A PMDD Crisis Guide, Guest Blogger Cat Stone

I figured you might be getting tired of me going on and on about relationships and such, so fellow PMDD blogger Cat Stone has graciously agreed to step in and do some guest posts, starting today with her PMDD Crisis guide. Please help me welcome Cat to Living on A Prayer, Living with PMDD...

Recently, I have been feeling much better. This is a real turnaround after many years of feeling like a pendulum swinging back and forth. I feel I have more control. I am coping with my bad days more effectively and achieving more on my good days... AND it's winter!

Up until now, it has been hard to write without getting too emotionally involved, and that's no good if you are trying to help others in an emotional state. I finally feel that I can share some practical advice, and I really hope it helps other women cope with PMDD.

Firstly, here's a little about what I have learned and coped with over the years. I'm not a Doctor, but I am an Aromatherapist, and have researched many therapies and theories over the years. I have also had PMDD for 20 years... since I was 13. I have lived with this disorder all my adult life. I don't remember a time when I wasn't feeling crazy and out of control on a regular basis. I used to believe I was really mentally ill. I just wanted to be taken away and put in a padded cell.

When I look back at this, the desire to be taken away, away from my kids and life, stemmed from the overwhelming feeling of being unable to cope. A week or month in a psychiatric ward looked more like a holiday. A break from the pressure, the relentless cycle of life, bills, kids, shopping, etc.

That never happened. They never took me away. I was a single mum with a 3 year old. No family or friends as I'd just moved to a new area after separating from my adulterous husband and being homeless. I would hit crisis every month. Crisis at this time in my life was volatile... I had been through so much emotional trauma by this time that I was reacting to everything, and was feeling more and more suicidal.

Screaming, frustration, anger, rage and shouting. Throwing things, kicking things, punching, scratching my arms with my own nails, drinking, sobbing, weeping, and suicidal feelings.

I would lose all control over myself. An ex-boyfriend said once that I made no sense while I was having an episode. Words would come out, but he couldn't understand me. I figured I was a raving lunatic. I feared for my daughter. I thought I was an inadequate mother. I felt she should be taken away from me. I digress.... I know that ladies reading this who have PMDD can relate to my story, and those people who don't suffer, will never be able to truly understand how it feels.

The point to my story is that I have been in crisis more times than I care to remember. It's taken me years to understand, years to develop ways of coping, years of trying different meds... I grieve the years I have lost to PMDD, the opportunities lost and the events I've missed.

In everything I study, there are different realms... We live in physical, mental, emotional and spiritual realms. In holistic therapy, we can become unwell or suffer dis-ease in any of the realms. I believe in the theory that everything is interconnected. An illness in the mind can become an illness in the body, and PMDD is a disorder in the body that causes a disorder in the mind.

PMDD is an invisible disorder. Women that suffer look no different to women that don't (unless you count the extra grey hairs and bags under the eyes!). PMDD dis-ables women. It robs them of approximately two thirds of their life, every month, without fail.

PMDD often gets misdiagnosed as Bi-Polar. I asked my Psychiatrist what the difference between the two is, and he said 'Bi-polar sufferers will have periods of time (weeks, sometimes months) when they function normally. Life is relatively normal. Then they will swing, either up or down, again for a longer period of time, and the cycle continues.

PMDD works on a much faster cycle. The ups and the downs can be weekly, sometimes even daily, and there is no long period of normal, functioning time.' PMDD sufferers may get a few days in a row of feeling OK, and believe me, there is MUCH to do during those days... sort out problems, fill in forms, do the shopping, clean the house, catch up on work. It all too quickly deteriorates and jobs end up having to wait again till the turmoil is over.

If you can get to the point when you know you're about to explode, when you can recognise the feelings building, when you are aware of your actions, then you have half a chance of diverting disaster. In my next few posts, I will be looking at each 'realm' in turn, and how PMDD affects you on different levels.

