affects the other. How you handle stress affects your PMDD and how you handle (or don’t handle) your PMDD definitely causes stress.

The best thing to do then, to get a handle on your PMDD, is to remove all sources of stress from your life. This in itself can be extremely stressful, but in the long run is much healthier than taking drug after drug to solve a problem that can not be fixed by taking drugs, no matter what the drug companies tell you.

So the same advice applies to forming or perpetuating family relationships that applies to forming and maintaining friendships—are the people you spend time with people who exhibit the positive qualities you would like to have more of in your life?

If not, then why are you spending time with them?

Sometimes you have to go out and create your own family. This works, too, because once you get right down to it, a family, like a home, is simply a place in your heart. You can create a home anywhere, and you can create the kind of family you’d like to have anywhere as well. To do that, however, you might have to first let go of the old one. Or at least limit contact with them until you are strong enough to stand up for yourself and can comfortably deal with the stress of the situation.

Until then, they’re going to keep getting to you, your PMDD will continue to worsen, and you’re going to continue to dread every family event that comes up that will be attended by people you don’t really like and wouldn’t choose as friends.

The choice, as always, is up to you. I can hear the “But you don’t understand!” comments now.

I can, and I do. Been there, done that. It wasn’t easy, it wasn’t fun, but I came out on the other side of it just fine, and this year, for Christmas, I had two of the best and most memorable holiday dinners I can ever remember having. I looked around and thought, This….now this is what I was aiming for all those years.

So I know it does exist.

And I wish it for each and every one of you.

Take care, God Bless, and I wish us all a healthy, happy, and prosperous New Year.

Thursday, December 23, 2010

Choosing Your Friends Wisely - Whether You Have PMDD Or Not

Okay, so we’ve learned that Relationships Begin With You, and that you need to be a friend to yourself before you can be a friend to anyone else, and that being a friend to yourself starts with slowing down and listening to yourself, mind, body, heart, and soul.

For instance, I’m late with this post because yesterday I was listening to my body and being good to myself. I woke up with a tremendous pain in my neck, one that had kept me up for most of the night, so I called my chiropractor first thing, made my first appointment in months, and then actually listened to him when he told me to go home and take it easy, instead of throwing myself headlong back into my life. I came home and took a three-hour nap, then spent the evening reading a book. This morning, I made sure I attended my Qigong (slow movement and stretching) class, knowing that would help to keep my positive healing energy going.

Was there a lot I didn’t get done? Yes. But do I feel 100% better? Yes. Much better than slogging through the day, trying to cross half a dozen more things off my to-do list before the holidays. Things that will still be there to do after the holidays. Right now, I need to take care of me, or I will be miserable over the holidays and no fun to be around at all.

So…that’s the difference that comes from listening to my body and attending to—instead of ignoring--its needs. Since I started doing this unfailingly, I haven’t had a PMDD episode to speak of. I’ve had a dip or two in mood that was quickly boosted by eating some whole-grain carbs, but other than that, life has been on a pretty even keel for several months now.

So today I want to talk about relationships with friends. A lot of women with PMDD have at one time or another isolated ourselves, because we don’t feel friends or family will ‘understand’ when we are having an episode, so it’s easier just to go into isolation and deal with it alone.

Easier, but is it healthier? Wouldn’t it be nice to know you’re still loved and people still want to be around you, even when you feel the most unloveable?

You do this by choosing your friends wisely. You do this by choosing friends who are patient, kind, and understanding. You do this by moving away from people who are not. As a PMDD woman, you need to look out for yourself, because nobody is going to do it for you. If this means ending or scaling back a few friendships and/or relationships, then so be it.

You have to do what is right for you. Why would you want to remain in a friendship that isn’t healthy for you?

You decide who you want to have in your life, and who you don’t. You don’t have to cut former friends out completely. You can simply put some distance between you--see them less often, speak less often, or speak only when you run into each other during social events--just don’t do anything one on one anymore.

Instead, surround yourself with the kind of person you would like to be. To me, that’s kind, caring, giving, compassionate, and loving. I’ve moved away from anyone who doesn’t embody the kind of qualities I want to see more of in my life. I’ve moved away from those who are negative, demeaning, demanding, needy, and live lives full of drama they create themselves.

Some people need a lot of drama in their lives to be happy. I’m not one of them.

I’m not saying you can only be friends with people who are the same as you…or people without any problems (is there such a person??)...not at all. I have many different friends, with all sorts of different lifestyles, problems, interests and beliefs--but they all hold the same caring qualities in common. They have patience and understanding, tolerance and compassion, and accept when I tell them I’m having an episode and can’t really participate in whatever is going on.

They allow me to talk about my PMDD openly, and even though they don’t understand it, and can not imagine what I am going through, they accept that I am going through something that is extremely painful, upsetting, and draining for me.

They don’t try to talk me out of it, tell me to get over it, tell me I’m being a witch or boring or no fun, or tell me to “smile,” “relax,” or “just cheer up.”

They let me be quiet when I need to be quiet, and understand if I say things that don’t quite make sense.

On my part, I feel it’s up to me not to snap at or lash out at these friends, and so I take full responsibility for that. If I slip, I apologize immediately, and explain that I am having a PMDD day.

Remember, your PMDD is an explanation, but never an excuse.

In this way I have created a circle of friends who might not understand fully what PMDD is about, but respect and understand that I know what’s going on, and if I say I’m having a bad day, then they accept that I am having a bad day, and don’t expect or ask for more than I am willing to give.

Sometimes I don’t feel like going out or meeting anyone at all. Sometimes I will go to whatever it is, a meeting, a dinner, a lunch, or church, and just sit there and be quiet. Sometimes I will openly talk about what I am feeling inside, and how it completely goes against the reality of my life. (Or how my inner thoughts reflect the opposite of what is going on in my life, and how that doesn't make any sense at all.)

My life is pretty darn good. I have been abundantly blessed in ways tangible and intangible. I have a supportive family, caring and understanding friends, a warm and comfortable home, work that fulfills me, and a son who has been well-trained to deal with a woman’s hormonal moods--while at the same time accepting no disrespect from me or any other woman because of those moods.

I didn’t always have these things. I’ve been working at it for ten years, slowly pruning away what needed to go, and moving into the forefront of my life what needed to stay for me to live the kind of life I want to live—calm, creative, fulfilling, and productive.

I lost touch with some friends along the way. But as I began to better understand myself, I gained new, more accepting and understanding friends.

Studies show that if you hang around certain kinds of people, you will become more like them. If you surround/align yourself with hard workers, you’ll work harder; if you surround yourself with positive people, you’ll be more positive; if you hang around with those who take an active part in maintaining their health and well-being, you’ll be more active and healthier overall; if you keep company with goal-oriented people, you’ll attain a few goals, yourself.

In general, if you hang around successful people, you’ll be more successful.

The flip side of that works just as well: if you surround yourself with complainers, you’ll complain more; if you surround yourself with people who like to overindulge in food, drink, toxic environments or substances, whatever; you’ll do more of the same. If you hang with people who do things you know are detrimental to your health and well-being, you’ll do more than you may personally want to, just to fit in.

So choose the people you want to be with carefully. If you want to be well, then make friends with those who are also trying to be well. If you want to complain, then make friends with those who complain. Either way, you will have friends…

But which friends are more likely to help you make progress toward successfully managing your PMDD?

Think about it, and then adjust your life accordingly. Listen to your body, notice how you feel before, during, or after you’re around certain people. Some people can get you churned up just thinking about being around them. Take time to notice who these people are in your life. Don’t just go through life on auto-pilot, accepting whatever comes your way. That’s probably what got you where you are today, and why you’re reading this post.

So slow down, come to know yourself, make friends with yourself, and then choose the rest of your friends wisely. One small step at a time.

Until you have the life you really want.

