Singer-Songwriter, Grace Gonzalez, Joins Forces with Global Charity to Raise Awareness for Debilitating Health Condition That Puts Women “Out of Commission” for Nearly Half Their Life

BOSTON, MA, October 2020 -- Singer-songwriter, Grace Gonzalez, first found musical success when her songs gained the attention of Grammy-Award winning producer Trina Shoemaker, American Songwriter Magazine, chosen as a Yamaha guitar ambassador, and in a 2020 Toyota U.S. ad campaign featuring her own, “Little Piece of Home.” Now, Grace has turned her musical talents to a life-saving cause with the release of her new single, “Out of Commission.”

“Out of Commission” is about mental health and specifically the cyclical anxiety and depression that takes Grace out of commission after she ovulates or 10 days before her period each month. The condition she suffers from, Premenstrual Dysphoric Disorder (PMDD), is a life-threatening cyclical, hormone-based condition that is commonly underdiagnosed, misdiagnosed or dismissed entirely by many in the medical community. PMDD impacts approximately 1 in 20 women and AFAB (assigned female at birth) individuals of reproductive age - a staggering 60 million worldwide.  Symptoms include severe depression, mood swings, irritability or anxiety in the two weeks before menstruation.

“I have received my deepest inspiration during “hell week,” said Gonzalez. “It is in that time, where I feel so disconnected from myself and the world, that I can channel my suffering into songs. I feel so lucky for the gift of songwriting and don't know how I would get through the depths of PMDD without it. And I’m honored to help shine a light on this devastating condition by working with the International Association for Premenstrual Disorders (IAPMD).”

Grace’s journey with PMDD began when she got her period. Like many, her life changed drastically and the cyclical life-altering symptoms occurred for years without a clear understanding or diagnosis. At the age of 21, she withdrew from college due to severe cyclical anxiety and depression, and was finally diagnosed with PMDD. After her diagnosis, Grace turned to IAPMD for information and support when she was feeling lost and alone. “IAPMD helped me make sense of it all and find ways to move forward and heal,” added Grace. 

“We’re grateful that Grace is helping raise awareness and funds for PMDD,” said Sandi MacDonald, IAPMD Co-founder and Executive Director. “As an IAPMD Ambassador, Grace is sharing her music and her story to help shatter the stigma and accelerate progress toward a world where people with PMDD and PME can survive and thrive.” 

The IAPMD’s Global Survey of PMDs 2018  showed that 30% of those experiencing the condition have made a suicide attempt during a PMDD episode. Shockingly, patients also waited an average of 12 years for an accurate diagnosis and saw six healthcare providers in the process. Although PMDD has been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) for years, it continues to be disregarded or misunderstood by doctors and the general public. 

About IAPMD:

The International Association for Premenstrual Disorders (IAPMD) is the leading patient-led health organization with a mission to inspire hope and end suffering in those affected by Premenstrual Disorders (PMDs) through peer support, education, research, and advocacy.  Since our founding in 2013, we’ve helped over half a million people from more than 100 countries find answers, community, and hope. What began as a collective of fellow sufferers has grown into a global movement accelerating progress being made around the world on PMDs and PMDD in particular.

About PMDD:

While PMDD is directly connected to the menstrual cycle, it is not a hormone imbalance but rather a severe neurobiological reaction to the natural rise and fall of estrogen and progesterone. Symptoms occur the week or two before menstruation and go away a few days after bleeding begins. There is no blood or saliva test to diagnose PMDD, but these tests can rule out other underlying disorders. Diagnosis is done by tracking symptoms for at least two menstrual cycles. 

 

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PMDD and Suicide in the Luteal Phase Needs More Research: You can help!

Below is a request for help from a fellow PMDD Advocate.  Please contact her if you can help.  Together we can save lives.  And please go here to see the documents she has found so far.

Hey all

I need help.

Tonight I piqued the interest of my psychiatrist when I quoted a post from another PMDD group, "23 completed female suicide autopsies were performed - 22 of those were in the LUTEAL PHASE of their cycle." His jaw dropped. 

Last night I did 20 mins of research into the following theory that has been in my head for the last 12 months. 

Here it goes:

The true number of completed suicides resulting from PMDD cannot be known until all coroner reports are researched to see where the individual was at during her menstral cycle. Right now, even if 100% were in the luteal phase or menstruating phase of their cycle, it is highly likely those individuals would have a previous mental health diagnosis of another kind. For example, borderline personality disorder or bipolar, given PMDD mimics the symptoms of these two illnesses. Therefore, the completed suicides would then be attributed to either of those illnesses and not PMDD. 

IF PMDD is the culprit and merely mimicking BPD or BP, until further research is done and looked at, PMDD suicide rates will not be truly known. The accuracy of actual lives taken by PMDD cannot be measured. 

Therefore, it is imperative that further research into historical data on completed suicides and the menstral cycle stage the individal was at during the time of death is done - the true cost of lives due to PMDD suicides will not be known and neither will the severity of PMDD and it's potential to kill be taken seriously (thus SAVING lives). This is intricately connected to the amount of knowledge and extensive research that has been completed on BPD/BP and the lack of such for PMDD. 

If menstral cycles are indeed playing a part in the timing of completed (or attempted) suicides, it is currently the ghost in the machine.

Until this is ruled out, or confirmed, the true cost of life via PMDD deaths will not be known and neither will PMDD be taken as seriously as these other well known illnesses that it mimics. 

Could it also be that these illnesses are so prevalent in women to men (75:25) because of the mimicking and this unreasonable ratio of women to men is because PMDD is being counted as BPD or BP? If studies were completed and found menstral cycles to be a factor in completed suicides, could this be the turning point in diagnosing and treating PMDD in a more efficient and successful manner? 

Could understanding if menstral phases play a large part in completed suicides completely change the way in which the entire mental health system treats women? 

If the answer is yes, we are talking absolutely ground-breaking earth-shattering information that would change general practice, gynecology and psychiatry. It would blow everything out of the water. All of it. The whole medical industry would be brought to their knees... because right now, it is dismissing it as merely bad PMS when in fact, it is possibly one of the largest contributing factors to SUICIDES in the female population. 

So while my Doctor listened to me ramble about this, at the end of the spiel he told me that he thinks I'm on to something. I have spent an hour on Google and I am finding research mostly in Asia and India into this, but some say there is no evidence to show menstral cycles play a part in suicide while others have found 90% of 200 women were either menstruating or in the luteal phase when they died! 

If I can find studies for him - good/bad/ugly/useless, he is going to present it to one of the most prestigious universities in Australia as a PhD Thesis option for students. 

He flat out agrees that something is not right here. 

So.

I'm asking if everyone can help me out and comment with links they find into anything about this (please include the citation and page number). I can't do this alone and I really need some help this time. 

I feel this may be a big opportunity. I could be wrong, but ANY research into PMDD and ANYTHING that could save another life from being stolen by this illness, is worth our time. That's why we are all here. 

Australia is starting to light up and the ball has started to roll. This is another opportunity to possibly change something most of us think we won't live to see happen. 

Maybe, we will. 

If you can help me, please. I really need help with this one. 

Brie

(The Faces of PMDD) 

World Health Organization Validates Premenstrual Disorder as a Global Health Concern

BOSTON, MA, 14 June 2019 --  In a landmark decision, the World Health Organization (WHO) has added Premenstrual Dysphoric Disorder (PMDD) to the International Statistical Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11), validating PMDD as a medical diagnosis worldwide and confirming the growing scientific and medical understanding of this little known, debilitating and life-threatening condition.

This groundbreaking move gives PMDD its own ICD code (GA34.41), which will help drive diagnosis, treatment, reimbursement, and research. A staggering 60 million people globally, 1 in 20 people with menstrual cycles, suffer from PMDD, caused by an increased sensitivity to reproductive hormones during the luteal phase between ovulation and menstruation. This sensitivity leads to alterations in the brain chemicals and pathways that control mood and well-being. Symptoms include severe depression, mood swings, irritability or anxiety, and drastically increases the risk of suicidal behaviors. Appropriate diagnosis and treatment of PMDD are therefore important not only for reducing suffering but also for saving lives.

