What Real Love Looks Like

Since February is the month for relationships, I've linked to a post by fellow author, blogger, and women's health and wellness advocate Tara Mandarano, written about relationships.  It's not PMDD specific, but the wisdom in it applies all the same...  

A real relationship is two flawed people refusing to give up on each other. It's encountering everyday obstacles and unexpected hurdles and finding a way through them together.

It's talking it out when you'd rather give each other the silent treatment. It's listening to the other side of the story when you believe yours is the only valid perspective.

It's holding hands and hugging it out after an argument. It's hanging on for dear life when you go through emotional hell and feel totally beside yourself.

It's finding time for each other at the end of the day, when you're feeling fraught and spent and just want to read a book or scroll through your phone.

It's putting away your phone.

It's not hiding things on your phone.

It's being together in the same room even when you feel galaxies apart. It's building a bridge between hurt feelings and new beginnings even though it's so, so hard.

To read more, please go here.

Tara is also the author of an essay in the newly released BIG: Stories about Life in Plus-Sized Bodies.  

PMDD and Self-Awareness - What Has Your PMDD Taught You?

Today's post is an insightful guest post that describes a journey of self-awareness.  I have long said that self-awareness (and then self-acceptance) is the key to mastering your PMDD. You know yourself better than anyone else does.  Take the time to get to know you, and learn to be your own best friend. Not a moment of that will be wasted, because doing so will bring you many steps closer to wellness.  Get to know who you are on good days and bad days.  Learn to love and accept all of you.  For me, personally, the results were life changing.  I learned to focus on my strengths, and, on days when I could not be anything resembling strong, to focus on my needs. My guest today shares the difference it has made in her life, and in the comments we both hope you will share what you have learned about yourself through your PMDD.

Ladies here is what I have learned about my PMDD, or what PMDD means for me:

1) Low tolerance for fake and false people.

2) Hate lies and lying.

3) Low tolerance for people pleasers.

4) We are super intuitive and creative (could be blocked).

5) Don’t push me or have me multi-task above the pressure I put on myself.

One thing I am grateful for is PMDD has allowed me to get to know all of me, the good, the bad, the ugly. Yes, I am super loving and passionate and I can get super irritated and angry as well especially if I feel sarcasm, slimy, abusive, inauthentic, people pleasing, shifty behavior.  Also, to the ‘super smiley-my life- is-perfect people’ - I don’t buy it one single bit.

I am glad that I know my rage, I know her well.

I know my grief, I get down on my knees and weep.

I know my sexy bad ass, she can be sensual AF.

I don’t want to be around fake people or people pleasers, I will have to mirror that bullshit.

I am not interested in small talk.

I am an extrovert but my introvert demands a lot of alone time and I love her for that!

I need to create and often. If I don’t I get cranky.

I need alone time. If I don’t I become a bitch on wheels.

BOUNDARIES are super important.

Successful relationships are ones that are mutually beneficial and fair. I have stepped away from all the ones where I was giving more.

I follow my turn on. I don’t bother if I am not turned on by a place, a person, an event, a function. If I do go I will just become cranky.

My anger and my bitch are there to protect me to remind me to get back into my body and out of my head. To tell me when I have self-abandoned me in order to please someone else or self-sabotaged me away from my dreams.

Next time I will be kinder to me and not leave me again.

No means NO and does not convert to yes the more you whine or beg. With my kids: I am your mom, I won’t always be popular. Suck it up.

On any request: I will tune into my body and ask Do I want to do that now with this person? (It's okay to say maybe another day).

I need variety. People and places. Sameness bores me.

Nature turns me ON. It’s not a luxury but a necessity!

My body needs to move! OFTEN.

Music makes me FEEL good!!!

I would love to hear what you have learned about yourself on your PMDD journey.

The Voices of PMDD - Don't Wait Until It's Too Late

Day 100. 100 days since I have had my menstrual period. I’m 54 years old and finally heading into menopause. After a lifetime suffering from PMDD you would think this gives me joy, but all I taste are the ashes of my family, my ambitions, and myself. For decades PMDD has taken a monthly flamethrower to them all, and now I can only sift through the embers and mourn.

This disease has done terrible damage to everything that I wanted to be, and the person that I thought I was. Even though my husband understood the illness, my monthly insanity finally broke him and he was in the final stages of leaving me a year ago when leukaemia struck. Now we live together but separate, as I help him through the long dangerous recovery. We get on well enough but the loving intimacy is gone. He can’t tolerate me touching him, even as a comfort. Too late. Too late.

My grown sons love me but despise my behaviour. I’m sure I have ruined trust in women for the youngest one.

I work hard and am mostly appreciated at the office but it’s clear that my regular loss of emotional control has permanently stalled any career advancement.

I was a bright and positive young woman who truly believed I had a shiny place to make for myself and my family in this world, but this disease has made me betray the little girl that I was, the one who believed she was good and would do good things.

So I urge every one of you to fight, fight harder than I did, look for answers and for care that actually works for you whether it’s SSRIs, birth control, supplements, cannabis, diet, exercise, or therapy. Don’t get complacent. Don’t give up. Don’t assume your family can put up with this forever. Don’t wait until it’s too late. Too late is closer than you think.

~Anonymous

The Voices of PMDD: Sharing our Struggles

Today we have a guest post from a woman who has taken what I think is the very healthy step of naming her PMDD.  Naming your PMDD helps to separate you from your disorder.  You are not your PMDD and that is what we all need to remember when PMDD strikes.  We are more than our PMDD, and better than our PMDD.

I call her Agatha. 

Some of you may have met her unknowingly. Her presence is noticed only by my few nearest and dearest...and even most of them don’t understand her. I’ve decided to talk about Agatha because I spend so much time as/with her, I am tired of trying to explain myself, or feel guilty, or desperately sad that things annoy me when they shouldn’t even make a shadow. 

Agatha is my PMDD...or who I am for up to two weeks out of the month. Yes...EVERY month. I have PMDD...Pre-Menstrual Dysphoric Disorder. Have you heard of PMT (or PMS if you’re American)?  Well, PMDD also has to do with the menstrual cycle, but is a million time worse. Maybe a billion...at least. After I have ovulated and the hormone levels change, so do I. I become someone that has taken me years to recognise, and more to understand. I describe it as having the ‘Dementor’s Kiss’; Harry Potter fans will of course understand the reference. For the rest of you, that is when all of the happiness you have ever felt, experienced, or hoped for, is sucked out of your soul, leaving you with no choice except to dwell on every bad thing that has ever happened to you...in the deepest pit of despair. 

