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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

Wednesday, July 11, 2012

PMDD and Why Me?

Okay, we’ve heard enough stories for a while of what it’s like to have PMDD.We all know what it is by now.  And we know there is not much we can do about it once an episode hits.  The best we can hope for is to ride out the storm.  So a question I’m sure all of us have asked at one point or another is Why Me?
 Well, today I’m going to look into the possibilities I’ve uncovered so far.   First, however, a little background.  When does PMDD happen?  And How does PMDD progress? 
You don’t get it before your first period.  Girls, on average, in part due to the tremendous amount of environmental toxins being dumped into our lives, are now getting their first period at age 12.  Your probability of developing PMDD increases with each hormonal event in your life thereafter: pregnancy, miscarriage, abortion, or birth.  (You do not experience PMDD when you are pregnant, because you are not menstruating.) With each new pregnancy, your chances of developing PMDD increase.  And unless your PMDD is addressed, it will continue to worsen with each hormonal event, and as you age, becoming increasingly difficult through perimenopause, until it stops when you reach menopause.
But don’t start cheering yet…if your PMDD is not addressed before menopause, you run the serious risk of developing Major Depressive Disorder after menopause. 
The average age of menopause is 51. 
So, that means, on average, women have approximately 40 years during which we can develop PMDD.
What causes PMDD?
Nobody knows for sure just yet, but scientists do know it is a biological event that manifests as emotional symptoms.  What does that mean?  It means PMDD is caused by something that happens in your body and shows itself in your moods.  The closest science has come to defining what happens is that whatever happens, happens in concert with your menstrual cycle, and involves your hormones.  The hormones they are looking at the most these days are estrogen and progesterone.  It’s not that you have too much or too little, or maybe not even the balance between them, as this is still being studied, but that something goes awry in your brain when processing these hormonal fluctuations in your body.
That’s right.  Something goes wrong in your brain.  No news to us, right?  We’ve known all along something wasn’t right with our brains, with our thinking processes, during an episode of PMDD.  Why else would we say and do the things we say and do during an episode and not the rest of the month?
But I won’t go into all of that right now.  For now it’s good enough to know there is a biological “something” that happens where our brain does not properly process the fluctuating levels of our reproductive hormones during the second half of our menstrual cycle.  This leads to a disconnect in the brain, like when an extension cord comes apart from a plug, or when your cell phone coverage drops.  The result of this disconnect is a depletion of serotonin in the brain, the neurotransmitter that in part governs our moods, and our ability to be happy. 
This is why we crave carbs.  Carbs increase the level of serotonin in our bodies, and therefore improve our moods.  Problem is, most of us reach for the WRONG kind of carbs.  You know who you are and what you eat.  Not just any carbs will do.  But that’s the subject of another post. 
This is why doctors prescribe anti-depressants.  Certain antidepressants, called SSRI’s, help to increase the level of serotonin in our brains.  Problem is, we’re not low on serotonin all the time, and antidepressants come with a bunch of side effects that can make your symptoms worse.  Plus they don’t work at all for at least 40% of the women who take them.  (So if you’re one of the 40% or more, don’t blame yourself!)
This is why doctors prescribe birth control pills.  Birth control pills keep you from ovulating, which is the main cause of this shift in your hormones that your brain does not process correctly.  But again, this is treating only the symptoms and not the underlying cause, and birth control pills have their own array of side effects -- including death. 
Never mind that some women would rather be dead than suffer from another episode of PMDD.  I, for one, am not interested in taking something that could kill me when there are so many less drastic options to try.
Which brings me to the question of what contributes to PMDD?  Weight, lifestyle habits, including smoking, drinking, drug use, caffeine and sugar consumption, stress, trauma, abuse, and yes, genetics.  We’ll get more into genetics in another post.  For now it’s enough to know that in some cases, you really “can’t” help what happens to you when you’re experiencing an episode of PMDD.  It could be in your genes.
And if it’s in your genes, you’re not going to be able to cure it with a magic pill, be it synthetic or natural.  The best you can hope to do is manage the condition.
So what can you do about your PMDD?
You can address the things that apply to you. I’m not going to touch weight, because there are sooo many factors that go into a woman being overweight that it’s the most difficult of all for us to address.  (That’s a whole other blog post in itself as well, maybe even two or three.)  But yes, you can quit smoking, yes, you can cut down on your drinking, maybe even eliminate it altogether.  Same goes for caffeine -  you can cut out caffeine and not die – not like other options mentioned above.   You can cut back and even eliminate eating sugar.  And please do not make the mistake of thinking sugar substitutes are the answer to the situation.  If you’re determined to go that route, you’d be better off to keep eating sugar.  Raw sugar if you must, but no sugar is the best route of all.  Sugar feeds PMDD, and it also feeds cancer.  So think about it, and do what you can.
If you’re a sedentary soul, you can get more exercise.  Two to three half hour walks a week will do wonders for your PMDD.  45 minutes is even better.  Work your way up to whatever time you can spare.  Really, how can you not spare the time, when your life is at stake? 
Over-exercising is just as bad as not getting enough exercise.  More on why some other time.
Stress – starting to sound like a broken recording here, I know.  The stresses in our lives are as numerous and varied as our PMDD symptoms.  You know yours.  Get rid of them.   Don’t you deserve a better life? 
Rest – get as much as you can, especially during an episode.  Learn how to “Just Say No.”  Start small and work your way up.  And do it gently.  Don’t put it off until it becomes a snarl.
Nutrition – there’s a reason fresh, whole foods are good for you.  They’re packed with the nutrients your body, including your brain, needs to function properly.  You can’t get good nutrition from a box any more.  It just doesn’t happen.  And taking high quality, pharmaceutical grade vitamin supplements (not the cheap ones!) does help, but it doesn’t by a long shot make up for what you can do to make yourself feel better by simply eating foods as close to their natural state as possible.  Vitamins are meant to boost your nutritional balance, not replace what you lost from not eating right and depleting your body’s nutrients when you drink, smoke, and/or take drugs -- even common over the counter drugs. 
So there are a lot of things you can do to make your PMDD better.  Most, however, require time and effort.  It takes time to make good, healthy meals.  It takes time to listen to your body and become aware of what makes you feel better and what makes you feel worse.  It takes time to find the right treatment for your particular symptoms.  It takes time to make time for you, take time out for rest and relaxation, or deal with those messy stresses eating up your life.  It takes time to become comfortable with your emotions.  It takes time to work on your relationships.  It takes time to quit using the crutches you’ve been using to get through your however many years of PMDD.
But think of how many more years you have to go, and how it will only get worse if you don’t do something about it.  Do you want to spend your golden years depressed?
I know I don’t.  And I don’t want you to have to do it, either. 
You didn’t ask for the hand of cards you were dealt.  The best you can do is learn how to play them.  The information is out there. The willpower is inside you.  Are you going to sit around asking Why Me?
Or are you going to come to the table and say, Not Me. Not Today.
One day at a time.  That’s all you need to work with.  One hour at a time, if that’s all you have.  Pick one positive thing mentioned in this post, and do it for yourself, do it today.  Do the same thing tomorrow.  Keep doing it, one day at a time, until you have it down.  Then pick something else, and start the process all over again.  Baby steps are still steps in the right direction.
You can do it.  Because PMDD women are strong.  Super strong.  We have to be, with all that we have to deal with.