“This decision is a game changer for PMDD,” according to Sandi MacDonald, Board President of the International Association for Premenstrual Disorders (IAPMD).  “The WHO has officially classified PMDD as a true and diagnosable disorder, and differentiated it from the wide collection of premenstrual symptoms commonly known as PMS.”

Historically, PMDD has been studied and treated by both (1) nervous system (brain) experts (neuroscientists and psychiatrists) and (2) reproductive system experts (reproductive endocrinologists, obstetrician-gynecologists). This multi-specialty approach has been reinforced by PMDD’s ICD-11 cross-listing in multiple chapters; the chapter on mental, behavioral, and neurodevelopmental disorders, as well as the chapter on diseases of the genitourinary system (system of the reproductive organs and the urinary system). This will foster more effective collaboration between these specialties.

“Given that evidence-based treatment algorithms for PMDD require a broad set of clinical expertise and skills, it is becoming increasingly clear that multiple providers with different specialties are required to offer truly comprehensive care for PMDD,” according to Tory Eisenlohr-Moul, PhD, IAPMD Clinical Advisory Board Chair and Associate Director of Translational Research in Women’s Mental Health at the University of Illinois at Chicago.

“The IAPMD recommends that clinicians build collaborative, multidisciplinary treatment teams for PMDD patients in order to facilitate patient access to the full range of evidence-based treatments. It is our hope that the inclusion of PMDD in ICD-11 will facilitate greater collaboration among treatment providers of differing specialties,” added Eisenlohr-Moul.

The ICD is published by the WHO and used worldwide for morbidity and mortality statistics, reimbursement systems, and automated decision support in health care. In May 2019, member states agreed to adopt the ICD-11, to come into effect on 1 January 2022. The system is designed to promote international comparability in the collection, processing, classification, and presentation of these statistics. Like the analogous DSM (which is limited to psychiatric disorders and almost exclusive to the United States), the ICD provides a common language that allows health professionals to compare and share health information across the globe.

The International Association for Premenstrual Disorders (IAPMD) is the leading voluntary health organization which aspires to create a world where people with Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Exacerbation (PME) can survive and thrive. Our mission is to inspire hope and end suffering in those affected by Premenstrual Disorders (PMDs) through peer support, education, research, and advocacy. What began as a collective of fellow suffers in 2013 has grown into a global movement accelerating the progress being made around the world.

Shine a Light on PMDD - April is PMDD Awareness Month

BOSTON, MA, March 29, 2019 -- A global awareness campaign will kick off this April to help “Shine a Light on PMDD” on a little known, debilitating and life-threatening condition that takes an average of 12 years to be correctly diagnosed. 

Premenstrual Dysphoric Disorder (PMDD) is a cyclical, hormone-based mood disorder which impacts approximately 1 in 20 women and individuals assigned female at birth (AFAB) of reproductive age - a staggering 60 million worldwide. With symptoms including severe depression, overwhelm, and anxiety appearing in the two weeks before menses, PMDD takes a toll on sufferers’ ability to work and maintain relationships with partners and family. In the 2018 Global Survey of Premenstrual Disorders, out of 1,425 patients with prospectively-confirmed PMDD: 

● 16.8% reported having lost a job due to PMDD 

● 56.7% reported having lost an intimate partner relationship due to PMDD 

● 98% and 97% feel PMDD puts a significant strain on their intimate partner relationship and family relationships, respectively 

● 42.7% reported problems with parenting due to PMDD, with 10.5% feeling completely unable to parent during PMDD 

The relentless emotional and (for some) physical pain also drastically increases the risk of suicidal behaviors. In the same survey, 30% of patients with PMDD reported that they had attempted suicide to escape their symptoms. Sadly, this number does not include those with PMDD who have died by suicide, which suggests that 30% is a low estimate for the rate of suicidal behaviors in PMDD. Appropriate identification and treatment of PMDD are therefore important not only for reducing suffering but also for saving lives. 

The same survey also showed it takes an average of twelve years and six healthcare providers to receive an accurate diagnosis of PMDD. After years of suffering, individuals with PMDD describe learning about the disorder as a ‘lightbulb moment’. 

“PMDD has been invisible for far too long,” according to Amanda LaFleur, Co-Founder & Executive Director, International Association for Premenstrual Disorders (IAPMD), the global leader of PMDD awareness and education. “It’s underdiagnosed, misdiagnosed and, at worst, the lack of understanding leads to harmful ridicule and shaming of suffers. During PMDD Awareness Month we need to create millions of life-changing lightbulb moments across the globe so people can get the support and treatment they need!” 

This year, IAPMD is again collaborating with a coalition of organizations, including U.S.-based Me v PMDD and U.K.-based Vicious Cycle: Making PMDD Visible, to ‘Shine a Light on PMDD.’ Resources to support awareness-building are available on pmddawarenessmonth.org. Website visitors can access the PMDD Awareness Month Toolkit, find facts and figures about PMDD, create a fundraiser, and share their story.

Individuals with PMDD are encouraged to add their voice to the women's reproductive and mental health movement and receive timely updates on work underway to inspire hope and end suffering in those with premenstrual disorders. 

“This is a galvanizing movement in women’s health,” according to Sandi MacDonald, IAPMD Board President. “PMDD is a perfect storm where #MeToo and #TimesUp, meets mental health awareness, meets suicide prevention. This campaign will be that ‘eureka!’ or ‘light bulb’ moment of insight, and then sufferers and activists around the world are empowered to raise awareness of PMDD and increase access to effective treatment options.” 

While PMDD is directly connected to the menstrual cycle, it is not a hormone imbalance but rather a severe neurobiological reaction to the natural rise and fall of estrogen and progesterone. Symptoms occur the week or two before menstruation and go away a few days after bleeding begins. There is no blood or saliva test to diagnose PMDD, but these tests can rule out other underlying disorders. Diagnosis is done by tracking symptoms for at least two menstrual cycles. As noted above, women and AFAB individuals with PMDD are at an increased risk for suicidal behavior. Although PMDD has been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) for years, it continues to be disregarded or misunderstood by doctors and the general public.

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Organizational Contacts: 

Amanda LaFleur

Co-Founder & Executive Director, IAPMD 

amanda@iapmd.org 

www.iapmd.org 

1-800-609-PMDD (7633) 

Laura Murphy

Project Co-Founder/Director, Vicious Cycle

hello@viciouscyclepmdd.com 

www.facebook.com/viciouscyclepmdd 

Twitter: @viciouscyclepmd 

+44 7739 342590 

Sheila H. Buchert Co-Founder & COO, Me v PMDD, Inc. 

sheila.mevpmdd@gmail.com 

www.mevpmdd.com 

727-421-1489   

PMDD and Self-Awareness - What Has Your PMDD Taught You?

Today's post is an insightful guest post that describes a journey of self-awareness.  I have long said that self-awareness (and then self-acceptance) is the key to mastering your PMDD. You know yourself better than anyone else does.  Take the time to get to know you, and learn to be your own best friend. Not a moment of that will be wasted, because doing so will bring you many steps closer to wellness.  Get to know who you are on good days and bad days.  Learn to love and accept all of you.  For me, personally, the results were life changing.  I learned to focus on my strengths, and, on days when I could not be anything resembling strong, to focus on my needs. My guest today shares the difference it has made in her life, and in the comments we both hope you will share what you have learned about yourself through your PMDD.

Ladies here is what I have learned about my PMDD, or what PMDD means for me:

1) Low tolerance for fake and false people.

2) Hate lies and lying.

3) Low tolerance for people pleasers.

4) We are super intuitive and creative (could be blocked).