I now understand it has got worse the older I get, because I have more experiences. So there’s more happy to be sucked away, and more pain to be left with. PMDD doesn’t just mess with your mind and soul, it likes to play with your body too. Any pre-existing conditions are highlighted and heightened...luckily for me, I have a back condition, so usually I am in considerable extra pain in the lead up to the bleed. I also get a barely-controllable eczema outbreak, and permanent, draining headaches. Then there’s being so tired, that I’m not sure if I’ve been to sleep. And I’m pretty positive that the world tricks me by deciding to speak a different language to me...because I haven’t got a clue how to distinguish between words, let alone decipher what they are saying. It’s all very confusing, and delays cause you to feel very silly; therefore, it’s better not to talk to anyone.

Ah...but wait! Why would anyone want to talk to you anyway? You are nothing, and nobody. Your past experiences have shown you that, right? There’s no hope for you, so stay put and don’t move, because nobody wants you. Your children can’t stand you, you’re so irritable, and their noise hurts your oversensitive ears. They also want you to come out of your dark, safe hole - they want food, they want to talk to you, but they are far too loud for you, and they would be better off without you...right? You’re lucky your back is screwed, and your muscles are aching in every area, because then you can’t drag your unwanted, pathetic self into the road for some juggernaut to put the world out of its misery, fed up of having to have your unworthy ass live in it....no one could possibly want you around, and you should probably top yourself to do them a favour. Everyone you know would have a greater life without you in it. 

The disillusionment of the world eats you up, the unfairness of “the system” has you physically aching for the world to end. You dislike your family, you don’t want to talk to your friends...and there is nothing but pain and despair.

And then one day, I wake up and something feels different. I have a harsh stomach cramp, but that’s nothing compared to the aches and pains of the previous week. I smile at my text messages, and I kiss my husband - it feels nice. Everything feels nice, and everything looks nice. I go to wake my children up with the biggest hugs and talk about upcoming plans for fun things. Oh wow, I also need sex. Like NOW. I want sex ALL the time (see, there is an up side to imbalanced hormones!) my mind and body are depraved instead of in pain. It feels good. And I wake up the next day feeling the same...and so on. I have a wonderful two weeks of coping with everything and having big smiles, and then something happens that will either irritate the crap out of me, or a loud noise hurts my ears, or I wake up and can’t move because of back pain...so I check the calendar - shit, it’s Agatha time. 

I gave the person I become a name, so I can fight myself, tell myself ‘it’s just Agatha, she’ll go soon, just hold on’. This is my most recent tool for the battle - after exhausting diets, exercise, herbal treatments, vitamins, finally giving in to my Doctor and attempting anti-depressants. Nothing works. So it’s me against her.

She’s getting stronger, and I can feel her on her way. I’m not ready, I’m still not over last month’s visit. I want to keep smiling...but no, time to batten down the hatches, because she will be here by the weekend; I will be forced to face every demon I have ever encountered, and I’m scared.

Can’t give up though, I have to keep fighting. I can now differentiate between who I am, and what is caused by her. It’s me against her....

.....c’mon then bitch.

The Voices of PMDD - My Ten Year Struggle With PMDD

A guest post, written by a fellow PMDD blogger.

I was 20 years old when I knew things were not quite right. After suppressing my ovarian cycle for 3 months my symptoms were resolved and it was very clear I had a serious intolerance to my own hormones. I was told this is a complex situation that would disrupt my daily/monthly activities. What did this even mean? I struggled to understand this at such a young age, comparing my life (or lack of it) with my friends and those around me. I didn't even know it was called PMDD at this stage. I struggled to maintain relationships with family/friends, struggled to have a balance of life and each month was very much half lived. There were many dark days, spent alone hiding from the world. 

My GP at the time was completely ignorant to the severity of my symptoms, so much so that I started seeing a walk-in GP who has now become my main GP. He referred me to the PMS Clinic at Chelsea and Westminster Hospital in 2012- finally felt I was speaking with gynaecological doctors who understood and could help. I was excited to be cured and rid of this illness and I couldn't wait to finally start living a normal life. However, I was told there is no easy way to manage this and every case is individual, with a trial and adjusted medication plan. I went through rounds of Zoladex injections (surpressing my periods) and different doses of HRT to try control the PMDD. Zoladex was my saviour, ridding all my symptoms. The HRT gave me many side effects, but nothing was as bad as the PMDD. The doses of HRT had to be constantly adjusted, side effects become more unbearable and I decided to withdraw from the Zoladex and HRT in December 2013. It took about 8 months for my periods to return. Initially, things didn't seem so bad, but the hormones built up and the PMDD was back. I didn't quite know what to do and I was reluctant to go back on the Zoladex and HRT. I tried several contraceptive pills over a period of months, with no hope of control-august 2016. 

November 2016 to March 2017 was a blur, the PMDD was back. I was in denial, hiding the symptoms, struggling with work, found daily routines a strain and disengaged with activities. I avoided speaking to anyone about as I knew the only hope at this stage was to go back on the Zoladex and try other forms of HRT or I consider a Hysterectomy. I was 29 and couldn't quite understand how I was meant to make such life decisions. The questions of relationships, marriage and kids were always avoided. Eventually the PMDD became so overwhelming, I knew I was in trouble-emotionally I had entered a really dark place and the fear forced me to get help. I remember the walk to see my GP knowing he would take control and get me the help I needed. A couple of weeks later I was back at the PMS Clinic at Chel/West Hospital, on the Zoladex (suppression of my own hormones) and a different form of HRT. I was so anxious about taking this treatment again, but I had no choice. 

So where am I now? Life has been good since April 2017. I turned 30 years old in June 2017. I survived 10 years with PMDD!! I have learnt to appreciate the role of the medication and see how normal, balanced and full of life I can be when PMDD is not in control. Life feels new, exciting, opportunities seem possible and I feel so much love and happiness. I feel alive! I am able to forward plan and make commitments. I have also learnt to trust those around me - my friends have held me up during the most recent bad turn and reminded me of the person that I truly am. I never thought I would have such a strong circle around me and I cannot express how their energy and presence has been my saviour. For the first time in years I have been able to open up about my condition and my worries of the treatment and future. However, I still fear the future, the unknown impacts of the HRT. It is still a fight. I still worry about sharing all this with a man—will he ever accept me? what happens if I am taken off the medication? I want to get married, have kids and be happy. The difficulty lies in trying to achieve all this, whilst dealing with PMDD, taking medication that is variable and if it fails, the decision of having a Hysterectomy. It's a life changing decision, especially when you haven't had your own kids. 

