The Voices of PMDD - Battling the Darkness

Today's powerful guest post was written by Amanda Van Slyke, Founder and Editor-in-Chief of Flurt Magazine.  For more information, please visit Flurt's Facebook Page.

Every month around this time the darkness swallows me up. It seems to happen in an instant, where I previously felt more creative and fulfilled than I've felt in a long time. Just before the lights go out, I climb mountains of work that I've been trying to reach for weeks. I write essays full of passion and reach out to others for emotional connection. I walk down the street smiling ear to ear, thinking that maybe – hopefully, this time – I've escaped the torture I see others endure online. They post about how they can't do this anymore – about how it happens every month, and every month like clockwork it's the same thing – feelings of hopelessness, loneliness and isolation. But I am happy. I eat well and do yoga and meditate and run – everything you're supposed to do to get rid of the darkness. I think that if only people did what I did, they'd feel just as great as I do. I am the exception to the rule.

When I was younger, I came to a point where I'd felt like I had already died. I was a shell of a person, barely leaving my bed because of the fatigue and depression, stuffing my face with whatever temporarily took away the pain. I barely escaped to the west coast to get away from the darkness before it swallowed me whole – and I saw a lifestyle that could make me feel better. I stopped drinking, stopped eating sugar and dairy and gluten – and I know how you all feel about gluten, but it worked. For the first time in my life, my face cleared up. My bloated belly flattened. When I filled my body with fuel instead of poison, my energy started to come back. My depression started to lift. I could feel the oxygen coming back into my bloodstream. The more I took care of my body, the more I saw God through me – and I was an atheist.

I know that sometimes people take medication – SSRIs mixed with therapeutic conversation – and believe me, I've been on so many pills I considered swallowing them all at once. But pills took away something far deeper than the darkness – they took away my ability to feel your toes tingle and your whole body remember what spirituality feels like. And for me, I'm not willing to give up my God – the one that speaks to me through my own moans and screams. To me, feeling that numbness inside me might as well as be the death of me. So I tapered off my medication – well, after I tried to go cold turkey, and my boyfriend almost broke up with me. When I finally felt I was myself again – the one I had been searching for and didn't know could exist – I wanted everyone to know about the revolution.

And the revolution came in a plant based crusade. I felt like I had finally found a cure for the darkness. I went two years without eating meat, and I was so skinny my panties fell to the floor. But I still said that I was part of the movement. I shared photos of my recipes online, and talked about how well I was doing. But away from the limelight my diet fluctuated just as much as much as my mood. Just like I'd tapered off my medication, I tapered off fuel for my body, replacing it with poison – processed foods that were easy, thinking that just a little bit of junk food would make the pain go away. Because the pain never did, regardless of what I was eating. If I gave in and reached for the poison, it would spread throughout my body and the pain would inflate my belly and the lights would go out. And then I would say, "Screw it," like the people online that I thought just needed to be more like me.

I know now the darkness is inevitable. I know I need to do my best to choose the light – and that I won't choose it every day, nor will anyone else – even the gurus on Instagram who post photos of food I don't have the money to make. Because the darkness isn't a place where you only go when you're weak. Diet and exercise and medication is for the privileged – and I'm privileged enough – but sometimes I don't have much money for food or the will to leave my apartment, so I reach for something I know will be easy but harder in the long run. And then I spiral down – feeling hopeless, lonely, and isolated – where my only friend is the poison that I know will kill me. Because people die from this.

The darkness leaves you feeling like there's a hole where your heart should be – where you try to fill it with things to make the pain subside. Junk food, alcohol, sex, and drugs. But the real misery comes when you realize these things are never going to be enough. It comes from the knowledge that only finding self love can fill that hole – and trying to love yourself is hard when you never did. Once you see it's just you and the darkness, you can either stay up til morning or go to sleep. And while it's easy to say some are weak for not fighting, I don't blame them.

Because right now, I am unhappy. I walk around my apartment with swollen eyes, moping about how I'm just like everyone else, posting online about how I can't do this anymore, about how it happens every month, and every month like clockwork the darkness returns. But I know that soon the light will appear – so for today, I eat well, do yoga, meditate and run. I know it isn't a “cure,” but I know the more I take care of my body the more I'll see God through me. And maybe she can give me strength so I can see the light another day and remember what it's like to be happy – to smile ear to ear, thinking that maybe – hopefully, this time – I've escaped the darkness.

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.

PMDD, Prostaglandins, Pain, and YOU

How do our bodies experience pain?  Through chemical messenger hormones called prostaglandins that exist throughout the body (but do not physically move around in the body—despite being called messenger hormones).  Prostaglandins pass messages of pain to the brain.  Basically, they take care of their own little backyards, and do their work, good or bad, without straying too far from the cells that created them.  

