Five Secrets for Surviving PMDD

Sometimes when we’re on the edge, a little dose of truth is all we need to keep from toppling over. Here are 5 secrets that can make surviving PMDD a lot easier.

1. Resistance creates suffering. Yes, PMDD causes unbelievable discomfort and mental agony. But were you aware that when you resist that discomfort and agony, you are actually creating MORE of the same? The human race is quite masterful at wanting things to be different. We’ve gotten quite adept at overanalyzing, strategizing, manipulating, denying, oppressing, and yes, even brooding over what is. But what is, still is. With or without all the energy we expend pushing things away, blaming ourselves or others, and replaying events of the past or imagining disasters in our future, reality is still reality. The trick, and I tell you true, is to use that very same energy you’ve been wasting on what you cannot change and divert it into new channels that actually make you feel better. It’s so flippin’ simple and obvious, and yet doing it takes tremendous energy and refocus.  

2. Build your energy. Okay, so now you know. You’ve got to spend the energy you have differently and also increase your energy enough to be able to break out of old habits. So, you have to identify all the ways you waste or leak energy. It could be through crappy relationships, through poor diet, not getting enough sleep, and the less obvious ways of stuffing emotions, harboring negative thoughts, or denying yourself as a matter of habit everything you truly want in life (by, for example, not even asking for it!). And here’s another tip: the more comfortable you can become with your discomfort, the more energy you will reserve and build. When you want to flee or fight, but there’s no imminent threat, stop. Feel. Breathe, woman! I promise it will pass. 

3. You don’t need to fix yourself. I know. It’s hard to believe. But it is true. You don’t NEED to be any different than you are…no matter what you or anyone else has been telling you. I know PMDD sucks. I know it can turn you from sweet and loving to bitter and hateful in under 3 seconds. But the thing is, neither of those personalities is you. You are a deep and beautiful mystery created by Life, infused by life, and guided by life. Flawless! Next time you get the message that you suck, duck! Let that bullshit ride the airwaves right over your head and out the window. There’s nothing you can do to change what is until Life decides it’s time. And then all you have to do is not resist! So until then, dream a better life but without the underlying judgment that says, “I am not doing enough.” 

4. Let yourself off the hook. The nature of PMDD ensures you’re going to have bad days. Why beat yourself up about them? Why bash yourself with judgments and shame or guilt over what you thought or felt or did? Make reparations if you can, of course. But it is actually a complete waste of energy to chastise yourself for losing your temper or getting depressed again. It is useless to tell yourself to get a grip or get over it. And you certainly wouldn’t appreciate hearing that from someone else, so why do it to yourself? Accept that in every moment, you unquestionably do the best you can. If you could do any better, you would. Allow yourself your mistakes, forgetfulness, reactions… Whatever thoughts or feelings or emotions you experience, they really aren’t personal. They pass and evaporate, eventually. They aren’t YOU. 

5. Stop believing your complaints. PMDD causes sufficient misery to provoke numerous complaints. You’ve earned the right to complain. So if you need to vent, vent! It’s healthy! But that doesn’t mean you have to believe your complaints or use other people like sponges to absorb all of your problems. Whatever you need to express, do it with people who aren’t going to buy into and reinforce the story. But take care you don’t reach out to people who are going to devalue your experience either. What you feel is real. What you believe about it…not so much. It is a delicate balance, and it starts with you. Recognize that sensations arise in consciousness. You will never be able to control them, so don’t waste that precious energy trying so hard. Instead, learn to doubt them. Learn to see them for what they are. You’re not broken, doomed, hopeless, or useless and life hasn’t handed you an impenetrable bum deal. The truth is, life is so much easier than we make it…if we’re willing to let it be.

Liana's note:  The above 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.