This is my interpretation, my opinions, theories and my experiences. One thing is for sure.. although there are a lot of commonalities between PMDD sufferers, what works as a treatment, what helps you get through and survive is usually very different. There is no one way to treat PMDD. I am just sharing my way, in the hope I might be able to help others find their own path through PMDD.

My next post.... PMDD and the physical realm: Looking after the body to look after the mind.

Relationships and PMDD -- Doing Your Part

Last week I posted 20 tips for partners who live with women who have PMDD. While it would be ideal if your partner did all of these things, that’s still only 50% of the equation. You’ve got to bring something to the party as well. As any relationship book will tell you, it takes two to make a relationship—any relationship—work.

So if you’re thinking, “If I just love him enough,” or “If I just (do anything) enough,” it’s not going to work—not without you running yourself into the ground. Relationships are full of give and take, and only work well when each partner gives as much as he or she takes.

Even if you’ve got the best partner in the world, there are still things you can do to make your PMDD episodes run more smoothly. And if your partner is not supportive—then do it for you…because you’re worth it.

1. Chart your symptoms daily. It doesn’t have to be elaborate, one of those pocket calendars will do. Just write a few words each day: anxious, crabby, sad, sleepy, achy, bloated, cravings, weepy, snapped at __________. Use this to get in touch with your feelings and your body. Eventually you’ll discover patterns of symptoms.

2. Consult your chart/PMDD calendar when considering social events, activities, creative or household projects, vacations and such. Making major decisions comes under this heading, too. Don’t set yourself up for failure by taking on something big when you know you won’t be feeling up to it. Don’t just try to slog through your life the best that you can…be pro-active!

3. Learn to recognize when you are symptomatic, and consciously postpone thinking about anything that needs serious thought until you are feeling better. If you don’t, your decisions will be colored by your PMDD, and you may well end up asking yourself, “What the hell was I thinking when I decided to do this?”

4. Understand that if it is not treated, your PMDD will only get worse. It could end up a major depressive disorder and who wants that when you know it can be avoided?

5. Find a doctor who will listen to you. If the doctor won’t listen, change doctors. It’s your life at stake here. No one has as much to gain from finding the right treatment for you as you do. So take an active part in your own health and well being. Don’t just do what the doctor says because “the doctor knows best.” The doctor knows what the doctor knows, and if the doctor doesn’t know anything about PMDD, you need to find one who does.

6. Try whatever you need to try to feel better. If you don’t feel better, then stop whatever makes you feel worse, and try something else. This goes for both medical and natural treatments. If medication works for you, go for it. If it doesn’t, don’t keep hanging in there, thinking it will get better. Your doctor is not you. Your doctor can’t feel what you feel or experience what you experience. Only you can know what works for you and what doesn’t.

7. Do not let anyone make you feel inadequate because something that works for others is not working for you. There is nothing wrong with you if this treatment or that treatment doesn’t work. All it means is you haven’t found the right solution for you yet. PMDD is not a one-size-fits-all disorder.

8. Move your body. Fit exercise in whatever you can, whenever you can. Isn’t a healthy you worth it? Find a few kinds of exercise you enjoy and mix it up so it doesn’t get boring fast. A class here, a walk there, maybe Tai Chi today and Zumba tomorrow. Just put on some music and dance around the house with the kids or by yourself for a song or two. See if that doesn’t put some energy in your step. Park your car a few spaces away from the door instead of in the closest spot. 30 minutes of some sort of aerobic activity a day is best, even if it’s just cleaning the bathroom or carting laundry up and down the stairs, but if you have to start with 5 or 10 minute increments, then start there. Anything is better than nothing.

9. It is essential that you get enough rest. Sleep is when your body re-regulates itself and if you don’t get enough sleep, your body doesn’t have the time it needs to complete its repair job from whatever abuses you subjected it to during the day. (aka substance abuse, smoking, stress, overexertion, poor diet). The more sleep you lose, the harder it is for your body to catch up, and you fall further and further behind each day. This explains why you are so exhausted.

