PMDD and Your Brain

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.