PMDD Quote of the Week

~I hate that none of my friends and family really know the demons I battle every month and that all my hard work during my good days barely seems to count because of my bad ones.~

PMDD - When Women Who Don't Have it Do Harm to Those Who Do

April is PMDD Awareness Month.  Last week, I presented a Quote of the Week from a psychiatrist in South Africa who does indeed understand what PMDD is about and the need to treat it.  This week we present the flip side of the coin--the side most of us are unfortunately all too familiar with--in the form of a guest post by fellow blogger Twilah, written in response to a TED Talk in which a woman psychologist proceeds to negate the validity of PMDD by, among other things, dismissing PMDD and its sister disorder PMS as a cultural myth.

Twilah: This TED talk came to my attention because it was posted on a PMDD forum online. Other women complained that the talk seemed invalidating and dismissive of the illness they live with. I tend to agree with the feedback of the women affected by PMDD. This is my analysis.

The speaker, Robyn Stein DeLuca, opens by gauging the audience’s familiarity with the concept of PMS. She establishes that PMS is a familiar concept with easily recognizable symptoms. She goes on to point out that mainstream American media accepts and propagates ideas and assumptions about PMS.

DeLuca then drops her bombshell that after five decades of research the jury is still out on PMS. It’s poorly defined, treatment protocols vary… it may not even be real! She explains how historically the symptoms of the disorder described by psychologists varied so greatly that the very definition of PMS became meaningless! 

She goes on to outline the shabby research techniques and protocols that characterized the presumably five decades of research she referred to earlier. She claims that the DSM “…in 1994…redefined PMS as PMDD, Premenstrual Dysphoric Disorder.”

Actually the DSM didn’t distinctly include PMDD until DSM 5, which was released in 2013. Prior to that, the DSM 4 included PMDD not as a distinct mental illness, but as a “depressive disorder not otherwise specified.” The speaker heralds the clarity established by the diagnostic guidelines offered in DSM 5. She then points out that under the new criteria in DSM 5 the number of women affected by PMDD turns out to be only 3-8%, which she considers “not even a lot of women.”

So DeLuca opens with a claim that five decades of research hasn’t supported the premise that PMS exists. Then she points out how poorly conducted much of that research was. 

Okay…you are using five decades of research that by your own reports doesn’t count for anything to support your premise that PMS is a dangerous and erroneous cultural creation? It’s generally a bad idea to use volumes of poorly conducted research as support for anything. And a mere 3-8% of presumably the world’s female population is affected? If women are slightly less than 50% of the estimated 7 billion humans on this planet, and about 2 billion of these women are menstruating, then 3% of menstruating women translates to roughly 60 million women with PMS/PMDD…whichever she is calling it right now…because she wants to undermine a PMDD diagnosis by conflating it with a cultural concept of PMS!  (Liana speaks up:  I want to say here that PMS and PMDD should never, ever be used interchangeably, as they are two separate conditions, and while PMDD affects 3-8% of menstruating women, PMS is said to affect approximately 80% of menstruating women. That means this woman, aside and apart from the huge disservice she is doing to women who do have PMDD, is also dismissing the monthly experiences of possibly another 1.6 billion women and calling it "good news".) 

Head spins…

She goes on to posit that, “the PMS myth” persists because of cultural limitations on the role of women.

Now I won’t argue for a minute that many cultures, especially the American one to which she is primarily referring, frequently limit the roles of women. Popular conceptions of PMS have been used by sexist people to minimize women’s speech and self-advocacy. That is undeniable. But the irrational interpretations of a sexist culture have zero bearing on whether a medical condition is real. Many well established medical conditions are stigmatized and used to oppress individuals affected by the conditions. Think of any disease that might cause a person to wear a colostomy bag, think leprosy, think any one of legions of mental illnesses. Simply because a culture uses a diagnosis to oppress a person with the diagnosis does not mean there is no validity to the diagnosis. The cultural interpretation of the illness needs to be addressed, the disease doesn’t need to be denied. 

