Sharing Our Stories of PMDD

Today we have a guest blogger, Joya, who has graciously agreed to share her story of PMDD. I invite others to contact me who would like to share your story of how you discovered you had PMDD, were diagnosed, and what treatments--both successful and unsuccessful--you have tried in an effort to cope with this debilitating disorder. This helps every woman with PMDD to understand that while you are not alone, every case is as individual you are.

Welcome, Joya, and thank you for sharing your story with us.

I was diagnosed about three years ago.

Before I was diagnosed I felt awful & sick. I also thought I was losing my mind. It took a while for me to realize the awful feelings and the craziness were associated with my monthly cycle. I began to dread my cycle, but always looked forward to getting my period because I felt such a relief. There were times when I literally thought I was going insane. And the awful physical symptoms were at times too much to bear. I am grateful for my diagnosis as I have been empowered to find ways to help myself.

I am very fortunate I have a wonderful Doctor who listens to me and I believe he actually cares about my well being.

I have tried the following:

The Pill

Anti-Depressants

Accupuncture

Herbal treatments

Supplements

And I am currently using the Mirena IUD

Side effects & benefits I have experienced:

The pill was not a good choice, I cannot handle the extra estrogen at all. I completely lose it. For whatever reason the pill intensifies my symptoms.

Anti-Depressants-at first seemed like a cure! Then I started to feel depressed all the time, and I became listless and lethargic. I gained 25 pounds and felt awful and the benefits seemed to have flown out the window. I am not a fan of anti-depressants. I am no longer using them for treatment of my PMDD.

Acupuncture helps-mainly it helps with relaxation. It is also not a cure-all, but can be very helpful in terms of relaxation. It can be expensive and it takes quite some time before it actually reduces any symptoms. I would like to return to acupuncture if for nothing else, but the calming effect it as.

Herbal supplements & supplements: for me they help, but do not have the strength to reduce my symptoms to a manageable level. I use supplements in conjunction with the IUD.

The IUD has been helpful, it has reduced my symptoms. However, after a little over a year of using the IUD I feel the effectiveness wearing off. It makes me want to cry. And I do not really have a period at all and I don't like this part of it. The idea of searching for another effective treatment feels a little frustrating at the moment.

I consider myself blessed. I have very loving and supportive friends and family. I have been honest about my PMDD-it does affect my ability to socialize and I can withdraw pretty easily. I hate when I am unkind, or I lash out at someone I love when I am PMDD-ing. It is awful and I feel horrible, and guilty. In some ways I try to keep to myself so that I do not do anything I will regret later. I live alone and work primarily alone, so I do control my interaction with people as much as possible. I have recently entered a romantic relationship-I have been upfront about my PMDD, and he is a very understanding person. However, I am terrified I will scare him away, and I know this is a large part of why I keep to myself. I try to keep myself and others safe, but I am starting to feel that it is not the solution.

I cannot think of a shape for PMDD, as it tends to have several forms for me. At times it may be rigid and square, uptight and bound, whereas other times-it is wide open and expansive...It encompasses many colors...red would be the primary color, as well as black and dark blue...perhaps with flashes of purples and greens.

The worst thing about PMDD for me is the darkness, the sadness, and the nasty voice inside me that gets so loud that I believe it. I believe every ugly lie the voice utters. I have made some serious life decisions while under the influence of the PMDD monster, only to wonder later-'what the hell was I thinking'. The other thing is I feel like I cannot trust myself and I do not want to be around anybody. It sucks, I am for the most part a friendly, upbeat and kind person. The PMDD twists things and I get twisted with them and then come out the other side-wondering what happened. I hate that I listen to the ugly angry distrustful voice, rather than my true core voice.

I have changed my diet, I eat mostly vegetarian. I focus on nutrition. Whole grains, veggies, I do have fats, like peanut butter and such. I love fruit too! I make 90% of my meals at home, this is very helpful. Honestly, diet and exercise have had a profound effect on my ability to cope. I make sure I get enough rest as I cannot function without adequate rest. I LOVE to exercise and I LOVE yoga and walking outdoors! However, when the monster (PMDD) is in house, I have to literally fight with myself to exercise, and do what is best for me. As there are times when I drink wine, or eat too much, and usually regret it.

I also remind myself what is happening and that it is not ME-it is PMDD and it is chemical and biological, but this is not always helpful. I take hot baths and drink tea, I use drops of white chestnut for anxiety. Basically, I try to take of myself and be loving towards myself. I do struggle and sometimes I cave to the cravings for fatty food, wine, or cigarettes. I realize that this is a work in progress, and from experience I KNOW that taking excellent care of myself is my best bet!