Wednesday, December 15, 2010

Relationships - How To Be A Friend To Yourself

Okay, so I’ve said that Relationships Begin With You, and to love or be a friend to others, you first need to love or be a friend to yourself. What exactly does that mean? I mean, if somebody told me I need to be a better friend to myself, I’d probably get annoyed. What are you talking about, be a better friend to myself? I treat myself just fine, thank you. Give me some real advice, why don’t you? Don’t just spout platitudes like you’ve got it all covered, and I don’t.
So I started thinking about it. What does that even look like, being a friend to myself? How does one go about doing such a thing? The first answer I came up with was: Easy to say, hard to do. And why is it so hard? Because it requires thought. And most of us barely have time to think anymore, especially at this time of year. We live in a world of instant this, instant that, where technology has sped our lives up so much that half the time we don’t know whether we’re coming or going. All we know is we’re racing here and there, trying to get everything done that we think needs doing in December.
But we’re not really thinking, are we? We’re just doing. We’re doing all the things we’ve been conditioned to do since the cradle. We’ve accepted that this is how it is, this is how it’s got to be, and the last thing we have time for is to think about being good to ourselves. That, we leave up to the others in our circle, be it friends, family, or co-workers.
Wrong approach. Because everyone else is just as busy as you are, and people are only going to treat you with the same amount of care and respect that you give yourself. So to be good to yourself, the very first thing you have to do is SLOW DOWN. This goes against the grain, I know. If you’re a list-maker, you’ve probably got a list that has at least 50 things on it you need to do between now and the end of the year. You don’t have time to stop and think. Maybe come January you will, maybe not. Maybe by then you’ll have a whole new list to work off—that list containing your New Year’s Resolutions that somehow you never get around to following completely through on.
And why is this? Because while our intentions are good, most of us don’t stop and think about how to make those intentions a reality.
Awareness is the key—to success in all things, including being good to yourself.
You can start by asking yourself one simple question: What is the best thing for me to be doing right now? Right now is the critical part of the question. What is the best thing for me to be doing for my health and well-being right now? Is it making a healthy breakfast? Reading a daily meditation? Driving a parent to a doctor’s appointment? Cleaning the bathroom?
That’s a valid answer, because there are some of us who don’t feel right or settled unless the environment around us is clean and orderly. Others don’t care, so the answer would be different for them. And that’s okay. But try this for a week. Several times a day, stop and ask yourself, what is the best way to spend my time right now? What is the most important thing I need to take care of right now?
Don’t just run through your days like a mouse in a maze. Take the time to become consciously aware of what you are doing, and why you are doing it, each and every minute—or for as many minutes as you can hold the thought, while racing from commitment to commitment, or obligation to obligation.
Maybe it’s work. You need to get paid. Then be aware that you’re going to work, in order to get paid, so that you can provide your family with food, shelter, clothing, or luxuries. Are you going to work for a bigger TV, a fancier cell phone, or a new stove? Are you going to work for an island vacation, a school tuition bill, or new braces? Why are you doing what you’re doing, and is it the right reason and the best use of your time?
If not, then notice the gap between where you are and where you want to be, and think about what you can do to close that gap.
What about our so-called free time? Say you’re at home. What is the best way you can be using your time right now? Is it changing the sheets, helping a child with homework, paying bills, or do you just need a little time out? Time out to read a book, play with the kids, call your mother, or maybe make a cup of tea and sit down long enough to catch your breath, then jump back onto the treadmill of your life.
If you never ask yourself this question, you’ll never answer it. And if you take the time to answer it, you will more than likely be surprised by the answer.
The interesting thing is once you start asking yourself this question of what is the best thing I could be doing with my time right now, your priorities will start to fall in line, and you’ll start coming closer to where you want to be, to being the person you want to be.
I compare it to choosing a house. Many of us move into houses that are already built, and then work with what we have. But what if you had the opportunity to create your own house, to design it to have everything you ever wanted in a home? Fifteen years ago, I couldn’t have even envisioned the idea. I thought I had no opinions on such things. The question never arose, so I never considered it.
But then I had the opportunity to design my own house from scratch, and I found out I had very definite opinions on what I wanted. It was easier than I ever would have thought, to go into a store and pick out tile and countertops and flooring and lights and fixtures.
But nobody had ever asked me before, what I liked or didn’t like about my house, and so I never considered it. I just worked with or around what I had.
The same can be said of your life. What do you like or not like about it? What would you change if you could? What would you design differently if you could start from scratch? Then why don’t you? Start now. Start where you are. Start by taking a moment here and there to think about what you are doing right now, in this moment, and why. Then choose what you want to be doing next, and move in that direction. Eventually, you’ll find out you have very distinct opinions on what you like and don’t like, and how you do and don’t like to spend your time, who you do and don’t like to be around, what you do and don’t like to eat, what gives you energy and life, and what drains you of both.
But to do that, you have to start taking the time out to ask yourself one simple question: What is the most important thing I could be doing for myself right now?
Is it taking a few deep breaths, is it eating an orange, is it dropping a casserole off for a sick friend, or running an errand for a family member? It doesn’t have to be all about you. But it does have to be about what makes you feel good inside, because when you feel good inside, then you’re being a good friend to yourself.
Right now I need to get this blog post done. Why? Because it’s Wednesday morning and people will be stopping by the blog, expecting something new to be there. But at the same time, my cat has jumped onto my lap, looking for some love. Do I get annoyed and throw her off, because I have something else to do, or do I stop what I am doing to pet her and coo at her and give her what she came looking for?
I stop. I slow down long enough to feel the softness of her fur, appreciate the way she pushes her head into my hands, and listen to the contented rumble of her purr. I smile and use both hands, cuddling and stroking her until she relaxes and settles in my lap, happy just to be with me. She knew what she wanted, what she needed, and she came looking for it. It took maybe all of two minutes. She’s happy, and I’m happy, and we can both get on with our day. She, snoozing on my lap, and me, continuing to type.
What would have been served by throwing her off, by telling her I was too busy to deal with her right now? I learn a lot from my cats. When they’re hungry they eat, when they’re sleepy, they sleep. They don’t worry about what’s coming up next. They live in the moment, and are fully present to whatever is around them, be it a sunbeam on the carpet, the sound of the can opener, or somebody at the door.
We need to slow down like that. We need to be fully present in the moment. When we’re folding laundry or doing dishes, that’s what we need to be doing. Nothing more, and nothing less. We need to take the time to let our thoughts roam free, not use that time to make more lists in our head or angst about things already over and done with, or what we’re going to be doing twenty minutes from now. In twenty minutes, we’ll deal with whatever is happening then.
When we’re driving, we need to be driving, and not doing anything else. When we’re at the store, we need to be shopping, and nothing else. When we’re talking to another person, we need to be doing that, and nothing else. When we’re praying, we need to be praying. The same goes for having a meal, so that we can stop and think about what we are putting into our bodies. Is it something that is good for us, or not? Or are we just wolfing down fast food while we chauffeur the kids to wherever it is they have to go and talking on the phone in between bites?
Tell me. How is that being good to yourself?
Liana Laverentz is the award-winning author of two books on PMDD, PMDD and Relationships, and PMDD: A Handbook for Partners.  Both books are based on the most asked questions by her readers, and therefore the most popular posts on this blog. Both books are also an excellent resource for understanding your PMDD and for starting a meaningful conversation with loved ones who want to know more about this debilitating disorder we live with daily. 

