A PMDD Valentine: Not All Chocolates Are Equal

For Valentine's Day, a post about chocolate (and a few other things), first written in 2009, but updated and still relevant today.

Having come freshly off a week of spending up close and personal time with my evil twin, who kicked my butt so badly the last day she was here I had to take a three-hour nap in the middle of the day, on top of getting a full night's sleep, today I feel uber-qualified to write about how it feels to experience PMDD. The thing is, now that the episode (aka her latest visit) is over, it's the last thing I want to think about.

I look around and see all that didn't get done over the week, the laundry piling up, the floors that need to be cleaned, the clutter of all I didn't feel up to coping with and simply set aside, and would much rather regain some semblance of control over my life—if only its external appearance—than write about the dark place I inhabited for eight full days and change this time around.

Why such a long visit this time? I think I know. I think it had something to do with my recent road trip: the stress of travel, the staying up later than usual, sleeping in strange environments, the change in diet, the miniscule amount of alcohol consumed, although in comparison to my usual alcohol intake, it was a big jump. Add that to the copious amounts of caffeine I consumed while on the road, the pasta-heavy fare at the conference, and I think I'm getting the picture. At home, I'm usually alcohol and caffeine free-or close to it. An occasional cup of coffee, usually one cup of caffeinated tea in the morning, if I feel the need, and chocolate only when "the cravings" come.  I hadn't had pasta or bread in weeks before the conference.

Why? All of these are bad for women with PMDD. Caffeine, alcohol, sugar, flour, hence the bread and pasta. But why am I so sensitive to their effects? I know women who practically live on caffeine and sugar, others who drink freely, others who love their bread and pasta. Is it possible they feel as miserable as I do, or more so, but deny their misery and continue to self-medicate with food and drink?

Because attempts to self-medicate is what these addictions (for lack of a better word) are. My research is showing there are very few true physical addictions in life. Most compulsions are emotionally or psychologically based. Only in rare cases is an addiction physiological.

That's not to say we can't get cravings. But cravings are cravings, temporary urges for some kind of substance to relieve our mental, emotional, or physical discomfort. Cravings are not addictions, although when you are in the throes of one, it can feel like an addiction. But as someone writing a book on dealing with addiction recently pointed out to me, "You're not going to stick a gun in someone's face for a piece of cake."

Cravings are the body's signals that some physiological need is not being met. You're low on some vital nutrient, to be exact. Your body is saying, for instance, "I'm low on magnesium," and you feel a sudden urge to eat a banana, or some almonds, maybe some oatmeal, or, yes, some chocolate.

Chocolate is one of the best known substances we crave. What confuses the issue with chocolate is not only its physical healing properties (of which there are many), but its emotional associations. We associate chocolate with feeling good. But not all chocolate is equal. Some are better for us than others. Much better. Others are almost useless, physiologically speaking. In the example above, a banana would provide as much magnesium as a 1.5 ounce chocolate candy bar, but a handful of almonds or cashews would provide almost three times as much magnesium as either the banana or candy bar.

So why do we reach for chocolate? It's as much for the emotional fix as the nutrients needed. More confusion arises when we don't know the difference between types of chocolate, due to the marketing and advertising claims of their manufacturers. Manufacturers is the key word here. Quality chocolates from true chocolatiers abound with the beneficial properties of chocolate. True dark chocolate is a rich source of flavanoids and antioxidants, with the cacao bean containing more than twice as many antioxidants the so-called superfoods like blueberries, kale, spinach, or broccoli.

It's the cheap, mass-marketed brands that—while they may contain tiny amounts of chocolate's beneficial properties—have processed most of the antioxidants and flavanoids right out of the chocolate. To derive any benefit from eating these lower quality chocolates, you need to eat way more than is healthy for you. When this happens, the negatives outweigh the positives—and you could end up outweighing all your friends.

If that's not enough, did you know that adding milk to your chocolate, or even drinking milk with your chocolate can negate its good effects?

Meanwhile you're bewildered, thinking, "Chocolate is supposed to be good for me, right? Milk is supposed to be healthy for me. Isn't that what the ads say? By eating chocolate and drinking milk, I'm doing something good for my body, right? So why do I feel so miserable?"