10. Eat healthy. Whole foods, as close to their natural state as possible. Avoid alcohol, caffeine, sugar, sugar substitutes, anything made with high fructose corn syrup (yes, you might have to start reading labels), white rice and white flour, for starters. Start being aware of what you eat, and as you pour that cup of coffee, know you are contributing to your PMDD, and know that you are choosing to do so. Ask yourself, is this candy bar, energy drink, glass of wine, piece of cake worth feeling miserable two weeks from now?

11. Get yourself some high quality dark chocolate for when the cravings come. Not that mass-produced stuff that comes in a bag. No matter how good it tastes, it’s not going to help you like true chocolates from a chocolate store will. There are plenty online to choose from if your town doesn’t have a chocolate store. A bonus is you’ll need less of the high quality stuff to feel better, so you might even lose some weight.

12. If you snap out at someone, stop, apologize, and explain to them that it’s not them, it’s your PMDD. Don’t let hurt feelings fester, on either side of the relationship. If they’re not open to an explanation of PMDD, just say, “I’m sorry, I’m having a bad day,” and leave it at that. Everybody has bad days now and then.

13. If somebody is trying to bait you, walk away. Don’t let their bad mood spark yours. Tell them you’ll be back or continue this conversation when you’re both in a better mood.

14. Ask for help when you need it. If you don’t have anyone in your life who is willing or capable of doing this, find new friends who will be supportive and encouraging. Even if they’re just online. PMDD forums and discussion groups abound. You don’t need to go through any of this alone.

15. Do not let your negative thoughts and feelings get the better of you. Every day, all day long, our minds run rampant with thoughts. Good ones, bad ones, even strange ones. One way to get a handle on this is to learn how to still your mind. But that takes dedicated time and effort. If you’re not at a place in your life where you can take the time out to meditate or practice some form of deep breathing exercise that stills the mind, at the very least, when the negative thoughts come, push them right back out of your mind and refuse to dwell on them. Say to yourself, “That’s my PMDD talking, not me,” and consciously change the subject.

Remember (as long as PMDD is your only problem), you are in control of your mind…your mind is not in control of you (even though it very much feels like it). You need to refuse to give those negative thoughts any air time, because if you don’t, they will loop endlessly through your mind, creating deeper and deeper ruts, until negative thoughts are all you know and you end up with major depressive disorder. This is how PMDD women become suicidal.

Some wonderful ideas on how to mentally shift gears are in this article from Women to Women. The article is about perimenopause, but unless you die first or have your ovaries surgically removed, thus throwing you into instant menopause, you’re headed for perimenopause anyway. Why not learn how to deal with it in advance?

Be blessed, and keep me posted on your progress!

Top 20 Tips for Partners Dealing With PMDD

What follows is my most widely-read blog post, completely updated in December 2015 and included in my book, PMDD: A Handbook for Partners. That said, here is the post that inspired the book.

