PMDD and Why Me?

Okay, we’ve heard enough stories for a while of what it’s like to have PMDD.We all know what it is by now.  And we know there is not much we can do about it once an episode hits.  The best we can hope for is to ride out the storm.  So a question I’m sure all of us have asked at one point or another is Why Me?

 Well, today I’m going to look into the possibilities I’ve uncovered so far.   First, however, a little background.  When does PMDD happen?  And How does PMDD progress? 

You don’t get it before your first period.  Girls, on average, in part due to the tremendous amount of environmental toxins being dumped into our lives, are now getting their first period at age 12.  Your probability of developing PMDD increases with each hormonal event in your life thereafter: pregnancy, miscarriage, abortion, or birth.  (You do not experience PMDD when you are pregnant, because you are not menstruating.) With each new pregnancy, your chances of developing PMDD increase.  And unless your PMDD is addressed, it will continue to worsen with each hormonal event, and as you age, becoming increasingly difficult through perimenopause, until it stops when you reach menopause.

But don’t start cheering yet…if your PMDD is not addressed before menopause, you run the serious risk of developing Major Depressive Disorder after menopause. 

The average age of menopause is 51. 

So, that means, on average, women have approximately 40 years during which we can develop PMDD.

What causes PMDD?

Nobody knows for sure just yet, but scientists do know it is a biological event that manifests as emotional symptoms.  What does that mean?  It means PMDD is caused by something that happens in your body and shows itself in your moods.  The closest science has come to defining what happens is that whatever happens, happens in concert with your menstrual cycle, and involves your hormones.  The hormones they are looking at the most these days are estrogen and progesterone.  It’s not that you have too much or too little, or maybe not even the balance between them, as this is still being studied, but that something goes awry in your brain when processing these hormonal fluctuations in your body.

That’s right.  Something goes wrong in your brain.  No news to us, right?  We’ve known all along something wasn’t right with our brains, with our thinking processes, during an episode of PMDD.  Why else would we say and do the things we say and do during an episode and not the rest of the month?

But I won’t go into all of that right now.  For now it’s good enough to know there is a biological “something” that happens where our brain does not properly process the fluctuating levels of our reproductive hormones during the second half of our menstrual cycle.  This leads to a disconnect in the brain, like when an extension cord comes apart from a plug, or when your cell phone coverage drops.  The result of this disconnect is a depletion of serotonin in the brain, the neurotransmitter that in part governs our moods, and our ability to be happy. 

This is why we crave carbs.  Carbs increase the level of serotonin in our bodies, and therefore improve our moods.  Problem is, most of us reach for the WRONG kind of carbs.  You know who you are and what you eat.  Not just any carbs will do.  But that’s the subject of another post. 

This is why doctors prescribe anti-depressants.  Certain antidepressants, called SSRI’s, help to increase the level of serotonin in our brains.  Problem is, we’re not low on serotonin all the time, and antidepressants come with a bunch of side effects that can make your symptoms worse.  Plus they don’t work at all for at least 40% of the women who take them.  (So if you’re one of the 40% or more, don’t blame yourself!)

This is why doctors prescribe birth control pills.  Birth control pills keep you from ovulating, which is the main cause of this shift in your hormones that your brain does not process correctly.  But again, this is treating only the symptoms and not the underlying cause, and birth control pills have their own array of side effects -- including death. 

Never mind that some women would rather be dead than suffer from another episode of PMDD.  I, for one, am not interested in taking something that could kill me when there are so many less drastic options to try.

Which brings me to the question of what contributes to PMDD?  Weight, lifestyle habits, including smoking, drinking, drug use, caffeine and sugar consumption, stress, trauma, abuse, and yes, genetics.  We’ll get more into genetics in another post.  For now it’s enough to know that in some cases, you really “can’t” help what happens to you when you’re experiencing an episode of PMDD.  It could be in your genes.

And if it’s in your genes, you’re not going to be able to cure it with a magic pill, be it synthetic or natural.  The best you can hope to do is manage the condition.

So what can you do about your PMDD?