DeLuca’s assertion that PMS is a largely Western concept is irrelevant also (Liana: as well as totally untrue). Lots of women’s health issues are more marginalized in non-Western societies. That has no bearing on their realness or validity. If society at large and physicians in particular choose not to discuss the high infant mortality rate in any country that doesn’t hold women in high regard, that doesn’t mean high infant mortality doesn’t exist in that country. That means it isn’t talked about or researched in that country.

To say that diagnosis and treatment of PMS or PMDD is anti-feminist is more hurtful to 60 million women than much run of the mill sexism. To have other women, who we would hope are our allies, take a stand to deny us diagnosis and treatment for a life threatening condition is morally reprehensible. 

Because that’s what PMDD is. It is a life threatening condition. The 3-8% of women who are affected by this disease experience job loss, relationship difficulties, relationship loss, depression, and potentially suicide. And this woman thinks it is helpful to stand up in a forum like a TED talk and tell people that it’s really no big deal that over 60 million human beings deal with this disease every month? To suggest it is a cultural problem and not a medical problem? She criticizes what she calls “the medicalization of women’s reproductive health.” I criticize the politicization of a medical disorder. I criticize speech that discourages further well conducted research into a life threatening illness.  (Liana:  Up to 30% of women with PMDD regularly experience suicidal ideation or attempt suicide.  15%  those succeed.) 

The root of the problem is not a cultural misperception about PMS. The root of the problem is that an endocrinological disorder is being treated as a mental illness. The problem is that the hormonal health of women is being handed to psychologists and psychiatrists for treatment. Imagine going to a psychiatrist for your diabetes or your hypothyroidism. What do you think the outcome would be? What do you think the data would show? Imagine a man being told to go to therapy instead of being given testosterone supplementation for age related testosterone production changes.  (Liana:  I half agree, but also disagree.  If psychiatrists and psychologists are the only medical professionals attempting to take PMDD on, then I would gladly go to them over accepting no medical help at all.  But I do believe PMDD is more an endocrinological disorder than a mental one.)

DeLuca says that, “…the success of medication in treating PMS symptoms vary from woman to woman.” She uses that as evidence to support the invalidity of a PMS diagnosis. Of course the success rate of using psychiatric drugs to treat a hormonal disorder would have varying rates of success! Considering the efficacy of antidepressants to treat depression is disputed, with estimates ranging all over the place, it’s not surprise the efficacy is unpredictable when you prescribe a psychiatric drug for an endocrine condition. I’m sure you’d find the same kind of inconsistency if you prescribed Prozac for erectile dysfunction. A man just might get an erection because increased serotonin made him happier overall. (Liana:  If the medication doesn't work, that does not mean the condition is not real.  It means the medical options provided are not addressing the medical issue.)

But wait, we’re talking about women.

This presentation is so off base. The problem isn’t that a make believe, culturally based illness is being given credence. The problem is that a hormonally based illness is being investigated by mental health professionals, simply because one aspect of its presentation is similar to recognized mental illnesses. The problem that American society uses the term PMS to dismiss or demean women’s emotional states is a completely separate issue from research and treatment of a disease that may affect more than 60 million women. The problem is that an educated women would stand up in front of an audience of thousands and undermine the health concerns of millions of fellow women.

Let’s not back away from helping women because existing research is incomplete or inconclusive. Let’s fund more and better studies. Let’s take seriously the complaints of millions of women that their health is being affected by their hormones. Let’s listen to women’s voices instead of dismissing them. 

Twilah's blog can be found here.  

Readers Speak Out: Advice for Partners of Women with PMDD

Today I uncovered another gem of wisdom from a reader on how to approach your partner's PMDD.  Rather than leaving it buried in the comments section of another post, I've decided to feature it here:

I just found this blog searching for something to help my husband know what to do with me. I feel better now, but I fear I'll regress and we'll struggle again as a family. I have PMDD. I say DO NOT bring it up when she is at her worst. She is completely irrational and doesn't want to answer stupid questions or talk about how she is feeling. [In that moment] it seems so obvious to her that you should know how she is doing. Don't bring it up on a date or otherwise special time between you two. It is better to ruin a good day or week to get her help, than to keep living like how you are and end up divorced.

