Holiday Treats for Those with PMDD

Two Christmas treats I've uncovered this month...

The first is the best overall medical write up of PMDD I have ever read, and I do mean ever, starting with the first line where it defines PMDD as "a diagnosis to indicate serious premenstrual distress with associated deterioration." 

What I like about this write up is that it DOES NOT, anywhere, or anyplace, or at any time, refer to PMDD as a "more severe form of PMS," which PMDD most definitely is not.  You can have both PMS and PMDD at the same time, but they are not interchangeable, as so many articles and essays and websites either claim or imply, and they are not the same disorder, with one simply being a more severe version of the other.  The fact that so many PMDD resources say they are only muddies the already murky waters of PMDD, leaving everyone searching for help more confused than ever. 

So...I heartily recommend that you read this emedicine Medscape article and learn the latest about PMDD.  I'm sure there's information here you haven't read before.  And if you have just recently discovered you have PMDD, there is no better place to start your research than with this overview.

The second treat I've uncovered is this delightful free PDF entitled Let's go menstrual! by Miranda Gray. This 34-page PDF is a super easy read that helps us to understand our monthly changes, and provides a great way to enjoy and take pride in (rather than dread and loathe and curse) your menstrual cycle.  Ms. Gray breaks our cycles down to four seasons.  PMDD women would benefit the most from the section entitled The secrets of the Autumn and Winter phases.  

Seriously....this PDF "gets" what it's like for us, provides excellent tips and resources on how to cope, and finds a way to put a positive face on our periods and PMDD.

Couldn't we all use a little positivity going into 2014?

So let's welcome the new year and our new beginnings and successes with these two excellent resources for women with PMDD.

Surviving the Holidays with PMDD

Wow, here I am, a year later, still researching my post on progesterone...there's so much information, pro and con, to sift through.  I seem to uncover new information daily and it's all conflicting.

 

You see, the truth is, I want to be able to say progesterone is good for you and it works miracles for your PMDD...unfortunately, that is not what I am finding...

 

So I keep looking.  But I think it's time to stop researching, and just write the post.

In the meantime, going in to the holiday season, I thought we might revisit a few posts on relationships to remind ourselves of what's important, what's not, and what we can do about it.

Here are the links to my series of posts about all sorts of relationships, because between now and when life settles down again in January, we'll most likely be dealing with more people than we do the rest of the year combined. So bookmark this page, and refer to it as needed :)

Relationships Begin With You

Learning to Treat Yourself Like a Friend

HOW to be a Friend to Yourself

Choosing Your Friends Wisely

Choosing Your Family

How to Survive Family Gatherings

It's Not Personal, It's Just Your PMDD

Finding the Right Partner

Dealing with PMDD - Advice for Men

and, as a reminder,

They Only See Our Failures

Take care, God Bless, and may your holidays be happy.

Preparing Ahead for Your PMDD

Hello and welcome...today we have a fantastic guest post by Renell that was originally posted on Facebook.  I've chosen to add my two cents worth in italics (Sorry! It's the writer/editor in me!) so if it reads like two people are talking here, that's why.  Please feel free to leave any positive suggestions YOU might have for coping with/managing your PMDD in the comments section.  I'm sure we could all use a bit of help in that area.  Thank you for stopping by, and may this help you in preparing for the next time your PMDD comes around...

I now turn the keyboard over to Renell...

Hi, everyone!  I'll get right down to business: In recognizing a common theme in the comments on the Facebook PMDD loops I belong to, I'd like to offer some tips for support I've found helpful in my own therapy. We all know that every single month like clockwork our hormones will wreak havoc and PMDD will rear its ugly head. If you're anything like me, you suffer through it and once the symptoms subside you're so glad to feel normal again that you forget you have PMDD at all.

Or at least we want to forget!  This is one of the places where denial comes in...when the episode is over and we want to just pretend it didn't happen, so we don't have to deal with all the problems we created during the episode.  Unfortunately...