5) Don’t push me or have me multi-task above the pressure I put on myself.

One thing I am grateful for is PMDD has allowed me to get to know all of me, the good, the bad, the ugly. Yes, I am super loving and passionate and I can get super irritated and angry as well especially if I feel sarcasm, slimy, abusive, inauthentic, people pleasing, shifty behavior.  Also, to the ‘super smiley-my life- is-perfect people’ - I don’t buy it one single bit.

I am glad that I know my rage, I know her well.

I know my grief, I get down on my knees and weep.

I know my sexy bad ass, she can be sensual AF.

I don’t want to be around fake people or people pleasers, I will have to mirror that bullshit.

I am not interested in small talk.

I am an extrovert but my introvert demands a lot of alone time and I love her for that!

I need to create and often. If I don’t I get cranky.

I need alone time. If I don’t I become a bitch on wheels.

BOUNDARIES are super important.

Successful relationships are ones that are mutually beneficial and fair. I have stepped away from all the ones where I was giving more.

I follow my turn on. I don’t bother if I am not turned on by a place, a person, an event, a function. If I do go I will just become cranky.

My anger and my bitch are there to protect me to remind me to get back into my body and out of my head. To tell me when I have self-abandoned me in order to please someone else or self-sabotaged me away from my dreams.

Next time I will be kinder to me and not leave me again.

No means NO and does not convert to yes the more you whine or beg. With my kids: I am your mom, I won’t always be popular. Suck it up.

On any request: I will tune into my body and ask Do I want to do that now with this person? (It's okay to say maybe another day).

I need variety. People and places. Sameness bores me.

Nature turns me ON. It’s not a luxury but a necessity!

My body needs to move! OFTEN.

Music makes me FEEL good!!!

I would love to hear what you have learned about yourself on your PMDD journey.

PMDD and Your Brain

A while ago, I read the book Women’s Moods: What Every Woman Must Know about Hormones, the Brain, and Emotional Health. It was a great book about overall hormonal health and described how hormonal issues are physiological occurrences in the brain that manifest as emotional behavior, because the hormones involved affect the areas of the brain that regulate our emotions.

On the one hand, I wished I’d read this book years earlier than I did, as it was first published in 1999. On the other, I’m glad I didn’t. While the authors completely explain the devastating effects women's hormones can have on your emotional life, they are firmly in the camp of using medication to treat these brain disorders that affect women throughout our reproductive years.

That’s fine if you want to go that route, but there are other options available now to women who suffer from hormonal issues. In 1999, these options were given a cursory mention and dismissed. Which means if I’d read the book any earlier than I did, I would have come to the conclusion that there was no alternative to my PMDD, short of medication.

That, for me, would have been very depressing indeed.

I know there are millions of women out there who have severe hormonal issues that may well require medication to control them—notice I say control them—not manage them. Me, I manage my symptoms through nutrition and exercise and positive lifestyle choices. If I took medication I wouldn’t need to be so vigilant about my health—the medication would theoretically handle the problem for me. But in my case, with the PMDD, I can’t see taking medication every day for something that only occurs a few days a month.

Still, there are days when the thought of it tempts me. But most days it does not.

As I said, to have read this book any earlier would have been devastating for me. Because the authors insist over and over that without treatment, your hormonal issues will only get worse. That there is no light at the end of the tunnel without treatment—this is absolutely true--but their treatment of choice is not mine.

That aside, I was able to read the book and learn much about the causes of hormonal issues and how and why these issues can and do get worse later in life without some type of intervention.

Hormonal issues are a very serious and practically rampant problem for women. Yet some days it seems like the only people paying any attention to us are those who can profit from our condition(s). Most of the information women receive regarding "hormonal imbalances" (a term I take exception to) comes from companies whose drugs have been approved for treatment of these "imbalances."

We need more than to be told a certain medication (or two, or three) can solve  our problems. We need to understand the underlying causes of our hormonal issues and find ways to heal ourselves from within and prevent the need for chemical solutions. We need to understand the unique female brain/body connection and how it makes us vulnerable to mood problems at the most challenging times in our lives. Puberty, pregnancy, post-partum, peri-menopause, menopause, and post menopause.

Every time you have a child, your hormones undergo an enormous amount of stress, and yet society acts as if there’s nothing to it. Life goes on and you cope.

But what happens when your ability to cope fails you? What happens when, as these authors aptly describe it, you have an internal “earthquake” and mood disorders erupt?

All this attention is given to heart health, but brain health is equally important. We need to learn to care for our brain as diligently as we do our heart. Not only the heart can be compromised by a woman’s genetic make up, life experiences, and stress load, but so can the brain.

If our brain doesn’t work right, we don’t work right, and all sorts of life-chaos can happen. No amount of "being strong" or "powering through" is going to re-regulate a brain that has gone askew. It just isn’t going to happen.

The way this book and many others describe it, our brains have neurological pathways that become worn over time like ruts in a road. When any situation arises, our brains immediately locate the memory of how we dealt with that situation in the past, so that we can effectively do so again. And each time we deal with that situation again, a new pathway is created over the old pathway.

This works fine if your brain is healthy, or operating at optimum level. But what if your brain is not? Then your brain is creating new pathways over damaged roads, and only more damage ensues.

Genetics plays a factor in this, of course, but so do your thought processes. In short, how we deal with stress affects our hormones, which in turn affects our brain. This stress can come from any and all sources, trauma from an accident or abuse, be it physical, emotional, sexual, mental, spiritual, financial, you name it, or from naturally occurring life events such as birth, death, marriage, divorce, loss of a job or health or relationship, to name just a few.

When your hormones are doing what they should, your body deals with these stresses in a normal and healthy way. When your hormones are compromised, your body and brain do not. Little stresses can be magnified into big stresses, completely out of proportion to the situation. When your hormones are compromised and your brain is dysregulated, you can feel like you are under attack 24/7. Your brain makes no distinction between the threat of an oncoming car or someone who simply disagrees with your point of view. Both, to your dysregulated brain, are threats to your very existence.

It’s not logical, in fact it is completely irrational, but that’s what it is. Your dysregulated brain is not properly processing the threat.

This is why women with mood disorders like PMDD or even simple hormonal fluctuations seem so irrational at times.

But we’re not crazy, or imbalanced--far from it. Rather, something has compromised our hormonal system, something that has yet to be scientifically identified and verified, something we have no more control over than we do an allergic reaction.

This is not to say there is nothing we can do to prevent our hormonal eruptions.  We all know that once one begins, it is unstoppable, because the PMDD brain is out to win at all costs.  But there are ways to minimize our eruptions, and this blog* is full of tips for that.  If you're looking for the information all in one place, try my book, PMDD and Relationships, or, for the supportive partner, PMDD: A Handbook for Partners.   Both are based on the posts in this blog.

*Use the search box at the top of the page to locate topics you are interested in reading more about.  Type in the subject, and if I have written anything about it, a list of posts will appear.  This will save you a lot of time spent scrolling past stuff you're not interested in.

The Voices of PMDD: Sharing our Struggles

Today we have a guest post from a woman who has taken what I think is the very healthy step of naming her PMDD.  Naming your PMDD helps to separate you from your disorder.  You are not your PMDD and that is what we all need to remember when PMDD strikes.  We are more than our PMDD, and better than our PMDD.

I call her Agatha. 

Some of you may have met her unknowingly. Her presence is noticed only by my few nearest and dearest...and even most of them don’t understand her. I’ve decided to talk about Agatha because I spend so much time as/with her, I am tired of trying to explain myself, or feel guilty, or desperately sad that things annoy me when they shouldn’t even make a shadow. 