You can address the things that apply to you. I’m not going to touch weight, because there are sooo many factors that go into a woman being overweight that it’s the most difficult of all for us to address.  (That’s a whole other blog post in itself as well, maybe even two or three.)  But yes, you can quit smoking, yes, you can cut down on your drinking, maybe even eliminate it altogether.  Same goes for caffeine -  you can cut out caffeine and not die – not like other options mentioned above.   You can cut back and even eliminate eating sugar.  And please do not make the mistake of thinking sugar substitutes are the answer to the situation.  If you’re determined to go that route, you’d be better off to keep eating sugar.  Raw sugar if you must, but no sugar is the best route of all.  Sugar feeds PMDD, and it also feeds cancer.  So think about it, and do what you can.

If you’re a sedentary soul, you can get more exercise.  Two to three half hour walks a week will do wonders for your PMDD.  45 minutes is even better.  Work your way up to whatever time you can spare.  Really, how can you not spare the time, when your life is at stake? 

Over-exercising is just as bad as not getting enough exercise.  More on why some other time.

Stress – starting to sound like a broken recording here, I know.  The stresses in our lives are as numerous and varied as our PMDD symptoms.  You know yours.  Get rid of them.   Don’t you deserve a better life? 

Rest – get as much as you can, especially during an episode.  Learn how to “Just Say No.”  Start small and work your way up.  And do it gently.  Don’t put it off until it becomes a snarl.

Nutrition – there’s a reason fresh, whole foods are good for you.  They’re packed with the nutrients your body, including your brain, needs to function properly.  You can’t get good nutrition from a box any more.  It just doesn’t happen.  And taking high quality, pharmaceutical grade vitamin supplements (not the cheap ones!) does help, but it doesn’t by a long shot make up for what you can do to make yourself feel better by simply eating foods as close to their natural state as possible.  Vitamins are meant to boost your nutritional balance, not replace what you lost from not eating right and depleting your body’s nutrients when you drink, smoke, and/or take drugs -- even common over the counter drugs. 

So there are a lot of things you can do to make your PMDD better.  Most, however, require time and effort.  It takes time to make good, healthy meals.  It takes time to listen to your body and become aware of what makes you feel better and what makes you feel worse.  It takes time to find the right treatment for your particular symptoms.  It takes time to make time for you, take time out for rest and relaxation, or deal with those messy stresses eating up your life.  It takes time to become comfortable with your emotions.  It takes time to work on your relationships.  It takes time to quit using the crutches you’ve been using to get through your however many years of PMDD.

But think of how many more years you have to go, and how it will only get worse if you don’t do something about it.  Do you want to spend your golden years depressed?

I know I don’t.  And I don’t want you to have to do it, either. 

You didn’t ask for the hand of cards you were dealt.  The best you can do is learn how to play them.  The information is out there. The willpower is inside you.  Are you going to sit around asking Why Me?

Or are you going to come to the table and say, Not Me. Not Today.

One day at a time.  That’s all you need to work with.  One hour at a time, if that’s all you have.  Pick one positive thing mentioned in this post, and do it for yourself, do it today.  Do the same thing tomorrow.  Keep doing it, one day at a time, until you have it down.  Then pick something else, and start the process all over again.  Baby steps are still steps in the right direction.

You can do it.  Because PMDD women are strong.  Super strong.  We have to be, with all that we have to deal with.

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

More Tips For Partners Dealing With PMDD

Last week’s post, while it will go a long way toward stabilizing your relationship with a woman in the throes of a PMDD episode, was barely the tip of the iceberg. So this week I thought I’d continue with some tips and information on how to cope with your partner when she’s feeling her worst.

Once again, most articles I read in researching this post were about how awful it is for the partner, who has to deal with all sorts of aberrant behavior on the part of his or her loved one. In these articles, there doesn’t seem to be much understanding or empathy for the woman actually going through the brain changes over which she has no control.