I wrote this account for my fellow PMDD sufferers—you are not alone. The best advice I can give you is to find a GP who listens to you and lean on your friends when you are at your lowest point. Do not allow yourself to be alone. Do not hide or be ashamed. Face the PMDD head on. Those around you will make the decisions for you when you are not able to—trust in them. The other advice I can give you is to live life. Do not self hate. Make the most of the good days, rejoice in experiences, build relationships and laugh. Make the decisions that you need to, that best suit you and your life, so you can find a way of truly loving yourself.

Living with PMDD - Realize, Relief, Repeat

REALIZE, RELIEF, REPEAT
[Living With PMDD]
By: Danni Hanna
When you REALIZE it’s time, it’s already too late
Being engulfed in its flame is always your fate
Depression sets in.. in its bi monthly routine
Next comes the anxiety and the fatigue
Panic attacks make their appearance
And the joys in life make their disappearance
Suicidal thoughts fill your brain
But you know soon enough you’ll be off this train
The train runs on an endless track
Circling, circling, circling back
Exercise, medication, eating right
Won’t help you win this fight
Two weeks free, two weeks trapped
Two separate identities on constant relapse
One identity starving for control
The other is on an easy stroll
Career and relationship changes fill the void of sleepless nights
But freedom is coming into sight
The day of RELIEF has arrived
As per usual, right on time
An exchange of pain occurs in an instant
From mental to physical, it’s always consistent
Anxiety and depression leave your side
Feelings of comfort and amusement fill your mind
Quickly forgetting the two weeks of hell
You become trapped within its spell
You never seek help
Because this is the best you’ve ever felt
Unaware you’re still riding the train
Two weeks pass by and the hormones enter your brain
Once again the exchange has been made
Those joyous feelings briskly fade
So go ahead and take a seat
The journey of this train is about to REPEAT

PMDD: Suddenly it All Makes Sense

Now I know why!

I know why two weeks out of every month I am waiting to feel like myself again. I know why for two weeks I suddenly don’t give a crap about anything I was excited or cared about in the weeks before. I know why I feel contempt for everyone and everything when I recently felt so in love with it all. I know why I suddenly doubt my abilities and talents. I know why I isolate myself on certain days…when I just know I’m not going to be able to accomplish the simplest of tasks without getting irritated or downright angry. I know why I am afraid to schedule anything in advance, lest whatever I have to do falls on a day when I am incapable of behaving reasonably. I know why hateful thoughts become so insistent and pervasive despite the fact that just two weeks ago, I was 100% certain I had finally transcended them all. I know why I can’t stand to be touched, when just last week, I couldn’t get or give enough hugs. I know why I suddenly feel so disconnected from my friends, doubt their friendships, and suddenly want to walk out on my husband.

In my quest to understand, I’ve been given plenty of opinions. I’ve heard some labels, and some I even tried to make fit. But in the end, I knew they didn’t. I knew I wasn’t “bipolar”. I knew I wasn’t “borderline” or “mood disordered” (even though that’s still the involuntary category in which I’m pegged). I knew I wasn’t “just imagining things” either. Nor was it the whole story that I was “just hormonal”. Something inside me had changed in the last couple of years and something was happening throughout my menstrual cycle to make me feel like two completely different people. Only recently, it had gotten much worse.

The Fighting Bell Rings

In one corner: a woman full of radiance and quick to smile. She can be so full of love inside herself to the point of bursting. She is centered and enthusiastic, bright and cheerful, optimistic and strong. She’s not perfect, of course, but she’s so okay with that. She’s on top of her thoughts and more than willing to be alive. She is excited about projects and new ventures…even if they are challenging. Anything seems possible…anything reasonable, that is. (She isn’t about to jump off a building or into traffic.) She believes in an abundant universe and that she has something to offer the world. She enjoys the company of others and lives to laugh, create, and feel gratitude. She would never dream of hurting herself or anyone else. She may have bad days, but she recovers quickly.

In the opposite corner: a bedraggled, wild-haired psycho who has to apply every ounce of her will to not lash out…though she eventually does, usually by imploding on herself or exploding at those closest to her. She is the wily animal who shudders at her own hateful attitude as she mourns the loss of her other self. She is the one who simply CAN’T control anything. She is full of shame for her inability to control herself. After all, hasn’t she learned anything? She cannot forgive or forget. Everything is the end of the world. She stomps to feel she exists, yet the very force of her enraged feelings lifts her off the ground. There is no justice, no joy, no purpose, and no comfort to give or receive. All is bullshit. She isolates to protect herself and others from this “thing” that has overtaken her, but life pokes and prods all the same.

Eckhart Tolle, author of The Power of Now, talks about the pain body in his work which comes close to matching the insane being that shows up in my mirror every month. There’s also this idea in spiritual circles about embracing and integrating the shadow-self. I wholeheartedly agree with the importance of doing that. It’s powerful stuff, but I don’t think it is the whole story for me. Always favoring the holistic over the quick fix, I’ve been exposed to a lot of different teachings in my quest for well-being. But none of them have satisfied this itch under my skin that what I was dealing with wasn’t just some egoist resistance on my part, wasn’t just some weakness in my character, lack of awareness in my being, or deep wounding from childhood . In fact, I have LOADS of awareness and more strength than a lot of people. So, something wasn’t jiving.

Something else is going on. Whatever it is, this pain body feels universal…not personal…yet it attacks in a personal way for sure. It isn’t a permanent state of being but it is one that, when I’m in it, feels like the only state of being I will ever know. Sometimes, it turns on a dime…a cruel word, a task gone wrong, a frustration or irritation that sends ever-widening ripples of tension out into my environment…but, and here’s the key, only at certain times within my cycle.

What I’ve discovered is the term PMDD or Premenstrual Dysphoric Disorder. Though I don’t agree with a lot of the psychological/medical establishment bullshit (excuse my language…but let’s call it what it is) behind it, it has come closer than anything else I’ve ever encountered to explain what’s been happening increasingly so with me since going through a period of intense and prolonged stress.