Wednesday, December 8, 2010

Relationships - Learning to Treat Yourself Like a Friend

So last week I said Relationships Begin With You, and that is true. The most important thing of all for a PMDD woman is to have a good relationship with yourself. Obviously I have a good relationship with myself, or I wouldn’t be here, boldly putting myself out there for all the world to read about. I like myself, I enjoy my own company. I’ve learned how to listen to myself, in good times and bad.
One of the best things I’ve learned along the way was that “What you think of me is none of my business.” It’s what I think of me that matters, and as long as I am happy with me, as long as I like and respect myself, that’s what counts.
Surprisingly, adopting this belief didn’t turn me into some self-centered egomaniac. I think that was always my greatest fear…if I put myself first, won't I turn into some kind of monster who doesn’t care about anyone else? Then everybody will really hate me. (Because we all know that PMDD women regularly think everybody hates us.)
I think that’s why I put it off for so long. As women, we’re raised and socialized to put everybody else first. Love means doing for others. It’s how we get love, how we show love, how we determine our worth in the world.
Or at least that’s what we’re raised to believe. But the Bible says to love your neighbor as yourself. Here is a link to an excellent blog post on the subject, one that includes eight specific quotes from the Bible that say to love your neighbor as yourself. I am a woman of faith, but my purpose here is not to preach, so I’ll leave that to others....
But to me, to love my neighbor as myself means to love others as much as I love myself.
Not more, not less.
So to do that, I have to love myself first.
Loving yourself is hard when you’re a PMDD woman. You do and say things you regret all the time. We’re conditioned to beat ourselves up when we make mistakes. I’m not sure why this is, because it makes for a lot of miserable people in the world, but the bottom line truth is everybody makes mistakes, not just women with PMDD.
Think about all that energy wasted in beating ourselves up. Think about all the good and positive things we could be doing with our time and energy instead. Think about how much happier your life would be if you simply acknowledged your mistakes, did what you could to make amends, accepted that you'd done your best with the information you had at the time, and then got on with your life.
Just think about it for a minute. Can you imagine how different your life would be?
So the first step to loving yourself, is to accept yourself as you are, right here and now. Are you in the middle of a bad episode, or are you doing well today? Is your day just so-so? That’s fine, too. Start right where you are. If you’re having a bad day, what can you do right now to make your day a little better? Take a nap? Call a friend? Eat some chocolate? Read a book? Watch a movie? Make a cup of tea and just sit there feeling miserable for a while? Then go ahead and DO it.
Nobody says you have to be happy all the time. There is nobody on this planet who is happy all the time. And there’s nothing wrong with giving yourself a little down time, a little pampering, to help you get back on your feet again.
I have a real dislike for taking drugs. Any kind of drug. I’m all about natural health and healing. I’m especially against the unnecessary use of pain pills and anti-depressants. But a friend once explained it to me this way: When you’re in constant pain, when your body has gone haywire and is sending an uninterrupted stream of “I hurt” and “I feel miserable” signals to your brain, then what is the harm in taking an occasional pill to chemically interrupt that endless loop of biochemical messages running through your body? What's wrong with giving your body a little period of pain-free space to figuratively take a deep breath and have a chance to recover itself from that endless stream of pain messages circulating through your system?
Along those same lines, if your pain is mental, as well as physical, then what is the harm in briefly taking an anti-depressant to stop the endless loop of negative thoughts running through your brain? Just long enough to get you back on your feet again.
In the case of a PMDD woman, certain anti-depressants have been clinically proven to provide relief within hours in 60% of the women who take them during an episode of PMDD. But you only need to take them while you’re having an episode. (That’s the part the drug companies don’t tell you.) For some reason, even though anti-depressants usually take several weeks to kick in for the truly depressed, these same anti-depressants can act quickly in the case of a woman simply having an episode of PMDD (although there’s nothing simple about an episode of PMDD).
So, in the case of chronic physical pain, taking a pain pill can give you small break in your constant misery. Just enough time for you to catch your breath and remember what it feels like to feel good again, and marshal your resources for the next wave of pain.
In the case of mental pain, if you’re one of the 60%, a SSRI anti-depressant can give you a quick break from that endless loop of negative thoughts in your head.
In the case of emotional pain, talking to someone, or pampering yourself in some way—listening to music, stroking a pet, reading a book, taking a walk, making a cup of tea—can give you that same little space between the endless loop of emotional pain you are feeling.
Spiritual pain—read a book, watch a program, listen to a tape, or go to a place of worship and spend some time in silent contemplation. Just you and your maker. Quiet time with the spirit that lives inside you.
That’s what’s known as being good to yourself. Whichever of these areas is calling out to you the loudest, start there. Baby steps. Take time out to get a handle on your pain, be it physical, mental, emotional, or spiritual. If you don’t do it, nobody’s going to do it for you.
Because you’re the only person who knows what is going on inside you. You’re the only person who knows just how hard it is to be you.
Especially on the days when you are not feeling like you.
So loving yourself comes from taking care of yourself. From listening to yourself and attending to your own needs. The more you do this, surprisingly enough, the less selfish you will become, because along the way, you manage to develop empathy, and realize you’re not as alone in your pain as you thought you were.
That’s when friends come in, and that’s what I’ll talk about next week. Finding supportive friends, being it on line or in your own neighborhood.
Until then, be blessed, and find just one way each day to be good to yourself. You’d do it for a friend or loved one. Why not for yourself?
Liana Laverentz is the award-winning author of two books on PMDD, PMDD and Relationships, and PMDD: A Handbook for Partners.  Both books are based on the most asked questions by her readers, and therefore the most popular posts on this blog. Both books are also an excellent resource for understanding your PMDD and for starting a meaningful conversation with loved ones who want to know more about this debilitating disorder we live with daily. 

Thursday, December 2, 2010

Relationships Begin With You

I’ve been getting a lot of requests for information on relationships, so I’d like to start writing about that subject today.
Relationships are hard, no matter who you are, or what your situation might be. Relationships for a PMDD woman can be almost impossible to sustain, because, due to our hormonal fluctuations, we’re literally a different woman every day. We feel differently, think differently, and act differently every single day.
There’s an old joke that goes like this: A woman marries a man thinking he will change. A man marries a woman thinking she won’t change.
Unfortunately, both end up being disappointed.
Change is inevitable. That’s our only guarantee in life, short of death and taxes. Life comes and goes in cycles, and nothing stays the same. You will change, I will change, your family and/or partner will change, your circumstances and situations will change. Mentally, physically, emotionally, spiritually, financially, and otherwise. Accept that now, and you’ll be a lot further ahead of the game than most of us.
Why? Because nobody likes change, even when it’s a change for the better. Change takes work, whether it’s a change we embrace, or a change we resist. We like to be comfortable in our surroundings and relationships. We like knowing what we’re in for, how our day will go, what we’re up against, what to expect. A certain stability gives us a good foundation for dealing with all the surprises Life throws our way, be they blessings or challenges.
A PMDD woman, just like anyone else, likes to have stability in her life. Unfortunately, that’s not a luxury we can rely on, given the tumultuous ups and downs caused by our menstrual cycles. And what affect us, affects the people around us—in particular the people closest to us. Our friends, relatives, and significant others. It takes an incredible amount of inner strength to be the kind of people we want to be, when our brains just won’t work right. Even the most patient and loving person loses it at times—think of Jesus in the temple, ranting at the moneychangers.
So how can you expect yourself to be any better, or different? How can you have the kind of relationships you want?
The first step is awareness. First you have to realize and accept that your PMDD is a part of you, and isn’t going to go away, not without making some serious changes in your life. The more awareness you have, the better it gets, but it never really goes away. You have to stay vigilant, and when you slip, as we all inevitably do, there’s a very good chance our symptoms will return.
So how do you gain this awareness? By taking the time to listen to your body and be good to yourself. Your first, and most important relationship, needs to be the relationship you have with yourself. You’ve got to take care of you, before you can take care of anyone else. You’ve got to love yourself, before you can truly love someone else, no matter who that someone else might be.
Most PMDD women spend a great deal of time hating ourselves. Beating ourselves up, for things over which we have no control—in particular our thoughts and moods, which then affect our words and actions. I don’t need to tell you how the cycle goes. You’ve already been there, done that, at least once a month for as long as you’ve had PMDD.
So the first thing you have to do, no matter how awful may think you are, or might have been to yourself in others in the past, is to stop beating yourself up. Just stop it. Right here. Right now. Stop it. You are who you are, and that’s where you start. Don’t be dragging all that baggage from past PMDD episodes along with you. Let go of it and start anew. Today is a new day, and today you are going to be good to yourself, if only for a few minutes.
Because change is hard, and works the best if you do it in baby steps. Not many of us can suddenly start shoving everyone else aside to carve out time to be good to ourselves. We have commitments and responsibilities, and if we’re very lucky, people who depend on us for some measure of support, comfort, and stability.
But we also have a commitment and responsibility to ourselves, to be as good to ourselves as we can possibly be. That doesn’t mean chucking it all and hopping the next plane or cruise ship to some exotic destination, as tempting as that sounds. It just means take a few minutes, either at the beginning or the end of your day—or even in the middle, if you miraculously find yourself alone for a few minutes with nobody around you wanting or needing something from you—and remember what it is that makes you happy.
The choices are as limitless as the number of people reading this. Each one of us has at least one thing in this world that makes us truly happy, probably a couple dozen such things if we really take the time to think about it, but for now, just start with one. What is it that makes you happy?
Now what do you need to do or change to make that situation happen? How far are you right now from making that happen? What do you need to do right now to get there? Is it something you do, or something you want to do for someone else? Is it some way of being? If it’s something you do, then what do you need right now to do it? Do you need ingredients? Supplies? Or do you just need to pick up the phone and call someone? Send them a letter or card? Get in the car and go and see them? Or do you just need to cross the room?
Figure out what it is you need, then figure out a time when you can do it. If you’re not doing anything right now, then get started. Make a list if you want to. Write it down. Then put it somewhere you’ll see it often. Go to the store if you have to, to get those supplies or ingredients. If you’re not feeling up to doing that, then work with what you have right around you. Do you like to doodle? Read? Pray? Listen to music? Take a bath or long, hot shower? Talk to friends? Cook? Sing? Dance? Sew? Garden? Take walks? Maybe playing with your children brings you joy. Or spending time with a pet. Spending time with your significant other. Not everybody recharges best when they are alone.
The bottom line is whatever it is that makes you happy, find a way to do it. Nobody should deny you the time and space you need to soothe your spirit and settle yourself. If they try, be gentle but firm. Say I’m doing this for me, so that I can be a better mother, spouse, partner, sibling, daughter to you. Be the change you want to see in the world, and your world will change around you.
But don’t expect it to happen overnight. Part of the problem is we live in a world of quick fixes and instant gratification. People have come to expect things to be easy, to right themselves with the swipe of a credit card, the popping of a pill, the immediacy of a text message. With PMDD, it doesn’t work that way. With PMDD, you have to work doubly hard to be the change you want to see in the world, because not only are you bumping up against the rest of the world, who most of the time is bumping back (to say the least), half the time you’re fighting yourself.
But it’s not really yourself you’re fighting. It’s your PMDD. I don’t want to be like this, you say. Then don’t. Stop fighting your PMDD. Accept it and roll with it. Start where you are, and start being good to yourself, by eating right, getting enough rest, taking the time you need to calm and settle yourself, then listening to your body and giving it what it needs, and listening to your heart and doing the same.
As your relationship with yourself improves, little by little, your relationships with others will improve, and your PMDD won’t be running (or ruining) your life anymore. Eventually, it will end up being nothing more than a bad memory.
Liana Laverentz is the award-winning author of two books on PMDD, PMDD and Relationships, and PMDD: A Handbook for Partners.  Both books are based on the most asked questions by her readers, and therefore the most popular posts on this blog. Both books are also an excellent resource for understanding your PMDD and for starting a meaningful conversation with loved ones who want to know more about this debilitating disorder we live with daily. 