First, you need to get your wife medical help. When you have an opportunity to talk—not in public—ask her if she's ever had PMS. She may not have realized her moods are associated with her cycle. You're either going to get a "Yes, dumb***" answer or a "No, not really, I don't think so."

Depending on how that goes, tell her you've done some research, you think her moods might be associated to her cycle, or, if she knows she has PMS, that it might be something more serious. Tell her about PMDD. Read her the symptoms. Ask her if this is how she feels sometimes. Feel bad for her, say you're sorry she has to endure that every month. Let her know there is help available.

I know it sounds insane. I know you shouldn't have to put up with it. I also know how well I'm doing now and wonder how much better last year could have been for my marriage if my husband would have reacted to me differently. If he could have said, "How are you doing? Not well? Let's get you to the doctor," instead of "You're so mean and I don’t have to put up with this." I think I would have felt better. I was already on an antidepressant. It wasn't working.

What I need to feel better is a new prescription and a husband who will back off when I'm irritable and take care of the kids. When I have a bad day, I need him to think, "She's mad, hmm, let's look at the calendar, yep, she's pre-menstrual, I'm going to leave her alone, not mention PMS, and take care of the kids until she feels better."

It might be a few hours, it might be a few days, but it won't be a few weeks like it was last year when he was mad at me for having a bad day; then I felt worse, then there was a fear he'd leave me. I get it, I wanted to leave me, too, but women with PMDD, I'll speak for myself at least, need to feel wanted and loved and worth it to help.

So that is my advice, stranger. Ruin a good day to get her the medical help she needs. Say, "I took next Thursday off work, would you like me to take you to the doctor?" If you have kids, arrange babysitting. It's so hard for moms to find an hour to go to the doctor, especially if she doesn't feel she's worth helping. Even if it's not PMDD she has, make sure she gets bloodwork done. They should be testing her thyroid to make sure there aren't issues there.

Either way, good luck, and from the wife's perspective, thank you husbands who stick it out and deal with us. Some of these marriages seem beyond repair, but husbands can do so much to help. Think of how she is doing and what you can do to help, even if that means just leaving her alone for a bit. She’s not rejecting you. She feels like s***. Unless she comes to you, your touch will be repulsive. It’s not personal, it’s just how she feels. Know that she cannot help how she feels when she is pre-menstrual. For me, I feel angry, tired, sad, and irritable so I am distant to try to protect the ones I love most (from me).

Perhaps your wife [doesn't] care so much if she is mean, but I care. I bet deep down she cares too because she loved you enough to marry you and doesn’t want to be mean to you. You don't have to understand it, you won't ever. You just have to love her through it. Hopefully she's worth it to you.

PMDD and Relationships - Buy with this link and the Gia Allemand Foundation gets a Donation

On sale now for Kindle at Amazon.  Click on the hyperlink below the cover in this post to take you to the link. Ebook versions are available at Smashwords as well.  Also available in print at Amazon.  A donation goes to the Gia Allemand Foundation for every Amazon sale when you sign in to Amazon Smile, and choose the Gia Allemand Foundation as your charity.  Doing so doesn't cost you a penny extra.  In return, you receive more than 220 pages of understanding what it's like to be in a relationship when you have PMDD, and how to make your relationships better.

Use this link for the Gia Allemand Foundation to get a donation

PMDD doesn't do normal, but every woman who lives the monthly nightmare that is Pre-Menstrual Dysphoric Disorder deserves to have strong, true, and lasting relationships, just like her non-PMDD enduring friends.  Based on the most-read posts in the blog Living on a Prayer, Living with PMDD, this book is for people in difficult relationships and focuses on how to deal with a loved one's PMDD.