PMDD will remind you it's here to stay once that dreaded ovulation day rolls around yet again. Embracing this disorder means we need to accept its existence in our lives and plan for it.

I like that...embracing this disorder.  Might as well, because it's not going to go away.

Let's try to be proactive rather than reactive to our PMDD. Here are some ways you can plan ahead. These tips are useful whether you choose natural therapy or medication to relieve your symptoms.

1. Mark off the dreaded luteal phase on your calendar for the upcoming month so you know when the PMDD symptoms will likely begin.

2. Plan your activities around these days according to how your mood is likely to accept them. Make sure your partner knows what's going on as well so that he/she can help you with extra support.

3. Do housecleaning or laundry ahead of time. I clean the entire house the week before my luteal phase so that when I am in the PMDD zone I don't have major cleaning to be bothered with. It also helps to relax in a nice clean house.   I love this idea, Renell!

4. If you only take meds during your luteal phase and they take a few days to kick in, consider taking them a few days early so they have already kicked in on the first day of ovulation (Warning: Discuss this with your Dr. if you're not sure that this is okay given the type of meds you are taking)
.
5. If you are highly irritable during your PMDD episodes schedule time to be alone. Sometimes it's hard for us to be around anyone during this time. Don't feel bad for needing this and do whatever you can to carve out time for yourself.  (I added the bold).

6. If you are prone to getting depressed during this time, schedule time to be around supportive friends who can help. No sense in going through this alone. Calling a friend or family member over to simply talk in your sweats or pj's helps quite a bit.

7. Shop ahead. Stock the fridge with healthy foods like leafy greens, fruits and healthy carbs to boost your energy during this phase. You'll crave junk food and if you already have healthy food on hand you'll be less likely to drive through a fast food joint for a greasy salt, sugar, and fat-laden meal that will only make you feel worse.

8. This one is important: Lower your alcohol intake. Again if you're anything like me you'll start guzzling the wine in hopes that it will relieve your anxiety. I don't usually get drunk, just a glass or two at a time. But doing this every night for weeks is not a good thing and the alcohol can actually make our anxiety and depression worse. It can lead to alcohol dependency among other serious health problems. It also is dangerous to mix with many medications that a lot of us are on. I personally recommend that you stay away from alcohol altogether during your luteal phase. It's just not worth it and its effects are deceiving.

She's right, ladies.  Alcohol is a depressant, and when you're already depressed....sure, it makes you feel good and alive and dare I say "normal" for a couple of hours—maybe—but after that, our bodies pay in ways we can't even imagine.  Renell has addressed the obvious, the possibility of alcohol dependency and the danger of mixing your meds with alcohol.  But alcohol can also mess up your blood glucose situation and don't forget....when we're having a PMDD episode every negative thought is magnified many times over, plus...our brain isn't processing information correctly to start with. 
 
So why add alcohol into that mix?

Just think about it the next time you reach for that attempt at self-medication.  Try doing something good for your body instead.  Something you've prepared for ahead of time.

Okay, now it's your turn. What are some DO AHEAD ideas that have helped you plan for your PMDD?

Should Your PMDD Symptoms be Classified as a Mental Disorder?

Here is a link to a National Public Radio (NPR) News Morning Edition segment that asks the question, Should Severe Premenstrual Symptoms Be A Mental Disorder?  Listen to the eight minute segment (play it while you're working on something else at the computer if you're short on time) and decide for yourself.  You might also recognize the names of some ladies interviewed for the segment.

The embedded YouTube segments below the written version of the NPR post are also well worth watching. 

Thank you for stopping by, and I know it's a lot to hope for, but may you be having a PMDD-Free Day! 

Is the Pill Really the Answer for Your PMDD?

Whether you're taking the Pill for contraception, or for your PMDD, you need to read this book.  If you can't afford the book, then read Holly's blog of the same name.  Make sure you are making an informed choice when you pop that pill in the morning for your PMDD.  