Wednesday, November 10, 2010

How Carbon Monoxide Poisoning Can Mimic PMDD

You know I’ve written about how PMDD can be (and has been) confused with several other conditions, like thyroid problems, insulin resistance, anemia, or even bi-polar disorder--which is just one part of why PMDD is so hard to diagnose--but last week I got an unwelcome surprise when I encountered yet another condition that mimics PMDD…

Carbon monoxide poisoning.

That’s right, the silent killer that’s the leading cause of accidental deaths in America. You can’t see it, smell it, or taste it, but the Centers for Disease Control estimates that more than 400 Americans die from unintentional CO poisoning, more than 20,000 visit the emergency room, and more than 4,000 are hospitalized annually due to carbon monoxide poisoning. Fatality is highest among Americans 65 and older.

On Saturday, I joined the ranks of those ER visit statistics. I started feeling badly on Wednesday. I work at home, in a relatively new house that is extremely air-tight and energy-efficient (something I’ve been rather thrilled with to date, as it keeps my heating and electric bills low.). I do a lot of work at my dining room table, which is less than ten feet away from my kitchen stove.

Little did I know I had a gas leak at the stove. All I knew was I was having an enormously hard time concentrating on my work that afternoon. I couldn’t think straight, and had absolutely no motivation to work. Thinking it was my PMDD kicking in, I ate some carbs...then ate some more. I took some 5-HTP...then took some more. No dice. All I wanted to do was take a nap. The thought of going for a walk kept entering my mind, but my body and mood simply wouldn’t cooperate, and I just couldn’t muster the energy to put on my sneakers and coat and go outside.

That evening I opened the windows for another reason, and inadvertently resolved the problem. Thursday and Friday I went out of town and felt fine, which lead me to believe I’d simply had a fleeting episode of PMDD. I returned home Friday night, and within an hour again felt tired and listless, with no desire to do much of anything besides sleep. Again thinking my serotonin level was down and I needed some carbs, I went out and got a pizza for dinner.

The expected boost in energy and clarity of mind didn’t happen. Instead I got more and more tired, until I just couldn’t stay awake any more. Plus I started to feel nauseous, and wondered if I’d gotten a bad pizza.

Nothing to do for an unrelenting case of PMDD but go to bed, right? So that’s what I did. The following morning, I overslept by two hours. When I went to make my morning tea, I was shocked that the clock said 8:00 a.m. instead of 6:00. What was wrong with me? I’d gone to bed at my regular time, and slept an extra two hours. Why was I so tired? Why did my head hurt and my joints ache so badly? And why the hell couldn’t I think straight?

I checked my PMDD calendar. The timing didn’t seem right, but since I’m in perimenopause nothing comes on schedule any more, so that didn’t help much.

Okay, time to start my day. After being gone for two days, I had a lot of work to catch up on.
But I just…couldn’t…get…started. Couldn’t even figure out the first thing to do. I thought of some errands I needed to run, but had absolutely no desire to get going, to move in any way.

Finally, I simply stood in my kitchen and went inside myself, trying to figure out what was wrong. What was different about this episode of PMDD and why none of my usual tricks to boost my serotonin level and mood were working.

All I knew was everything ached, and I felt miserable---like when I’ve been exposed to too many chemicals or fragrances. Chemical sensitivities and heightened allergies are a symptom of PMDD as well. My insides swell up and the pain caused by the pressure on the meridian nerves in my arms can reduce me to tears.

It felt like that. It felt like I was being poisoned.

I got the idea to call the gas company, and have them come and check things out. So I found the number and called---and they called 911. Next thing I know, I’m being told to get out of the house and wait for emergency services. The gas company, fire department, and an ambulance arrived within minutes.

It seems I had not one, but two leaks. One from the stove, and one from the boiler in the garage. Both were putting out carbon monoxide and my wonderfully energy-efficent house was not allowing the air to properly circulate.

I declined a trip to the emergency room via ambulance, but got a friend to drive me to the ER to be checked out. Fortunately, my levels were not dangerously high, but my symptoms were quite evident. They included:

Flu-like symptoms, fatigue
Impaired judgment
Memory problems

All of which can also be experienced by a woman having an episode of PMDD.

I credit the fact that I’m still alive to two things—my awareness of my body, due to my constant attempts to keep my hormones balanced, and to my Qigong classes, which include deep breathing, and therefore keep a strong, steady supply of oxygen circulating through my system.

Which only goes to underscore my belief that a woman with PMDD needs to take better care of herself than most. While every woman could benefit from relaxation techniques, quiet time, good nutrition, and exercise…women with PMDD are more sensitive than most to just about any life event, environmental toxin, or ingested food, drink, or substance that can stress the body, so we need to be extra vigilant about our health and well-being.

That said, as a public awareness announcement, here are some sources of carbon monoxide you need to be especially careful around:

Gas water heaters
Kerosene space heaters
Charcoal grills
Propane heaters and stoves
Gasoline and diesel powered generators
Cigarette smoke
Propane-fueled forklifts
Gasoline powered concrete saws
Indoor tractor pulls
Any boat with an engine
Spray paint, solvents, degreasers, and paint removers

Take care and be well. Be especially vigilant when the cold weather comes, and if you don't have them already (I didn't, but do now), get yourself a carbon monoxide detector or two.

And the next time you're having an episode of PMDD that just won't quit--try looking at your external environment for a possible cause.

Wednesday, November 3, 2010

Women and Insanity - Moving into the 1900s

Today I thought I’d continue my thoughts on Women and Insanity. Recently I watched the movie, The Changeling, starring Angelina Jolie. I didn’t know what it was about, just that it was Angelina Jolie and she had a missing child. What I discovered was this was a true story, a story about the disappearance of Walter Collins in 1928.

Now, women in 1928 had precious little rights, and especially single mothers like Mrs. Collins, who supported herself and her son by working at the telephone company. Until her son disappeared, she was a quiet, unassuming, hard-working single mom who adored her son and was just trying to make a good life and home for them to the best of her ability in the times she lived in. She got called in to work on a Saturday when she had planned to take her son to the movies, and (although this wasn’t made clear in the movie) instead sent him to the movies alone. He never returned.

Mrs. Collins spent five frantic months looking for her son, and the Los Angeles police department, who at the time was already under fire, was looking even worse. So they concocted this scheme where another young boy would pretend to be her son, and they could announce that the case was closed. The only problem was that Mrs. Collins knew immediately that the boy was not her son, and protested. Because by closing the case, that meant the police would stop looking for her real son. So she became a mother on a mission, desperate to find her child.