Written with chapters for both the woman trying to cope with her PMDD, and her partner, PMDD and Relationships fills a need for understanding and hope.  Understanding of this often debilitating disorder that affects 3 - 8% of menstruating women, and hope for a normal life with friends and family.

Topics include how to develop a network of support and encouragement, and how to enjoy deep and abiding relationships in the midst of hormonal chaos.  You are not alone, and there is no reason for you to stay alone unless you choose to.  Even then, PMDD and Relationships can help you to deal with your PMDD and the world around you in a way that brings renewed joy into the life you were meant to live.

PMDD and Relationships

On sale now for Kindle at Amazon.  Click on the cover to take you to the link. Also available in print at Amazon. Over 220 pages of understanding what it's like to be in a relationship when you have PMDD.

PMDD doesn't do normal, but every woman who lives the monthly nightmare that is Pre-Menstrual Dysphoric Disorder deserves to have strong, true, and lasting relationships, just like her non-PMDD enduring friends.  Based on the most-read posts in the blog Living on a Prayer, Living with PMDD, this book is for people in difficult relationships and focuses on how to deal with a loved one's PMDD.

Written with chapters for both the woman trying to cope with her PMDD, and her partner, PMDD and Relationships fills a need for understanding and hope.  Understanding of this often debilitating disorder that affects 3 - 8% of menstruating women, and hope for a normal life with friends and family.

Topics include how to develop a network of support and encouragement, and how to enjoy deep and abiding relationships in the midst of hormonal chaos.  You are not alone, and there is no reason for you to stay alone unless you choose to.  Even then, PMDD and Relationships can help you to deal with your PMDD and the world around you in a way that brings renewed joy into the life you were meant to live.

PMDD Tales from the Front: Hitting Rock Bottom

I have a favor to ask… a gentleman has written to me asking What does rock bottom look like?

His story is in the comments section of my post Dealing with PMDD - Advice for Men.  His wife is in denial about her PMDD, and in other posts I have written that the denial is part of the PMDD, while guest poster Cat Stone added that often you have to hit rock bottom before you seek help.

My rock bottom was in early 2009, when (due to the onset of perimenopause) I realized I was spending more days in PMDD mode than not.  I didn’t like myself, didn’t like who or what I had become (basically a sad, unmotivated recluse) didn’t like feeling so freaking sad for what seemed like all of the time.  I knew I had PMDD, but I was convinced I could beat it with positive thinking and mind over matter alone.

So I went to my doctor in tears, and asked for anti-depressants.  She obliged, but a few days later the PMDD cloud passed, and I put the anti-depressants away (for good), and started my PMDD research in earnest.  The result was this blog, which I started in 2010.

Others, though, have reached a much worse low point before seeking help.

I hadn't alienated friends, family, or co-workers, because I tend to withdraw when an episode hits.  I am also a writer who works at home, so people are used to me disappearing for weeks and months at a time while I work on projects.  So I hit my personal low when I was alone in the house, and it didn't involve any sort of public meltdown.  My tears that day were because I felt like I was admitting to failure...admitting I couldn't handle my PMDD all on my own.

Admitting I had PMDD was never a problem for me.  I was grateful and relieved to learn the nonsense in my head had a name.  It was admitting I couldn't handle it without help that was my personal low.  I wanted to think I was stronger than that.

It turns out that I am.  But I wasn't on that day.

If you would share here when you reached your personal rock bottom, perhaps we can be of some help to this man asking for insight, and, I suspect, for hope …  at least enough hope to allow him to continue to stay in the relationship until his wife accepts that she has PMDD. 

PMDD Wars: Supportive Partners, Women in Denial

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

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

Only she's not interested.

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

Sound familiar?

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

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

You don't do that by:

Playing the blame game

Expecting your partner to change

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

Ignoring your partner's needs

Being abusive to your partner

Denying there is a problem

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

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

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

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

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

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

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

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

He knew what I meant.