To quote author Laura Werschler, who wrote the foreword for Holly Grigg-Spall's book:

"Sweetening the Pill explores and challenges the ways in which the pill and other drug-based contraceptives damage women’s health, threaten our autonomy and thwart body literacy. What we don’t know about our bodies helps pharmaceutical companies “sell” their contraceptive drugs, and keeps us “addicted” to them... Prescribing the pill, or other forms of hormonal contraception, has become, in the minds of most health-care providers, the “standard of care” for being a girl. It is all too common to subjugate a girl’s menstrual cycle to synthetic hormones that superficially “regulate,” but actually suspend the maturation of her reproductive system. And for many girls, the use of hormonal contraception continues well into their 20s, without awareness of what might be or has been sacrificed."

This sacrifice can include, but is not limited to, your mental and emotional stability, both of which are defining symptoms of your PMDD.

For more information, go here, or here.  Or even here.  Learn about what you are putting into your body.  You will be surprised at how many questions these resources will be able to answer.

The Voices of PMDD, The Bigger Bitch, by Michelle

Today I am grateful to be offering a guest post which perfectly sums up the PMDD struggles we face from within...because what people without PMDD don't realize is that during an episode of PMDD, we are fighting OURSELVES as much as we are fighting with them.  So thank you, Michelle, for putting into words what so many of us feel monthly - month after month, and year after year - when the dark side of PMDD hits. 

For more great posts from Michelle, please visit her blog at Why am I Happy?

When I awoke this morning it was a normal day, I felt like my normal self. Within two hours what had passed for normalcy faded in the face of criticism and judgment. And all of it from someone that I can’t just punch in the mouth like they deserve. It is coming from HER. She is the bitch... the illness, the voice of self-doubt, the one that tells me how much everyone hates me and how worthless I am. The arch villain to my super self, otherwise known as PMDD. 

So I sit low in my desk chair trying to not draw attention to myself, like the small, scared girl I have become. There is a mean, angry, judgmental authority figure standing over my shoulder berating me, no matter what I do, no matter where I go. I feel so beaten down and broken, so battered, a heavy weight on my shoulders.

What do you do when the abuse you suffer is generated in your own brain? There are no shelters to escape to, no safe places to be had. Like the typical victim, I try to find ways to placate her, to distract her, to take the focus off of me…but she is relentless.

So I sit quietly, waiting. Waiting for the storm to pass. Waiting for the silence of my own mind to return. Waiting to feel safe again. There are no more tears to cry for my battered self-esteem. Wishing I could curl up and hold my knees to my chest and rock myself to sleep, just to try and get away. 

But I can’t give in. 

People rely on me. I have to be the best I can be, the one that always comes through. I have to survive this day professionally and personally.

So, ‘Fuck you.’ I say. ‘Fuck you for lying to me and trying to break my confidence. Now excuse me while I turn up the music, have a donut and get shit done, bitch.’ 

Why? Because fuck this illness. Because sometimes the only way to deal with her is to be the bigger bitch, to remember this is my head, my life, my rules. Today I chose to take that challenge and shove it in her face and succeed despite her barrage of negativity. 

Today it worked.

Here’s hoping tomorrow is a better day and that we can all be the bigger bitch when necessary. 

Other posts along these lines that I would recommend reading are my own They Only See Our Failures, and A Perfect Storm of PMDD.

Birth Control and PMDD

Here's a link to another excellent article by Holly Grigg-Spall, about how your oral contraceptive may be affecting your relationships.  Just remember that in taking birth control for your PMDD, you are messing with your hormones, and your hormones are already messed up, so...

You do the math.

Oral contraceptives only mask the problem.  They do not cure it, or make it go away.  In the end, more often than not, they make the problem worse.  Because eventually you will go off of the Pill, and if it doesn't happen sooner, that's most likely when your hormonal issues will resurface and with a vengeance.