Agatha is my PMDD...or who I am for up to two weeks out of the month. Yes...EVERY month. I have PMDD...Pre-Menstrual Dysphoric Disorder. Have you heard of PMT (or PMS if you’re American)?  Well, PMDD also has to do with the menstrual cycle, but is a million time worse. Maybe a billion...at least. After I have ovulated and the hormone levels change, so do I. I become someone that has taken me years to recognise, and more to understand. I describe it as having the ‘Dementor’s Kiss’; Harry Potter fans will of course understand the reference. For the rest of you, that is when all of the happiness you have ever felt, experienced, or hoped for, is sucked out of your soul, leaving you with no choice except to dwell on every bad thing that has ever happened to you...in the deepest pit of despair. 

I now understand it has got worse the older I get, because I have more experiences. So there’s more happy to be sucked away, and more pain to be left with. PMDD doesn’t just mess with your mind and soul, it likes to play with your body too. Any pre-existing conditions are highlighted and heightened...luckily for me, I have a back condition, so usually I am in considerable extra pain in the lead up to the bleed. I also get a barely-controllable eczema outbreak, and permanent, draining headaches. Then there’s being so tired, that I’m not sure if I’ve been to sleep. And I’m pretty positive that the world tricks me by deciding to speak a different language to me...because I haven’t got a clue how to distinguish between words, let alone decipher what they are saying. It’s all very confusing, and delays cause you to feel very silly; therefore, it’s better not to talk to anyone.

Ah...but wait! Why would anyone want to talk to you anyway? You are nothing, and nobody. Your past experiences have shown you that, right? There’s no hope for you, so stay put and don’t move, because nobody wants you. Your children can’t stand you, you’re so irritable, and their noise hurts your oversensitive ears. They also want you to come out of your dark, safe hole - they want food, they want to talk to you, but they are far too loud for you, and they would be better off without you...right? You’re lucky your back is screwed, and your muscles are aching in every area, because then you can’t drag your unwanted, pathetic self into the road for some juggernaut to put the world out of its misery, fed up of having to have your unworthy ass live in it....no one could possibly want you around, and you should probably top yourself to do them a favour. Everyone you know would have a greater life without you in it. 

The disillusionment of the world eats you up, the unfairness of “the system” has you physically aching for the world to end. You dislike your family, you don’t want to talk to your friends...and there is nothing but pain and despair.

And then one day, I wake up and something feels different. I have a harsh stomach cramp, but that’s nothing compared to the aches and pains of the previous week. I smile at my text messages, and I kiss my husband - it feels nice. Everything feels nice, and everything looks nice. I go to wake my children up with the biggest hugs and talk about upcoming plans for fun things. Oh wow, I also need sex. Like NOW. I want sex ALL the time (see, there is an up side to imbalanced hormones!) my mind and body are depraved instead of in pain. It feels good. And I wake up the next day feeling the same...and so on. I have a wonderful two weeks of coping with everything and having big smiles, and then something happens that will either irritate the crap out of me, or a loud noise hurts my ears, or I wake up and can’t move because of back pain...so I check the calendar - shit, it’s Agatha time. 

I gave the person I become a name, so I can fight myself, tell myself ‘it’s just Agatha, she’ll go soon, just hold on’. This is my most recent tool for the battle - after exhausting diets, exercise, herbal treatments, vitamins, finally giving in to my Doctor and attempting anti-depressants. Nothing works. So it’s me against her.

She’s getting stronger, and I can feel her on her way. I’m not ready, I’m still not over last month’s visit. I want to keep smiling...but no, time to batten down the hatches, because she will be here by the weekend; I will be forced to face every demon I have ever encountered, and I’m scared.

Can’t give up though, I have to keep fighting. I can now differentiate between who I am, and what is caused by her. It’s me against her....

.....c’mon then bitch.

The Voices of PMDD - My Ten Year Struggle With PMDD

A guest post, written by a fellow PMDD blogger.

I was 20 years old when I knew things were not quite right. After suppressing my ovarian cycle for 3 months my symptoms were resolved and it was very clear I had a serious intolerance to my own hormones. I was told this is a complex situation that would disrupt my daily/monthly activities. What did this even mean? I struggled to understand this at such a young age, comparing my life (or lack of it) with my friends and those around me. I didn't even know it was called PMDD at this stage. I struggled to maintain relationships with family/friends, struggled to have a balance of life and each month was very much half lived. There were many dark days, spent alone hiding from the world. 

My GP at the time was completely ignorant to the severity of my symptoms, so much so that I started seeing a walk-in GP who has now become my main GP. He referred me to the PMS Clinic at Chelsea and Westminster Hospital in 2012- finally felt I was speaking with gynaecological doctors who understood and could help. I was excited to be cured and rid of this illness and I couldn't wait to finally start living a normal life. However, I was told there is no easy way to manage this and every case is individual, with a trial and adjusted medication plan. I went through rounds of Zoladex injections (surpressing my periods) and different doses of HRT to try control the PMDD. Zoladex was my saviour, ridding all my symptoms. The HRT gave me many side effects, but nothing was as bad as the PMDD. The doses of HRT had to be constantly adjusted, side effects become more unbearable and I decided to withdraw from the Zoladex and HRT in December 2013. It took about 8 months for my periods to return. Initially, things didn't seem so bad, but the hormones built up and the PMDD was back. I didn't quite know what to do and I was reluctant to go back on the Zoladex and HRT. I tried several contraceptive pills over a period of months, with no hope of control-august 2016. 

November 2016 to March 2017 was a blur, the PMDD was back. I was in denial, hiding the symptoms, struggling with work, found daily routines a strain and disengaged with activities. I avoided speaking to anyone about as I knew the only hope at this stage was to go back on the Zoladex and try other forms of HRT or I consider a Hysterectomy. I was 29 and couldn't quite understand how I was meant to make such life decisions. The questions of relationships, marriage and kids were always avoided. Eventually the PMDD became so overwhelming, I knew I was in trouble-emotionally I had entered a really dark place and the fear forced me to get help. I remember the walk to see my GP knowing he would take control and get me the help I needed. A couple of weeks later I was back at the PMS Clinic at Chel/West Hospital, on the Zoladex (suppression of my own hormones) and a different form of HRT. I was so anxious about taking this treatment again, but I had no choice. 

So where am I now? Life has been good since April 2017. I turned 30 years old in June 2017. I survived 10 years with PMDD!! I have learnt to appreciate the role of the medication and see how normal, balanced and full of life I can be when PMDD is not in control. Life feels new, exciting, opportunities seem possible and I feel so much love and happiness. I feel alive! I am able to forward plan and make commitments. I have also learnt to trust those around me - my friends have held me up during the most recent bad turn and reminded me of the person that I truly am. I never thought I would have such a strong circle around me and I cannot express how their energy and presence has been my saviour. For the first time in years I have been able to open up about my condition and my worries of the treatment and future. However, I still fear the future, the unknown impacts of the HRT. It is still a fight. I still worry about sharing all this with a man—will he ever accept me? what happens if I am taken off the medication? I want to get married, have kids and be happy. The difficulty lies in trying to achieve all this, whilst dealing with PMDD, taking medication that is variable and if it fails, the decision of having a Hysterectomy. It's a life changing decision, especially when you haven't had your own kids. 

I wrote this account for my fellow PMDD sufferers—you are not alone. The best advice I can give you is to find a GP who listens to you and lean on your friends when you are at your lowest point. Do not allow yourself to be alone. Do not hide or be ashamed. Face the PMDD head on. Those around you will make the decisions for you when you are not able to—trust in them. The other advice I can give you is to live life. Do not self hate. Make the most of the good days, rejoice in experiences, build relationships and laugh. Make the decisions that you need to, that best suit you and your life, so you can find a way of truly loving yourself.

