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. 

Hello! It’s Not Just PMS. PMS and PMDD Are Not the Same Thing

Let's set the record straight once and for all, shall we? PMS and PMDD are not the same thing.

I remember PMS. I had it as a very young girl and woman. It was signified by the typical energy drop, irritability, cravings, weepiness, bloating and leaden legs that preceded my period. It was a pain in the...well, you know. It made it a challenge to go about life as usual, but I managed, because PMS is manageable. At least, it was for me. I have a huge pain tolerance!

At some point in my life, something switched on...or maybe off. Either way, PMS started to transform into something a lot less friendly. I was markedly becoming an entirely different person for several days before my period, changing back again as soon as the blood flowed. This wasn't about bloating and irritability. This was about marked personality changes characterized by extreme sensitivity to stimulus and anger. Simply put, I couldn't stand to be around people, and I couldn't handle the simplest of frustrations.

Enter peri-menopause. Now at age 48, PMDD has become an even bigger nightmare. With the shifting of my hormones comes a much more unpredictable barrage of cyclic symptoms including anxiety, rapid mood swings, rumination and self-sabotage the likes of which even years of extreme personal development can't help me tackle. Add to the mix suicidal fantasy, full-on rage, and an aversion to my partner with its characteristic withdrawal and silence that is completely destructive. Marked personality changes have become unrecognizable personality! Day-long crying jags have replaced weepiness. And bloating and cramping have morphed into days of constipation, muscle aches, headaches, and other inexplicable weirdness including strings of 12 hour naps! This ain't PMS, folks!

I wonder how many of my well-meaning associates who say they have or had PMDD really know what they are talking about. Did they have those simple cramps, bloating, and mood changes I recall from my youth? Do they think that is PMDD? Do they understand that PMDD is a life-altering, destructive, and altogether demonic monthly possession which leaves one feeling completely effed-up? I have to wonder. Because often, something in the way they say it or look at me or how they live their lives makes me think they don't. The dead give-away is of course, "It went away with exercise and dietary changes" or "You just have to think more positively".

These two female "things," PMS and PMDD, are often lumped together. There is no harm in that, necessarily. The problem arises when everything that is generally known about PMS is transferred to PMDD and an assumption is made that they are in fact the same thing or so closely associated as to be kissing cousins. In actuality, they are entirely different races. And speaking of races, it's a lot easier to run the PMS race, let me tell you. The PMDD race? Honey, it's a never-ending marathon of trials over which a woman has very little control, no matter the extent of her efforts.

Are you suffering from PMS or PMDD? Learning the difference can make a world of difference in understanding yourself and your symptoms. For more information, visit the National Association for PMDD/Gia Allemand Foundation website. 

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

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.  

PMDD Quote of the Week - A Doctor's View

April is PMDD Awareness month.  I can't begin to imagine how much further we would be along the path to health and healing if we only had more doctors like this.  This woman "gets" it.

What is PMDD?

"A reproductive disorder whereby women experience transient physical and emotional changes around the time of their period, PMDD is associated with a level of impairment that is similar to major depressive disorder and poorer quality of life compared with community norms, therefore it should be considered a serious health condition. PMDD can have adverse consequences on a woman's social functioning, relationships, work productivity and healthcare use..."

and

"Treatment generally continues for duration of a woman's reproductive life.  If one considers that a female typically menstruates 300 - 500 times during her lifetime, timely identification and initiation of appropriate treatment may prevent impairment.  This, together with support and TLC from loved ones or spouses, can go a long way in improving the quality of life of PMDD sufferers."

~Dr. Eileen Thomas, a specialist psychiatrist at Akeso Clinic, Milnerton (Cape Town, South Africa)

To read the full article, go here.

As Dr. Thomas so rightfully points out, a female can experience up to 500 menstrual cycles during her lifetime. I also mention this in my books, PMDD and Relationships, and PMDD:  A Handbook for Partners.  Below are a couple of sample excerpts:

Let’s do the math. The average age of female puberty is 12; the average age of menopause is 51. Round that off to 40 years of menstruation. Multiply that by 12; that gives you 480 months of periods if you never have children, less if you do. Let’s go with 450 periods for now. That gives you 900 weeks of pre-menstrual issues. Divide that by 52 weeks per year, and you get 17+ years that a woman can spend in the living hell that is PMDD.