Because all the chocolate in the world isn't going to solve your problems, honey, and while I may crave it like mad at times, neither is it going to make my PMDD go away. For all its mood-enhancing abilities, even the finest Belgian chocolate won't "cure" dysphoria.

Dysphoric is the opposite of euphoric. Euphoric means happy, dysphoric means depressed. As in depression. But only pre-menstrually, which I suppose can be considered a blessing.

In some atypical cases, however, the dysphoria can come AFTER a woman begins her period. Lucky me, I'm atypical. Mine usually starts on Day 3, if it's going to come. It doesn't always come. Which is what drives me batty, trying to keep on top of what I need to do—or to avoid—to keep it from returning.

I lead too full and rich a life to keep being knocked flat by this unwelcome change in my body. It makes me feel like I'm constantly behind—on everything.

As women, we all know "it will never get done," but to have something come along and steal a full week or more out of your month, something that no matter what you do or don't do seems to be totally beyond your control...it's more than frustrating. It's crazymaking.

I'm here to tell you you're not crazy. I'm here to tell you there are scientifically proven physiological reasons for why you crave the things you do—like carbs—and what happens to your body as a result of that. I'm here to tell you there's help, and hope, but it's far from easy, living in a body that seems to have a will of its own at times, and a manufacturing and marketing culture that promotes unhealthy foods as healthy because of their base ingredients, while completely ignoring the toxic effects of their processing processes.

That said, the first step is to forgive yourself for falling short of your own expectations, and to understand that what is happening to you is as involuntary a response as an allergic reaction. You cannot control it. You can try to soften it, to be sure, by living a universally healthy lifestyle (once you understand what that truly is) but you cannot control it.

Nor can you deny it and simply plow through it, as most women do. We have commitments, responsibilities, schedules, and deadlines. We have people counting on us to be there for them.

But first, we have to learn how to be there for ourselves. My book PMDD and Relationships, addresses this topic in detail. I can hit on a subject here and there in a blog post, but the book...the book covers it all, from start to finish. And if you are a partner here looking for information about PMDD and how to live with the woman you love: PMDD: A Handbook for Partners is for you. Click on the book covers in the sidebar for more information.

So be good to yourself today, and every day, and when it comes to chocolate—insist on the good stuff. 

Because you are most definitely worth it.

Happy Valentine's Day, all!

Remember: When it comes to chocolate, the darker, the better.  You might have to work your way up to it (I'm now at 70% cacao), as it can taste bitter at first.  But the darker it is, the better it is for you (and your blood pressure!).  And don't drink milk with it because that interferes with your body's ability to absorb the antioxidants in the chocolate and therefore dims its beneficial/healing effects.

Liana Laverentz is the award-winning author of two books on PMDD, PMDD and Relationships, and PMDD: A Handbook for Partners.  Both books are based on the most asked questions by her readers, and therefore the most popular posts on this blog. Both books are also an excellent resource for understanding your PMDD and for starting a meaningful conversation with loved ones who want to know more about this debilitating disorder we live with daily.   More information on PMDD can also be found on Liana's Facebook page, Living with PMDD.

Stress and the PMDD Woman

So what causes stress in a PMDD woman?

Well, trauma, for one.   Trauma, (such as a life-threatening accident, war, imprisonment, witnessing or being the victim of a violent crime, including abuse of any sort, a death or major upheaval in the family, especially one over which you feel you have no control) can predispose a woman toward PMDD.  Incidents of trauma like these create neural pathways in the brain that can lead a woman with PMDD to over-react both physiologically and emotionally to normal everyday stressors in her life by producing an excess of "fight or flight" hormones, among other things.  Once this neural pathway has been opened, via trauma, the ruts are established and only get deeper with each new stressor.

 

To top it off, stress can contribute to further chemical imbalances in the brain.

So which came first, the chicken or the egg?  Is it stress that aggravates your PMDD or does your PMDD stress you out? 

 

The answer is both.  Lucky you.

Other sources of stress that work both ways include: 

Addiction

PMDD women are more prone to addictive behaviors, including sexual addiction, relationships addiction, drug addiction, nicotine addiction, alcohol abuse, and emotional eating, all of which bring stress into your life. 

Substance Abuse

This has to do with the reward/pleasure center of the brain, which is basically not working right during an episode of PMDD.  What you think will bring you pleasure or relief from your weepiness and edginess and anger in fact does not, because your brain is not processing information properly to start with.