Meanwhile, the police tried to tell her she didn’t know her own son, and why couldn’t she be happy with the one she had? They tried to make her out as a loose woman, having had five months to party and live it up while he was gone, and now that he was back, she wanted to deny her son and shirk her responsibilities toward him. She finally became so outspoken that the chief of police had her committed to an insane asylum until she signed a paper that said the boy was her son and she had been mistaken. She refused.

Call me na├»ve, but I was shocked that this could happen less than 100 years ago. I mean, my initial post about women and insanity had to do with pioneer women in the 1800s. You’d think things would have improved in a century or so. But apparently not. I also found this, from a college paper on women and mental illness.

It states: "Mental illness during the Victorian era revolved around the empowerment of men. Hysteria fuelled from a fear of intellectual women. Women were denied tasks such as reading or social interaction due to a fear of becoming a hysteric. (Remember, hystera is the Greek word for uterus.) Women were further forced into the stereotypical passive housewife role. Anorexia was an attempt to fit the male standard of beauty. These women refused food in order to appear "feminine" and become a frail ornament for their husbands to show off. They also furthered the idea of the passive housewife, lacking personality or emotion. Those who took a stand for their beliefs or exercised a sexual emotion were deemed insane as they rejected the feminine ideal. Such women were forced into asylums to keep others in line; they were sacrificed to show that those who spoke up would be punished. Thus, the rest of the women remained silent. And finally, spinsters and lesbians were a major threat to male domination. These women preferred life without sexual interaction with men. They rejected the social norms of woman as passive, emotionless accessories and instead embraced personal choice. They too were deemed insane and subject to male-induced public criticism to try and reform them as well as fuel the idea that this sort of behavior was not acceptable."

So poor Mrs. Collins never had a chance. Fortunately, however, there were enough people in the community who would stand up for her, and went looking for her (as she was whisked out the back door of the police station and off to the mental institution in the dead of night) and found her and got her released. She then was able to get released all the women in the institution classified as Code 12, which turned out to be a euphemism for someone the police wanted to get rid of.

A book on the subject I would recommend is Women of the Asylum: Voices from Behind the Walls, 1840-1945 (Paperback)

Here’s a snippet of what one reviewer had to say about it:"This book is an interesting compilation of personal accounts of women who were imprisoned in asylums for various reasons, usually at the request of a relative. It seems throughout most of this time period, all it took to get a person imprisoned in an asylum was a statement from the doctor that the person was insane. Consequently, if a woman angered a man in her family, he could have her imprisoned by pointing out that she was not performing her duties as a woman around the house and for the community, such as at church…often, individual thinking landed a woman in the insane asylum.

"One of the women questioned the doctrine of her church; thus, was imprisoned for religious problems. This same woman wrote a very articulate account of her treatment and the treatment of other women in the hospital, which made me wonder exactly what it was that they saw wrong with her views on the church. The only conclusion I could draw was that it had to be her individuality that brought her into the asylum.

"The most striking thing about this book is to look now onto what these women went through, and consider these were absolutely normal occurrences at the time…While these stories explain the reasons women landed in the asylums, they also told of the treatment of them and the other inmates. These stories are clear, but the authors/editors also explain what types of treatments were used at different times and how these all tied in with how the patients actually responded. While you can see their legal rights starting to improve towards the end of the time studied here, there is a definite slip in the treatment and attitude towards the inmates as these hospitals grew in size…"

The bottom line, I think, is that the times dictate what is crazy and what isn’t, and I have to wonder why it is that no matter where you look, even today, women seem to fall on the wrong side of crazy every time.

Take care of yourself, be blessed, and know you're not crazy.

Tuesday, November 2, 2010

Women Died for the Right to Vote -- Exercise Yours!

Courage in women is often mistaken for insanity. ~Quoted by a male doctor who examined women's suffragist Alice Paul when the government wanted her to be seen as suicidal for her hunger strike in an effort to gain women the right to vote.

If you don't do anything else today, make sure you GET OUT AND VOTE!

Sunday, October 31, 2010

Women and Insanity -- Pioneers with PMDD?

A little something extra today in honor of Halloween. PMDD is not a new condition. It's been around in one form or another since at least the time of Hippocrates. Back then it, and just about any other condition relating to women's hormones, was called hysteria, hystera being the Greek name for uterus.

This is why anyone with a uterus is considered hysterical at times, and why they call the removal of your uterus a hysterectomy.

But I digress. PMDD is not, as some believe, a disorder made up by the drug companies to sell more drugs. It's a condition happily exploited by drug and supplement companies, to be sure, and even some doctors (more on this in a future post), but it's far from a made up condition. You know it, and I know it, and anyone who has ever lived with a woman who has PMDD knows it.

That doesn't mean we're not accountable for our actions. PMDD is an explanation--not an excuse, or free pass--for bad behavior. We owe it to ourselves to understand the condition (and therefore ourselves) as fully as we can, and to then promote a positive awareness of PMDD everywhere we go. It's only by focusing on the positive--what works, what helps, what provides solid help and answers--and not the negative--the fear, the stereotyping, the ridicule--that we will get mainstream medicine to pay any genuine attention to PMDD and other women's health issues.

That said, today I thought I'd offer up a special post on women and insanity, to let us know where we might have ended up, had we been born in another time.

Please welcome my guest blogger, Wild Rose Press author Loretta Rogers.

Because divorce was a rarity during the pioneer/frontier days, men devised other ways to get rid of unwanted wives and children, and that was by declaring them insane and placing this unwanted loved one in an insane asylum. Actually these early asylums were in reality prisons and not medical centers. These institutions were filthy, dark places where people were treated more like animals than human beings. The asylums usually provided only the basic necessities of life. Food was poor, cleanliness was not stressed and the rooms were often very cold. Diseases were quick to spread throughout the asylum.

Some of the reasons women were institutionalized are unbelievable. In the early 1800’s wives and daughters were often committed for not being obedient enough to their husbands or fathers. You’ve heard the term, “children are to be seen and not heard.” This applied to wives as well. If a woman spoke out and went against the “norm” she could be committed.

With no birth control, it wasn’t unusual for a woman to give birth to another baby while still nursing her last child. And a brood of six to twelve children wasn’t unusual either. With her body no longer firm and supple, her energy level somewhere between zero and double zero, and with the daily routine of cooking, cleaning, plowing, and all the other demands, a woman was run ragged. It’s no wonder she grew old long before her time.

All the husband and/or father had to do was simply write the word “lunacy” on the admission form. Lunacy was an acceptable reason for divorce. The woman’s husband would declare her insane, put her in the asylum and then file for the divorce. A few months later, his marriage records to a younger bride usually showed up.

Other reasons to be “put away”, were depression, alcoholism, just being a little different from the norm, and even going through menopause. Doctors just didn’t know how to deal with mental issues and the result was to put their patients in the asylum. These women were locked up and forgotten by their loved ones. The fathers/husbands often forbid the family members to visit. It was as if the wife or daughter had simply died. Most of these women did stay at the insane asylum until their death.

If a father had no sons, but didn’t want his daughter to inherit his fortune or worldly goods, he could have her declared insane, institutionalized, and leave his money to a favorite nephew or his ranch to a ranch hand he considered as a son. If a man’s wife had died in child birth and he couldn’t find a woman to wed who was willing to become a stepmother to his large brood, or if he couldn’t marry off any of his eligible daughters, he simply declared them as lunatics and placed them in an asylum. Sometimes daughters were committed for unwanted pregnancies. Other children were committed for being disobedient or for illnesses such as Down’s Syndrome or Autism. Being born deaf or mute, retarded or physically disfigured was another reason a child might be committed.

Oftentimes, the husband might tell others that his wife or child had died. If a newspaper office was available, he might even have an obituary printed. Yet the person was very much alive at the asylum. While it was rare for a sane person to be released from an asylum, it did happen. Imagine what it was like for this woman. Having been declared dead, she had no identity.

Some of these asylums were built next to, or part of, the prison system. This was to help cut back costs of care, food and facilities. Rape was prevalent in asylums. Because women had been declared insane, it was deemed they had no powers of reasoning, no feelings or emotions. In other words, they were considered walking zombies. Because of this deranged thinking, (no pun intended) prisoners and even asylum employees used the women for their own pleasures.

If you are into genealogy and have run into a brick wall trying to locate a female relative, the US census has a place on some of their census, example 1850, that had a place to mark if deaf, dumb or insane. The probate section may carry Lunacy Record Books at the county courthouses. Some Wills will declare if someone is insane or having lunacy. If someone seems to have disappeared, they may have been “sent away.”