Seventeen years, people!

and 

Seventeen years is a long time to feel and/or be out of control. Seventeen years is also a long time to be on medication, especially medication that studies now show doesn’t work more than half the time.

Listen, nobody knows for sure what causes PMDD. All scientists know is 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/expresses 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 have looked at the most are estrogen, progesterone, and now a metabolite of progesterone, called allopregnanolone.

Some schools of thought are convinced it has something to do with the levels of these hormones in your body, and whether they are in the right balance or not. But you can’t detect PMDD with a blood test, and every estrogen/progesterone blood test I have taken has shown my levels to be perfectly normal, even when I was in the middle of a PMDD episode.

I think the best science has come up with so far is that yes, PMDD does have to do with your hormonal fluctuations, but it’s more that something goes awry in your brain when processing these normal and natural 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, but not during the rest of the month?

As part of PMDD Awareness month, I invite you to share in the comments section below any adverse consequences YOU have experienced in your social functioning, relationships, work productivity and/or healthcare use due to your PMDD.  Share to help make aware!

The Voices of PMDD, A Guest Post by Alice

I have a demon living in my head, and it is a part of me. There are two of me existing in the same space. We share the same face, the same experiences and the same memories, yet one half of me is a rational and pleasant person to be around, and the other is living a crazy, illogical and chaotic existence. 

The sensible and sane version of me feels weak and small, and powerless to resist the overwhelming and destructive demon that can only be caged for 10 days of the month.

I have a fear that builds within me on day 8 of my cycle. I sit and wait for the demon to come crawling into my headspace and start making a mockery of me. The moment I open my eyes of day 10, the paranoia starts rumbling in my solar plexus. It starts as a vibration, then rumbles into a deep thunder roll, before bringing a brain fog down over my eyes. My ears are open, but I cannot hear. My eyes are open, but I am blind. My hands are strong, but my body is weak.  I am aware of this happening to me, but I have been removed from my body and I am watching myself from above. I am screaming at myself to stop, breathe and take heed, but I cannot make myself hear. I begin to live the next two and a half weeks behind a think pane of frosted glass. I see and hear the evil bubbling up in my throat, ready to come blurting out. Some days I can gather my strength and control the demon and suppress it, but others I am overpowered and subdued.

When the demon is released, I feel it creeping out the crown of my head. I feel a cold, slimy gel like substance slide down over my face. My eyes get heavy. The muscles in my face drop, and feel sad. The corners of my mouth droop, and the tone is lost in my neck. My eyelids are heavy and downcast, and my soul retreats. My shoulders slump, and I become a hunched shell of a woman. My breathing slows and my abdomen tenses and flops at the same time. My legs are heavy and my shoes feel like they have lead soles.

Then the anger sets it. The demon steps into my shoes and grows tall. It stretches its limbs and cracks its knuckles ready for battle. It starts to look for a fight. The anger simmers in my chest, using my heart as a power source. I feel it spreading out. A burning rage runs through my veins. A chemical fuelled fire that burns so hot. I am now in the cage. I cannot get free. I watch this demon take over my body. I scream, shout, and destroy everyone and everything around me. I hit myself and slap my face. I scratch myself and tell myself I am stupid, pathetic and don’t deserve to exist. I am evil and utterly disgusting. I hate myself. I am a vile creature, not worthy of love, not worthy of being called a person, not worthy of life. I wish that I had the courage to end it all, but I don’t really want to die. I just want to be free.

I collapse in a heap, exhausted. My life is in tatters around me. I have told my husband to leave and have cried and begged for forgiveness. I want him to touch me and then I want him to hurt me and then I want to be alone.

The next day finally arrives and I am so exhausted I cannot move. The demon is sleeping. For now. I hurt. Every muscle and joint in my body is excruciating. My pelvis is mobile and I can feel each bone grinding. Every step is an effort. I cannot think how I will make it through the day. I force myself out of bed because if I don’t I never will. I feel like my back will split open and my hips will fall out of their sockets.