He took me home and I went right to bed. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Instead I went to bed. 

Because I know the difference between me and my PMDD.

And because our relationship matters to me.

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

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

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

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

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

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

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

No one does.

PMDD and Denial

So what did I do two weeks ago when I was hit with my latest double header? (And yes, that means I am in the throes of another one now -- right on schedule.) I worked, I wrote, and I slept. (Three hour naps are not unusual when my hormonal system gets so far out of whack.) I just pared my life down to the bare bones, ate take-out from the Whole Foods Co-op or heated up all-natural frozen entrees, focused on my work (I work at home, due in part to my PMDD), and wrote my heart out. Took a walk when I needed a boost in my serotonin level. Took time out for me.

But I didn’t do any of that until I finally admitted that I was having a problem. And so, it got me to thinking. Why was it that I waited so long to admit my PMDD was acting up again? Why was I so deep in denial? Because I had work to do, a schedule to maintain, a life to live. I didn’t have time to give in to some strange, intangible brain disorder that keeps me from getting the things done I wanted to get done. I wanted to be normal.

PMDD women want to be normal more than anything else in the world. We don’t want to admit there’s something going on in our brains that just isn’t quite right. Something that even the medical professionals can’t agree on, much less define. We can find a thousand excuses for why we are so clumsy at times, or so ravenous, or irritable, edgy, disoriented, anxious, or weepy. We deny and deny and deny there is anything wrong with us, or that we are in any way acting strangely, because to admit that we are doing so means we will have to stop and deal with it somehow, and how can you deal with something that defies description?

Somehow we’ve convinced ourselves it’s just easier to ignore the symptoms we can’t explain and plow onward. Because that’s what women do. We just keep going until we can’t go any more. PMDD women are especially strong and stubborn in this regard. We go and go and go until we collapse. Or until our behavior becomes so erratic that someone in our life can’t stand it anymore and says, “What’s wrong with you?”

Even then we deny it. There’s nothing wrong with me. If you’d just pick up your clothes, fix the faucet, turn down the TV, do your homework, call me, stop calling me, show up on time, take the trash out, talk to your parent/child/boss/sibling, move your car, paint the bedroom, fill out the report, do what I ask, everything would be fine. The problem is you, not me. You’re what’s wrong with me.

And off we head into another relationship disaster, be it with our children, parents, co-workers, siblings or partners.

The bottom line is there is something wrong with us. But it’s not something we have any control over, any more than we have control over our allergies, genetic predisposition to any number of diseases, eye color, or shoe size. And it’s not something we can explain, unless we’ve done a whole boatload of research—only to find out it’s different for every woman, because we each live in different circumstances and environments and the biological rhythms of our bodies are unique to each of us. No two women are alike. Some have some symptoms, others have others. They come at different times of the month. Before periods, after periods, some even before and/or after ovulation.

What we do have control over is how we respond to our PMDD. And denial is just not an option. Not if you don’t want to leave a landscape littered with big mistakes, bad decisions, and tattered and broken relationships behind you everywhere you go.

To get a handle on your PMDD, you need to get a handle on yourself. You need to find a way to spend time on you, spend some time with yourself, getting to know your body and your unique hormonal rhythms. You need peace and quiet to do this. You can’t do this in the middle of your latest financial, household, work, school, or family crisis. You also need to like yourself to do this. You need to believe you are worth the time and effort.

Sometimes I feel like I live a totally self-indulgent life. I do what I want to do, go where I want to go, see who I want to see, and generally manage my life so that it encounters the least amount of stress and conflict. No drama queen here. I don’t have time for drama. It only sets off my PMDD, and God knows I don’t want any more experiences with that if I can help it.

So I take care of myself. I eat right, I exercise, I manage my stress. And even then I still get hit with the occasional strong episode of PMDD. But just imagine if I didn’t do all of that. How out of control my life would be. How joyless, how miserable, how sad and self-destructive.