Living with PMDD - Realize, Relief, Repeat

REALIZE, RELIEF, REPEAT
[Living With PMDD]
By: Danni Hanna
When you REALIZE it’s time, it’s already too late
Being engulfed in its flame is always your fate
Depression sets in.. in its bi monthly routine
Next comes the anxiety and the fatigue
Panic attacks make their appearance
And the joys in life make their disappearance
Suicidal thoughts fill your brain
But you know soon enough you’ll be off this train
The train runs on an endless track
Circling, circling, circling back
Exercise, medication, eating right
Won’t help you win this fight
Two weeks free, two weeks trapped
Two separate identities on constant relapse
One identity starving for control
The other is on an easy stroll
Career and relationship changes fill the void of sleepless nights
But freedom is coming into sight
The day of RELIEF has arrived
As per usual, right on time
An exchange of pain occurs in an instant
From mental to physical, it’s always consistent
Anxiety and depression leave your side
Feelings of comfort and amusement fill your mind
Quickly forgetting the two weeks of hell
You become trapped within its spell
You never seek help
Because this is the best you’ve ever felt
Unaware you’re still riding the train
Two weeks pass by and the hormones enter your brain
Once again the exchange has been made
Those joyous feelings briskly fade
So go ahead and take a seat
The journey of this train is about to REPEAT

My First Memory of Having PMDD

It’s hard to pinpoint my first true memory of having PMDD. I think I struggled against my PMDD for so long, denying that I had a problem, that it manifested long before I admitted there was something wrong with me. No one else I knew went through these struggles, or if they did, they didn’t talk about it. They managed, they coped…why couldn’t I? What was wrong with me that I was fine one day, and could barely get out of bed the next? I think I blamed it on everything and anything else but me, sources outside myself, school, work, friends, family, whoever I was in a relationship with at the time--because I was young and healthy and mental-type problems only happened to other people.

The first episode I can remember which I would now attribute to PMDD was a two-week period in my freshman year of college, toward the end of the semester and year, when I simply didn’t get out of bed except to go to class. I was doing well in my classes, not having any problems to speak of, and then suddenly this period of total sadness and hopelessness and lethargy hit, and I had no motivation to do anything or go anywhere. Then just as suddenly it lifted, and for the remaining weeks of the semester I raced around like a madwoman, trying to catch up and make sure my grades didn’t suffer.  I was eighteen years old.

Now, looking back, I can see countless repetitions of this scenario, where I’m sailing along, and life is fine, and then suddenly...it isn’t. When all indications are that I should be happy beyond measure--having achieved every goal I’d set for myself to that date--but I wasn’t. I used to think there was just something inside of me that liked to make life a little more challenging. Something that liked to let me fall behind, just so I could prove that I could catch up and still come out ahead. Now I realize it was the PMDD dragging me down. Now I think about how much I could have accomplished, had I known what was happening and learned to manage my PMDD, like I eventually did.

But I don’t dwell on those thoughts, because those opportunities have come and gone, and negative thoughts will bring anybody down, not just a woman with PMDD. There’s no sense in feeding the fire. What’s come and gone has done just that…come and gone. The only moment we can do anything about is the moment we’re in right now. And right now, I know that most, if all negative thoughts I have stem from my PMDD and I’m just not going to give them any more air time. I’m still as stubborn as I was as a teenager, still as determined not to let the sadness and negativity get me down, only this time I know what I’m dealing with. Now I’m able to separate the two, my usual self and my PMDD self, and when my PMDD hits, I’m able to label my self-defeating thoughts as PMDD thoughts and just set them on a mental shelf to be dealt with later.

The beauty of this tactic? When later comes, those thoughts are no longer relevant. Mostly because they weren’t true to start with. On PMDD days now I rest and take it easy. I find something positive and uplifting to read or watch or listen to, and focus on small, sometimes mindless tasks that I know need to be done and have been saving up for just such a day. Organizing receipts or CDs or books on a shelf. Folding the laundry. Nothing heavy, nothing demanding either physically, mentally, or emotionally. For instance, sorting through old photographs probably wouldn’t be a good job for a PMDD day. The emotions they dredge up might not be positive, might make you miss someone or someplace or stir up regrets. Or they might remind you of a happier time, and instead of making you smile, might make you feel like you’ll never be happy again. That’s the PMDD brain talking, not you. And whatever it is saying is certainly not coming from God.

I bring God into this because my faith was and is a big part of my experience with PMDD. Without faith in something bigger than myself, I never would have come to have faith in myself. I can’t tell you how many times I thought there has to be a way to make this madness stop. The first book I picked up was Prayer, Faith and Healing: Cure Your Body, Heal Your Mind, and Restore Your Soul. I’d tried everything else. Maybe it was time to give prayer a chance. And so I started. With baby steps. One by one, one day at a time, learning how to listen to something positive outside myself for a change, until I learned that God was inside of me, too, and I could go within for the answers I needed. They didn’t have to come from outside sources.

The stronger I became on the inside, the more those negative external voices dimmed to background noise. Such as well-meaning friends and family with unsolicited advice, and not-so-well-meaning friends and family with selfish needs and demands.  Not to mention well-crafted advertisements pointing out all the areas in which I was lacking in my life, or organizations with agendas on how I needed to live my life, and countless books, magazines, radio and television programs telling me I could have it all, while at the same time measuring me by artificial standards no one person could ever hope to attain.

It’s hard enough navigating life with all your faculties intact. But when you’re a woman with PMDD, operating on half power or less half the time or more, life gets really challenging. So don’t beat yourself up. The world is more than happy to do that for you. Accept that you’re not perfect and you’re never going to get there, then relax and enjoy your life. When you’re feeling good, take on all you want to, and when you’re not—take time out to take care of you.

If you take nothing else from this post, take this: Don’t spend another day beating yourself up for something you have no control over. Do start listening to your body, and giving it--and yourself--the respect you deserve. If you don’t know how to do that, if you’re scratching your head at the very thought of it,  like I once was, then check out my blog, my Living with PMDD Facebook page, or my book, PMDD and Relationships, for more information on how to better manage your PMDD, as well as support, encouragement, and tips on how to be a better you…all month long.

PMDD Symptom Play by Play Number 2

The following guest post was written by the blogger Cheekyminx. With her permission, several of her posts about PMDD are being featured on this blog. To find out more about her work as a PMDD Advocate, please visit her Facebook page, PMDD Life Support.

I did promise to write another PMDD symptom play by play, and since my symptoms just kicked in today, I thought now would be as good a time as any to bare my "hormotional" soul. This isn't easy. In fact, it sucks. It's dreadfully intimate, questionably revealing, and even harder to admit. But I am committing. So here we go...

8 Days Out

So what changed in me that I knew that symptoms had kicked in anyway? Well, I felt constipated and bloated today (first time since last cycle), I started pulling my hair out (not intentionally...my fingers just go to my hair and when I pull them away, my hair follows!), and most importantly, I feel just plain flippin' irritated for no extraordinary reason about EVERYTHING. I feel somewhat hair-triggerable, if you will. So I'm starting to avoid the things that trigger me (being everything, meaning isolated myself). I have to add that this month has been an incredibly stressful one already with plenty of relationship tensions. I was already irritable, but it felt different than it does today. I wish I could explain it. There is an accompanying intolerance now that wasn't there before...an inability to censor. My diplomacy skills are fading. Many say that PMDD magnifies what is already there. If that's true, this month ought to be a "real blast".

7 Days Out

I just flipped out over my husband saying, "don't worry", when I couldn't find how to reverse an action he told me to take in some software, messing up my work view. I did warn him my symptoms were coming on.

So are men really that stupid? Don't ever effing tell me how to feel! And certainly DO NOT belittle my frustrations with your petty sentiments of projection. YOU "don't worry"! I'm frustrated. Deal with it! Ouch! Okay, last two nights...a touch of insomnia. Today, RAGE! I think I could pick up this 20-ton glass desk and hurl it out the window like it was made of cardboard! There is a jittery tension just underneath my skin accompanied by an overwhelming desire to be alone in the house...for the rest of my life. I have ghost cramps too. That's what I call cramps that arrive before my period.