I feel like I have to start by saying that I’m not interested in excuses for bad behavior. I’m not looking for a convenient explanation for bouts of anger or anxiety or anything else. I’m not trying to protect my identity as a “got my act together--no problems here” person, nor am I holding my shadow aspects in a closet of denial. I’m not interested in using the label of PMDD to explain away or justify crazy-making, just as I’ve never been interested in the label of “depression” to explain away unexamined pain and the absolutely natural waves of ups and downs that society would rather call a disease than a sign of being human in the world in which we live. What interests me about PMDD is that elements of it actually fit and explains myself to myself.  What fascinates me is that there are other women who feel like I do…that it is a real phenomenon to be examined and explored. It is a real phenomenon to be healed.

I’ve joined a couple of online PMDD groups, and what I’m noticing is that a lot of women feel they have no choice but to treat PMDD with very toxic antidepressants and hormone-related treatments that further disturb the delicate balance of the body. Some even decide to remove a part of their bodies, having hysterectomies, and are overjoyed with the results. I know many women get absolutely ill with vomiting. Why is the newly established “disorder” which was recognized in 2013 seem to be increasingly prevalent? I have my own theories circling around my head…the poisoning of our food supply perhaps or our increasing exposure to radiation and toxins. Who knows?

For me, it is mostly a mood challenge though I also get headaches, stomach aches, sleep disturbance, and other physical manifestations. Nothing like vomiting, thankfully. I feel incredibly blessed by and grateful for the management tools I’ve found that are side-effect free and have a great deal of sympathy for those who are buying into the system of big pharma (whose sole interest is to get everyone on their drugs regardless of whether it actually helps or even does more harm than good) and a patriarchal medical system (with a track-record of locking women away for their complaints). We can be products of the system that would call us “mentally disordered” offering us only what they deem as the answer or we can access inner qualities we can cultivate to cope and turn to more natural therapies until we discover what combination works for us. I know what my choice will always be. And that means that sometimes, I choose to live with a very difficult, very challenging state of being with very little outside assistance at my disposal. So be it.

Not just regarding treatment, PMDD is a hot topic of debate. In addition to being controversial in the medical community, there is, as with all conditions, a lot of general ignorance around PMDD. As I mentioned, it’s only been acknowledged since 2013. Right away, people assume it is PMS with a different name or an excuse for why a woman suddenly gets bitchy, tired or crampy. Or they draw other ill-informed conclusions. One woman made the mistake of sharing her condition with her employer to be told they feared she posed a threat to either herself or coworkers at work. I suspect there are people in their employ at far greater risk of flying off the handle, the ones they’d least suspect. Others are told, even by well-meaning friends, that it is all in the head and are told to chill out or get over it or try some quick fix. Clearly, those who don’t experience it are not in a position to offer advice!

Here’s the thing about PMDD. We may think about bludgeoning judgmental, self-righteous ignoramuses who think they know all the answers, but we tend not to act on it. Good thing, because there are plenty of them around.

Just as I have been (unprofessionally) mislabeled before discovering what is known as PMDD, I am sure there are women ascribing their behavior to PMDD when it truly belongs in another camp altogether. Supposedly, 40% of women who seek treatment for PMDD may have either what is known as PME (premenstrual exacerbation) or even an underlying mood disorder such as bipolar. It’s complicated. Of course, the professionals will continue to debate if any of this is real or not, some kind of anti-female rhetoric or not, or whether it is a mental disorder or not. This just muddies the waters, but what’s to be done? Human beings are intricate and unknowable and this “dis-ease” is extremely complicated because there are so many variables! In the meantime, there are those of us who live the spectrum. There are those of us who know.

Speaking of the spectrum…

There is PMS, the catchall that pertains to the mild, acute fluctuations of mood, irritability, fatigue, appetite changes, and cramping that affect 30 to 80% of menstruating women. It may be uncomfortable, but it is not generally debilitating.

There is PME. This is when a condition from which a woman suffers, such as asthma or an eating disorder, is worsened during PMS. So, PMS disappears after one’s period whereas PME symptoms merely improve.

Now there is PMDD which affects 3-9% of menstruating women. (With a female population of over 3 billion on the planet, 3-9% of those with periods is no small number!) With PMDD, the symptoms associated with PMS become debilitating and can include: depression or hopelessness, anxiousness, irritability, low energy, lack of interest, sleep and focus disturbance, loss of control and feelings of overwhelm, and suicidal thoughts. These symptoms tend to intensify as a woman nears her period and finally begin to abate a few days into her period. Women with PMDD generally feel themselves again for 7 – 10 days after their menses before entering the cycle again.

I’m not crazy about another label…another diagnosis…especially one categorized as a depressive disorder which, to me, shows very little understanding of the scope of symptoms different women have. I’m not crazy about listening to “experts” tell me about myself and never have been. What I am interested in is knowing my own truth for myself, suffering less, finding ways to cope and relate, and living as fully as I can. And I want to help other women reeling with this monthly curse and feeling that they are robbed of half of their lives to do the same.

Do I believe in PMDD? Not as boxed-in psychological babble and checklists, certainly. I’ll never see a doctor for it myself. But it is a condition with which I resonate with unquestionable certainty. I’ve charted my cycles. I know when “the shift” is about to occur. I know when it is over. I know it is linked to my cycle. I know the changes I feel are described by other women who think they have PMDD, too. I know the challenges such changes bring and the impact they have on my life. I know my perspective goes out the window. I know some months are worse than others. And I totally relate to the increasing amplification of symptoms as I near my period and that feeling of complete and utter relief when suddenly the sun is shining again a day into it.

Maybe we need another word for it…one not bound up with so much baloney…one immune to the twisted machinations of men who hate women and women who hate themselves. I don’t know. Here’s what I do know: this is my experience. Maybe it won’t be mine in two years. Maybe it wasn’t mine two year ago. But it is mine now. Bravely facing that self and being open about it with others going through the same experience is crucial. There is power in numbers, and we’ll learn more by exploring this together. If nothing else, maybe the diagnosis of PMDD will simply prove to be a means for women to talk about what being alive as a women today is like for them. That itself is a relief.

Liana's note:  The above guest post was written by the blogger Cheekyminx. With her permission, several of her posts about PMDD are featured on this blog. In the meantime, to find out more about her work as a PMDD Advocate, please visit her Facebook page, PMDD Life Support. 

PMDD: Into Me See

The following is a guest post by the blgger 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.