I work with a master metal smith-he is my dad. We design and create custom wedding rings. I work with 30 stores and retail clients from all across the globe! I am very fortunate to have the work I have. I work alone as most of my correspondence is via email. I love working with an artist and I love working with my clients. I am grateful for all of my clients. So I do not have a career I have a job, a wonderful job. I long for a career, but that is a long and painful subject for me. I have searched for 15, plus years to answer the 'what am I going to do with my life'? question only to still not know the answer. It causes me extreme grief. As I have taken endless classes and been in and out of school, etc...

For now, I am letting it go. I just recently withdrew from school, as the combination of work, school, PMDD and my learning disabilities proved to be too much for me. I am struggling with not feeling like an utter failure and feeling like I have liberated myself. I do not have children, I have a cat, whom has been with me for 15 years. I care for her deeply and she has been a most loving and loyal companion over the years.

I would like to have a career that I can pour my heart and soul into. I would like to love freely and create. I would like to be of service to the people, the Earth and the animals. It is unfortunate that every single month for two weeks I kinda fall apart and lose my grip. However, I refuse to give up and I hope that I can find a way to do what I long to and be even with PMDD.

I believe yoga and meditation are helpful. Yes, they help me to relax and change my focus and help me to slow down and breathe.

"Love all, trust a few. Do wrong to none." Unknown.

"Everything we see or seem is but a dream within a dream." Edger Allen Poe

Dealing With PMDD - Advice for Men

I’ve spent quite a bit of time searching the internet for Resources and Advice for men dealing with a woman who suffers from PMDD. Unfortunately, most articles lump PMS and PMDD together, which does a great disservice to women with PMDD. In the comment sections of these articles both men and women express anger and resentment toward the women who experience true PMDD: the men claiming the articles give women a license to behave badly two weeks out of the month, and the women claiming the women with extreme mood swings give all women a bad name.

So, to clear a few things up…

20% of women suffer no pre-menstrual symptoms at all
80% of women suffer from some combination of pre-menstrual symptoms
20-40% experience moderate discomfort pre-menstrually
Up to 10% of women suffer from PMDD

This post is written for the men who have partners in the last category.

But before we get started, a quick primer on the differences between PMS and PMDD.

PMS deals primarily with physical symptoms. Bloating, aching, cramping, tenderness, fatigue, headaches, food cravings, and mild mood swings are the most well-known of the more than 150 symptoms possible. A little irritability, tension, sadness, weepiness, or any combination thereof is par for the course.

The major component of PMDD is mood swings in the extreme. PMDD actually affects your brain’s capability to regulate itself, and therefore affects just about every other hormone in your body. That’s not to say a woman can’t have the bloating, aching, cramping, fatigue, cravings, and other physical symptoms. If she does, it may well be that she suffers from both PMDD and PMS, and once she gets her PMDD under control, all she’ll be left with is some PMS.

Frankly, I think most women with PMDD would be happy to simply suffer some form of PMS. Because PMS is to PMDD what a headache is to a migraine. There is a distinct difference, and that difference is biological—not mental. The biology of PMS and PMDD share many similarities, but at some point they split into completely different paths. An explanation of that is beyond the scope of this post, but I’ll be happy to write about it some other time.

For now, it’s enough to know that PMS and PMDD are two completely different things.

That’s not to say your relationship won’t benefit from the advice in this post if your partner simply has PMS. But we’re not talking about PMS here today, we’re talking full-blown PMDD.

1. Both you and your partner should mark the time on a calendar when you expect her to be pre-menstrual. This can be hard if her cycle is not regular, but do the best you can to identify patterns. An explanation of my pattern is here, and can give you an idea of what symptoms to look for.

If your partner is in denial, and claims there’s nothing wrong with her—mark your own calendar separately. In many cases, the man can tell before the woman that she’s entering into her pre-menstrual phase, because he’s watching from the outside, while she’s busy trying to cope—either consciously or sub-consciously--with the unwanted changes going on in her brain and body.

Please note: There are women who are in complete denial that anything different is happening to them, and then there are women who know what’s happening, but “really don’t want to deal with this right now” because they are too busy to, and so they pretend nothing is happening, and they really aren’t feeling any differently, until it’s too late to do anything about it, and the episode erupts full force.

Determine which type of woman you are living with, and keep track accordingly. Apparently there are several applications available on the iPhone and Android phones to help you track her cycle, but an old-fashioned calendar will do just as well.

2. If she’s indicated that this is what she would prefer, try to stay clear of her until the episode passes. This has nothing to do with you, or her love for you. It’s simply due to her heightened sensitivity to any combination of the five senses. She literally can’t handle any more sensory input—be it bright lights, loud noises, touch of any kind, strong smells, or even certain foods. If a PMDD woman has allergies of any kind, they can be exacerbated pre-menstrually. If she has any another condition, such as arthritis, diabetes, or fibromyalgia, they can be exacerbated as well.