6 Days Out

6 days? I don't know if I can last another six days. Today was rough. I cried this morning. I cried this afternoon. I cried tonight. I'm feeling incredibly insecure, let down by and estranged from everyone in my life, anxious, grumpy, and deeply sad. I have wished that I would simply die. Since that's unlikely, I just vegetate with Netflix until bedtime with grateful anticipation of the total unconsciousness it brings...and hope I never wake up.

5 Days Out

Didn't sleep well last night, ironically. In fact, I was ruminating in a way that only comes on with PMDD...a hateful, angry way. I swear, I don't know where this shit comes from. I seem to manufacture it in spite of my desire for peace. Each time I woke in the night, I pounded my pillow and cursed bitterly. This morning, I did my best to isolate myself. I tried to be on my best behavior too, bearing in mind today's best bore more resemblance to a caged animal than to a somewhat decent human. Despite my PMDD Tourette's, a lovely symptom where pure shit just gushes from my lips, I managed to hold-back on some of my impulses to push and stomp. With every bite of my tongue, a part of me celebrated the tiny victory (quite alone...as it was evident to no one but me) while in the next moment I was unbridled...judging, criticizing, blaming, fed up with the same old crap...emotionally abusing my husband while at the same time hearing in some vague and distant background all the kinder things I wish I was saying instead. They were too remote for access. They were a distant land. I wanted to run to my room, to be safe, to protect not only myself but him--the only measure I have at my disposal...isolation. It was too late. His deepest wounds were activated, his own mind becoming the same enemy mine had become to me. It would seem PMDD can be contagious, even without the hormones. My husband reacted and in turn became the emotional abuser, taunting me, drilling me, pressing me, driving me to tears with his own screams of how crazy I am, how uncaring, how hopeless, telling me nothing my PMDD mind hasn't already been telling me, but reinforcing it in a way that broke and battered my already damaged spirit. He threatened me...with quitting, with walking out. He's promised that so many times, and today, I wish he'd follow through. That same distant part of me was proud of him for speaking up for himself in the only way he knew how...not for how he did it, though. How he did it hurt. I must admit today, I had suicidal thoughts. I had world-destroying thoughts. And I cried and heaved, shook and crouched in a corner, desperate to be free of this storm inside of me and the external manifestations of it. Emotionally spent, I listened to a looping recording of a mantra about 20 times which calmed my suspiciously empty mind. I can't believe I'm writing this.

4 Days Out

After yesterday, I'm really emotionally exhausted and kind of blank. I've lost a day. I thought it was Thursday but it's only Wednesday. That's been happening a lot, but I don't relate it to PMDD. It's living in the middle of nowhere! There's nothing I want to do...or feel or think. Despite needing some groceries, I can't make myself go. I feel like the remnants of a bird that has burned in flames but has yet to arise once more from the ashes. I continue my deluge of mantra listening. And I eat chocolate. I know my situation is complex. I have many marks against me right now. To be honest, I probably have some form of PTSD after two years of the worst stress of my life which I admit at least half of it I took on willingly, arrogantly even, in addition to being peri-menopausal and PMDD. I also have no grounding, having moved to a foreign country where I cannot speak the language and where my support network is still fairly non-existent. I had a massage therapist when I could afford her, and now, I have a talk therapist who I will have my first session with tomorrow (Thursday. Not today, Wednesday.) It's a trade-off. There's the recent passing of my mother, too. It's a lot to cope with. Add "relationshit" to the mix, and it's tough to tease apart the symptoms of PMDD from the disaster that is my life. So everything just swirls together into a big complicated mess. Charting saves the day and preserves what little sanity I have left by revealing an intensity of symptoms at certain times of the month. I will persevere. I am resilient. I am determined, too. And in moments, I am remembering who I am.

3 Days Out

This morning, every bone hurts. It was very difficult to get myself up and moving. I would love a massage, but I don't have the funds for one. Yin yoga will have to suffice. My symptoms were less today, which historically, has happened...things can actually mellow before the actual onset of my period. Although, usually without fail, I blow out the day before. We'll soon know...

2 Days Out

Last night, I slept 12 hours!! Pretty typical right before. My dreams were very bizarre. My hair continues to fall, and I had ghost cramps again. Another thing that's started today is a weird head-to-toe itchiness; I've heard other women complain of this too, so I'm no longer surprised. When provoked earlier, I quite easily lost my cool outwardly, but overall, in my head, I feel more stable today, so I'd have to relate any emotional symptoms to other things in my life and not necessarily PMDD. Or maybe I'll start early. The cramps are a good indication I might.

1 Day Out

Surprise! Guess what's here, sparing me an extra day of misery and uncertainty? How am I feeling? The first thing I noticed was the intense ache from head to toe as I pulled myself out of bed at a fairly human time of day. I feel about 20 years older in body. Add a headache and the typical cramping in my lower gut, too. But I can handle the physical symptoms; they are kind of a joy after the week I've had. Emotionally, I feel tentative (as the rest of my life is still incredibly challenging). But I don't feel that uncontrollable sense of building blood-level tension that prompts me to catastrophize and explode (not that I couldn't given the right stimulus...but that I don't feel that "hair-trigger" thing). My mind is also quieter. When I woke this morning, from a dream about pastries and cookies, my first thought wasn't "Oh, fuck, I'm still here; shit, shit, shit!", it was more like, "I'm up." There was no punching of pillows or immediate tears. How do I explain it? It's like an equilibrium, a balancing out. A relief! So can I count on a few days of relief? Or will something fluctuate and turn me mental again? Sometimes, on day 5 or 6, I rebound into "crazy-land" for a day. Sometimes, I'm okay until I ovulate. It's difficult not knowing. It's difficult not knowing, too, whether outside circumstances will inflict traumas that bring the stormy inner waters back to the surface. I hope not. I need some peace. I need some rest. My problems are all still there. My relationship is still falling apart. I still live in the middle of nowhere in a foreign country. I'm still dealing with loss and grief and change of massive proportions and living an unrecognizable life. Somehow, somehow, there's something accessible now that feels like strength, like resilience, like patience, and even serenity. Holy crap! Did I just feel myself smile?

PMDD Symptom Play by Play Number 1

The following guest post was written by the blogger Cheekyminx. With her permission, several of her posts about PMDD are being featured on this blog. To find out more about her work as a PMDD Advocate, please visit her Facebook page, PMDD Life Support.

Talking and writing openly about Premenstrual Dysphoric Disorder is something I'm compelled to do, both for myself, other women, and the people who love us. I'm trying to understand myself and this very complicated phenomenon that seems to slip and shift into unrecognizable forms within a recognizable framework every month. Since learning about PMDD, I am now free to witness the cyclical changes taking place in my body and mind with some objectivity. As my body becomes more and more sensitive to the hormones surging through it, I'm less fearful about why I'm suddenly losing control, wondering how much worse it will get. It's easier to pay attention to the process, fascinated and taking notes.

Truly, as hard as it is to understand, things can be very different month to month. What I've done here is journal some of my symptoms in the days leading up to one period a few months ago. Were I to do this monthly, no doubt the expression of symptoms could be different each time. Typically, women begin to experience symptoms 14 to 11 days out from menstruation. The actual period tends to bring relief either instantly or within a couple of days. But again, this is only generally speaking. What I have garnered on the forums and from my own experience is there are exceptions to this rule, and a woman should not rule out PMDD just because she doesn't fit some erroneous profile that was originally established on a very small base of women. And if, like me, your hormones are in flux anyway due to perimenopause, you might indeed be a bit all over the symptom map!