Ignoring your PMDD is like ignoring a train bearing down on you. A wreck is inevitable. Studies have shown that if you leave your PMDD untreated, it will only grow worse over time, and you have a very good chance of ending up with a major depressive disorder. Is this what you want for your life? I know it’s not what I want. I also know that ignoring my PMDD, denying it, doesn’t make me more normal at all. It only makes things worse.

Fortunately, I am surrounded by friends and family who are supportive. I have worked hard to reach that place in my life, and have had to weed out those who were not understanding or supportive of my efforts to acknowledge, understand, and manage my PMDD. I say manage, because there is no cure, despite what many on the internet will tell you.

There are many things you can do to lessen the severity of your symptoms, and most of them are mentioned somewhere in this blog. Most of them are also free, or relatively inexpensive. Which is why you don’t hear a lot about them. The only ones you hear about are the ones people are making money off of. And while some of these methods may work in part, they don’t address the overall problem. Only you can do that, though a careful assessment of your life, priorities, relationships, nutritional needs, and fitness activities. No magic pill is going to do that for you, no matter how hard you might try to convince yourself that it will. PMDD is not a one-size-fits-all disorder. We’ve got to stop treating it like it is. Putting PMDD women on anti-depressants to suppress (not solve) their hormonal imbalances, is like asking every woman to wear a tent dress. It might cover the body, but it’s not a good fit.

That aside, however, the first step is to stop denying we have a problem. Forty years later, I’m still guilty of doing it, even with all that I have learned about the disorder. Is it any wonder those who haven’t done the research I have are equally caught up in denial? And what about those who don’t even know PMDD exists? All they do is run around thinking they’re crazy, but denying it to themselves and everyone else.

You can’t possibly think that to wake up one morning feeling fine, then slowly start to lose your fine motor skills, become agitated and confused, weepy, exhausted, irritable, and ravenous before dinner time is normal. The ability to wash away all of that with 45 minutes of aerobic exercise is also not normal. The fact that doing so buys you a couple of hours of PMDD-free time is not normal. The inevitable sink in mood and energy level when it wears off is also not normal.

But it is what it is, and it’s all we’ve got to work with. PMDD doesn’t do normal. Accept that and just do what you can to get through it. Surround yourself with people who will support you in your efforts toward good health and wellness. Weed out the people and situations in your life that don’t. Take time for yourself, be good to yourself, and most of all, when the episodes come…don’t deny them. Just find your own way to relax and go with the flow—no pun intended J.

The Queen of Denial

She’s baaaack! And I’m not talking about me, writing this blog post. I’m talking about The Alien, or my PMDD self. After several months of relatively mild episodes, suddenly I’m hit with a humdinger. You know from my previous post, A Perfect Storm of PMDD, that I am one of the unfortunate many who have atypical PMDD, in that it occurs both before and after I menstruate. Kind of like a hurricane, with menstruation in the middle, serving as the eye of the storm, where I might feel lousy physically, but I’m clear-headed and things are relatively calm.

So, about ten days ago, I could feel a storm blowing in. I notice I’m starting to get agitated about things that don’t usually faze me. I realize I am emotionally looking for a fight, anywhere I can find it. I check the calendar, confirm it’s about that time of the month, and warn those closest to me that it may be a rocky few days. I back away from conversations and situations I know will set me off, and postpone any important decisions or discussions for a few days.

The storm came and went, no major incidents, other than a couple of afternoon naps due to extreme sleepiness. Menstruation started, and life was good again, aside from the physical discomforts of having a period. Usually, the second half of my PMDD begins on Day 3 of my period. So when Day 3 came and went with no trouble, I thought I was in the clear, home free, another PMDD episode averted. Kudos to me once again for not letting my PMDD get the better of me and wreaking all sorts of havoc in my life and personal relationships.

But this was not my usual period. This one lasted six days instead of three. Not a problem. I’m okay. Life is still good.