Unfortunately, my research has uncovered a complete lack
of serious information for men on the subject of PMDD, so here
it is, short and sweet, a list of the top 20 things you can do for
your partner with PMDD.
1. Believe her. When she tells you what she’s
experiencing, believe her. Even if it doesn’t make sense.
Because PMDD doesn’t make sense. The symptoms are as
unique and individual as the woman having them.
2. Do not tease her. Do not make fun of her, as this is a
serious and often debilitating condition. Would you tease a
combat veteran for having PTSD? During an episode, a PET
scan of a woman with PMDDʼs brain shows the exact same
configuration as that of a vet with PTSD. This womanʼs brain
truly believes she is under attack, and will respond accordingly.
(This will cause her to do and say things she would never even
consider during her non-PMDD days.)
3. Chart her symptoms daily, either together or on
your own. If she refuses to admit there’s a problem, then do it
on your own so that you can be prepared for when the storm
hits.
4. Consult your chart or app when considering social
events, activities, or vacations and such. Surprises and big
decisions come under this heading, too.
5. Learn as much information as you can about
PMDD from reliable resources. If they have a product to sell
you, any type of product, proceed with caution.
6. Understand that if it is not treated, her PMDD can
only get worse. It could end up as Major Depressive Disorder.
7. Help her to find a doctor who will listen to her and
help her. This may take several tries, as most doctors are not
trained in the treatment of PMDD. Traditionally trained
medical doctors will only offer you birth control or
antidepressants, since they are the only drugs medically approved
for treatment of PMDD by the FDA. Your best bet is to find a
naturopathic doctor or nurse practitioner.
8. Don’t let her negative thoughts and feelings get the
better of her—or you. If she shares them with you, gently
remind her it’s the PMDD talking, not her, and postpone any
major changes or discussions/decision making for a few days.
9. Be supportive and encouraging as she tries different
things to feel better. Make a note of what works and what
doesn’t. Share this with her doctor. Do not blame her if any
medication she is prescribed does not work. It does not work for
most women. Science does not yet understand the brain well
enough to know what is biologically going on during an episode
of PMDD, despite what the television ads tell you.
10. Help her to get enough rest. Sleep is when our
bodies re-regulate themselves. If we don’t have enough (sleep)
time to do the work needed, we start the day at a disadvantage.
11. Join her for moderate exercise. Exercise is always
more fun with a friend. I have found a walk of 45 minutes can
buy me up to two hours of PMDD-free time.
12. Encourage her to eat healthy. (Avoid alcohol,
caffeine, sugar, sugar substitutes, energy drinks, anything made
with high fructose corn syrup, and white rice and flour, for
starters.)
13. Buy her some high quality dark chocolate. Keep it
on hand for the bad days.
14. Do what you can to keep stressful situations to a
minimum. PMDD feeds on stress.
15. Do not accept any behavior that is abusive. Ever.
16. Do not return such behavior if it happens. Calmly
walk away and resume your conversation when she is more in
control of herself. Be firm about refusing to engage when she is
out of control or abusive. When she gets this way, the PMDD
bully in her brain is in full control, and determined to destroy
whatever it can.
17. Remember that she literally is not herself during
an episode of PMDD. Try not to hold the things she says and
does against her. It’s not personal, and it’s not about you. It’s the
bully that has taken over her brain egging her on.
18. Be as comforting as she will allow you to. If she
won’t let you near her, let her know you will be nearby if she
needs you. To her brain during this time, allowing comfort
equals weakness. Weakness equals vulnerability. Vulnerability is
dangerous to the PMDD brain.
19. Don’t expect her to be full of sunshine and
laughter when she’s not having a PMDD episode. A
healthy, balanced, and emotionally well-rounded woman feels
every emotion—not just the good ones.
20. Last, but not least: Do not blame every time she
becomes irritated, annoyed, angry, afraid, or upset on her
PMDD. Nothing is more irritating than having a genuine
concern or grievance, and being told, “It’s your PMDD again,
isn’t it?”
Maybe it is, and maybe it isn’t. Take the time to check her
chart to see if she’s supposed to be having an episode, and then
carefully sort through (usually by talking it out) and separate
what is her PMDD and what is a genuine fear or concern on her
part. Encourage her to feel and express the full range of
emotions, just like people without PMDD do.
More than anything, a woman with PMDD just wants to
feel normal. These 20 tips will go a long way toward helping
your partner do just that.

Note:  PMDD: A Handbook for Partners, and its sister book, PMDD and Relationships, are available in both ebook and print.  If you participate in the Amazon Smile program, please consider designating the National Association for Premenstrual Dysphoric Disorder (NAPMDD) as your chosen charity.  You can also buy these (print) books on the NAPMDD website, where $1 from each purchase goes to support the NAPMDD Awareness Fund.