Here's a quote from Holly's article:  Professor Jayashri Kulkarni, the director of Monash Alfred Psychiatry Research Centre in Melbourne, Australia, found women on the pill are twice as likely to be depressed, anxious, have poor self-esteem, feel irritable, hostile, and numb to experiences.

Sound like anyone you know?

“We’ve seen the destruction of relationships, due to women becoming irritable, hostile and prickly when taking the pill. And then they look back and say ‘that wasn’t me’. There can be the breakdown of marriages,” Prof. Kulkarni describes.

You don't deal with a problem by covering it up.  If you are having any of these mood or emotional issues and are on the Pill, don't be so quick to blame yourself alone for feeling any of the above.  Your moods could be getting a boost--and not in the right direction--from your birth control pills.

What Happened to Me?

For those who are curious, I've written about why I disappeared for a few months earlier this year.  The short version is brain surgery for two aneurysms we discovered by accident.  A longer version can be reached by clicking on my new Personal Stories link.  Thank you again for your prayers and well-wishes.  With your help and continued prayer, my recovery continues...

Taking Yaz or Yasmin for Your PMDD?

How many women know Yaz Flex, Yaz, Yasmin and Beyaz are 99% similar in composition? ~Holly Grigg-Spall, author of the Sweetening the Pill blog and book.

If you are taking Yaz or Yasmin for your PMDD symptoms, you need to read this.  So many of you have written to tell me you are being told the PMDD symptoms you experience are "all in your head."  Well, if you are experiencing any of these reported mental, physical, or emotional side effects for Yaz or Yasmin, don't let anyone tell you they are "all in your head." 

If you choose to take these drugs, then do so knowing the risks.  Don't be taken by surprise.

Another quote from Holly: Monash University in Australia is one of the few facilities to have undertaken research into the correlation between birth control pills and depression. Professor Jayashri Kulkarni found that women on the pill were twice as likely to experience depression, anxiety, and mental numbness.

Sound familiar?  If so, you have a choice to make. 

But at least it's an informed choice. 

Progestins, Bio-Identical Progestins, and Progesterone

Research on the post about progesterone and progestins is nearly complete and the information will be divided into at least four parts: progestins, more about progestins, (including LARCs, or Long Acting Reversible Contraceptives), bio-identical progestins, and progesterone itself. I don't know when they will be done, as some medical issues have cropped up that limit my time at the computer.
When they are complete, however, I will come back and link to them in this post.

In the meantime, I hope you will find other useful information here, and wish you peace, prosperity, and as many PMDD-free days as possible.

PMDD and Losing Weight Update

Today's post is an update to an old post, PMDD and Losing Weight.  I added an update to the beginning of the original post, outlining my recent success with taking Iodoral to support my enlarged thyroid (also called a goiter).  I hope you'll find the information helpful. 

Continuing the Conversation about Depo-Provera

In keeping with my latest posts on progesterone, progestins, and birth control, I 'm posting this link to a post about Depo-Provera.  I know many of you have had negative experiences with the shots and this may help others to think twice about getting them for your PMDD.  There's a lot of good information on this site overall regarding all things menstrual, so it's well worth your time to look around once you get there. 

Enjoy, and may you be having a PMDD-free day.

Are Oral Contraceptives Really the Answer for PMDD?

Is Levora® making your PMDD worse?  We're going to take a little side trip today, because in the past month alone I've had over 100 requests for information on this subject.  According to information provided by the website Drugs.com, it's possible.

Levora® is a combination drug that contains female hormones that prevent ovulation and also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus. It's primarily used as an oral contraceptive that provides 21 active white tablets and 7 inactive peach tablets.  The tablets contain levonogestrel (a totally synthetic progestogen) and ethinyl estradiol (a synthetic estrogen).  Inactive ingredients in the pills include FD&C Yellow No.6 (which may contain aluminum) and three forms of lactose.