So...If you could find a way to cut these "chemical messengers of pain" off at the pass, your brain would not register your pain. 

Sounds simple, right?  It is.

Even better, if you can keep your prostaglandin production in positive balance, there won't be any menstrual pain messages for your body to send. 

First, some important background:  Just like with cholesterol, there are two main types of prostaglandins in our bodies.  (Actually, there are three, but let's keep it simple.)  And just like with cholesterol, there are good and bad prostaglandins.  Sort of like Dr. Jekyll and Mr. Hyde, a reference every woman with PMDD understands.

The short version is:  Series 1 (and 3) are the Good Guys, Series 2 are the Bad Guys. 

The Bad Guys are also called antagonistic prostaglandins.  Think of it this way: They antagonize your body, making it, and you, feel uncomfortable. 

Antagonistic prostaglandins are made from a fatty acid that comes from ANIMAL products.  We're talking meat and dairy here.  These bad-for-you prostaglandins can also be found in corn oil, soybean oil, and other light vegetable oils.  (At least one of which is in most, if not all, processed baked goods.  I point this out, because PMDD women tend to flock to baked goods (aka carbs) when having an episode.)

So what are these prostaglandins anyway, and why do we need them?

Have you ever touched a hot pan?  It's prostaglandins that let you feel that pain.  Have you ever burnt or cut yourself and then stared at your hand for a split second, knowing you did something painful, but it hasn't kicked in yet?  And then it does...like wildfire?? 

That's your prostaglandins rushing to the rescue, while telling your brain to make sure you move away from the danger, and starting clotting procedures to save the burnt/cut/bruised part of your body.

This is a good thing.  Something we all need for survival.

Prostaglandins are a subset of a larger family of substances called eicosanoids.  Eicosanoids are hormones that help with regulating different body processes.  As a side note, eicosanoids are found in chocolate.  Could this be why we reach for chocolate to dim our pain?  Is it possible that in craving chocolate, we subconsciously seek a way to create some good prostaglandins?

Prostaglandins help with many things, such as:

Blood vessel dilation

Muscle contractions

Inhibition and promotion of blood clotting

Regulation of secretions, including digestive hormones

Cell division and growth

Body temperature regulation

Lowering (or raising) blood pressure

Immune system responses

PMDD women are mostly concerned with the first few on the list above.  In addition to those, we need prostaglandins for several more reasons, including ovulation, ending our monthly menstrual cycle, sperm motility and fertility issues, immune system interactions, and uterus contractions in childbirth and when we menstruate.

For instance, there's a normal surge of prostaglandins at the end of your menstrual cycle, which causes your period to come.  And those painful contractions and cramps you get during your period?  The ones that radiate down your legs into your thighs, knees, calves, and even into your feet?  The kind that make you want to vomit, they're so intense?  That's your prostaglandins in action, as well. 

So why do our uterine muscles even have to contract? To help us shed our uterine lining during menstruation.  The problem is, some women release more Series 2 prostaglandins than other women.  These higher levels of Bad Guy prostaglandins create more cramps and PAIN.  And yes, unruly prostaglandins can even cause constipation, diarrhea, and/or a fever at that time of the month. The first two because prostaglandins can affect the muscular movements of your intestines and the third because of prostaglandins' connection to fighting infections and regulating your body temperature.

Tell me something good about prostaglandins, then.

Well, prostaglandins metabolize quickly.  So your body can not store prostaglandins, but instead creates them as needed.

The good news is you DO have a say in what kind are created, Series 1 or Series 2, by your food and nutrition choices.

Since we want the good guys to win, we'll start with the bad.

 Series 2 Prostaglandins (the Bad Guys)

These are produced by trans fatty acids, or trans fats, found in hydrogenated oils, meats, fried foods, junk foods, and dairy products.  There is a special enzyme in our bodies that helps to create Series 1 prostaglandins.  High stress, too much sugar and flour (baked goods) slow this special enzyme down, so that the Series 1 prostaglandins aren't made fast enough, which allows the Bad Guy Series 2 prostaglandins to get the upper hand.

Trans fats are also bad for the structure of your nerve and brain cells, areas in which PMDD women need to be particularly protective.  Trans fats also hamper our ability to create Good Guy Series 1 prostaglandins.

There is much hope though: Series 2 prostaglandins are formed at a slower rate than Series 1 prostaglandins.  So if you eat the right foods and avoid the wrong ones, you can easily tip the scales in your favor and avoid much of your monthly influx of pain and inflammation.