So the first thing I want to emphasize once again is empathy. Put yourself in her place, and my guess is you’ll discover you wouldn’t want to have a body and brain you have no control over for several days a month. How would you feel if your thoughts—due to a biological disconnect between your brain and your mouth—came out as something else entirely—something actually hurtful to those you love the most? How would you feel if no matter how hard you tried to eat right and/or stay in shape, your body suddenly just wouldn’t cooperate? What if it actually undermined all your best efforts by bringing on intense cravings for things you know you shouldn’t eat, cravings for things that actually make your condition worse?

How would you feel if for up to half of your life, nothing you thought or said or did made sense?

One article I read said women could be touchy—touchy!—about being labeled as a raving lunatic for a few days a month. As if the women involved had no business being so sensitive. Who wants to be called insane? Do you?

It also said very few women will admit they’re affected by PMDD. Again, would you feel comfortable telling people, “Oh, don’t mind me, my mind just goes berserk every now and then?” Would you want the strange looks that come with such a statement, would you want people steering a wide path around you because you just admitted there’s something not quite right about you?

So don’t try to be helpful (or antagonistic) by pointing out her PMDD symptoms. She’s well aware of what she is feeling. Anxious, edgy, jittery, depressed, clumsy, fat, foolish, frightened, sleepy, weepy, ravenous, disorganized, out of control…the list goes on.

Even more important is that you don’t make fun of her for any of the above.

Again, if you knew people were going to ridicule you for something you have no control over, would you openly admit to having such a problem? How can any woman win the admiration and respect of the friends and family she loves and respects in such an antagonistic enviroment?

Your best bet is to save your meant-to-be-funny comments and war stories for your friends, to be shared privately, and simply act like nothing out of the ordinary is happening when the PMDD is in effect. Help to make your partner feel as accepted and normal as possible.

This does not mean you have to accept any kind of behavior she throws at you. Abuse is abuse, whether your partner means it or not. PMDD is an explanation, not an excuse, and you don’t have to accept abusive behavior under any conditions. For more on this, go to last week’s post.

Don’t spring any big surprises on her. Remember she’s doing everything she can just to cope with her everyday life, to stay on an even keel in a body emotionally tilting one way and then the other, just to get through the day without being labeled crazy. Big news, big plans, big surprises can wait for a day when she’s better equipped to handle them.

Besides, you should never trust any big decisions made while she is under the influence of her PMDD. This includes decisions she may come to regarding your relationship. If she says she wants out…do what you can to stay calm, and wait until the storm passes. If when it does she still wants out…then you have a different problem, and one that is beyond the scope of this blog.

Take it easy on social activities. If you felt like a beached whale and couldn’t seem to control what you put in your mouth, would you want to go to a party and spend it stuffing your face at the food table? A food binge can be great fun, if that’s what you want to be doing—if that’s your way of celebrating good times or good news. But if you’re watching your weight—and what woman isn’t at one point or another?—taking her food binge show on the road is the last thing she wants to be doing.

The same goes for her emotional outbursts. It’s hard enough to keep a lid on things at home. Do you really want to put her in a situation where she spends the evening either snarling at your friends and family or weeping at every little misinterpreted comment? Because during a PMDD episode, the PMDD brain will focus on the negative, and even if you didn’t say or mean anything negative at all, even if you compliment your partner, her brain is being flooded with negative thoughts and images, and eventually the dam will burst—putting a huge damper on your evening out.

And then she’ll feel miserable about it. About ruining your plans/evening/event. Whether she did or did not, and whether she admits it or not, she will blame herself for anything that goes wrong during these dark periods of time in her cycle.

So remember to track her symptoms and plan social events to avoid head-to-head conflicts with her PMDD episodes if at all possible. She’ll appreciate you all the more for your understanding.

Be understanding of her cravings. Both men and women seek comfort food when they are feeling miserable. During a PMDD episode, a woman will especially seek carbs. Doing so is a natural way to boost, for instance, the level of serotonin* in her body, and she knows this on a subconscious level. Where it gets confusing is the food and advertisement industries have done their best to convince us certain foods and drinks are healthy when they are not. So while on a very primitive level, your partner is craving something to boost any number of feel-good hormones in her body and make her feel better, what manifests is a desire to eat everything in sight in the hopes of finding that magic solution.