For more specific information on patient-reported Levora side effects, go to: the Rate a Drug site

and/or Treato: The Voice of the Patient.

It should also be noted that continuous combined birth control formulas (such as the one found in Levora®), as opposed to sequentially-based hormone regimens that mimic the natural female cycle, have also been shown to frequently lower a woman's sex drive.

According to Dr. Winnifred B. Cutler, in her book, Hormones and Your Health, a test on monkeys showed that the combination of ethinyl estradiol and levonogestrel (the combination in Levora®) caused large elevations in the stress hormone cortisol, as well as great increases in their heart rates.  Rising rates of cortisol, among other things, messes with your metabolism, causes you to gain weight and 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.

For instance, Dr. Cutler also recommends that women avoid ethinyl estradiol after age 45 because it also increases the risk of having a stroke.  In fact, she recommends that (no matter what your age) you have your triglycerides and CRP (C-reactive proteins) checked (via blood tests) if you start ANY oral estrogens at three and/or six months after you start taking them.  You will need to switch hormone regimens if your CRP or triglycerides rise, as rising levels of either of these is predictive of heart disease, even more so than rising levels of LDL (aka the bad) cholesterol. 

No matter what form of oral contraceptive you may be taking, I urge you to find out what exactly is in it, and if it is a continuous formula or a sequential one.  This will go a long way in determining which side effects may or may not apply to you.  Besides, it's just plain smart to know what you're putting into your body.  For instance, if you're having trouble thinking and remembering things, it might be due to the ethinyl estradiol in your hormone pills.  "Estrogen like" as in synthetic estrogens, is not the same as bioidentical estrogen.  Far from it.  Each will have a different impact on your thinking processes.

The rest of the information that follows seems to be the standard patient information for all oral contraceptives, which include Levora®, but may or may not be specific to Levora®.  Still, I looked up the medical terminology you find in your patient information packets, and translated them into everyday words we can understand.

That said, you should not take any combination birth control pills if you have high blood pressure, heart disease, a blood-clotting disorder, circulation problems, diabetes, pre-diabetes, unusual vaginal bleeding, liver disease or liver cancer, jaundice caused by birth control pills, a heart attack, stroke, or blood clot.  Note that there is the possibility of a risk of heart disease even in very young women who take oral contraceptives.  So if you are young, don't go around thinking you're invincible. While a cause and effect relationship has not been scientifically established, some studies have also reported an increased relative risk of developing breast cancer, particularly at a younger age.  This increased risk appears to be related to how long you take the pills.  The risk for benign liver tumors increases after four or more years of use.  (Death can occur if a tumor ruptures.)  Studies have also shown an increased risk of developing liver cancer in long term (greater than 8 years) use of oral contraceptives.

You should discontinue use of your oral contraceptive if you experience unexplained or complete loss of vision, bulging eyes, swelling of the optic nerve, or lesions (scars, bumps, bubbles) in your retinal veins.

Also, be aware that cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use.  This risk increases with age and with heavy smoking (15 or more cigarettes per day). 

Still, if you use oral contraceptives, you should not smoke.  Period.  If you are looking for a way to go off the pill, please check out this website. 

If you do smoke while taking oral contraceptives, some nasty things that can happen include heart attack, blood clots (in the lungs and legs), stroke, liver tumors, and gallbladder disease.  The risk increases significantly if you already have high blood pressure, high cholesterol, diabetes, and/or are obese.  Obesity is defined as having a body mass index of more than 30.  You can figure out your BMI here.  

Oral contraceptives have also been shown to cause glucose intolerance in a significant percentage of users.  Oral contraceptives containing greater than 75 mcg of estrogen (which Levora® does) can cause abnormally high levels of insulin. People with too much insulin have frequent episodes of low blood sugar (hypoglycemia). These episodes can be characterized by a lack of energy (lethargy) and/or irritability. Repeated episodes of low blood sugar increase the risk for serious complications such as seizures, intellectual disability, breathing difficulties, and coma.