With 11 days to go...The first thing I notice is an almost instant loss of my sense of humor. It was there one second, gone the next. My husband noticed it since we had been laughing for days prior. It isn't that things have ceased being humorous so much as that I have stopped being able to find humor in them. Even my face feels like it has forgotten how to move upward into a smile. The next thing I finally notice is growing fatigue. In fact, I'd slept 12 hours for two nights in three days. This is an absurdly long amount for me to sleep. I didn't even wake to relieve my bladder which is a common occurrence during a night of much less sleep. I gave into this need for sleep instead of fighting it off, and I think it did me a world of good. I also notice my body feeling colder. I wear a sweater and my hands ache with cold even though the temperature isn't that different from weeks prior. Then there's the hunger. I'd probably be eating all day long if I could. The menu? Salty chips, roasted nuts, dark chocolate, and butter on all manner of cakey-bready things. Unfortunately, the baker where we used to get our organic sourdough stopped taking orders, so I'm left with unfulfilled pangs and cravings for hot buttered toast or French toast. When it comes to food, I know I can't give into every craving anyway. I'd be the size of a buffalo. So, I balance things as best I can eating oat crackers and high-quality chocolate along with the grapefruit and parsley juice and salad and fruit. For the weeks leading up to this time, I was making banana shakes using almond milk, including the spices turmeric, cardamom, and cinnamon...each known to alleviate various PMDD symptoms like depression. I've also started taking magnesium which is supposed to help with symptoms. We'll see if I notice anything.

With 6 or 7 days to go...I felt like I was doing better this time around contrasted with last month. Is it the spices? The magnesium? Luck? I've noticed that, generally, I have good months and bad months. This makes the whole concept of PMDD even harder to understand and, for some, to believe. And yet, other women express the same experience. Some say every third period is the worst. I seem to have three on, three off...way off. Will this be a good month? Weepiness has set in and my legs are starting to feel like two leaden logs, so maybe it is too soon to tell. (Note from Liana: this good month/bad month pattern has been explained by whether or not the woman is ovulating.  If  you ovulate, you will experience PMDD symptoms.  As we enter perimenopause, we have fewer and fewer ovulations.  No ovulation = no symptoms.)

5 days and my mind is off and racing. I can't stop over-analyzing, over-thinking, and over-compensating. Some who know me might say I'm always like that. Okay, so, imagine that ramped up by 10. I've become afraid of the world, and what were merely challenges have become insurmountable obstacles. My husband is doing his best to distract me and also to listen to me without himself becoming depressed and defeated. Somehow, I've managed to regain my sense of humor, and this is really saving the day. Squirrel! 

4-2 days: Could I actually get through this month without losing it completely? I've had three social obligations in the last three days, and though as an introvert I'm feeling the drain, it isn't debilitating. The fact that I could even be social just a few days before my period is somewhat of a miracle.

1 day to go and everything I thought I'd managed to escape this cycle has come down full-force. The internal pressure I feel...how to describe it...has increased dramatically, making me very antsy...agitated. I feel like a combustible material. Pour the wrong remark over me and I will blow up.

So what happened next? I was attempting to control an out-of-hand ant problem (yes, ironic...me being antsy and all). My husband was pressuring me to leave for grocery shopping because the stores would close soon. He wasn't helping or taking part in what I saw as a near-disaster. Yes, I realize ants are not a near-disaster, but PMDD magnifies everything by about 1000. Couldn't he see what I was dealing with? I became furious.

So my husband asks, "Why are you acting like an asshole?"

Wrong move. That was it. The end of marital bliss. I may well have been an asshole, but I didn't need anyone pointing it out to me, thank you very much. I tore the shopping list in two, gave him his half and wished him luck. Despite wanting to call a truce in the market, I couldn't bring myself to do it because of the way he was now behaving...like an asshole.

The thing is, if I act like a big-enough asshole, then eventually, so does my husband. And then, we're lost. We're lost for an hour, a day, a week...hard to tell. But I know I can't engage with him AT ALL if he's also going to be a two-year old. And then I hate him because he doesn't have a "hormotional" excuse and could be making all this so much easier for us both.  (emphasis added)

Why couldn't he just have grabbed me, hugged me, and told me the ants were a little problem and that if I could just walk away I would feel better? Herein lies the greatest PMDD difficulty for me and countless others. Our behavior becomes exceedingly difficult if not impossible to control. (Liana adds: and once we have reached that tipping point, we are literally unable to go back, to retreat, to regain control.  All our efforts to soften our PMDD symptoms (meditation, herbs, vitamins, exercise, rest, nutrition, mantras, art or music therapy) are done in an effort to not reach that tipping point.  Because once we have, all is lost for that day or that PMDD episode. This is what most people do not understand.  We can't stop, once the emotional cascade begins.)

We're not doing it to be difficult. We're not doing it because we like throwing tantrums. We don't even get any pleasure out of it. Well, maybe some do. I don't. Mostly, I see a madwoman taking over my body and wonder how on earth to reach her, calm her, and love her. It is no easier for our significant others who try desperately to understand us as we're suddenly shooting daggers at them when five minutes ago they could do no wrong.

My husband and I talk about this stuff when we can. When I'm back to my old self again and after he's recovered, we talk about this funny thing called PMDD. We strategize and decide we can handle it. We make-up and go about our lives...laughing, loving, sometimes bugging each other, but getting over it. But then, when it rolls around again, it seems neither one of us remembers what to do. It's a common amnesia.

When I can, I will do another symptom play by play post. In the meantime, have you noticed similar symptoms in your own or a loved one's life?

PMDD: Suddenly it All Makes Sense

Now I know why!

I know why two weeks out of every month I am waiting to feel like myself again. I know why for two weeks I suddenly don’t give a crap about anything I was excited or cared about in the weeks before. I know why I feel contempt for everyone and everything when I recently felt so in love with it all. I know why I suddenly doubt my abilities and talents. I know why I isolate myself on certain days…when I just know I’m not going to be able to accomplish the simplest of tasks without getting irritated or downright angry. I know why I am afraid to schedule anything in advance, lest whatever I have to do falls on a day when I am incapable of behaving reasonably. I know why hateful thoughts become so insistent and pervasive despite the fact that just two weeks ago, I was 100% certain I had finally transcended them all. I know why I can’t stand to be touched, when just last week, I couldn’t get or give enough hugs. I know why I suddenly feel so disconnected from my friends, doubt their friendships, and suddenly want to walk out on my husband.

In my quest to understand, I’ve been given plenty of opinions. I’ve heard some labels, and some I even tried to make fit. But in the end, I knew they didn’t. I knew I wasn’t “bipolar”. I knew I wasn’t “borderline” or “mood disordered” (even though that’s still the involuntary category in which I’m pegged). I knew I wasn’t “just imagining things” either. Nor was it the whole story that I was “just hormonal”. Something inside me had changed in the last couple of years and something was happening throughout my menstrual cycle to make me feel like two completely different people. Only recently, it had gotten much worse.

The Fighting Bell Rings

In one corner: a woman full of radiance and quick to smile. She can be so full of love inside herself to the point of bursting. She is centered and enthusiastic, bright and cheerful, optimistic and strong. She’s not perfect, of course, but she’s so okay with that. She’s on top of her thoughts and more than willing to be alive. She is excited about projects and new ventures…even if they are challenging. Anything seems possible…anything reasonable, that is. (She isn’t about to jump off a building or into traffic.) She believes in an abundant universe and that she has something to offer the world. She enjoys the company of others and lives to laugh, create, and feel gratitude. She would never dream of hurting herself or anyone else. She may have bad days, but she recovers quickly.

In the opposite corner: a bedraggled, wild-haired psycho who has to apply every ounce of her will to not lash out…though she eventually does, usually by imploding on herself or exploding at those closest to her. She is the wily animal who shudders at her own hateful attitude as she mourns the loss of her other self. She is the one who simply CAN’T control anything. She is full of shame for her inability to control herself. After all, hasn’t she learned anything? She cannot forgive or forget. Everything is the end of the world. She stomps to feel she exists, yet the very force of her enraged feelings lifts her off the ground. There is no justice, no joy, no purpose, and no comfort to give or receive. All is bullshit. She isolates to protect herself and others from this “thing” that has overtaken her, but life pokes and prods all the same.