It’s best to have good quality carbs already on hand for when these cravings strike. I find that multi-grain toast with no-added sugar jam (not artificial sweeteners, as they can make PMDD symptoms worse), a bowl of whole or multi-grain cereal with almond or cashew milk, or a bit of good quality dark chocolate does the trick. When we consume large amounts of cheap chocolate candy (or cereal) we are looking for the same effect, but in the wrong place. The added calories from the sugar and fat that come along with the added amount of chocolate needed to reach the same feel-good hormone boost as a good quality piece of chocolate only cause our PMDD symptoms to worsen. They also cause us to gain weight.

But sometimes, the woman’s level of feel-good hormones dips so low that nothing short of a pizza will do. If that’s the case, then go for it guilt free. You might even plan pizza night around her cycle, and see if that improves things.

Take on some of her workload. Whatever you can do to help out, do it with an attitude of love, not resentment. If she asks you to help around the house, do what she asks. If she wants you to run an errand, please do the same. The slightest bit of effort to appreciate what she’s going through will go a long way toward soothing her, and is it really worth the effort to argue over whose turn it is to take out the trash?

It’s true that things that don’t usually bother her will bother her greatly when she’s having an episode. Just keep in mind who your real partner is, and go along with what she says. The sooner you do, the sooner her episode will pass.

That’s right, stress will prolong her episode, so if you want it to end sooner, the best thing you can do is to go along to get along, as long as it’s a reasonable request.

If you’re a mature adult, you know what reasonable and unreasonable is. We don’t need to go into it here.

Treat her like you appreciate her. Every woman loves to be appreciated, no matter what mood she’s in. During an episode of PMDD, with all those negative thoughts running an endless loop inside her head, your partner needs extra special care. Reassurance is always nice, but might not be believed or accepted. Understand that the negative thoughts in her brain are overwhelming the positive ones you’re trying to get across. Be patient. Be persistent. Let her know you care, and you’re there for her if she needs you. She’ll meet you more than half way if she possibly can.

If she doesn’t, it’s because she can’t, or doesn’t understand enough about what’s happening to stop the train of negative thoughts in her mind. It’s not because she doesn’t want to, or doesn’t love you. It’s not about you at all. So remember that, and try not to take the things she says and does personally. In a few days time, the woman you love will return, and when she does, it would be a good time to discuss what may have gone wrong during her most recent episode.

A lot of women will want to forget what happened, pretend it didn’t happen at all, and that’s quite normal, but not the best way to deal with it. Talking it out with your partner when she’s feeling herself is the best way to prevent unwanted behaviors and situations in the future.

The bible says it best : Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres. ~ 1 Corinthians 13

All a woman with PMDD is looking for is the same thing everyone wants—love and acceptance.

The more you accept, the less you’ll have to. What we resist persists. So don’t fight your partner’s PMDD. Go with it, roll with it--and watch the waves grow smaller over time. 

For more information, check out my book, specifically written for partners of women with PMDD. 

*Serotonin is only ONE of several feel-good hormones in our body.  The serotonin-deficiency theory highly touted as the answer to PMDD has never been proven, but has been marketed heavily to women with PMDD.  More on this in another post.

A Summary of What A PMDD Woman Needs to Avoid So Far...

Today I’m going to do a summary of the past few blog posts. I’ve chosen to start with sharing what NOT to do if you want to feel better as opposed to starting with what you CAN do to feel better. Why? Because even if you do the kinds of things which in a perfect world should make anyone feel better--such as eat whole foods, drink plenty of filtered water, exercise, and get plenty of rest—as long as you’re still doing the kinds of things that can make your PMDD worse all your positive efforts won’t matter. At best you’ll be canceling out the good with the bad and will still feel miserable and won’t have any idea why. You only get even more frustrated because your well-intentioned efforts to the good don’t seem to make any difference, and you might want to give up on trying, and then give up on hope.

Never give up hope. Never. This disorder can be managed, and it can be done without surgery or drugs.

You just have to be very careful about the way you live your life. You have to increase your awareness of the world around you, and you have to make conscious choices as to what to accept and what to avoid. If you don’t make your own health and wellbeing a priority, nobody else will, and that’s a fact. That much is true for anyone with any kind of condition. Nobody is going to do the hard work for you. You have to do it for yourself. PMDD is no different from any other disorder in that regard.