Liana is the author of PMDD and Relationships, a book written to help a woman with PMDD gain personal awareness, and insight into why she says and does the things she does.  PMDD: A Handbook for Partners, was written to help explain the unexplainable to partners of women with PMDD.  Either one of them can be used as a resource on tips for how to handle PMDD, or as a conversation starter for someone who wants to explain their PMDD to a loved one to someone they care about.  Both are available in ebook from Amazon and Smashwords (Kobo, ibooks, Nook, and Overdrive), and in print from Amazon, and the International Association for Premenstrual Disorders, or IAPMD.  For more information, please check out Liana's Facebook Page, Living with PMDD.

Wednesday, July 4, 2012

PMDD and the Trip of a Lifetime

This time last week I was in Alaska with six girlfriends.  You’d think, since it was the trip of a lifetime, one I had been wanting to go on for over twenty years, one I had been  planning and saving for and working toward for over a year and a half, that I would be having the time of my life. 

I would have been, if my PMDD hadn’t decided to come along. 

The warning signs started over two weeks ago, with the second day on the cruise ship.  I awoke, went to breakfast, went to a nature talk on what we could expect to see in Alaska, and could not stay awake to save myself.  After the lecture, I bailed on my friends, went back to the cabin, and slept soundly until I met up with everyone again for lunch.

I spent the afternoon feeling groggy, but okay.  Then we met for dinner (yes, you eat a lot on cruise ships – it’s part of the experience).  Somewhere in the middle of the meal, I literally felt something in my brain snap into place, like two pieces of a puzzle.  Like a connection that had come unplugged had suddenly been plugged back in.  I felt awake, energized, clear-headed.  Now I could get on with my cruise and have fun.  I  said as much to my companions.  We danced the night away.

Clearly, since that incident happened over two weeks ago, I was ovulating.

A few days later, the sleepiness returned, despite getting the best sleep of my life on the gently rocking ship.  On the tenth day of the trip my irritability arrived.  I snapped at my companions, and realized instantly I was having an episode.  I managed to hold my tongue for the rest of the day, but my inner thoughts ran rampant on every negative thing I could think of regarding the trip.  By evening I was in tears. 