Series 1 Prostaglandins  (Our Heroes)

Series 1 prostaglandins are made from a fatty acid primarily found in fish and fish oils, known as EPA. (The most critical of the Omega-3 essential fatty acids).  This EPA is the ONLY material that our body uses to make the Series 1 prostaglandins that reduce pain and inflammation.  

Our bodies need three types of Omega-3 fatty acids to stay healthy:

ALA - which comes from green plants, and provides the building blocks for EPA

EPA - which comes from marine plants and fish, and provides the building blocks for DHA

and

DHA - which comes from marine algae plankton, fish and mammals, and are especially helpful for maintaining healthy eye and brain tissue (something I am especially delighted to hear).

And here's more good news:  The essential fatty acids found in olive oil and nut oils, while they don't make/create Series 1 prostaglandins, they do block the paths of your Series 2 Bad Guy prostaglandins.

 

Here are some more items you can stock up on to help combat your Bad Guy prostaglandins:

(and I'm not talking about any heat-processed stuff you get off the shelf...be sure to read your labels!)

evening primrose oil

naturally fermented fish oil

flaxseed oil

borage oil

starflower oil

a high quality Vitamin B-complex vitamin (B vitamins are essential for creating Series 1 prostaglandins)

with an extra dose of Vitamin B-6 on the side for your PMDD

Most of these you have heard of before as being beneficial during an episode of PMDD.  Now you know why they have been suggested.  And get this: painful menstrual cramps are not considered to be a symptom of PMDD, but rather PMS.  You can indeed have both PMS and PMDD at the same time.  You can also reduce your symptoms of PMDD until all you have left is PMS.  But cramps?  That's pure PMS.

Other ways to combat Bad Guy Prostaglandins:

Aspirin and other NSAIDs do block prostaglandins produced in inflamed or injured parts of our bodies.  These NSAIDs also act on prostaglandin sites in the central nervous system involved in transmitting messages of pain.  This is why ibuprofen is usually the drug of choice when the cramps begin.   

However:  The enzyme bromelain from the stem of the pineapple has been proven to inhibit the Series 2 prostaglandins and reduce pain at a much higher rate than that provided by painkillers. 

This is great news, especially because of how toxic NSAIDs are to your gastrointestinal tract.  At a minimum, NSAIDs can cause erosion of the stomach lining and ulcers, and at a maximum, death by gastrointestinal bleeding without warning.  PMDD women bleed enough.  God knows we don't need to bleed any more.  NSAIDs can also raise your blood pressure and push you along the path to heart disease, the number one killer of women.  More on NSAIDs in another post.

Why this Prostaglandin and NSAIDs information is important to you, outside of your PMDD

If your body is not in balance, and you have too many Series 2 prostaglandins, you can be susceptible to diseases linked to excessive inflammation (such as heart disease, cancer, diabetes, and Alzheimer's) and/or developing blood clots, which can also lead to strokes and death.  The latter connection is especially dangerous for women taking birth control pills for your PMDD, or HRT for perimenopause.

So, to recap:

Your prostaglandins will do the job they were meant to do.  What type of prostaglandins your body creates is entirely up to you.  The fuel (or fatty acids) your body uses to create prostaglandins (as needed) builds up in your body over time...so you want to make sure you have the right fuel on hand when the time comes.

Series 1 prostaglandins have the opposite effect of Series 2 prostaglandins.  Series 1 prostaglandins reduce inflammation, dilate blood vessels, and inhibit blood clotting.  They help us to recover from injuries by reducing pain, swelling, and redness.  They are part of our natural defenses against infection. 

Series 2 prostaglandins are created in response to trauma or stress, including trauma or stress on the body created by our food and drink choices.  Series 2 prostaglandins supply blood to the traumatized area, which in turn causes inflammation and pain.  On one level this is a necessary protective measure for injury to the body, but on the other, such as when the Series 2 prostaglandins supply more blood to your uterus, swelling it up and aggravating your cramps, this process works against you.  However, if you have more Series 1 prostaglandins in your system than Series 2, your period can be pain free. 

Basically, your cramps are letting you know your prostaglandins are out of balance. 

What, specifically can you do to put things back in balance? 

Well this is the part nobody wants to hear, so if you want to keep on having cramps, stop reading now. 

Otherwise, to cut down on the amount of Series 2 pain-producing prostaglandins only you can create in your body through your food and drink choices...

Avoid these top ten culprits.

1.  Sugar

2.  Wheat

3.  Caffeine

4.  Soy

5.  Alcohol (which also depletes your vitamin B levels)

6.  Dairy products, especially milk and cheese. 

7.  Red meat (plus that steak you so love may well contain growth hormones that include estrogen, another big problem area for women)

8.  Saturated fats and oils - palm oil, butter, margarine, lard, and fried foods (especially when eating out, where you have no idea what kind of oil they used.)