I am riddled with guilt.  I hate myself and am filled is embarrassment and disgrace. I have humiliated myself and all of those around me by seeking to destroy every relationship that is there to protect me. I have spat in the face of love and kicked it when it was down. I deserve to be in the gutter. I did not deserve to wake up today. Everyone would be better off if I had never opened my eyes again. The demon would be dead. I would be gone from everyone’s life. Their suffering would be over. My pain would end. I no longer have the strength to think about this anymore, so I allow the brain fog to be my shield.

I spend the day trying to apologise, but each time I do it becomes less and less valid and more meaningless. I am a liability. I cannot be relied upon to be stable. I scared my husband, my one true love. I made a mockery of our marriage.

Then the cravings start. I have to have food! I don’t care what food, but it must be now and it must be good. The pain in my stomach is unbearable. It feels like I haven’t eaten for a month. I could cut off my arm and eat it. I need sugar. I need carbs. I need starchy and stodgy food. Give it to me now or I will kill you!

I know I should do the washing up, clean the bathroom, vacuum the house, wash my hair, brush my teeth and change my underwear. But I do not care. I cannot move off the sofa. I will do it another day. I will do it later. Anything but do it now.  I try to overcome this lethargy by writing a list, but I get distracted, I get tired, I get frustrated. I panic. I freeze. I cannot breathe. My heart will explode. I am going to die if I do not hide under the blanket and suck my thumb.

I go to bed. The tears roll down my face. They are warm and soothing. The demon runs over me and claims me for its own. The sobbing is uncontrollable but feels so good. I sleep.

I wait for my period to come. I wait for the release. The flow of blood that drains my anger, drains my anxiety, my despair and my hatred from my body. I am cleansed. I am released from my cage.  The walls of my cage are stripped away as my womb cries with relief. I can breathe fresh air. I can feel the touch of my husband. I can laugh again.

The demon is a hot, fierce animal that lives within me. Only it is me. I am the demon. My greatest fear is that this will always be a part of me. I fear that I will fight this demon until I take my last breath. I fear that it will take away everything that is precious to me and leave me a shadow of the woman I could be. I will not let it win. I cannot let it win. This is not who I was born to be. I can be great, I can be wonderful, I can be beautiful.

I have PMDD, it does not have me. I am beautiful. One day I will believe this.

The Four Seasons of PMDD

I know I mentioned this in my last post as a real treat to find, but I want to spend a little more time on WHY I think the 34-page free PDF called Let's go menstrual! by Miranda Gray is so amazing.  For one, it treats our menstrual cycles as something to be welcomed and honored and worked with, not cursed and concealed and ashamed of. Something that can be used as a positive force in our lives. 

We all know that with PMDD we feel differently on different days.  This booklet shows you in simple, easy to understand terms, how to make the most of your good days, and even how to make the most of your bad days. 

So I encourage you to use this booklet to raise your awareness of the different *seasons* of your monthly cycle, and to tailor your expectations to match what is naturally going on in your body during any one of these four seasons.  In the end you will learn how to better meet your own mental, physical, emotional, and spiritual needs, and doing this will help you to feel good about yourself.   In particular, the author says (and I heartily agree), you will feel more:

Comfortable with (and in) your own body

In control because you know WHY you are feeling the way you do

Confident in your abilities (as long as they are tailored to your moods or seasons)

Empowered to created positive feelings about yourself

Now what PMDD woman couldn't use a little more comfort, control, confidence, and empowerment?  Tell me what woman anywhere couldn't use a few more positive feelings about herself? 

PMDD women in particular need to read the section about the Autumn/Fall of our cycles, the problem-finding (and solving!) portion of our cycle, where the booklet tells us we can feel the need to "clear out our (mental, physical, emotional and spiritual) rubbish, to curl up alone, and to sleep more."

Ms. Gray then tells us the Winter Phase is a time when we tend to reflect on the year (or cycle) just over, daydream about the future, what we want to do in the year ahead, and commit to our new resolutions.  It's a time of rest, relaxation, and meditation, among other things.  I personally use it to curl up in my big cozy chair and catch up on my reading.  

Do not miss the list of suggestions for your Winter Phase, which coincides with the time of your bleeding.