Lower doses of estrogen cause less glucose intolerance, but the progestogens in your oral contraceptive can also increase insulin secretion and create insulin resistance.  Therefore pre-diabetic and diabetic women should be especially careful while taking oral contraception.  Talk with your doctor frequently. 

The incidence of high blood pressure also increases with increasing concentrations of progestogens.  Women with a history of high blood pressure or high blood pressure-related diseases, as well as kidney disease, should use another method of contraception.

If you start to get migraines, or your migraines become more severe, stop taking oral contraception until you determine the cause.

When taking any oral contraceptive, you should follow up regularly with your doctor.  You need to pay special attention to your blood pressure, breasts, abdomen and pelvic organs, including pap smears.   Women--especially younger women--with a strong family history of breast cancer should think twice about taking oral contraceptives.

Birth control pills can also be a problem if you have varicose veins, a history of depression, an underactive thyroid, seizures or epilepsy, and/or a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram.

As with any drug, you could have an allergic reaction to Levora®.

If any of these adverse effects occurs while you are taking oral contraceptives, call your doctor immediately:

·        Sharp chest pain, coughing of blood or sudden shortness of breath (indicating a possible clot in the lung)

·        Pain in the calf (indicating a possible clot in the leg)

·        Crushing chest pain or heaviness in the chest (indicating a possible heart attack)

·        Sudden severe headache or vomiting, dizziness or fainting, disturbances of vision or speech, weakness or numbness in an arm or leg (indicating a possible stroke)

·        Sudden partial or complete loss of vision (indicating a possible clot in the eye)

·        Breast lumps (indicating possible breast cancer or fibrocystic disease of the breast: ask your doctor or health care provider to show you how to examine your breasts)

·        Severe pain or tenderness in the stomach area (indicating a possible ruptured liver tumor)

·        Difficulty in sleeping, weakness, lack of energy, fatigue or change in mood (possibly indicating severe depression)

       Jaundice or a yellowing of the skin or eyeballs, accompanied frequently by fever, fatigue, loss of appetite, dark-colored urine or light-colored bowel movements (indicating possible liver problems)

It's the references to depression and anxiety that concern and confuse me.  Why would a doctor prescribe something for your PMDD when it could cause more of the very same symptoms you already have?  Plus increase your chances of developing heart disease, among other things.

Side effects they don't consider serious (but you might) include:

Increased blood pressure

Mild nausea

Breast tenderness or swelling, nipple discharge

Freckles or darkening of facial skin, increased bodily hair growth, loss of scalp hair

Rashes

Changes in weight or appetite

Fluid retention, particularly in the fingers and ankles

Problems with contact lenses

Headache

Anxiety

Dizziness

Vaginal itching or discharge

and

Decreased sex drive

And this is not a complete list of side effects.

Special note:  Certain drugs can make birth control pills less effective:  These include Phenobarbital and other barbituates, seizure medications, and St. John's Wort, which many PMDD women use to counter their depression.  So beware if you are self-medicating with St. John's Wort.

In all, there doesn't seem to be a lot of scientific information on the internet specifically about Levora® making your PMDD symptoms worse...which is probably why people are looking for it.  I hope this post has answered some of your questions, or at least pointed you in the right direction for the answers you seek. 

That done, I need to get on my personal bandwagon and ask you to reconsider using birth control to treat your PMDD.  Is the increased risk of heart disease, the number one killer of women, worth the risk of masking your PMDD symptoms for a few years?  Think about this.  Just because fertility and PMDD both involve hormones does not mean the medications for them are interchangeable.  That's like throwing something against a wall to see if it sticks.  A good naturopath or nurse practitioner should be able to help you come up with a hormone regimen individualized for your needs and your body. 

The problem with PMDD begins at ovulation.  Did you know bioidentical estrogen in high enough doses can prevent ovulation?  Without all the unpleasant side effects listed above.