More Tips For Partners Dealing With PMDD

Last week’s post, while it will go a long way toward stabilizing your relationship with a woman in the throes of a PMDD episode, was barely the tip of the iceberg. So this week I thought I’d continue with some tips and information on how to cope with your partner when she’s feeling her worst.

Once again, most articles I read in researching this post were about how awful it is for the partner, who has to deal with all sorts of aberrant behavior on the part of his or her loved one. In these articles, there doesn’t seem to be much understanding or empathy for the woman actually going through the brain changes over which she has no control.

So the first thing I want to emphasize once again is empathy. Put yourself in her place, and my guess is you’ll discover you wouldn’t want to have a body and brain you have no control over for several days a month. How would you feel if your thoughts—due to a biological disconnect between your brain and your mouth—came out as something else entirely—something actually hurtful to those you love the most? How would you feel if no matter how hard you tried to eat right and/or stay in shape, your body suddenly just wouldn’t cooperate? What if it actually undermined all your best efforts by bringing on intense cravings for things you know you shouldn’t eat, cravings for things that actually make your condition worse?

How would you feel if for up to half of your life, nothing you thought or said or did made sense?

One article I read said women could be touchy—touchy!—about being labeled as a raving lunatic for a few days a month. As if the women involved had no business being so sensitive. Who wants to be called insane? Do you?

It also said very few women will admit they’re affected by PMDD. Again, would you feel comfortable telling people, “Oh, don’t mind me, my mind just goes berserk every now and then?” Would you want the strange looks that come with such a statement, would you want people steering a wide path around you because you just admitted there’s something not quite right about you?

So don’t try to be helpful (or antagonistic) by pointing out her PMDD symptoms. She’s well aware of what she is feeling. Anxious, edgy, jittery, depressed, clumsy, fat, foolish, frightened, sleepy, weepy, ravenous, disorganized, out of control…the list goes on.

Even more important is that you don’t make fun of her for any of the above.

Again, if you knew people were going to ridicule you for something you have no control over, would you openly admit to having such a problem? How can any woman win the admiration and respect of the friends and family she loves and respects in such an antagonistic enviroment?

Your best bet is to save your meant-to-be-funny comments and war stories for your friends, to be shared privately, and simply act like nothing out of the ordinary is happening when the PMDD is in effect. Help to make your partner feel as accepted and normal as possible.

This does not mean you have to accept any kind of behavior she throws at you. Abuse is abuse, whether your partner means it or not. PMDD is an explanation, not an excuse, and you don’t have to accept abusive behavior under any conditions. For more on this, go to last week’s post.

Don’t spring any big surprises on her. Remember she’s doing everything she can just to cope with her everyday life, to stay on an even keel in a body emotionally tilting one way and then the other, just to get through the day without being labeled crazy. Big news, big plans, big surprises can wait for a day when she’s better equipped to handle them.

Besides, you should never trust any big decisions made while she is under the influence of her PMDD. This includes decisions she may come to regarding your relationship. If she says she wants out…do what you can to stay calm, and wait until the storm passes. If when it does she still wants out…then you have a different problem, and one that is beyond the scope of this blog.

Take it easy on social activities. If you felt like a beached whale and couldn’t seem to control what you put in your mouth, would you want to go to a party and spend it stuffing your face at the food table? A food binge can be great fun, if that’s what you want to be doing—if that’s your way of celebrating good times or good news. But if you’re watching your weight—and what woman isn’t at one point or another?—taking her food binge show on the road is the last thing she wants to be doing.

The same goes for her emotional outbursts. It’s hard enough to keep a lid on things at home. Do you really want to put her in a situation where she spends the evening either snarling at your friends and family or weeping at every little misinterpreted comment? Because during a PMDD episode, the PMDD brain will focus on the negative, and even if you didn’t say or mean anything negative at all, even if you compliment your partner, her brain is being flooded with negative thoughts and images, and eventually the dam will burst—putting a huge damper on your evening out.

And then she’ll feel miserable about it. About ruining your plans/evening/event. Whether she did or did not, and whether she admits it or not, she will blame herself for anything that goes wrong during these dark periods of time in her cycle.