Eckhart Tolle, author of The Power of Now, talks about the pain body in his work which comes close to matching the insane being that shows up in my mirror every month. There’s also this idea in spiritual circles about embracing and integrating the shadow-self. I wholeheartedly agree with the importance of doing that. It’s powerful stuff, but I don’t think it is the whole story for me. Always favoring the holistic over the quick fix, I’ve been exposed to a lot of different teachings in my quest for well-being. But none of them have satisfied this itch under my skin that what I was dealing with wasn’t just some egoist resistance on my part, wasn’t just some weakness in my character, lack of awareness in my being, or deep wounding from childhood . In fact, I have LOADS of awareness and more strength than a lot of people. So, something wasn’t jiving.

Something else is going on. Whatever it is, this pain body feels universal…not personal…yet it attacks in a personal way for sure. It isn’t a permanent state of being but it is one that, when I’m in it, feels like the only state of being I will ever know. Sometimes, it turns on a dime…a cruel word, a task gone wrong, a frustration or irritation that sends ever-widening ripples of tension out into my environment…but, and here’s the key, only at certain times within my cycle.

What I’ve discovered is the term PMDD or Premenstrual Dysphoric Disorder. Though I don’t agree with a lot of the psychological/medical establishment bullshit (excuse my language…but let’s call it what it is) behind it, it has come closer than anything else I’ve ever encountered to explain what’s been happening increasingly so with me since going through a period of intense and prolonged stress.

I feel like I have to start by saying that I’m not interested in excuses for bad behavior. I’m not looking for a convenient explanation for bouts of anger or anxiety or anything else. I’m not trying to protect my identity as a “got my act together--no problems here” person, nor am I holding my shadow aspects in a closet of denial. I’m not interested in using the label of PMDD to explain away or justify crazy-making, just as I’ve never been interested in the label of “depression” to explain away unexamined pain and the absolutely natural waves of ups and downs that society would rather call a disease than a sign of being human in the world in which we live. What interests me about PMDD is that elements of it actually fit and explains myself to myself.  What fascinates me is that there are other women who feel like I do…that it is a real phenomenon to be examined and explored. It is a real phenomenon to be healed.

I’ve joined a couple of online PMDD groups, and what I’m noticing is that a lot of women feel they have no choice but to treat PMDD with very toxic antidepressants and hormone-related treatments that further disturb the delicate balance of the body. Some even decide to remove a part of their bodies, having hysterectomies, and are overjoyed with the results. I know many women get absolutely ill with vomiting. Why is the newly established “disorder” which was recognized in 2013 seem to be increasingly prevalent? I have my own theories circling around my head…the poisoning of our food supply perhaps or our increasing exposure to radiation and toxins. Who knows?

For me, it is mostly a mood challenge though I also get headaches, stomach aches, sleep disturbance, and other physical manifestations. Nothing like vomiting, thankfully. I feel incredibly blessed by and grateful for the management tools I’ve found that are side-effect free and have a great deal of sympathy for those who are buying into the system of big pharma (whose sole interest is to get everyone on their drugs regardless of whether it actually helps or even does more harm than good) and a patriarchal medical system (with a track-record of locking women away for their complaints). We can be products of the system that would call us “mentally disordered” offering us only what they deem as the answer or we can access inner qualities we can cultivate to cope and turn to more natural therapies until we discover what combination works for us. I know what my choice will always be. And that means that sometimes, I choose to live with a very difficult, very challenging state of being with very little outside assistance at my disposal. So be it.

Not just regarding treatment, PMDD is a hot topic of debate. In addition to being controversial in the medical community, there is, as with all conditions, a lot of general ignorance around PMDD. As I mentioned, it’s only been acknowledged since 2013. Right away, people assume it is PMS with a different name or an excuse for why a woman suddenly gets bitchy, tired or crampy. Or they draw other ill-informed conclusions. One woman made the mistake of sharing her condition with her employer to be told they feared she posed a threat to either herself or coworkers at work. I suspect there are people in their employ at far greater risk of flying off the handle, the ones they’d least suspect. Others are told, even by well-meaning friends, that it is all in the head and are told to chill out or get over it or try some quick fix. Clearly, those who don’t experience it are not in a position to offer advice!

Here’s the thing about PMDD. We may think about bludgeoning judgmental, self-righteous ignoramuses who think they know all the answers, but we tend not to act on it. Good thing, because there are plenty of them around.

Just as I have been (unprofessionally) mislabeled before discovering what is known as PMDD, I am sure there are women ascribing their behavior to PMDD when it truly belongs in another camp altogether. Supposedly, 40% of women who seek treatment for PMDD may have either what is known as PME (premenstrual exacerbation) or even an underlying mood disorder such as bipolar. It’s complicated. Of course, the professionals will continue to debate if any of this is real or not, some kind of anti-female rhetoric or not, or whether it is a mental disorder or not. This just muddies the waters, but what’s to be done? Human beings are intricate and unknowable and this “dis-ease” is extremely complicated because there are so many variables! In the meantime, there are those of us who live the spectrum. There are those of us who know.

Speaking of the spectrum…

There is PMS, the catchall that pertains to the mild, acute fluctuations of mood, irritability, fatigue, appetite changes, and cramping that affect 30 to 80% of menstruating women. It may be uncomfortable, but it is not generally debilitating.

There is PME. This is when a condition from which a woman suffers, such as asthma or an eating disorder, is worsened during PMS. So, PMS disappears after one’s period whereas PME symptoms merely improve.

Now there is PMDD which affects 3-9% of menstruating women. (With a female population of over 3 billion on the planet, 3-9% of those with periods is no small number!) With PMDD, the symptoms associated with PMS become debilitating and can include: depression or hopelessness, anxiousness, irritability, low energy, lack of interest, sleep and focus disturbance, loss of control and feelings of overwhelm, and suicidal thoughts. These symptoms tend to intensify as a woman nears her period and finally begin to abate a few days into her period. Women with PMDD generally feel themselves again for 7 – 10 days after their menses before entering the cycle again.

I’m not crazy about another label…another diagnosis…especially one categorized as a depressive disorder which, to me, shows very little understanding of the scope of symptoms different women have. I’m not crazy about listening to “experts” tell me about myself and never have been. What I am interested in is knowing my own truth for myself, suffering less, finding ways to cope and relate, and living as fully as I can. And I want to help other women reeling with this monthly curse and feeling that they are robbed of half of their lives to do the same.

Do I believe in PMDD? Not as boxed-in psychological babble and checklists, certainly. I’ll never see a doctor for it myself. But it is a condition with which I resonate with unquestionable certainty. I’ve charted my cycles. I know when “the shift” is about to occur. I know when it is over. I know it is linked to my cycle. I know the changes I feel are described by other women who think they have PMDD, too. I know the challenges such changes bring and the impact they have on my life. I know my perspective goes out the window. I know some months are worse than others. And I totally relate to the increasing amplification of symptoms as I near my period and that feeling of complete and utter relief when suddenly the sun is shining again a day into it.

Maybe we need another word for it…one not bound up with so much baloney…one immune to the twisted machinations of men who hate women and women who hate themselves. I don’t know. Here’s what I do know: this is my experience. Maybe it won’t be mine in two years. Maybe it wasn’t mine two year ago. But it is mine now. Bravely facing that self and being open about it with others going through the same experience is crucial. There is power in numbers, and we’ll learn more by exploring this together. If nothing else, maybe the diagnosis of PMDD will simply prove to be a means for women to talk about what being alive as a women today is like for them. That itself is a relief.

Liana's note:  The above guest post was written by the blogger Cheekyminx. With her permission, several of her posts about PMDD are featured on this blog. In the meantime, to find out more about her work as a PMDD Advocate, please visit her Facebook page, PMDD Life Support.