Fortunately, a lot of what contributes to overall health and wellbeing—and what detracts from it—is the same no matter what your condition. But in the case of a PMDD woman, since we are extra sensitive to just about everything, we need to be extra careful with what we eat, drink, and ingest.

That said, just a few of the things we need to avoid in order to feel better are listed below:

1. Chlorinated pools
2. Alcohol
3. Caffiene—this includes energy drinks as well as caffeinated coffee, tea, and cocoa
4. Chocolate—with the exception of a small piece of dark chocolate daily
5. Nicotine
6. Refined sweeteners—including sugar, corn syrup, high fructose corn syrup, or any processed sweetener.
7. Sugar-Free Food and Drinks—including Splenda (Sucralose)—(you know what gives Splenda that lovely granulated look that reminds you of sugar? Chlorination!)--Nutrasweet and Equal (Aspertame)
8. Prescription Drugs in General, but especially
9. Anti-Depressants
10. Birth Control Pills, Yaz in particular (see video at the bottom of the page)
and
11. Artificial Hormone Replacement Therapy
(not bio-identical hormone replacement therapy)
12. Over The Counter Drugs in General
13. NSAIDS in particular
14. Processed food—anything containing sugar, corn syrup or high fructose corn syrup in particular
15. Low Fat Everything -- just eat less instead of buying all that low-fat stuff—studies show it doesn’t work to help you lose weight anyway
16. Artificial Anything

This is impossible, you say. I can’t avoid all of that. Fine. Don’t. Keep putting stuff in your body that makes you feel rotten, then going to doctors for drugs that aren’t helping and in fact make you feel even worse. It’s your choice. All I’m here to do is make you aware that you do have other choices. They are hard choices, to be sure, and confusing choices at times, because of all of the conflicting information out there, but you know the truth. Your body tells you the truth every day. It tells you by the way you feel. Your body knows you CAN live without all these substances you’ve come to depend on to get you through your day, and you CAN feel better.

Put it this way:
What do you have to lose by giving up any or all of the things listed above?
What do you have to gain?

Think about it. Awareness is the key. I can’t say that enough. I still drink an occasional diet soda, take the occasional ibuprofen, eat the occasional piece of pie. But I do it knowing what I’m putting into my body, and knowing I will pay for it later. I make that choice consciously and as time goes on, the longer I am away from any of the substances listed above, the worse it makes me feel if I one day decide to have something I know I shouldn’t.

I’m not here to tell you what to do. I’m writing this for the women who don’t even know or realize these things are a problem, and are contributing to their misery. For women who want to understand what’s wrong with them and want to find out things they personally can do to feel better.

Sometimes it’s easier to give up something (like cookies or wine or NSAIDs) than to start something new (like meditation or exercise or taking a daily nap). So pick something to give up, just one thing for now, and let me know how it goes. In time, you’ll be able to pick another, then another. But for now start slow. Doing so gives you a much better chance of success. Too much change at once will only overwhelm you until you feel deprived and cranky and throw up your hands in defeat and frustration. Been there, done that. Who hasn’t?

If you have any questions, please ask them here (in the comments section) or send me an email at info (at) livingwithpmdd.com. I will address your question either privately via email or here in general (no names mentioned) in a future blog. I want to know what you want to know about.

Have a blessed week, and if you do nothing else, simply take a moment to stop be aware of what you reach for in the course of a day.

Even MORE Things A PMDD Woman Needs to Avoid to Feel Better

I really hate to be the continued bearer of bad news, but the list gets longer each day, which for a PMDD woman, can be pretty depressing.

But these posts can also help you to realize that, no, it's not all in your head, and yes, there are tangible things in your environment that are contributing to your PMDD. Things that you DO have some control over. The keys to managing your PMDD are awareness and positive choices, so today I'll address three more things you need to avoid if you want to feel better...in addition to those I wrote about in my previous two posts. (Please scroll down and check them out if you really want to know how to manage your PMDD.)