Of course, the Spring and Summer Phases have equally invaluable lists of characteristics and suggestions for maximizing your well-being.  The suggestion I liked best for the Spring Phase, (when we are full of confidence and are our normal, non-PMDD selves) is to "Use your self-confidence to do something different from your usual routine."

That's right, the time to take on something new and unfamiliar is your Spring phase.  But the KEY to success is to only work on that project in your Spring Phase.  Set it aside when Fall and Winter come.  Do not let the innate negative energy and thoughts that those seasons bring to you undo all the positivity you have created in your Spring and Summer seasons.  Both Spring and Summer will come around again (that's the beauty of cycles), and there is no harm in working toward your strengths.

Use your Spring and Summer seasons to discover just what those strengths are.  The booklet even tells us what to watch out for in these highly positive and productive seasons, such as doing too many things at once, or doing too much for others, and ignoring our own needs.

Ms. Gray also tells us that Summer is the best time in our cycles to be sociable and work on relationships.  But also to be wary of wishing we could be this light and cheerful and confident forever.

Then, in the Fall and Winter seasons, we are to (among many other things) focus on NOT BELIEVING the negativity in our minds, and not to try to maintain a Spring or Summer schedule when our body is crying out for some rest and relaxation. 

We need this rest and relaxation to prepare us for the renewal that comes with Spring. 

So, to recap: 

Cycle Days 1-6 are your Winter Phase (rest, relaxation, take care of yourself)

Cycle Days 7-13 constitute Spring (a time of renewal, rebirth, and creative energy)

Cycle Days 14-20 should be your social and sharing Summer phase;  (but is often where the problems begin in PMDD women instead); and

Cycle Days 21-Day 1 (first day of bleeding) is your Autumn/Fall phase (when PMDD strikes the hardest)

For more information, please visit www.optimizedwoman.com.  There is a newsletter you can sign up for, and all sorts of good articles there, on how to increase your awareness of your body and its cycles. 

Holiday Treats for Those with PMDD

Two Christmas treats I've uncovered this month...

The first is the best overall medical write up of PMDD I have ever read, and I do mean ever, starting with the first line where it defines PMDD as "a diagnosis to indicate serious premenstrual distress with associated deterioration." 

What I like about this write up is that it DOES NOT, anywhere, or anyplace, or at any time, refer to PMDD as a "more severe form of PMS," which PMDD most definitely is not.  You can have both PMS and PMDD at the same time, but they are not interchangeable, as so many articles and essays and websites either claim or imply, and they are not the same disorder, with one simply being a more severe version of the other.  The fact that so many PMDD resources say they are only muddies the already murky waters of PMDD, leaving everyone searching for help more confused than ever. 

So...I heartily recommend that you read this emedicine Medscape article and learn the latest about PMDD.  I'm sure there's information here you haven't read before.  And if you have just recently discovered you have PMDD, there is no better place to start your research than with this overview.

The second treat I've uncovered is this delightful free PDF entitled Let's go menstrual! by Miranda Gray. This 34-page PDF is a super easy read that helps us to understand our monthly changes, and provides a great way to enjoy and take pride in (rather than dread and loathe and curse) your menstrual cycle.  Ms. Gray breaks our cycles down to four seasons.  PMDD women would benefit the most from the section entitled The secrets of the Autumn and Winter phases.  

Seriously....this PDF "gets" what it's like for us, provides excellent tips and resources on how to cope, and finds a way to put a positive face on our periods and PMDD.

Couldn't we all use a little positivity going into 2014?

So let's welcome the new year and our new beginnings and successes with these two excellent resources for women with PMDD.

Is the Pill Really the Answer for Your PMDD?

Whether you're taking the Pill for contraception, or for your PMDD, you need to read this book.  If you can't afford the book, then read Holly's blog of the same name.  Make sure you are making an informed choice when you pop that pill in the morning for your PMDD.  

To quote author Laura Werschler, who wrote the foreword for Holly Grigg-Spall's book:

"Sweetening the Pill explores and challenges the ways in which the pill and other drug-based contraceptives damage women’s health, threaten our autonomy and thwart body literacy. What we don’t know about our bodies helps pharmaceutical companies “sell” their contraceptive drugs, and keeps us “addicted” to them... Prescribing the pill, or other forms of hormonal contraception, has become, in the minds of most health-care providers, the “standard of care” for being a girl. It is all too common to subjugate a girl’s menstrual cycle to synthetic hormones that superficially “regulate,” but actually suspend the maturation of her reproductive system. And for many girls, the use of hormonal contraception continues well into their 20s, without awareness of what might be or has been sacrificed."