I've said I wanted to write about some of the things that help me to cope with PMDD. Maybe another day. Right now, NOTHING is helping. In fact, everything is just making it worse! I suspect, hell, I know from reading the forums, that this is pretty common. Nothing helps, at least it seems that way, and everything is an irritation. A speck of dust in the wrong place can make me want to jump out the window. Yes, it’s irrational. That’s kind of the point, and I don’t need to be reminded of it…  At least I have some control over a speck of dust.

The reason nothing helps is because nothing makes this chemical shit-storm of body and mind go away. It is still there, demanding attention, making me behave in ways I cannot stand. But there are things that do bring modicums of comfort. I can take a bath. Sitting in the sunshine smelling the grass helps, too. There are also my standbys of yoga and meditation. I would be lost without them, but sometimes, they aren’t enough. Really, they’re never enough…not during PMDD. They just offer a bit of relief and keep me as stable as possible.

The saddest thing may just be that so many of us have to get through this pretty much unsupported and alone. Very few people get it enough to be of help. The fact is, if you don’t have it, you just don’t get it. This includes friends, roommates and partners who, needless to say, have a very hard time of it, and often wind up making everything worse, even if they don’t intend to. Even if it was me on the receiving end of this phenomenon, I don’t know how I would respond. I guess it would depend on my own mental state that day. Sadly, PMDD ruins plenty of relationships.

But one can dream that suddenly, it wasn’t such a horrible thing for others to cope with…

Dream Sequence

I wake up and I can feel the stirring of hormonal reaction inside my body. The good days have passed. Shit! Here we go again. Two weeks until my period when I can think and act straight again and not detest myself for having no control.

In walks my husband with a bouquet of flowers. “Good morning, sunshine!” he says.

“Drop dead.” Shit, I think to myself. Did that just come out? Oh, crap, oh crap, oh crap. I want to enjoy the flowers. They are so beautiful. Please, please, please let me just enjoy the flowers. How did he know how much they would mean to me? And yet, I can’t express it. The only words out of my mouth are “drop dead?” What is wrong with me?

“Honey, I won’t take what you said to mean anything,” he says. “I know what day this is…um…I know any day now I’ll be losing you for a week or two to that whatever it is…but I just want you to know, I’m going to do everything I can to make it easier for you this time.”

Really? I think, heart melting inside while I roll my eyes on the outside thinking of what a damned irritating [insert cuss word] he usually is at this time. How does he intend to do that? Go on vacation for two weeks without me? He would abandon me like that!

I go down to the kitchen expecting crumbs on the cutting board, knowing I’m about to get all wound up, and what’s this? The kitchen has been cleaned! I mean, really cleaned! The floor actually sparkles. It’s a miracle!

“Do you want breakfast?”

“Just leave me alone,” comes out of my mouth while "Yes, please make me your lovely eggs" never leaves my lips.

“I’ll make some eggs. If you don’t want them, you don’t have to eat them. If you do, I’ll leave them here for you.”

Hmm…what’s gotten into him? I start to think paranoid and judgmental thoughts. I just manage to hold back the bitter words that want to exert my independence, “I can make my own eggs!”

“Oh, by the way, I know how much it’s been bothering you that I hadn’t fixed that sink since we moved in two months ago, so guess what?”

What? Another empty promise to fix it…someday…next year? I’m biting my tongue because I KNOW I’m thinking with way too much exaggeration. Words start leaking out…words I KNOW will only do more harm than good…

“I called the plumber. He’ll be here next week when you feel better.”

He… I can’t help but smile. The tension in my body that usually just gets tighter and tighter is starting to untwine. This is all getting to be too much.

“I also tidied my room just so you won’t have to be repeatedly irritated by the disorder in there. I know it affects you and makes things worse. In fact, I’ve decided to take care of everything on this here list that I normally force you to tolerate and remind me of month after month like I’m deaf. I may let things slide at other times, but I realize it just makes things worse once your cycle again. Besides, it really is my responsibility…”

Oh, my God! I just want to cry now. I have to cry. So out it comes. I am sobbing uncontrollably. Great. Now he’ll take it personally and the world falls to shit.

He doesn’t say anything. He gets a pained look on his face…and then, it happens. Another miracle. He takes me by the hand, leads me upstairs, and holds me on the bed while I finish crying. At first, I push him away. I can’t bear to be touched. It actually hurts. But he holds me even tighter. He isn’t trying to get me to stop crying, or offering me Kleenex, or asking me what’s wrong. He’s just there. Strong. Reassuring. And I feel safe for what feels like the first time in my life.

When I stop, I feel stupid. I feel embarrassed. And I push him away. He doesn’t say, “I can never do anything right.” He doesn’t throw up his hands. He doesn’t call me crazy or make me feel worse than I already do. He just says, “Honey, I love you. I’ll give you some time and space. I’ll go get some groceries because I know we are out of bananas and chocolate…and frankly, that scares me right now.”

I want to say, “and we need lettuce” but I can’t get it out my mouth. Why the fuck can’t he remember the fucking lettuce? And then I cry some more, ashamed of my ridiculous thoughts but also, feeling a strange sweetness inside. I think I’ll bake him some cookies.

I know. It’s just a dream. Maybe it is too much to ask. Is it catering and kowtowing? Is it just too utopian? To expect another person to be able to behave this way when faced with judgment, contempt, rage, and the other unpleasantries that consume a woman in PMDD? Is it too much to expect someone not to take such seemingly personal attacks personally? To be able to be in our heads knowing what it is we need or want when it is suddenly impossible for us to just speak it? To be able to set aside their own discomforts with whatever has taken us over to wonder, my God, what is it like for her?

I suppose so. People are people after all. There no such thing as a Stepford Husband.

Then again, maybe this is all it would take to change the patterns and break the cycles. Maybe, PMDD is a dis-ease in consciousness designed to make us learn things we never would have otherwise about ourselves and each other, given the compassion and support to get through it. What are the lessons? If we knew that, we wouldn’t be going through it. Maybe learning them would be the difference between escalation and management.

Or is it just spiritual bullshit to think there are lessons. And even if there are, what if they aren’t being learned?

If nothing else, maybe this little dream illuminates the secret machinations of the very complicated and unsettling PMDD mind.

I hope so.

