Is PMDD Real? : A Psychotherapist with PMDD Shares Her Story

Today we have a guest post from Dr. Chantal Gagnon, who has been kind enough to fill in for me while I continue my research on progestins and progesterone.  Thank you, Dr. Gagnon, and welcome!

IS PMDD Real?

THE SHORT ANSWER: Yes, it's real.

THE LONG ANSWER

PMDD can be thought of as an extreme form of PMS (Pre-Menstrual Syndrome), but with symptoms that are more severe and debilitating. PMDD symptoms can be physical, such as bloating, headaches, breast tenderness, etc., but typically the symptoms that have the greatest impact for women with PMDD are emotional and behavioral symptoms. For up to two weeks near the time of their period (but less time for some women), PMDD sufferers can experience a range of emotions and behaviors, including depression, suicidal thoughts, anxiety, tension, irritability, anger, even to the point of rage, self-loathing, mood swings and feeling overwhelmed. These symptoms can often feel severe or extreme. It's common during this period of time for women to start fights, give people "a piece of their mind" (i.e. become verbally abusive), and perceive their mates negatively. Sometimes women quit a job or end a relationship or scream like a banshee in the midst of an episode.

What causes PMDD is a sudden drop in the neurotransmitter Serotonin following a shift in hormones as a result of the menstrual cycle. The same biochemistry is implicated in PMS, but women with PMDD either are more biologically sensitive to hormonal shifts in general, or the hormonal shifts they experience are bigger. Depending on which study you look at, this disorder affects between 5% to 10% of women, and may get worse with age (30's and early 40's), possibly because stress can make symptoms worse (women report more stress during the years of raising a family and building a career).

How I Discovered I Had PMDD

My first semester as a counseling student I took a course on psychopathology (mental health disorders). The class was focused on learning and understanding the diagnoses listed in the DSM - the Diagnostic and Statistical Manual of Mental of Mental Disorders published by the American Psychiatric Association (APA). We also learned about disorders that the APA was considering adding to the next version of the DSM. PMDD was one of them. I remember thinking at the time: "This is complete BS! These psychiatrists are taking normal PMS and making it a "disorder" so that pharmaceutical companies can sell more drugs." So, for the first several years of my career, I did not believe PMDD was real. I even did a presentation in another class about how the DSM tries to create "disorders" out of normal behavior, and of course, I included PMDD in that presentation.

I was wrong. I discovered my error in judgment when I developed PMDD in myself in my 30's. I noticed that a day or two before my period, I became suddenly and severely depressed - everything in my life seemed hopeless. It was almost as if I was a different person. But the day my period started, I felt completely better. Weird, I thought. But then, the pattern continued and I became more aware of it. Sometimes my symptoms were depression-related, other times it was irritability and anger. When I got married, it got worse because I couldn't isolate myself from people during those few days of my cycle (which had been a fairly effective coping strategy in the past). My husband was always around now :) So, unfortunately for him, he got caught in the PMDD storm!

Finding Resources and Learning to Cope

So, Ken (my husband) and I began looking for answers. I had a hunch PMDD might be the issue, but I had never really believed it was a real disorder. Plus, I wanted to be mindful to not just be making excuses for my bad behavior. Around that time, we found Liana's website and blog: Living with PMDD (www.LivingWithPMDD.com). Wow, what a great resource! Through her site, a book about PMDD, and discussion board posts from other women relating their experiences with this disorder, I discovered that this was indeed what I was living. I later confirmed the diagnosis with a psychologist, and my husband and I have developed coping strategies that are effective for us, and for my particular symptoms. Needless to say, I now know that PMDD is indeed real. I'm one of the lucky ones though, because I only experience severe symptoms two to four times a year. With proper planning, improved stress management, and coping skills most months have been OK, and for the months that aren't Ken and I now know how to surf that wave, instead of getting caught in the rip current.

Every women is different, and PMDD manifests differently in different women. If you suspect (or if you know) that you have PMDD, it's important to find compassionate support people, educate your family on the disorder, and put into practice coping strategies that will work for you.

Dr. Chantal Gagnon is a licensed psychotherapist, author, and life coach in Plantation (Fort Lauderdale), Florida. To read her blog or learn about her services, visit www.LifeCounselor.net or follow her on twitter @DrChantalGagnon