This sacrifice can include, but is not limited to, your mental and emotional stability, both of which are defining symptoms of your PMDD.

For more information, go here, or here.  Or even here.  Learn about what you are putting into your body.  You will be surprised at how many questions these resources will be able to answer.

What Happened to Me?

For those who are curious, I've written about why I disappeared for a few months earlier this year.  The short version is brain surgery for two aneurysms we discovered by accident.  A longer version can be reached by clicking on my new Personal Stories link.  Thank you again for your prayers and well-wishes.  With your help and continued prayer, my recovery continues...

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.

The Connection Between Menstruation and PMDD

There’s one school of thought regarding PMDD that claims PMDD is not biological in nature at all, but rather a set of fanciful and imaginary symptoms devised by women as a means of expressing our discontent with our lot in life. Mad at your husband? Claim PMDD. Mad that you don’t get paid as much as a man when you’re doing the same work? Claim PMDD. Mad that the evils of the world have been attributed to women by organized religion? Claim PMDD. Feel like it’s unfair that you have to stay home with the kids while your partner gets to go out into the world and make his mark during power lunches, golf games, and beers with the guys? Claim PMDD.

In short, we’re not happy with our designated role in society, and so we have come up with a way to protest this arrangement by behaving badly and (hopefully) getting away with it. Science and medicine have nothing to do with it. There are no biological reasons for behaving the way we do. We’re simply a bunch of disgruntled women who have decided we don’t like the status quo.

So the best way to combat this insurgency is to deem us mentally ill, and classify our behavior as insane. Socially insane, if not legally so. The next step is to get us to buy into the stereotype. To get us to believe we are as crazy as they say we are. I’ve just been over at Facebook on the PMDD pages. The posts are full of women calling themselves crazy bitches and other references to insanity.

You are not insane. Your PMDD is real. It’s a biological condition, caused by a temporary fluctuation in your female hormones that *somehow* creates an imbalance in the chemicals in your brain, which in turn causes a disconnect in your thinking processes. It’s this mysterious *somehow* that nobody in the medical field seems to be able to pinpoint, any more than we know the underlying cause of cancer, or diabetes, or any number of disorders and conditions. Just as with those diseases, we’ve been able to identify many contributing factors, but not the actual cause(s).

Having just this week taken another quick dip into that realm of being disconnected, the memory is fresh in my mind. For the past three days, the weather here has been phenomenal. Perfect. Warm, sunny, splashes of vibrant color breaking out everywhere. It’s spring here, and rebirth and renewal are in the air. How can we help but feel blessed by the natural beauty that surrounds us? The generation of new life, the knowledge that whatever may be happening in our own, small, individual lives, overall, Life goes on, and it is inherently good.

As I sit or walk outside and experience nature blossoming all around me, hear the birds chirping, feel the sun and breeze on my face, see and smell the trees and flowers coming into bloom, I can intellectually understand the wonder and beauty of it all, can mentally acknowledge that Life is indeed beautiful—and it is--but am I feeling the Love?

Not. Why not? Because my brain chemistry has been temporarily altered, due to the fluctuations in my menstrual cycle, and there is a clear and distinct disconnect between my thoughts and my emotions.

Yesterday I wanted to weep. The day before that, I wanted to rage. The day before that, I was too tired to appreciate anything but the chance to take a nap.

This has nothing to do with my designated role in society. This has to do with my brain chemistry, period. I am not wanting to weep over the fact that women don’t get paid as much as men who do the same work. I am not raging at the idea that women have been blamed for all the evils in the world due to the doctrines of organized religion. I am not exhausted from having to take care of the dishes and the laundry and the myriad tasks that comprise taking care of a household and family. In fact, I do these tasks with love, as they bring me great satisfaction, knowing my home and family are lovingly cared for.