9.  Refined carbs - white bread, pasta, flour, pastry, and cakes. Stick with whole grain breads and pastas, etc.

10.  Food additives and preservatives  -  Virtually anything processed, frozen, and or pre-packaged for your convenience.

You don't have to give these up, but if you don't, the cramps will continue to come. It's that simple.

At least now you will understand what causes cramps, and understand that the key to making your period a lot less painful depends entirely on YOU.  

Preparing Ahead for Your PMDD

Hello and welcome...today we have a fantastic guest post by Renell that was originally posted on Facebook.  I've chosen to add my two cents worth in italics (Sorry! It's the writer/editor in me!) so if it reads like two people are talking here, that's why.  Please feel free to leave any positive suggestions YOU might have for coping with/managing your PMDD in the comments section.  I'm sure we could all use a bit of help in that area.  Thank you for stopping by, and may this help you in preparing for the next time your PMDD comes around...

I now turn the keyboard over to Renell...

Hi, everyone!  I'll get right down to business: In recognizing a common theme in the comments on the Facebook PMDD loops I belong to, I'd like to offer some tips for support I've found helpful in my own therapy. We all know that every single month like clockwork our hormones will wreak havoc and PMDD will rear its ugly head. If you're anything like me, you suffer through it and once the symptoms subside you're so glad to feel normal again that you forget you have PMDD at all.

Or at least we want to forget!  This is one of the places where denial comes in...when the episode is over and we want to just pretend it didn't happen, so we don't have to deal with all the problems we created during the episode.  Unfortunately...

PMDD will remind you it's here to stay once that dreaded ovulation day rolls around yet again. Embracing this disorder means we need to accept its existence in our lives and plan for it.

I like that...embracing this disorder.  Might as well, because it's not going to go away.

Let's try to be proactive rather than reactive to our PMDD. Here are some ways you can plan ahead. These tips are useful whether you choose natural therapy or medication to relieve your symptoms.

1. Mark off the dreaded luteal phase on your calendar for the upcoming month so you know when the PMDD symptoms will likely begin.

2. Plan your activities around these days according to how your mood is likely to accept them. Make sure your partner knows what's going on as well so that he/she can help you with extra support.

3. Do housecleaning or laundry ahead of time. I clean the entire house the week before my luteal phase so that when I am in the PMDD zone I don't have major cleaning to be bothered with. It also helps to relax in a nice clean house.   I love this idea, Renell!

4. If you only take meds during your luteal phase and they take a few days to kick in, consider taking them a few days early so they have already kicked in on the first day of ovulation (Warning: Discuss this with your Dr. if you're not sure that this is okay given the type of meds you are taking)
.
5. If you are highly irritable during your PMDD episodes schedule time to be alone. Sometimes it's hard for us to be around anyone during this time. Don't feel bad for needing this and do whatever you can to carve out time for yourself.  (I added the bold).

6. If you are prone to getting depressed during this time, schedule time to be around supportive friends who can help. No sense in going through this alone. Calling a friend or family member over to simply talk in your sweats or pj's helps quite a bit.

7. Shop ahead. Stock the fridge with healthy foods like leafy greens, fruits and healthy carbs to boost your energy during this phase. You'll crave junk food and if you already have healthy food on hand you'll be less likely to drive through a fast food joint for a greasy salt, sugar, and fat-laden meal that will only make you feel worse.

8. This one is important: Lower your alcohol intake. Again if you're anything like me you'll start guzzling the wine in hopes that it will relieve your anxiety. I don't usually get drunk, just a glass or two at a time. But doing this every night for weeks is not a good thing and the alcohol can actually make our anxiety and depression worse. It can lead to alcohol dependency among other serious health problems. It also is dangerous to mix with many medications that a lot of us are on. I personally recommend that you stay away from alcohol altogether during your luteal phase. It's just not worth it and its effects are deceiving.

She's right, ladies.  Alcohol is a depressant, and when you're already depressed....sure, it makes you feel good and alive and dare I say "normal" for a couple of hours—maybe—but after that, our bodies pay in ways we can't even imagine.  Renell has addressed the obvious, the possibility of alcohol dependency and the danger of mixing your meds with alcohol.  But alcohol can also mess up your blood glucose situation and don't forget....when we're having a PMDD episode every negative thought is magnified many times over, plus...our brain isn't processing information correctly to start with. 
 
So why add alcohol into that mix?

Just think about it the next time you reach for that attempt at self-medication.  Try doing something good for your body instead.  Something you've prepared for ahead of time.

Okay, now it's your turn. What are some DO AHEAD ideas that have helped you plan for your PMDD?

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.