Therefore, when we refer to the ‘good old’ days, we might remember these women and their lives, and be thankful that they paved the way for us.

Loretta C. Rogers, Isabelle and the Outlaw.

Wednesday, October 27, 2010

A Perfect Storm of PMDD

Unfortunately, I’m one of those atypical types who has my PMDD served up in three different courses, which is one big reason it took me so long to get diagnosed. All the sites and information said specifically that for it to be PMDD, all symptoms must abate at the onset of menses, or when your period begins.

But mine never did. Mine came in three separate stages. Which I finally learned is possible as well. God knew I’d been living it long enough—but to see it actually mentioned in a book? Finally I could go to my doctor in confidence and get diagnosed.

I often compare my symptoms of PMDD to the course of a hurricane. Prior to the onset of my period is the building storm, the wind and the rain, with symptoms of irritability, edginess, an inexplicable, almost ravenous hunger, and cravings for salt and three specific foods---cheese, chocolate, and oranges. I have yet to figure out why, although occasionally I get glimmers of understanding and I am sure I will find the answer some day. But for now it’s enough to know that that’s what I crave, and when I find myself reaching for nothing but those three things, I know a storm is about to blow in.

On my pre-period days I also get jittery, clumsy, confused, and distracted, unable to focus on any one task for any length of time. My handwriting even changes. Usually, it’s comfortable, loose, flowing. When I’m having an episode of PMDD, it’s spiky, jerky, and messy. At times it looks like the handwriting of a much older woman. I’m always startled to see it come out that way, but not totally surprised, because as I’m writing, my hand doesn’t seem to work properly—which might also account for my tendency to drop things more than usual during those periods of time.

Anyway, the unfamiliar handwriting is generally one clue that something is happening in my brain. My typing is also affected. I have a friend who pointed out that I don’t bother to capitalize in my emails when I am having an episode of PMDD and I don’t do a lot of smiley faces. It’s as if to do either would take too much effort.

So in my case first comes the storm of irritability, anger, and rage. Snapping out at the drop of a hat. Lashing out at someone who didn’t say anything out of the ordinary, but just struck me as wrong. Feeling under attack and wanting to hit someone, anyone. Just give me a chance. Not a reason, but a chance. I call these my wanting to “drink, smoke, and be bad” days. Impulsive behavior does its best to take over, and I can fully understand in those days why some women go out and do completely irresponsible things they later regret. I’ve felt like doing so more times than I can count, and have complete empathy for those who give in to these bizarre urges. If I didn’t have a core of responsibility inside me that keeps me anchored in good times and bad, I would go out and do the same.

Usually the worst thing I ever did was go shopping and buy all sorts of things I didn’t need or never wore. If I were to look at my credit card statements for those time periods I’m sure I would see a pattern of spending that coincides with the pre-menstrual portion of my PMDD episodes. Fortunately, now I understand what is happening and stay home on those days instead of going shopping. Because inevitably the bill would come, and I would wonder why on earth I had done such a thing.

When I worked as an analyst for the government, on my pre-menstrual days I would suddenly notice that I hadn’t received a response on this project or the other, and would call up the parties in question and remind them I was waiting to hear from them. On any other day it wouldn’t have bothered me. People get busy, people go on vacation, people have priorities, people forget. In the overall scheme of things, my projects were never that vital. Most of the time, I was tolerant and flexible.

But on a PMDD day, everyone I came across was either incompetent or personally holding me back from untold success. I might not rant at them directly--after all, even on my worst days I knew you catch more flies with honey than vinegar--but I would complain to anyone else who would listen about how I seemed to be the only person around who could get things done and do them right. I had no tolerance for even the slightest delay or mistake. On those days, you didn’t want to mess with me.

Then my period would come and I’d be miserable in a new way for a couple of days. Cramps, backaches, and pain that sometimes radiated as far down as my knees, and made me feel like I wanted to throw up. Breathing hurt. I would lie very still, hot pack pressed to my lower abdomen, which felt like someone was slowly trying to pull my insides out with a three pronged gardening tool. Every single month. That, if you want to believe it, was the eye of the hurricane. The first two days of my period.

Then the sadness kicked in. On Day Three. Always on Day Three. If it was going to come, that would be the day. It didn’t always come, still doesn’t. Now I know it has to do with whether I release an egg or not that month. No egg, no sadness. Woo hoo! Party time.

Not quite. But at least it’s a lot more pleasant around here when the sadness doesn’t come. Because when it does, I’m tired all the time, my head feels like it has an iron band around it, I sigh incessantly, big, deep sighs like the weight of the world is on my shoulders—and for me, it is. Most everything looks hopeless, every good idea I had during the month goes to s***, I want to weep at every turn, you don’t dare tell me a joke or tease me, and I spend a lot of time wondering why I even bother.

During this phase of my PMDD, I used to beat myself up incessantly over the people I had snapped out at the week before. Now, at least, I don’t do that any more. I know I didn’t mean it, and in most cases it doesn’t get that far anymore, because I have a much deeper awareness of what is going on and can catch myself in counterproductive behavior.

Now, when I catch myself starting to snap out, I apologize and explain I am having a bad day. Most of my friends know what that means. If the person isn’t my friend, it’s okay to leave it at an apology without an explanation. By all means, if at all possible, never ruin a perfectly good apology with an explanation. You don’t need to justify yourself or your behavior. You just need to acknowledge it, apologize for it if the incident warrants an apology, and move on.

But back then, as I said, I would beat myself up incessantly. Which only intensified my sadness and made me feel like a totally worthless human being. My friends couldn’t possibly be my friends. They wouldn’t be my friends if they knew the real me. How would I ever find anybody to love me if I was so impossible to be around. Yada yada yada. You know how it goes.

The bottom line is the first part of my personal hurricane is the moody, bitchy, out of control part. Then would come the eye of pain and two days of solid pain but surprisingly clear thinking. Fortunately, now, as I begin to enter menopause, it’s just the clear thinking part, and a huge surge of positive energy. It’s a definite reprieve in the storm.

Then the sadness comes. The first D in PMDD. My depression. Or The Fog, as I call it. Back then it was devastating. How could anybody not hate me? Now I am able to separate myself from it and while it is still not pleasant, I know I am not my depression. I rest, relax, take it easy, spend time reading or listening to music or doing something quiet and non-demanding, secure in the knowledge that it will pass. I do what I can to help it pass sooner. I take walks, take naps, eat right and take supplements. I do not allow my negative thoughts to take over. In fact, I smile at them, knowing I know better. God does love me and so do the people in my life. My ideas are good ones and I am full of creativity. I am strong, capable, and competent. Just running a little slower than usual today. Just a tad off my stride. It will pass and I will be fine.

And I am.

One day The Fog lifts, and its back to the torrid pace of my life as usual—until the next wave of cravings and irritability hits.

Liana Laverentz is the award-winning author of two books on PMDD, PMDD and Relationships, and PMDD: A Handbook for Partners.  Both books are based on the most asked questions by her readers, and therefore the most popular posts on her blog, Living on a Prayer, Living with PMDD.  Both books are also an excellent resource for understanding your PMDD from within and starting a conversation with loved ones who want to know more about this debilitating disorder we live with daily. 

Wednesday, October 20, 2010

Overcoming Your PMDD Starts With Being Good To Yourself

I am a work in progress. One thing I have that a lot of people don’t have, or don’t make the time for, is self-awareness. I’ve been digging into this PMDD thing for so long that I’ve finally learned how to separate my real self from my PMDD self. How do I do this? I’m constantly checking in with myself to see how I am feeling, and trying to determine the reasons for why I am feeling the way I am—if it could possibly be my PMDD (based on where I am in my cycle) or if it’s something else.

In doing this, I’ve learned I’m super sensitive to just about everything I eat, drink, and breathe in. For instance, yesterday I went to get my hair cut. This morning I woke up with a sore throat and congested cough. Am I coming down with something? No. It’s a reaction to all the chemicals I inhaled while getting my hair cut. All I have to do is drink plenty of fluids today and I will be fine.

So I’m constantly weighing, measuring, sifting, adjusting. If I feel a little off, I ask myself—what’s new? What did I do differently today or yesterday? Where did I go that I don’t usually go? What did I eat or drink that I don’t usually eat or drink? What stresses did I encounter that I don’t usually encounter?