While I’m not happy with the societal conditions described above—I’d certainly like to get paid as much as a man in the workforce, and I’m not at all thrilled with the idea that women have been relegated to the status of a less than second class citizen by my faith, or that society in general sees women as either sexual objects or useless, with no in-between--those conditions are ever present every single day of my life. Those are my reality.

Why then, am I not furious, weepy, and/or exhausted every day if I’m so discontented with my lot in life?

You see? The theory that PMDD is just an excuse for women to express their unhappiness with the way things are just doesn’t make sense.

There are some theories that during a woman’s pre-menstrual time the so-called *veil* is lifted and we can see our overall connection to Life more clearly. For a few brief, shining moments, somewhere in the middle of our busy, overscheduled days, or maybe even the middle of our restless nights, we might suddenly see our relationships as they truly are, or discover an important revelation about our finances, our work situations, our living conditions--maybe entertain a thought or two that causes us to consider or reconsider any doubts we might have about our choices or our beliefs…

But it doesn’t cause us to go bat shit insane.

Think about this. It can’t be just your period coming that makes you go over the edge. Periods are a natural, normal part of the cycle of life, of fertility, of renewal.

To send you over the edge, something else has to be going on. Maybe even a lot of something else’s. Maybe even someone standing there, giving you a push.

Hey, it happens. More often than we’d like to admit. But that’s a topic for another day.

Today, we want to try to sort out what your part in all of this is.

So traditionally, the second half of the menstrual cycle is a time of personal insight, intuition, and clarity. This is normal. This is natural. This is the way God intended it to be. There was a time when a woman’s menstrual cycle was revered, respected, and yes, celebrated. A time of rest, reflection, and the potential for great wisdom.

Unfortunately, for us and for society in general, now it’s become nothing more than a curse, an inconvenience, a way for society to deem us as somehow unclean and flawed. Something to be ridiculed, suppressed, and avoided as much as possible.

Why is this, and how did it come to be?

That, too, is a topic for another day, but something we need to be thinking about in the meantime. So please, take some time out this week to think about your period. What it means to you. How it was explained to you, how you think about it, feel about it, handle it, and discuss it—if you even do. Or do you ignore it, pretend it simply isn’t happening?

How can we ignore something so fundamentally crucial to the well being of our bodies? How can we hate it?

PMDD women hate it because our menstrual cycle is what sets off this monthly--sometimes bi-weekly if we’re especially sensitive—chemical imbalance in our brains. The chemical imbalance that causes us to say things we don’t mean, do things we don’t want to (and would never do otherwise), make bad choices and decisions, hurt the people we love the most, and want to hurt ourselves.

But what if we came to understand it better? Came to understand that it’s not really the menstrual cycle—I mean, at least 90% of women who menstruate don’t have PMDD—but rather something unique that happens to PMDD women, in concert with our menstrual cycles.

In other words, don’t kill the messenger.

Just like women have been unfairly blamed for most of what’s wrong in the world by various sources, aren’t we unfairly blaming something normal and natural and an essential part of Life for something that really happens in our brains?

After all, isn’t when your period starts when the PMDD symptoms stop?

So let’s try flipping this idea around and see what happens. Can you just, just for a month or two, try seeing your period coming as something good and positive? Can you start to learn the natural rhythms of your body, and come to realize that your PMDD is just one aspect of a really complicated biological condition? A condition caused by something somewhere out of balance?

Can you start to look for the things in your life that might be out of balance, and allow the natural and normal process of wisdom and clarity to come through as you wait for your period to come? Can you make note of the thoughts that arise, and not act on them in your PMDD state, but set them aside until the PMDD passes and you can deal with your thoughts rationally?

In short, can you learn to be your own best friend? Can you stop beating yourself up for things you can’t control? Can you stop buying into the societal conditioning that women are too emotional and irrational to start with, and you’re just a crazy bitch in the extreme?

Because I think that once you do…once you take a few minutes out to stop and THINK about what you are allowing yourself to believe, about yourself and others, and once you try to view your menstrual cycle in just a slightly different manner, as I’ve suggested here, you might come a little closer to understanding this mysterious chemical imbalance that wreaks so much havoc in your life.

And once you do that, you’ll be able to start sorting out what is your PMDD, and what is not.

And as you begin to start untangling all the different threads that make up your Life, you’ll start to feel better.

Count on it.