The following has nothing to do with substance abuse, but is just one example of how my brain doesn't work right during that time...I walk around the track at my local gym.  I time myself.  On a good, comfortable day, I can do one lap in one minute.  Sometimes I can do it in 55 seconds, when I am pushing myself, and sometimes I'm just not feeling up to par and it takes an extra 5 - 10 seconds.  

But on an average day, I do one lap in one minute.

When I am having an episode of PMDD and force myself to go and walk around the track, and I feel like I am moving through molasses and every step is a challenge...imagine my surprise to discover that according to the second hand of the clock, I am actually moving at my normal pace of one lap per minute.

PMDD screws with your perceptions.  Of everything.

This includes what you see, what you hear, what you feel, what you think, and what you reach for to numb the pain.

Depressed people in general like to self-medicate (Remember, the first D in PMDD stands for Dysphoria, or depression) and jumpstart the reward/pleasure center of the brain with external substances, both legal and illegal.  But the PMDD brain does not respond properly to these stimulants, leaving the woman vulnerable to addiction.  Things that only add to the muddle going on in your brain are unresolved conflicts from the past, destructive behavior patterns, cycles of abuse, day to day stress, relationship issues, and cultural conditioning--all of which can lead to substance abuse in non-PMDD women as well.

So not only do the same things that set other women off set PMDD women off, but:

Our brains do not process the information properly during an episode...which leads to all sorts of drama...which only adds to our level of stress...thus leaving PMDD women more prone to substance abuse disorders, whether from the differences in our brain chemistry or the issues and situations that arise as a result of our choices and actions...which are also in part dictated by our abnormal brain chemistry.  

Did you get all that? 

The bottom line is it's a vicious cycle, and no matter which way you look at it, PMDD women lose.

Adolescent Abuse

Briefly, studies have shown that women who have been abused in adolescence are more likely to develop PMDD.

Childhood Abuse

A scientific link has been found between women who were abused as children, and women who develop PMDD.  Again, this has to do with the faulty neural pathways developed in times of trauma, affecting the "fight or flight" response in the brain.

Physical Abuse

Physical abuse has the same effect on the brain as trauma. Women in abusive situations are also more prone to anxiety and depression disorders, which adds to the burden on the brain.

Sexual Abuse

Studies have shown sexual abuse to be a precursor to both Major Depressive Disorder and PMDD, no doubt through the connection to trauma.  A link has been established between sexual abuse, PTSD, elevated thyroid ratios and PMDD.

Next up:  Ideas for reducing the amount of stress in your life.

PMDD and the Confrontational Relationship

So...why did I write that last post?  To show that no matter who you are, even if you know what you are dealing with and have the best of intentions, when you have PMDD, you will fail to come through for someone, somewhere, somehow, in some way.  It's inevitable.

My PMDD is part of why I work at home.  I realized long ago I could never work a full time job outside the home.  Going to the same place every day, seeing the same people, and me not being the same from day to day...

They would think I was crazy.  Like I thought I was crazy all those years.  What do you mean, your brain hurts?  You look fine to me.  What do you mean, you just can't cope?  What do you mean, you can't stay awake?  What's the problem?  Why can't you think?  Why can't you stay focused? How could you make such a mistake?  This isn't like you at all, Liana.  What's wrong with you?

I didn't have answers to any of those questions.  So I stuck to low-paying part time jobs to make ends meet.  I could handle being away from home for 3-5 hour shifts most days.

Now I work at home, don't have to deal with anybody if I don't want to, and only work on the good days.  When a bad day comes along, I take time off and pamper myself.  I realize most women do not have the  freedom to do this...however, I created that freedom as a result of understanding my needs regarding PMDD.  I've built my home and work life around my PMDD.

And I still screw up.  Just like I described in my last post.

 

I didn't have a meltdown.  No, my anger is more cold than that.  If I'm having a meltdown, you're safe--the only one in trouble is me.  It's when I get real quiet that you need to watch out.  Because when I get PMDD angry I mean to cut, I mean to wound.  I mean to kill your spirit.

 

I know this behavior is unacceptable, but in my PMDD state of mind, I do not care.  It's fight or flight, reptilian brain, survival of the fittest, and I am going to come out on top of this confrontation, real or manufactured, no matter what.  It's a fight to the death, baby, not because it really is, but because that is what my PMDD brain is telling me.