But then yesterday morning, I started noticing things. Like I tried to address an envelope, and my handwriting was all jumpy and spiky. My hand couldn’t control the pen the way it usually does. My typing was off, too. Kept hitting the wrong keys.

No matter. I’m just in a hurry.

Then I went to a funeral, at a church I had never been to before. I got lost. Suddenly I’m feeling anxious, confused, and my thoughts are scattered.

No biggie, it can happen to anyone.

At the funeral, all I wanted to do was weep.

Not a problem. People are supposed to be sad at funerals.

I came home, fixed myself something to eat. I work at home (in part due to my PMDD), so I started to work in my sun-drenched living room.

Suddenly I couldn’t keep my eyes open any longer.

Nothing unusual there, I told myself. The room was warm and I had just eaten.

Never mind that the room is equally warm and sunny most days, and I eat lunch every day about the same time and don’t get sleepy.

Finally I give in and take a nap, unable to concentrate or stay awake. It still hasn’t dawned on me, what is happening.

I wake up, totally ravenous, and wanting nothing but CHOCOLATE.

Still haven’t caught on. Or if I have, I’m in denial. I don’t have time for this nonsense. I have work to do.

A friend calls. We’re supposed to meet later on, go to Qigong class together. I want to know how soon “later on” is. Is it 4:30, 5:30, 6:30? If it’s sooner rather than later, I’ll wait to eat with my friend. If it’s later, I’ll eat now. No big deal either way, I just want to know, so I can plan my evening accordingly.

Somehow that simple conversation goes totally awry, and I end up in tears.

Bingo. The Alien has struck again. Now I know what’s going on. My PMDD has returned for round two. My head hurts, my eyes hurt, all I want to do is cry, and go back to sleep. But I’m too agitated and upset to go back to sleep, and I’m so effing hungry I want to scream. But I just ate a full meal a couple of hours ago. There’s no logical reason to be so hungry.

My friend calls back to see if I’m all right. How do I explain that everything is fine…but it’s not? How do I explain PMDD? This isn’t the type of conversation you want to have over the phone. It’s best that the other person can see the glassiness in your eyes, the exhaustion on your face, the lack of energy and slump of your body.

I fix something to eat (healthy carbs!) and work on a small project that only needs minimal concentration for an hour or so.

My friend arrives, and I try to explain what happened. He asks, “What can I do to help?”

The only answer I can come up with is, “Just be nice to me. I’m fragile today. Oh, and you might need to run interference for me at class. I’m not feeling very social right now.”

We go to class, and all goes well. I manage to muddle through the social aspects of class. The Qigong exercises get the blood circulating, produce the necessary boost in endorphins and serotonin. By the end of class, which was the absolute last thing I wanted to go to—I’d much rather have crawled back into bed and tried to sleep away my exhaustion—I was feeling 100% again, and had bought myself a couple of PMDD-free hours.

Because in my PMDD-induced confusion and misery I had forgotten what I could do to help myself. Light aerobic exercise. When I’m in the throes of a PMDD episode, and the last thing I want to do is get up and move, that’s the very thing I need to do. A simple walk is all it takes. After about 30 minutes, I start to feel better. By 45, I’m back on an even keel. An hour of any kind of light cardio activity and all symptoms are gone…

For about two hours.

So by the time I got home, I was back to being myself again. A totally different person. I was able to make it through the rest of the evening without incident.

But as soon as I opened my eyes this morning, I felt that heavy wet blanket of depression closing in on me again. The iron band around my head, the irritated eyes, like I’ve been crying (but I haven’t), the mental fuzziness, the sense of exhaustion even before I get out of bed.

There’s no denying it this time. It’s going to be another PMDD day.

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 her blog, Living on a Prayer, Living with PMDD.  Both books are also an excellent resource for understanding your PMDD and starting a meaningful conversation with loved ones who want to know more about this debilitating disorder we live with daily.