Postscript: I shared this with my husband who said it helped him understand me better. I told him I wasn’t going to post it because it just felt too exposing. But then, on one of the Facebook forums, I read a post from a young woman who had just had a blowout with her boyfriend. She was so upset, and I could feel the shaking in my own body…  I thought about what my husband said, that this helped him understand. I thought about what he did for me after reading this: fixed the sink, took me grocery shopping, didn’t walk away when I was emotionally over-stimulated but held me instead. He just wants me to be happy. Given a little information, he actually wants to put it into practice. So, I’m getting over my damned self and sharing this now because it just may help someone else.

PMDD, From One Man to Another, Part 2

How do I survive? If I'm doing all of this, what am I doing for me? Well, it's taken a long time but, I've accepted the fact that it's not about me. It's not even about her. It's about the boys. If she's in a state, I trust her to handle it. I deal with the dudes.

WHAT ABOUT ME?

Don't get me wrong. I do things for me. I'm not talking about drinking or smoking or drugs (though my alcohol intake does increase on those PMDD days). For me, it's cooking. Something that has a beginning, middle, end. Something that involves the boys (so they don't bug mommy on the couch or in bed). Something that satisfies us. Something that's controllable by me. Something that's as challenging as I want to make it. Something that allows me to express myself to others. I can immerse myself in the process, pushing the stresses of the day to the side (at least temporarily).

Recently, I've been writing. I write how I'm feeling when she ups and leaves the dinner table or lashes out at me or tries to pick a fight just because she wants to argue. I keep track of the number of days she sleeps downstairs, while I deal with the boys through the night. I write lists (bucket, shopping, chores). I write quotes or words of wisdom and inspiration (to remind myself that I'm not alone...though it often feels like I am.)

My big one, though, is music. No, I don't write it or sing it or perform it. I listen to it. I have my 'mood music' to centre me. And, like her needs during her PMDD spells, what I need varies each time. It could be punk or rap or chillout or metal or classic rock or country...but when it's on, I'm in the zone, in the moment and in the mood. When I'm cooking, there's ALWAYS music on. Again, it shifts with my moods.

I'll say it: PMDD can be a selfish disorder if your partner blames every given frustration or moodiness or anxieties on it. And, trust me, it can go there. She will do what she needs to do for her when she needs to do it. Regardless of your intentions, there's very little you can do. She's been dealing with it, coping with it, handling it well before you entered the picture. She's dealt with it on her own and will continue to do so...ON HER OWN. Get over it. Seriously.

WHAT CAN YOU DO?

For the love of humanity, when she says to leave her alone, LEAVE HER ALONE.

When you're trying to decide what to make for supper, avoid at all costs, asking question after question after question. Stick to one simple question with a yes or no answer. Most likely, she won't eat any food anyway so it doesn't matter what you make!

Please ask her, once, "is there anything you need" or "can I get you anything" or "is there anything I can do?" - but do NOT ask every few minutes.

Be prepared. It's the scout's motto. It's important here, too. Have her comfort foods on hand: perhaps it's a particular chocolate bar (Lindt dark chocolate with hot peppers for my wife) or salty snacks (chips? nachos?) - don't be surprised if they disappear during her moments of deep darkness. Even if you wanted some, you can buy more. Again, this can lead down the road of selfishness but get over it.

This is a disorder requiring frequent, unexpected sacrifice. You're going to need to give up stuff - she may need your attention...ooooooooorrrrrrrr....she may tell you to 'get the f--- out' meaning you need to find somewhere else to be (pub? friend's place? ANYWHERE but home). The nice thing is that, if she's coming out of her state, she'll text you to come home. When you do go home, say very little. Maybe a 'how are you feeling?' but don't you dare overwhelm her with story after story about what you saw, did, or heard. It's not - and never will be - about you during these times.

One more thing. YOU. CAN'T. FIX. HER. Don't try. Don't tell her to 'go for a walk' or ask to go out for dinner or sex. Don't even consider telling her to 'get over it' or 'snap out of it' or tell her that it's nothing. It's everything. It's all consuming and all encompassing. It is a deep, dark hole that she's allowed herself to explore and it's scary as fu--. She doesn't want you down there with her. This is her own hell. You cannot and will not be her tour guide. Trust me. I've had my nuts in a sling one too many times thinking I could be the fixer...like I could be the solution to her problems. It sucks to not be able to solve a problem for her. I love my wife, but not having the tools to fix her hurts like hell. She's stronger than words can express...and it'll make you stronger the moment you accept the fact that you are not her knight in shining armor, rescuing her from a pit of despair.

So what are the solutions? There aren't any. Every month may be a different hell. Every time it rears its ugly head, it may be a different stimulus that exacerbates her anxiety. You can usually predict when the darkness may arise but be prepared for spontaneous combustion.

There are medications (my wife's on Cipralex). Does it help? Yes. Is it a cure? No. Her PMDD still comes...but not as frequently. We're down to ~8-10 days a month now. It lowers sex drive. Decreases appetite (with sporadic bouts of gorging). Ironically, it CAN increase anxiety (!) which, I thought, it was supposed to minimize...but, whatever.

There's therapy. I'm sure there is. We just haven't explored it. Yet.

There's exercise or yoga...something that centers the mind and body. But, dear man, don't suggest she work out while she's in the middle of an episode. You're likely to have a rolled up exercise mat shoved deep inside you through a very tiny orifice. 

Why don't I go out more? Because I never know when the PMDD will kick in or when the depression or anxiety will hit. I never know, going to get groceries, if I'll come home to find her on the floor. I fear leaving her with the boys on 'bad' days because I never know what to expect when I come home - will they be trying to wake her up? will she be locked in her bedroom, sobbing? will she be unleashing her fury on the boys as they wildly chase each other through the house? It's the fear of the unknown.

Don't be surprised if you slip into your own funk after a particular bout of PMDD. It's draining. It's exhausting. You'll be physically, mentally and emotionally wiped. You'll be worrying about her, questioning yourself, wishing you could do more (once you've accepted you can't), wondering if she's ok...it's a whirlwind that is uncontrollable. It keeps you on edge. She may have said something particularly hurtful or mean (just to get you going). That sucks big time. Then, when the dark clouds pass, when she's all kinds of relieved and 'nice again', you may be relieved...but you'll be mentally overwhelmed. You'll want to talk to her...and, perhaps, she'll want to share her thoughts (what you did right, what you did wrong) and that, in itself, further drains you. You don't want to hear all the things you did wrong (or didn't do at all) do you?