Even if she’s otherwise healthy, during an episode of PMDD a woman is literally is a walking bundle of nerves. Unfortunately for both of you, this heightened sensitivity and discomfort can be so distracting that it causes her an inability to focus on things like questions, requests, conversations, or simple instructions. (Now you know why she forgot to pick up your suit at the cleaners.)

Take the first one, for example: You have a question that requires more than minimal thought and consideration.
Examples would be:
Major purchases—car, appliances, maybe that boat/motorcycle/sportscar you’ve always wanted (not a good time to bring it up)
Health decisions
Financial decisions
Employment decisions
Decisions involving having or raising children
Vacation plans
Any change of routine or structure in your life

Why? Because during a PMDD episode a woman’s brain is not functioning properly. This has nothing to do with how smart or intelligent she is. This is her brain chemistry being disrupted due to the hormonal shifts taking place in her body. During a PMDD episode it can take all of her concentration simply to focus on the basics of getting through each day. If you come at her with anything resembling a major decision, it could overload her brain and cause a meltdown.

So if she asks for space during that time, please give it to her.

3. Be patient. Dealing with anybody on a short fuse can be challenging. If she snaps at you, or does something that irritates you, don't lose your temper and fight back. It won't do any good, and in most cases will only make things worse. Just (discreetly) take a deep breath, maybe say a prayer, and ignore whatever she just did that bothered you. Remember that she's not normally like this and she’ll be herself again soon.

4. Do not enable immature behavior. I’ve said all along, PMDD is an explanation, not an excuse. Being emotional does not excuse inappropriate behavior, any more than being drunk excuses offensive behavior. If she’s being immature, yelling, shouting, stomping, snapping, cursing, slamming or throwing things, don’t respond with your own immature behavior. She at least has an explanation for it—a biological explanation. What’s your excuse?

Stay calm and leave the room if you have to, until she settles down. Let her know you love her and you’ll be nearby, but you can’t have a conversation with her when she’s being irrational. Believe me, she knows she’s being irrational. But without conscious effort at awareness, she can’t stop herself any more than she could stop an allergic reaction. If you calmly point out that she’s being immature or irrational and say you’ll be happy to continue this conversation another time, things will settle down a lot more quickly than if you respond with your own emotional outburst.

5. Listen to her, even if she’s not making any sense. Try to figure out what the REAL problem is. If she’s complaining about something that’s never bothered her before, or doesn’t usually bother her, most likely what she’s saying is “I feel miserable, and there’s nothing I can do about it, so I’m looking for something else to change and hoping that will make me feel better.” This is a time of true desperation for her. She’s looking for anything, rational or irrational, that will make her feel better. This is a good time to suggest she take some time out for herself, maybe a hot bath, or a cup of tea and a good book, or whatever soothes her soul. Let her know you support her need to have a little time to pamper herself in whatever way makes her the happiest.

But beware of sending her out on a shopping spree. Retail therapy will only make things worse when the mood has passed and the bills come in.

6. Don't take it personally. During an episode of PMDD, you can count on her emotions getting the best of her, and she'll probably question your relationship. She might question you. Might question her whole life and everything she believes or stands for. This is normal and natural for a woman during an episode of PMDD. As mentioned in Number 5 above, she's feeling helpless, and sometimes when people feel helpless they look for other things they can control, and that might mean bringing up topics or suggesting changes that trigger your emotions. Your best defense against this is to stay level-headed and calmly say, "Ok, I understand." What you really understand is that you're still the same person she loved before her PMDD episode kicked in, and her change in perception of you and her life overall is the PMDD talking, not her. For more information on this, see my post It’s Not Personal – It’s Just My PMDD.

7. Be compassionate. Think about a time when stress or physical changes made you hard to get along with. Have you ever been sleep-deprived? Maybe you had an accident or were the hospital, and the chronic pain made you want to lash out at everybody. Put yourself in her shoes. Not only is she experiencing uncomfortable physical symptoms, but her hormones also ebbing and flowing, making it almost impossible for her to know how she feels or what she wants. Think of the effect testosterone has had on you, like when you get sexually aroused, or on any occasion when you felt aggression or rage. You remember how you felt caught up in the emotion, how it made you want to say and do things you ordinarily wouldn’t say or do. That’s what’s happening to her.