Processed Food -- I know it’s quick and handy and supposedly does the job of fueling your body, but by eating processed foods are you using the right grade of fuel for optimum health and well being?

NO.

The more naturally we eat, the better. We need to aim for foods that are as close as possible to their natural source. This means fruits, vegetables, nuts, seeds, lean meat protein, fish, eggs, whole grains, and some dairy. The same foods the general population needs to eat to feel better, but they are particularly helpful to a woman suffering from PMDD. Because PMDD women are extra-sensitive to everything we come in contact with, and everything that goes into our bodies.

One note of warning: Beware of the feel-good term whole grain. Read your food labels carefully. Just because the package says whole grain or whole grains on it does not mean what's inside is inherently good for us. Take for example fruit cereal bars, which make sure we know about the fruit and whole grain content in the bar, but neglect to mention the other things they contain, like corn syrup and other sweeteners and all sorts of big-word ingredients that are hard to pronounce.

When in doubt, the rule of thumb is: The fewer the ingredients listed on the package, the better the food inside that package is for you.

Low Fat Everything -- Fat in and of itself is not bad for you. It’s the quantity of fat consumed that can be problematic. Studies show that people who consume low-fat items tend to eat more of those items, which in the end causes them to consume more calories than they would have consumed had they eaten the regular item to start with

If only we’d all slow down, not eat so fast, let the original amount of (healthy) fat in food do its job and make us feel fulfilled.

So if you think you’re saving calories by eating low-fat ice cream or cheese or yogurt or snacks or cookies (not to mention a PMDD woman should avoid as much sugar as possible), think again.

Artificial Sweeteners – This is a biggie, and ranks right up there with low-fat items. Artificial anything is no good for a woman with PMDD, but artificial sweeteners are hell on a woman’s hormone system. You can either take it from me, who’s done the research for you, check out one of my favorite sites for women’s health issues in general, or check out these blogs on written specifically on the toxic effects of:

NutraSweet,
also known as
Aspertame,

and
Splenda

Splenda is also called sucralose, which is made by chlorinating sugar. Chlorine is another substance a PMDD woman needs to be careful to avoid, as it can wreak all kinds of havoc on your hormones, whether you soak in it or ingest it.

Here is one article on Splenda I particularly recommend:

You’ll have to decide how technical you want to get, so here are some more sites to choose from on the dangers of artificial sweeteners:

I’m not telling you what to do. Well, I am if you truly want to feel better, 100% of the time. If you want to feel better only part of the time, keep on drinking those diet sodas and eating those low-fat cookies, and eating those processed cereal bars for breakfast and snacks instead of some healthy oatmeal, or whole grain toast with no-sugar added jam. It’s up to you.

As someone has remarked, if you are what you eat, it seems the average consumer consists mostly of thickener, water, salt, and sugar. ~ Harvey Blatt, 'America's Food' (2008)

You are what you eat. Think about it. It’s not just a quote, or a quaint saying. It’s a warning. And one we’d all do well to take heed of, but those of us who suffer from PMDD especially.

But I never point out a problem without offering a solution as well. Here’s one place to find out exactly what you need to eat to have not only a healthy diet, but balanced hormones, and relief from your PMDD. When the article says eat less fat, it doesn’t mean eat low-fat and no-fat foods. It means just that….curb your intake of high fat foods. Cut down on portions. Don’t substitute fake food for the healthy fat you need.

Nobody says you have to give up all of these substances you have unwittingly incorporated into your diet on the same day, or all at the same time. Try it in stages. This week cut down on your diet soda consumption, next week (or month) try eating a healthier breakfast. Use some stevia to sweeten your food instead of sugar or Splenda. Next time you shop, buy regular cheese instead of low-fat. Try regular yogurt instead of low-fat, no-fat, or that overly sweet fruit on the bottom stuff. Change your refrigerator and your diet over slowly, one item at a time. In a few months, or even weeks, depending on how many changes you make, you’ll notice a substantial difference in the way your cupboards look, and the way you feel.

You are in charge of what you put into your body, and you alone.

Isn’t eating healthier worth feeling better?