It sounds mean or cruel or insensitive but, guys, suck it up. Man up and accept that your wife or partner or lover has PMDD. The more you learn about her & how she handles it the better off your relationship will be. It is an ongoing process, kind of like the Hobbits on their quest for the ring. It's an adventure but one fraught with chaos, insanity, danger and doubt.

What can you do? What can you say? It's easier said than done.

When she's not in a PMDD state, (and, please, don't inundate her with all of these questions at one time!)

~Ask her what you can have on hand for her (salty? sweet? Sex & the City box set?)

~Ask what you can do to help (tell her to be specific in what she wants from you - rub her lower back, check in without saying a word, hand her a cup of tea and walk out, etc)

~Ask her what, specifically, she needs from you (a conversation afterwards? a walk? etc)

 ~If you think medication is needed, tread carefully - choosing a safe time to mention intervention is paramount.

 If asking her to seek treatment is tricky, wait until you mention 'therapy'...that's another whole kettle of fish.

There's more, I'm sure...but if you have any questions, comments, ideas, suggestions, tips or stories to share, please do so...though it may feel like you're alone, know you're not...the fact you're exploring how you can help your partner demonstrates your strength and resolve.

Well done.

The above is a guest post in two parts by Chef Jay, who has decided to help raise PMDD awareness  by starting a blog for men about PMDD.  You can find his original post, and others, here.

PMDD, From One Man to Another, Part 1

What follows is a guest post in two parts by Chef Jay, who has decided to help raise PMDD awareness  by starting a blog for men about PMDD.  You can find his original post, and others, here.

Why am I writing this dissertation on PMDD? Simple. I need to. There aren't many resources out there for guys. There isn't a strong support system - the number of comments I've seen by guys saying "run away" or "get the F out of the relationship" or "she's crazy" are overwhelming, insulting and, at the very least, a disappointing commentary on the state of men.

Living with a wife with PMDD (who's had it most of her life) and growing up with a sister who, looking back, had something along the same lines, I can say the following: It's worse that what's described. Does it need to be said that PMDD is NOT PMS? Duh.

"...symptoms begin 7 to 10 days" - not always. It can hit at a moment's notice. The anxieties can skyrocket in a heartbeat. The moodiness can take over without warning...a sound, a question, proximity to other humans...anything. One moment, she's sitting at the dining room table, the next, she's heading to the basement to burrow into pillows and blankets, watching Downton Abbey (or whichever show makes her feel better).

If your partner, wife, girlfriend, significant other is anything like my wife (who, according to her doctor, is a textbook case for PMDD), hopefully my words might help, enlighten or support you in your relationship. It's not easy. I feel for you. Really. It's hard as hell. You can do this.

Let me say this first (and I'll say it a couple more times before this is through):

YOU ARE NOT ALONE.

Family is key. Hers, Yours...they need to understand what you're going through, why she couldn't make it to Thanksgiving supper or church or your nephew's recital. She probably doesn't want to be around people. Including you. Your life must continue.

But here's the tough part: she will take it out on you. Why? Because she loves you. If she's letting loose her irritations, her tirades, her anger, her frustrations upon you, it means she trusts you. She's let you behind the curtain. But what sucks is that you will be yelled at, loathed, be the focal point of her ire. And, most likely, she won't want to talk about it. She won't want to dwell on it. Once its passed, she's done with it, not wanting to recall the dark place she endured. Why? Because it's over...and, most likely, she won't want to consider how her words or actions (which she may or may not remember expressing) affect you or those around her. It makes matters worse. Or, at least, that's what I've learned. Often, picking fights is an outlet for the tension in her mind and body. My wife says it's because she loves me. It's hard as hell, but don't give into the temptation to engage in an argument when she's PMDD-y. Walk away. Seriously. She will, likely, say things to get you going, get under your skin or piss you off. Walk away. She's only doing it to drag you down. It'll make things so much worse because, likely, she won't recall engaging you in a volatile discussion and you will. And, if you're like me, you'll hold it against her. Remember, dysphoria is 'a state of unease or generalized dissatisfaction with life' - compounded with her anxiety, depression, restlessness, agitation and irritation...it's like a tornado within her body and her words are letting some of the destructive forces out, wrecking you in the process. The tornado knows not what it destroys. Walk away.

Here's the best way my wife described it: She's in a deep, dark hole. There's only one way out and, to get there, she has to go through the darkness. She said, 'when I come out, into the light, it helps if you're there waiting for me...it makes things easier.' - that, for her, for our family, I can do.

We have 2 kids. They're realising (at the ages of 4 & 6) that "mommy doesn't feel very good" rather often. Until medication entered our house, her PMDD symptoms were, on average, 16 out of 30 days. Things are getting better...the boys are well versed in the "don't wake mommy" talk...or "mommy's very tired today" chat...my 4 y/o will come into our bedroom to sleep with me when mommy stays downstairs. As he puts it "I'll sleep with you, daddy, so you don't get sad". 

One thing that's not often identified when discussing symptoms of PMDD is suicidal fantasies. I learned, quickly, that the fantasies are VERY different from tendencies. I was told, "hide the pain pills away from me because that's the way I'd probably do it...less mess for you to clean up". WTF? Nobody prepares you for that mindset.

So...What do I do? How do I cope? What keeps me grounded? Why do I stay in a relationship that, clearly, is emotionally volatile?

First off, the boys. Dude & Lil Dude. I'm there for them. I take them away, keep them occupied, keep them entertained, keep them busy...but I also get their meals, make their lunches, do their laundry, bathe them and put them to bed...and I wake them up, make them breakfast, get them ready for school...it's not an equal division of labor, I know...but it's what needs to be done.

Why do I do all that? Why do I also do the groceries and the laundry and make suppers? Simple. I don't know if it's going to be one of THOSE days. I made a promise to myself that I'd do what I could to start the day off positively and easily for her. I anticipate the worst (it's gotten to the point where I have a 50/50 chance of  being right). I try and do everything I can so her anxiety is lessened. I can't get rid of it...but I can lower it. She calls me a martyr. So be it. I'd rather do that than be one of the guys who, at the first sign of adversity, turns tail and runs.

Next Up:  PMDD  - From One Man to Another, Part 2 - How do I survive?

Great News! PMDD Tied to Sex-Hormone Reactive Genes

Today's guest post welcomes author Eryn Speers' unvarnished reaction to the news that National Institutes of Health (NIH) researchers have discovered molecular mechanisms that may underlie a woman’s susceptibility to disabling irritability, sadness, and anxiety in the days leading up to her menstrual period.  I couldn't have said it better myself, which is why I asked permission to reprint Eryn's original Facebook post here.  