 

Just like in addiction, when your brain is telling you you'll die if you don't get another hit, fix, drink, or smoke, a PMDD woman's brain is telling her she is under attack and needs to win this one or she will die.  Either that, or it's telling her to flee, which is when your PMDD partner withdraws from the relationship, either physically or mentally/emotionally, and leaves you wondering What the hell just happened?

In the case of withdrawal, she is sinking into a deep depression where nothing matters, nothing at all.  Not you, not your relationship, and sometimes not even her own life.

Whatever the circumstances, be it addiction or PMDD, what your brain is telling you is untrue — but hey, it's your brain sending you these messages, and it's very hard to stand up to your brain.  (Try saying "It's hard to stand up to my brain" sometime and see what kind of looks you get.)  But it is very hard to mentally override the organ that completely runs your body, especially when your emotions are involved.  It's so much easier to simply lash out at the person in front of you instead—blame them for whatever's going wrong in your life. To blame your own brain would mean you were somehow not quite normal.  Defective, even. 

 

I am telling you this now, while I am in my right mind, so that you can see the difference for yourself.   In general I am a sweet, talented, intelligent, compassionate and creative woman.  I have a lot going for me.  I run a successful business, am an award-winning author, and make my own hours.  I am in a long-term relationship with an amazing man.  We get along super well, and being with him is just so...well...easy.  We don't fight...even when my PMDD self is looking for a fight.   He refuses to engage. 

What he does is listen, and speak quietly.

 

You don't need to shout to get someone's attention.  A quiet comment said without malice will do just as well...as long as your partner is willing to work with you on the relationship.  Maybe a code word or phrase between you will do:  I'm feeling fragile today.  It's one of those days.  It's not you, it's my PMDD.

I am dedicated to my relationship.  Devoted to it.  Willing to do what it takes to make it work in good times and in bad.

I am fortunate indeed to have a partner who feels the same.  One who is kind, compassionate, caring, generous, and truly supports me in my goals and ambitions.

And yet I can forget all of that in a heartbeat when my PMDD comes around.  I hope I did come off as selfish and ungrateful in my last post.  A diva, a prima donna, a pampered princess and spoiled brat.  Here I've been given the gift of a trip to Europe for Pete's sake, and I'm incensed about a phone call he didn't make?

Do you see how out of proportion the anger can get?

That doesn't make it right.  I am simply explaining what happens in a PMDD woman's mind.  I'm not saying you have to accept that kind of behavior from her.  There are ways to take the fight out of her with just a few gently spoken words, if she is open to communication about her PMDD.  But anything you say in a judgmental, condemning, or non-approving way will get you the exact opposite of what you want.

 

A PMDD woman knows when she's behaving badly and does not need you to point it out to her in any negative context.  Her negative thoughts are already creating a bonfire in her brain — adding any more will only fuel the fire. She hates herself during this time as much as you hate what she's doing to you and your relationship.

If your relationship feels like it is going nowhere, it could be because of this PMDD loop you're on.

A loop that won't end unless you consciously stop, take a step back, take time out from your heated emotions, research PMDD, find a way to communicate your true feelings to your partner (not your in-the-moment emotion driven ones) and agree to help each other get through this.

What a PMDD woman needs most from her partner when she's feeling ugly and unworthy and unloved is your love and understanding.  She wants and needs your emotional support.  If she doesn't get it, if she doesn't feel safe enough to be vulnerable around you, if she feels even the slightest bit rejected or judged, her fight or flight instinct will kick in, and she will turn on you. The reptilian brain does not distinguish between loved ones or enemies.  It simply fights to win...

Even when there is nothing to fight about.

You know what I'm talking about.  You've been there.  So have I.  None of it makes any sense.  It never has, and maybe never will.

 

PMDD doesn't make sense.  Period.   That's the only thing everyone agrees on.

To those of you still living the nightmare, my heart goes out to you.  I've read your comments and stories and know the daily chaos and confusion you experience.  I was married for sixteen years.  The marriage did not survive the craziness of not knowing or understanding what my PMDD was about.  As a single woman I made seeking and finding treatment options a priority--and have now been blessed with both wisdom and a second chance. 

I want nothing less for you.