So remember to track her symptoms and plan social events to avoid head-to-head conflicts with her PMDD episodes if at all possible. She’ll appreciate you all the more for your understanding.

Be understanding of her cravings. Both men and women seek comfort food when they are feeling miserable. During a PMDD episode, a woman will especially seek carbs. Doing so is a natural way to boost, for instance, the level of serotonin* in her body, and she knows this on a subconscious level. Where it gets confusing is the food and advertisement industries have done their best to convince us certain foods and drinks are healthy when they are not. So while on a very primitive level, your partner is craving something to boost any number of feel-good hormones in her body and make her feel better, what manifests is a desire to eat everything in sight in the hopes of finding that magic solution.

It’s best to have good quality carbs already on hand for when these cravings strike. I find that multi-grain toast with no-added sugar jam (not artificial sweeteners, as they can make PMDD symptoms worse), a bowl of whole or multi-grain cereal with almond or cashew milk, or a bit of good quality dark chocolate does the trick. When we consume large amounts of cheap chocolate candy (or cereal) we are looking for the same effect, but in the wrong place. The added calories from the sugar and fat that come along with the added amount of chocolate needed to reach the same feel-good hormone boost as a good quality piece of chocolate only cause our PMDD symptoms to worsen. They also cause us to gain weight.

But sometimes, the woman’s level of feel-good hormones dips so low that nothing short of a pizza will do. If that’s the case, then go for it guilt free. You might even plan pizza night around her cycle, and see if that improves things.

Take on some of her workload. Whatever you can do to help out, do it with an attitude of love, not resentment. If she asks you to help around the house, do what she asks. If she wants you to run an errand, please do the same. The slightest bit of effort to appreciate what she’s going through will go a long way toward soothing her, and is it really worth the effort to argue over whose turn it is to take out the trash?

It’s true that things that don’t usually bother her will bother her greatly when she’s having an episode. Just keep in mind who your real partner is, and go along with what she says. The sooner you do, the sooner her episode will pass.

That’s right, stress will prolong her episode, so if you want it to end sooner, the best thing you can do is to go along to get along, as long as it’s a reasonable request.

If you’re a mature adult, you know what reasonable and unreasonable is. We don’t need to go into it here.

Treat her like you appreciate her. Every woman loves to be appreciated, no matter what mood she’s in. During an episode of PMDD, with all those negative thoughts running an endless loop inside her head, your partner needs extra special care. Reassurance is always nice, but might not be believed or accepted. Understand that the negative thoughts in her brain are overwhelming the positive ones you’re trying to get across. Be patient. Be persistent. Let her know you care, and you’re there for her if she needs you. She’ll meet you more than half way if she possibly can.

If she doesn’t, it’s because she can’t, or doesn’t understand enough about what’s happening to stop the train of negative thoughts in her mind. It’s not because she doesn’t want to, or doesn’t love you. It’s not about you at all. So remember that, and try not to take the things she says and does personally. In a few days time, the woman you love will return, and when she does, it would be a good time to discuss what may have gone wrong during her most recent episode.

A lot of women will want to forget what happened, pretend it didn’t happen at all, and that’s quite normal, but not the best way to deal with it. Talking it out with your partner when she’s feeling herself is the best way to prevent unwanted behaviors and situations in the future.

The bible says it best : Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres. ~ 1 Corinthians 13

All a woman with PMDD is looking for is the same thing everyone wants—love and acceptance.

The more you accept, the less you’ll have to. What we resist persists. So don’t fight your partner’s PMDD. Go with it, roll with it--and watch the waves grow smaller over time. 

For more information, check out my book, specifically written for partners of women with PMDD. 

*Serotonin is only ONE of several feel-good hormones in our body.  The serotonin-deficiency theory highly touted as the answer to PMDD has never been proven, but has been marketed heavily to women with PMDD.  More on this in another post.