The bottom line is this NIH discovery is good news for us all.  Please be sure to watch the five minute video (link provided) at the end.

I have been through the gambit, had my moments of doubt, and a few good months where I thought I was "free" of PMDD. Chalking it up to stress, or difficult times, only to have it return with a vengeance. In my frustration I began my research again, shaking my head every time I ended up down the same road: eat clean, eliminate sugar and caffeine, get your hormone levels checked, get acupuncture, see a naturopath, try anti-depressants and Cognitive Behavior Theory. The list goes on and on, as we know. What I, myself, have come to realize, is that all this conflicting information just makes it all worse. That's why I am taking this new research as a cue to stop blaming myself, and to stop listening to all the noise and babble about what the "correct" treatment of PMDD is. While it's a good idea for anyone to reduce sugar intake, exercise regularly, and investigate possible food sensitivities - these things will make anyone feel better in general, but to continue to go in circles just adds stress to what is already a stressful situation.

I hope this new research helps others to do the same. Yes, it means we still suffer until they find a way to use the info to come up with a therapy that targets the actual cause of the problem, as opposed to the symptoms. However, at least those of us who are desperate and tired of trying everything to no avail, can try to find some hope in knowing that they are really working on it.

This is a disorder on a cellular level, and I am ready to accept whatever treatments they come up with in order to get my life back. My hope is that those of you who are very anti-pharma will try to trust, for a while, and give yourself a break from feeling that the only one who can correct the problem is you.

This puts so much undo pressure on us, and also nurtures an environment of pessimism and fear. We deserve to feel better! This problem is not caused by us. This is not a matter of poor diet or lifestyle choices, or a hormonal imbalance. All we can do right now is cope as best we can, and we're all doing that.

We're here to support one another, and I feel that we should all encourage one another to stay open to the possibilities as the research advances. Please, I implore you to keep trying new therapies until you are finally free of this awful disease. If you want to take anti-depressants in the meantime because they help, great! If you want to take birth control, or stay 100% natural in your efforts to get through and lessen the severity of your symptoms - also great!

However, please don't let the way this disease makes you feel hopeless and useless allow others to tell you exactly how to approach your own health. Don't let the fear and skepticism of others stop you from trying a drug that has been specifically developed to treat this issue in the future. They ARE working on it.

Please watch the video, and find hope.

Have faith! ~ES

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 - After the Hysterectomy

In my first post, I shared what it was like for us in the trenches with PMDD.  This installment, I want to discuss what happened after my wife's hysterectomy, or how we finally got to life without PMDD.

The decision, I remember, was discussed a handful of times regarding whether my partner should have a hysterectomy. I remember us doing a lot of due diligence on the topic, mostly surrounded around her health. We knew we were at peace with the idea that we would no longer be able to have children—we already had two beautiful, healthy kids and we were truly blessed. The larger conversations centered around "then what?" What are the guarantees? What are the potential complications? What if the surgery doesn't work and what would the domino effect be, knowing she just had her entire reproductive house torn down and she still had PMDD?!

The decision was ultimately hers. She decided it was worth the risk of everything we had discussed, knowing the reward would mean so much more.

She had her surgery. It went well and we were told there would be no major side effects, just 6-8 weeks or physical recovery time. All good, right?

Let's harken back to PMDD and how most of us, even doctors, are learning on the fly. I obviously wasn't prepared for the three months after surgery and how PMDD kept creeping into our lives. It wouldn't go down without a kick in the gut, a roundhouse right to the head, and headlock for good measure. One of the hardest battles lied ahead and I was not any wiser to what the hell it was—again my preparation—or lack of it—didn't matter.

My wife fought for three months after her surgery. It was probably just as hard as when she had PMDD. I remember the emotional strain it took on her—how her body would never be the same. How the same place that had housed our children for almost 10 months was gone. It was an emotional rollercoaster. The fights still existed, the threats of divorce were still present, and it seemed at times as if one of my fears had come true—IT DIDN'T WORK!

As each day went by I was looking for a ray of hope. After she was fully recovered physically (try more like 3 months, not 6-8 weeks) some normalcy started to happen and it felt odd. We were always waiting for the next fight to happen. I was always tracking her episodes on my iPhone, trying to prepare for the next hostile takeover. We went back and forth at times really questioning if the surgery worked 100%.

It was a long road back emotionally for my wife post-surgery. It was harder, and took longer than any of us expected. PMDD gave us one last fight and didn't go down quietly...why should I have expected it to?

For whoever reads this, I leave you with this: It can and will get better. There are options for you and your partner. You don't have to live this way any longer. I know it is easier to run like hell than to stand and fight. I chose to stand and fight when at times I wanted to run far, far away.

I leave you with three points to help get you through it all:

1) Remember why you fell in love with her. It will carry you at times through the muck even though the woman you fell in love with might be a shadow of herself during PMDD.

2) It's okay to feel the way you do, no matter how much you might feel guilty for feeling a certain way. Things will cross your mind during her PMDD episodes that will have you questioning your sanity. You will feel like snapping at times. You will feel like doing irrational things just in the hopes that your wrong behaviors or attitudes are not so much payback for PMDD, but a pathway between staying balanced and losing your mind.

Talk about the way you feel with others even if they might not fully understand it. Just letting it go and letting out a good cry is also therapeutic. Don't hold it in. Find an outlet for yourself too. Your health still matters.

3) Lastly...Don't give up. She needs you still. She is fighting a swarm of demons that she doesn't want around. She doesn't want this any more than you do. [Whichever treatment option(s) you choose] Work towards achieving healthy solutions for both of you. There are solutions out there. Do your homework, reach out to PMDD survivors and their peers, and never, ever give up Hope.

You are stronger than you ever realized, partner, and God wouldn't give you anything you couldn't handle. Call it cliché but it's true. You were built for this for now, but it is not yours or hers to live with forever.

Liana's note: For more information on the basics of PMDD, please read my posts Dealing with PMDD - Advice for Men, and Confusion City.   Also worth reading are Top 20 Tips for Dealing with PMDD, and More Tips for Men Whose Partners Have PMDD.  All four posts are included in my book PMDD: A Handbook for Partners.  For those who prefer to have all this information (and much more!) in one convenient place, it's the book with the blue cover at the top of the sidebar. 

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.