I'm not recommending bioidentical estrogen as birth control, but to help manage your PMDD in a positive and healthy way?  It's certainly worth a shot.  Especially if you're in peri-menopause.

Of course you can't take unopposed estrogen in any form without adding back some progesterone, but again, with the right medical supervision, you can work out a regimen that best suits your body and needs and lifestyle.  That best suits YOU.  Rather than the one-size-fits-all mentality that prevails in the marketplace now.   

Don't you deserve to be treated as the individual that you are?

PMDD Wars: Supportive Partners, Women in Denial

I recently learned of a segment of the PMDD population I've left unaddressed--mainly because I had no idea it existed.  My post, Dealing with PMDD, Advice for Men, was written in response to the many posts I was seeing from women with unsupportive partners.  What, they wanted to know, could they do to help their partners understand their PMDD? 

So I put a post together, which in the end turned out to be three posts.  They're some of my most read posts, and I get the most mail regarding them.  But lately I have been hearing from men who love their wives and girlfriends, and would be more than willing to do whatever it took to help her to deal with her PMDD....

Only she's not interested.

Because she's not the one with the problem, he is, and if he can't deal with that, well, then...

Sound familiar?

It happens in a lot of relationships, and not just those that deal with PMDD.  One partner is trying to work things out, and the other is in denial.  Unfortunately, this is a sure-fire recipe for failure. 

For a relationship to succeed it has to have two consenting adults.  Two people behaving like grownups, each taking responsibility for their part in making the relationship work--or not work.  It's not about power, control, or changing the other person.  It's about doing your part to show your partner that your relationship is a priority in your life, and that you want it to last.

You don't do that by:

Playing the blame game

Expecting your partner to change

Trying to change your partner (for their own good or any other reason)

Ignoring your partner's needs

Being abusive to your partner

Denying there is a problem

Relationships require compromise, day in and day out.  They're not about one partner giving up all sense of self to cater to the wants and whims of the other.  It's a balancing act, and one that needs adjusting and readjusting daily.  It's hard enough to have a successful relationship between two healthy people.  Throw in some PMDD and your difficulties can increase exponentially.

But they don't have to.  Whether you believe it or not, you do have choices when it comes to your PMDD.  You can't control when it hits, but you can manage your reaction to it.  You can either take the path of least resistance and give in to your seemingly uncontrollable urges, or you can take a stand and say, "I am not my PMDD.  I am better than this." 

Your PMDD is not who you are, not the real you.  Root yourself in this knowledge and stand firm.  Refuse to let your PMDD get the better of you.  Refuse to let the negativity win.  Sure, you'll still be weepy and edgy and anxious and irrational at times....accept that that happens, but don't let it have free rein during an episode.  We all slip up now and then, but to totally immerse yourself in the negativity and irrationality...that doesn't do anybody any good--yourself, your partner, or your children.

Think of your children if you can't think of anything else.  Don't they deserve better than to see you not even trying to get along with your chosen mate?

This completely boggles my mind.  I myself entered a PMDD episode starting Friday night.  I knew it was coming, I could feel the storm approaching, and all I wanted to do was to be held.  Unfortunately, the circumstances for that to happen didn't fall in line.  It was payday and my partner was feeling flush.  He called and asked if I wanted to go out to dinner at our favorite restaurant.  I reluctantly said sure.  I was only going to heat up leftovers anyway.  Now I wouldn't have to do even that much.  In short, I adapted.  I decided to let myself be pampered another way since I couldn't have what I really wanted.  

But all night long, he kept asking, "Is something wrong?  You seem distracted."

Something was wrong, and I was distracted, but distraction is also an occupational hazard for me, so he's used to it.

Finally I said, "I can feel the storm coming."

He knew what I meant.

He took me home and I went right to bed. 