By constantly doing this, I’m able to detect patterns, and learn what (and who) to avoid. For instance, just going to church gets my sinuses flowing. I can smell the cloud of perfume ten feet away from the front door. The same thing can happen in restaurants, theatres, sporting or music events. This doesn’t mean I don’t go to those things. It just means I’m aware of what can happen, and if I feel a little funky afterwards, I know why.

I’m determined to live my life drug free. Because I feel this way, even taking two ibuprofen affects me as much as say, taking a narcotic painkiller would affect someone who isn’t used to it. Oddly enough, since the birth of my son--a major hormonal event--anything I take that is supposed to make me drowsy tends to have the opposite effect. I can’t take decongestants at all. Narcotics, like Tylenol with codeine, forget it. I’ll be up all night.

I’ve gotten so sensitive that even certain foods affect me strangely. It sounds crazy, I know, but what’s really happening is just a strong bio-chemical reaction that when processed in my brain affects my moods. So what is a natural physiological reaction to a substance, because of the imbalance in my hormones, manifests itself as a mood symptom. This can include irritability, weepiness, anxiety, lethargy, depression, or even euphoria.

I believe there are many women out there just like me. Women who perhaps aren’t blessed with the time and opportunities I have had to really sit down and be still long enough to try and figure out just what in the world is going on in their bodies and brains. We live in such busy times, running from one commitment to another, taking care of the loved ones in our lives, conditioned by our culture, society, and religious beliefs to serve others and place our own selves last.

This drastically affects our health and well-being, but since we are so busy all the time, we don’t have the time (or energy) to figure out what’s wrong, why we are feeling so out of kilter, maybe even miserable most of the time. And then our cycle kicks in, with our PMDD, and everything really goes haywire. We scream, we yell, we snap, and have wild mood swings. We lash out at loved ones and coworkers and store clerks and other drivers, and then, if we haven’t found a way or two to numb our conscience, we feel badly about our behavior and find ways to beat ourselves up and/or try to make amends if we can. We spend so much time trying to make it right with people, or beating ourselves up and engaging in even more destructive behavior, that we get even further run down and behind.

And then the cycle begins again. So we look for quick fixes, anything that will keep us in motion, fulfilling our commitments and obligations, keep us awake and moving long enough to get everything we need to get done in any given day done before we crash in front of the TV or into bed, exhausted, grateful that another day has ended and we have somehow survived.

It’s no way to live. So several years ago I made the effort to strip my life down to what’s important to me, and just focus on that. One of those things was my physical health and well-being. I figured if I could just take care of that—the rest of it would take care of itself.

Little did I know how difficult just doing that would be. It’s no wonder more people don’t take time out to do the same.

But I’m a persistent soul, and determined to figure this thing out. What I present here are things I have learned along the way. They might apply to you, they might not. Every woman is different, and due to her menstrual cycle, every woman is just a little bit different every day. That makes us mysterious and exciting, not bitchy and crazy. That makes us worth taking the time to get to know.

I’d like to take the time to get to know you, to hear your story, and find out what works and doesn’t work for you. I’d like to share those stories here and try to find common ground so that we can help each other to feel better if we can.

It can be done. It’s just that the information out there is so confusing and so conflicting. And we’re all so busy. It would be heaven if we could just Google PMDD and get the answers we need, find the quick fix, and get on with our lives.

But it doesn’t work that way. The first step, I have found, is to take the time to get to know yourself, physically, mentally, and emotionally. Emotionally, because you have to know what emotions are being caused by your PMDD, and what emotions are normal and natural for you to be feeling. Contrary to popular belief, women are allowed to get upset, become irritated, annoyed, and angry. It doesn’t always have to be PMS or PMDD causing it, and we shouldn’t have to put up with snide comments about it being “that” time again, every time someone doesn’t hold up their end of the bargain and we express our disappointment in that.

It’s about accountability, and knowing yourself enough to know when it’s your fault, and when it’s not. I don’t know about you, but I’m not interested in taking the blame for things that aren’t of my doing. I make enough mistakes on my own, without that added burden, thank you.

That said, I’ve come to realize that PMDD is an explanation, not an excuse, for why I do the things I do when I’m having an episode, and I still need to be held accountable for those things, to take responsibility for myself and my actions, no matter how badly I may be feeling. It’s up to me, and me alone, to sort out what’s the real me, and what’s my PMDD, and keep the two as separate as I can. You know how you feel like you’re a totally different person when you’re having an episode. You know that’s not you. It takes a lot of strength, determination and willpower to separate the two, and the effort can be exhausting. But it can be done.

For example, the past few weeks I’ve been feeling just plain blah. No energy, no willpower, no motivation. I wondered if it was my PMDD, just come to roost for a while, but no, PMDD comes in cycles. This had to be something else. My thoughts were validated when my PMDD did arrive, and whew! It was like the difference between night and day. For just a couple of days, I sank into that abyss, and knew the difference. Clearly, on those other days, there was something missing in my diet that needed to be boosted…what that is I’m still sorting out, but I now know that lethargy is not my PMDD.

But I also know my PMDD is not me. And so I’ve learned to separate the two, and set the PMDD aside when it comes. I know it’s there, and it would very much like to take over and run (ruin) my day, but I won’t let it. I acknowledge that it’s present, and that I’m not crazy, and I warn my loved ones that I’m having a bad day and it has nothing to do with them, but it would be best to avoid me for a day or two.

With that in place, I go about my business, and get as much done as my energy level allows. If I need to take a nap, I do it. If I need some quiet time, I take it. If I need to eat some carbs…I do it. Guilt-free. That’s the key. Never feel guilty about taking time to care for yourself. Would you feel guilty about taking care of someone else? Then why don’t you deserve as much care and comfort as they do?

I listen to my body and give it what it needs, without giving in to the wild emotional swings that wait in the wings, and without giving any air time at all to the negative thoughts swirling in my brain. That’s just my PMDD talking, I tell myself, and I refuse to listen to it.

So the next time it happens to you, give it a shot. Just take a deep breath and refuse to give in. You are stronger than your PMDD, and it’s time you let your PMDD know it. You can channel your rage and anxiety and depression into strength and calm and control with simple awareness and practice. It won’t be easy, not at first. It’s a lot easier to just give in and go with the flow. But where has that gotten you?

Think about it, and you’ll know.

Any time you’re feeling out of control, just go to any number of PMDD sites and vent. We know. We care. We understand. We won’t take it personally. We’ll help you through it…because really, we know all you want to do is vent and be heard.

And then, maybe, while you’re visiting one of the message boards, or blogs, you’ll come across a bit of info that makes the next time a little easier to handle.

Baby steps, is all I can say. Be good to yourself, and things will get better. I promise.

Wednesday, October 13, 2010

Confusion City

This post was completely updated September 23, 2015

One of the main problems I find in researching PMDD is that every woman’s hormones fluctuate daily in concert with her menstrual cycle, so it’s hard to separate what’s caused by normal female hormonal fluctuations and what’s caused by PMS or PMDD. To be clear: PMS and PMDD are not the same. PMDD is *not* PMS on steroids, although it can feel like it when you’re having an episode.

There is a definite brain component to PMDD that is not present in PMS. PMS mostly deals with physical symptoms (aches, pains, tenderness, cramps, bloating, etc.), with some minor mood fluctuations…a little irritability, a lack of energy or motivation, some weepiness, maybe more anxiety than usual.

PMDD ratchets these symptoms up a few hundred notches, to the point that these mood disturbances affect your ability to function and maintain stable relationships.

A lot of books and websites discuss the more mild symptoms of PMS, and then simply transfer the same thoughts and theories to PMDD. A lot of these sources even call PMDD a more severe version of PMS. This is not true. They are two separate conditions that unfortunately have enough in common to confuse everybody. But in the end, they take two different paths.
However, since they are often treated as similar, even interchangeable, by many media, for years I thought I had PMS, and couldn’t figure out why—if more than 80% of all women experience some form of PMS—why couldn’t I cope like everyone else did?
Because it wasn’t the same thing, and I didn’t know that.

So, while PMS affects (mostly) your body and (mildly) your mind on more or less a regular cycle, with more or less the same cluster of mind/body symptoms each month (specific to you as an individual), PMDD affects your brain’s ability to regulate itself, and therefore affects just about every other hormone in your body, too.

This is why you often feel as if something or someone else has taken over your body. You think one thing, and something totally different comes out of your mouth. You think you’re eating right, getting enough sleep and exercise, and suddenly one day you have no energy and your body simply won’t cooperate. There’s a missed connection there, and while it’s not “all in your head,” as many friends, relatives, co-workers, and even medical personnel would have you believe, it is happening in your brain.