8. Be forgiving and reassuring. Her insecurities will definitely come up during an episode of PMDD, and with her heightened sensitivity, every negative thought she has will be magnified ten times over. If she doesn’t consciously stop the negative thoughts, they will flow through her mind in an endless loop. If you can get her to talk about them, fine. Some women won’t want to, because they know the thoughts are irrational, even while they are having them, they just don’t know how to stop them. Nobody wants to share irrational thoughts, and then remember they did so when the episode is over—even if the only one remembering them is her.

If she feels unloved and insecure, she’ll probably act out, which will make you not want to be around her, which will "confirm" her negative thoughts. Most women feel insecure about their bodies to start with, maybe even their lovemaking, child-rearing, housekeeping, or professional skills, and if they’re in any way insecure about your feelings for them, this is when that insecurity will come out. So try to give her a few extra compliments (and don’t be offended if she doesn’t believe you, or snaps at you for it), and—if she’ll let you (remember those heightened sensory sensitivities)--be more affectionate. If she won’t let you near her, don’t make her feel badly by taking it personally. Guilt is the last thing she needs when she’s feeling unlovable. Tell her you understand and you’ll be around if she changes her mind. That could well be all it takes to melt her defenses.

More on this next week, as that’s enough for now. For more information, I invite you to scroll through my most popular posts, as indicated in the sidebar.

Take care, and good luck!

What's Special About Progesterone

Getting a late start today. It’s the last week before school starts and all is in chaos :). Today I want to write more about progesterone, since the subject came up. Again, I want to say there I nothing wrong with taking natural progesterone if your progesterone levels are low, but how are you going to know they are low without a blood serum test of your levels, taken during at least two different points in your cycle? Hormone saliva tests are notoriously inaccurate, and if you look closely, you’ll notice most companies that produce these saliva tests also conveniently produce product formulations that you can take to boost whatever their tests determine you are lacking in.

Some other day I will tell you about my experience with saliva hormone testing. Today I want to focus on progesterone and what it does for you.

Actually, it’s a good thing. Progesterone in and of itself is wonderful, and has a wonderful purpose. You know that it rises during the second half of your cycle, starting to rise just before ovulation. And as it does, it settles your mood and slows down your digestive system. That’s right. Just like progesterone smoothes out your mood, it smoothes out the muscles in your digestive tract to allow your body more time to process what you have eaten, and grab every morsel of nutrition it can from the food you eat before sending the waste on its way.

This is a big part of what causes that full, bloated feeling you get the last half of your cycle, and this is what often causes constipation during the same time frame.

Why? Because your body, in all it’s miraculous wisdom, is preparing to sustain a child. Your body doesn’t know (or care) whether you’re trying to get pregnant or not, so every month during your reproductive years it faithfully prepares to sustain a fertilized egg, whether you need it to or not. Slowing down your digestive system is just one way your body has of making sure that baby gets every ounce of nutrition it can get so that it will thrive in your womb.

When no egg is fertilized, the level of progesterone in your body drops, and this causes the buildup of tissue in your uterus to slough off because it isn’t needed, and pass out of your body via the blood you shed during your period.

Unfortunately, it also causes your mood to plummet.

But progesterone has a definite purpose. A purpose that drives women mad on the months when we are not hoping to conceive, because it makes us puff up and think we are fat. But all of that is just our body trying to hold on to the nutrients we have ingested…just in case.

Another time progesterone surges is during the first trimester of pregnancy, and that’s for the same reason. So that the baby growing inside you has the best chance your body can give it of getting all the nutrition it needs to survive.

Now, about those mood swings. During the last two weeks of your cycle, progesterone also causes your brain to at first become more relaxed and sedated, all warm and fuzzy, then gradually (and sometimes not so gradually), as the level of progesterone drops, more irritable, less focused, and a little slower. This is part of why you’re more sensitive to stress in the second half of your cycle.

Then, when no egg is fertilized and the level of progesterone in your system abruptly drops, this leaves your brain feeling somewhat shell-shocked. This is when you start snapping and screaming at your loved ones. Because your brain is feeling the effects of progesterone withdrawal, just like any addict goes through withdrawal when the source of their feel-good drug of choice is no longer available.

Our reactions to this loss of progesterone include feeling aggressive, negative, hostile, and/or even hopeless and depressed. This is when we weep at the drop of a hat, weep uncontrollably, become really obnoxious and confrontational, have panic attacks, and/or contemplate suicide.

Just like an addict.

So when we need it, progesterone is a very good thing.

When we don’t, it causes trouble.

What happens when we get too much?

Please read my previous post.

In closing, please try to be patient with yourself and understand that you really are not in control of this miraculous, yet incredibly frustrating (given our modern lifestyle) cycle that takes place inside your body each month, other than to provide your body with the best possible work and living environment and nutrition that you can--so that your body can do its job the way nature intended for it to do.