We spent the day apart on Saturday, seeing to individual tasks.  I felt all right most of the day, probably because I didn't have to interact with anyone, but around 5:00 p.m. I had an intense craving for carbs.  I ate a bowl of cereal. Shortly thereafter my partner arrived and off we went to church...where I could not stay focused to save myself.  My mind bounced from thought to thought to thought.

Afterward, now out of milk, we went to the grocery store.  I had three things I wanted to get: milk, brazil nuts (for selenium), and cat food.   It took every ounce of my concentration to stay on task, to simply remember those three items, and remember where each was located in the store.  Since by now I was feeling completely miserable--head pounding, joints aching, brain feeling like it was on fire--my mission was to get in, get my stuff, and get out. 

In church, I had let my mind wander, but now, I had to corral all those bouncing thoughts and force my mind to stay on track.  So deliberately focused was I that the minute we arrived in the parking lot, I jumped out of the vehicle and made a beeline for the store, completely ignoring my partner.  As soon as I entered the store, I saw the rack where I had last found the brazil nuts.

In that moment, nothing could have come between me and my goal. 

But they were out of brazil nuts.  They had almonds, walnuts, peanuts, pecans...but no brazil nuts.

My partner caught up with me as I stood in front of the nut rack, feeling completely derailed and wanting to weep.

I turned to him and said, "I want to cry, because there are no brazil nuts here."

I then asked him, "Am I acting strange?"

And he said, "Yes, I noticed something was off in church."

"I thought so," I said.  "It's that time again.  I'm having an episode."

I then turned away and went in search of the milk, once again leaving my partner behind.  As I was walking, I realized I was being rude.  I then recalled other times I had walked off without him and realized that each and every time it was during an episode. 

Suddenly it hit me that I wasn't trying to be rude--it was simply taking every ounce of energy I had to stay on task.  Otherwise I might look left or right, get distracted and we'd be wandering the store looking at nothing in particular until he said come on, let's go, and I would burst into tears for no apparent reason and our evening would be ruined. 

I stopped and explained this to him and we finished our shopping together.

But the whole time, I was feeling very angsty and edgy and primed to have a fight.  As he helped me out of the car when we got home, I said to him, "I could start a fight with you so easily right now."

He looked at me in surprise.  "About what?"

"That's just it," I said.  "About nothing."

I was overtired and achy and weepy and feeling like a toddler on the verge of a tantrum.  No lie.

Instead I went to bed. 

Because I know the difference between me and my PMDD.

And because our relationship matters to me.

It might not have been the most exciting ending to either evening, but at least it wasn't filled with a lot of drama that would leave each of us feeling devastated and alone.  My partner understood my need for rest and solitude because I was able to express it in a quiet and (somewhat) rational matter.  My partner understands my sudden rudeness and self absorption is not a reflection of him, but rather of my PMDD. 

With a different partner, it could have gone completely differently. 

If I had behaved differently, it could have gone completely differently.

Because inside of me was someone dying for a fight.  It didn't matter what the fight was about.  All I wanted to do was goad my partner into sparring with me until I could no longer stand my own irrationality and then burst into the tears I so desperately wanted to weep--and blame him for ruining everything.  Maybe even blame him for abandoning me or not loving me when he walked out the door in sheer frustration, for lack of knowing what else to do.

Not because he doesn't love me.  But because I wouldn't let him love me.  Wouldn't let him see my need, my vulnerability, my (what some would call) weakness, and wouldn't trust him to take care of me.

Think about it:  Which would you rather be...lovingly cared for, or crying and alone?

I'm still having an episode.  My head still pounds, my eyes hurt, my joints hurt, my back hurts, my brain burns, and I want to cry.  There is no doubt I could be drawn into an argument, any argument, with anyone, at the drop of a hat.  It may still happen...because sometimes the strength to hold the negativity at bay just isn't there.  But I do know that if it happens, it will only be for a moment, before I catch myself again, and remind myself that I am not my PMDD, and that my blindsided target doesn't deserve to be abused just because I am having a bad day. 

No one does.