So what are some of these hormones, and what do they do?

Here (in alphabetic order) are the ones most likely to affect your levels of PMDD.

Aldosterone – Never heard of it? Doesn’t matter. It still contributes to excess water weight gain when your progesterone levels are high, like in the second half of your menstrual cycle, when you feel all fat and bloated. Now you know (in part) why you get that way, and why (short of diuretics) there’s really nothing you can do about it but avoid salt, celebrate the fact that you’re a woman, and know that this, too, shall pass…

Androgens (DHEA and others) – When levels of these are too high they enhance your sex drive and aggressive tendencies, produce unwanted facial hair and apple vs. pear-shaped bodies in women, stimulate your appetite and contribute to waistline weight gain.

Cortisol – This affects your metabolism and tells your body to store more (more! more!) body fat, and is produced in even higher amounts under stress. (Remember, a woman with PMDD is more sensitive to stress to start with, so don’t be surprised if your levels are off the charts.)

Think about this: Our bodies have not changed much biologically since prehistoric times, and so are designed to respond to stress in a certain way that back then was perfectly normal and balanced. But stress back then might be due to a natural disaster, imminent death or starvation, attack by a wild animal, or, in later times, attack from a warring tribe.

Now our stress comes from sources like electronic devices, over-commitment, dashed hopes and unmet expectations, financial strain, unsafe drivers, emotional upsets, and major life changes like birth, death, marriage, divorce, surgery, change in employment or living location, to name just a few.

But our bodies still react in the same way they did in prehistoric times to these threats and upsets—as if we were literally under physical attack.

So up goes your cortisol, which, among other things, suppresses your normal immune functions, leaving you susceptible to every cold and flu that comes your way. In time your body can get so run down that you develop something serious, even terminal.

The Estrogens – Estradiol, Estrone, and Estriol These three wonder hormones are involved in over 400 crucial functions throughout your body and brain, including your metabolism, moods, body heat regulation, insulin sensitivity, pain levels (think muscle and joint pain, and headaches), and carbohydrate tolerance. Both too much and too little estrogen are bad for you, in ways too numerous to go into here. But know this—you have estrogen receptors in your brain, bladder, bones, muscles, blood vessels, skin, breasts, uterus, eyes, heart, and colon. It’s not just about sex anymore.  With all those receptors, you can easily take in too much estrogen—or, more appropriately, too much of the WRONG kind of estrogen (aka xenoestrogens).

Insulin – Lowers your blood sugar, stimulates fat storage.

Melatonin – Regulates your sleep cycles and body rhythms, promotes fat storage for hibernation (remember those cave dwellers) and increases your appetite for carbs. Melatonin also plays a role in Seasonal Affective Disorder (SAD) syndromes that affect your energy levels, weight gain, daytime sleepiness, and depressed moods.

Norepinephrine and Epinephrine – aka your Adrenaline Hormones. These govern your “fight or flight” responses. They increase your heart rate, lift your mood (or in excess cause anxiety), increase alertness, and dilate your arteries to provide more oxygen, glucose, and nutrients to your key organs in times of distress.

Remember what I said about how our bodies were initially designed to respond to threats and the differences between threats then and threats now? Some of us are living in a nearly constant state of fight or flight simply due to the lifestyles we live. But on top of that, when a woman enters her PMDD zone, her fight or flight switch comes on, but because of some missed connection in the brain—it does not shut off
Until her period comes.  That can last up to three weeks in the worst cases. 
Being trapped in that fight or flight state is exhausting, to say the least. You know how you feel when you're exhausted...apply that to a woman with PMDD ten-fold and you may begin to understand her emotional instability during her episodes. 
Progesterone – The jury is still out on this one. Some sources say too much progesterone can increase your appetite, increase fat storage, reduce insulin sensitivity, make you sleepy, depressed, and depress your sex drive.  Fatigue, breast tenderness, bloating, and vaginal dryness are also symptoms.  Other sources say too little progesterone can cause many of these same symptoms—in addition to anxiety attacks, insomnia, dizziness, irritability, difficulty concentrating, extreme changes in mood, muscle pain, joint pain, and urinary incontinence.
Who to believe?  All I know is progesterone supplementation is something that needs to be fine-tuned over the course of your cycle    .  I have found that, much like an upside-down U-curve, there seems—for me—to be a sort of sweet spot at the top of the curve; too little progesterone creates symptoms, too much progesterone creates symptoms.  The dosage needed can vary daily.  I have to constantly adjust and readjust my progesterone intake, using supplementation and nutrition.
So be wary of progesterone creams, especially over-the-counter brands.  Depending on what else is in them, you can get too much, too little, or none at all.  They are not regulated.  Other ingredients in the creams can also clog your pores and provide added fake estrogens if you do not read the label carefully.  Only a precious few progesterone creams perform the way they are intended to.  I use a cream when symptoms are particularly bad, but for the most part I take a 100 mg capsule of micronized progesterone daily, and double that on symptomatic days.  If you would like to know which brands I use, contact me directly. (info (at) livingwithpmdd (dot) com.)

Testosterone – It’s not just for guys. Too little testosterone can negatively affect your bone and muscle growth, metabolism, mood, energy level, and sex drive.

Thymosin – This little-known hormone plays a major role in the development of your immune system. Be good to it or be betrayed by it.

Thyroid – Affects your metabolism, nervous system, muscles and bones, energy levels, heart rate, body heat production, and brain activity. (Hello? Brain activity? Remember this.)

Okay, now I’m no doctor, but if you take the major symptoms of PMDD and bump them up against these hormones, you’ll find that too much or too little of eight of them can lead to weight gain, five of them can cause problems with your metabolism, five of them can affect mood disorders, six can cause problems with your energy levels, two can make you anxious, two can make you aggressive, three affect your sex drive, two reduce insulin sensitivity, two affect sleep cycles, two can depress your immune system, and two can affect your brain function…which can affect all of the above.

Let’s break that down into something more understandable.

Imbalances (for lack of a better word) in the following can cause weight gain:
Aldosterone (water weight gain)

Imbalances in the following can cause metabolism problems:

Imbalances in the following can cause mood disturbances:

Imbalances in the following can cause your energy levels to plummet:

Imbalances in the following can compromise your immune system:

Imbalances in the following can reduce insulin sensitivity:

Imbalances in the following can cause problems with brain function:

Or, to cross-match it another way…

DSM-V Symptoms of PMDD affected by hormone levels:

Markedly Depressed Mood (feelings of hopelessness, or self-deprecating thoughts)

Marked Anxiety, Tension, Feeling Keyed-up or On Edge

Marked Affective Lability (feeling suddenly sad or tearful or increased sensitivity to rejection)

Persistent and Marked Anger, Irritability, or Increased Interpersonal Conflicts
DHEA and other Androgens

Decreased Interest in Usual Activities (work, school, friends, hobbies)

Subjective Sense of Difficulty in Concentrating

Lethargy, Easy Fatigability, Marked Lack of Energy

Marked Change in Appetite, Overeating, or Specific Food Cravings

Hypersomnia or Insomnia

Subjective Sense of Feeling Overwhelmed or Out of Control

Physical Symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, or weight gain.
Aldosterone (water weight gain)

Do you see where I’m going with this? You could have PMDD, or you could have some kind of hormonal excess or deficiency that is exacerbated pre-menstrually (called Pre-Menstrual Exacerbation). It might actually be an insulin problem, or a thyroid problem, an auto-immune system problem, and not PMDD at all. Some doctors have been making great strides with theories of inflammation. Your problem might be PMDD or it might be something entirely different.
The reason to get a diagnosis of PMDD is not to brand you with the PMDD label, but rather to rule out any other treatable causes for your symptoms.
Once you get that something else identified and dealt with, you might be left with only PMS to deal with.  And wouldn't that be wonderful?
The bottom line is only you and a caring, knowledgeable, and forward-thinking medical professional will be able to identify and separate the many connected hormonal threads in your body and figure out what's working right and what is not. 
You are a beautiful, complex system of individual ups and downs, highs and lows, checks and balances.  Don’t let medical professionals simply hand you prescriptions for one-size-fits-all blanket treatments and/or try to make you feel to blame or as if you are not trying hard enough when they don't work. 
And most of all, don't let anybody tell you you’re crazy.
Because the only things out of kilter here are your hormones.
Keep searching until you find the right practitioner and answers for YOU.