I decided the best thing for everyone involved would be for me to go to bed early.  I did, and slept 14 hours.

The next day nothing, and I mean nothing could make me smile. 

Trip of a lifetime and I wanted to go home. 

I warned the ladies – Tomorrow I will be weeping.  They nodded in understanding.

It didn’t get that bad, fortunately.  Instead I mostly dragged through the day, sighing heavily, and privately wished I were home. 

Three days later I got my wish.  Once I was here, all I wanted to do was sleep.  (Well, I was awake for nearly 24 hours getting home.)  I took a nap every afternoon, claiming exhaustion from the trip.  But I knew I was hormonal, too, and warned those closest to me

My irritability returned, but again, after the first snap, I kept it inside…or at least I think I did.  My son did his best to make himself scarce, which only irritated me more.  Didn’t he miss me while I was gone?  He didn’t miss my PMDD self, that was for sure.  Still, I felt hurt and rejected.  I reached for the chocolate.

Monday comes…my work week begins.  I can’t get started.  I can’t get organized.  I wander around the house all morning, putting little things away, sorting this, filing that, clearing clutter, preparing myself to work, but doing no real work. 

That afternoon I take a 3-hour nap.  I awake ravenous and craving chocolate.  I am in full bore PMS mode (yes, you CAN have both PMS and PMDD) when that night and the next I make salty dinners.  Shrimp stir fry with Tamari the first night.  Tuna the second.  (I wanted tuna casserole, which is very salty, but somewhere in the day lost the motivation to make it, so settled for tuna salad and chocolate cake instead.)

My period is coming, but it’s not here yet. 

This morning I have brain fog.  I tried to pay bills.  Forgot to date one check, and forgot to include the credit card payment check in its envelope.  Par for the course with PMDD.  Small mistakes, but with big repercussions had I mailed them that way.  Instead, I ripped open the envelopes, made things right, and taped them up again.  At least I was still thinking clearly enough to catch my mistakes. 

At least I’m still thinking clearly enough to write.  That, too, may change in the next few hours.  Can you imagine how terrifying this loss of control is to a woman who does not know she has PMDD?  She has no idea what is happening to her.  All she knows is in the next few days, or even hours, she will lose her ability to both think clearly and control her emotions. 

And there’s absolutely nothing she can do to stop it.  Once that ship sets sail, it doesn’t stop until it wrecks.

Homes.  Families.  Relationships.

I am blessed in that I am in safe home, family, and relationship situations.  Those who are closest to me, those who spend the most time with me, are all understanding and supportive. 

But what if that wasn’t my situation?  What if I was in an abusive relationship?  Or living with someone who simply thought I was lazy and self-centered?  What if I lived with someone who called me crazy when this happened?  What if I lived with someone who didn’t want to be around me when it happened?  Who threatened to leave me if I didn't shape up?

What if I lived with someone who screamed and yelled at me, ordered me to snap out of it, called me names, and/or demanded, “What’s wrong with you?”

Self esteem takes a swan dive during a PMDD episode.  We feel unlovable to start with during this time.  Anything you say or do to make it worse will be magnified at least tenfold in our minds.  We are fragile and we don’t know why.  We need love and we want to be left alone.  It doesn’t make any sense to you, and it doesn’t make any sense to us.  We didn’t ask for this to happen, and in most cases it will be a long time (due to misdiagnoses and the hit or miss nature of treatments) before it stops happening.

And once an episode begins, nothing, nothing brings you joy…not even the trip of a lifetime.

So be patient with yourself, and be patient with your partner.  Finding the key to your individual situation will take time.  Look for answers from reputable sources.  Be wary of sources that claim to cure your PMDD.  Be cautious about anyone who stands to gain financially from your disorder.  Just like there are cheesy tourist traps when you go on vacation, there are those who only seek to profit from your PMDD misery.  Navigating the waters of PMDD products while searching for a solution can be choppy at best, and downright treacherous at times.  Hold on to the wheel (aka your sanity) with both hands, and if you have someone to help you when things get rough, be grateful for them and let them know it, no matter what ugly thoughts are going through your mind. 

Just keep mentally repeating, that’s my PMDD talking, not me, that’s my PMDD talking, not me.

Keep your mouth shut, and when the episode is over, thank them for being there for you.

The more you do this, the easier it gets.  And when you fail, see my post, They Only See Our Failures.

Take care, God Bless, and be proud of yourself.  Not every woman has the strength to wrestle with her PMDD, month after month after month.   But you are here, and looking for answers to yours.  That’s something worth recognizing and applauding.