She - An Inside Look at What It's Like to Have PMDD

I can sense she is coming, as my world starts to blur, she climbs into my body and claims it as hers.
Nobody sees her, she causes such pain.  She is nothing like me yet goes by my name.

It's like a possession no priest could exile, she's taken me over, she's stolen my smile.
My body is hurting, I'm wrecked and alone.  For two weeks a month, my body's her home.

Her rage has no limit, she's hurtful and cruel, she says things I wouldn't, and I look like a fool.
She drags me by force to the depths of despair, until I don't know myself, I am no longer there.

She damages my friendships and destructs my work, has me laid up in bed, exhausted and hurt.
And when I'm broken and lost and she's had her fun, she climbs right back out, I've survived another month.

And I take back my body, my mind and my heart, I repair all the damage, I make a new start.
I'm back and I'm happy, I'm thankful and free, though I know in good time she'll return for me.

Maybe one day I'll be free from her hell, she will no longer own me, and I will be well.
Until that day, I will swim the rough seas.
I won't let her drown me, for she isn't ME.

by Nicola James, 2016

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 Quote of the Week

~I wasn't always easy to get along with and I used to be less under control, but now I will warn the people in my life that I have PMDD and take responsibility for it but I still get harassed about it, like they think I'm making things up, like when it makes me irritable, or cold, or cry for no reason.  I make sure that they know it's that time and nothing is personal, yet they still act surprised when I show symptoms.  They try to debate me about my emotions, which after years I have come to accept I have less control over, but they don't trust me about my own experiences.~

Living with PMDD: Why Every Woman Should Be Practicing Hormonal Self-Awareness

Recently I stumbled across this gem of an article in Elephant Journal on hormonal self-awareness, written by Vironika Tugaleva, life coach, inspirational speaker, and award winning author of The Love Mindset.
One line that caught my eye was:  What a hormone surge does is it gets rid of a woman's ability to numb herself to the quality of her environment. 
With their permission, I have reposted the beginning of the article.  If the opening intrigues you, please click on the link to finish reading the article. Well worth your time.

Why Every Woman Should Be Practicing Hormonal Self-Awareness

by Vironika Tugaleva

I had a client once whose boss insisted on using positive-only language in the workplace. So, when giving feedback about mistakes and areas for improvement, he’d say, “You have a great opportunity to practice your communication and organization skills here” instead of “You’re awkward and messy.”

I thought that was just brilliant.

So, for me, around the same time every month, the opportunity comes to do some very deep self-awareness work.

The more I’ve become aware of the effects of hormones on my mind and body, the more amazed I’ve been that there was a point when I was not at all aware of these effects. There was a time when I would spend a week alternating between bitchy and depressed, thinking that the reason was whatever my mind told me was the reason.

Whether or not you’re a woman, stick out for this one, because if you are, then this is absolutely something you must know about yourself, and if you’re not, this will give you incredible insight into the behaviour of women in your life.  Read more here:

The Voices of PMDD, A Guest Post on Shattered Dreams

Continuing with my Summer of 2014 Voices of PMDD series, here is a post written in 2012 by a woman with PMDD that addresses the reality that what you see/experience of PMDD from the outside, as a partner, friend, colleague, or family member, is only the tip of the iceberg compared to the devastation that is going on inside the mind, body, heart and spirit of a woman with PMDD.  

Aside and apart from the episodes of PMDD themselves, there is no way on earth to measure/account for/quantify the cost of the shattered hopes and dreams of PMDD women (and our loved ones) due to our PMDD.  The fallout from these broken dreams is something a woman with PMDD has to deal with every single day of her life--not just during an episode.  The weight of our perceived failures, while staggeringly heavy when we are not in the PMDD zone, can prove unbearable during an episode.  This, I believe, is a good part of what leads to suicidal thinking. 

That said, I give you "The Hidden Injury of PMDD"

“I wanted to quit because I was suffering. That is not a good enough reason.” – Ted Corbitt

I almost decided not to write about PMDD.  The thought of sharing what is considered a mental weakness leads to an automatic assumption that I am a little off my rocker.
 
No one intentionally judges someone with bi-polar disorder or depression.  It is a slight shrinking away from the unknown and the unstable.  PMDD is similar to being bi-polar.  The difference is the consistency.  PMDD will hit every two weeks like clockwork.  About every third cycle, in my case, it is so severe I have to talk myself out of suicide.  My muscles and joints hurt so bad I feel my bones will crumble if I move too fast. Typing hurts.  Rolling over hurts.  The sadness is so deep there is no hope, no joy, no future.  It is only darkness for days and days.  And right as the pain is going to consume my mind and body, my cycle begins and the world is turned upright again as if the previous two weeks never happened.

It is vicious.  It is destructive.  It is painful and it is never ending.

I am told by those around me I am outgoing, extroverted and can do anything I set my mind to to. That is until they see me fall and wonder what happened.

I was just as confused until September 2011, when it became clear there was a pattern to the insanity.

My husband and I were in the middle of trying to start a photography and real estate business when it became clear we were facing something much bigger than we could have ever imagined.  I would soon discover my ambitions would be pulled out from under me like a ugly, worn out rug.

Up until then, I had hope I would one day shake whatever it was that tripped me up so much.   We thought it was connected to the abuse from my childhood or maybe my walk with God was really weak or maybe I was just a weak person in general.  Maybe, just maybe, if I tried harder, or prayed harder or exercised harder or ate better or something!!!!!  There had to be something I was doing wrong.

After we narrowed the diagnosis, I began facing the fact, I couldn’t do everything I dreamed of doing….and that pain is another post entirely.

I knew something was wrong, but I had no idea the symptoms grew worse and worse as you get older.  It made sense though, as I was moving into my 40’s, why the intensity was growing.
Friends only see me when I can leave the house. I venture out when I have energy and drive. This causes so much confusion when I meet new people.  I am vibrant and joyful at first and when I am pressured into social situations during the “luteal” phase, they see a quiet, sad often “sick” stranger they don’t recognize.

I can’t imagine how it is interpreted.

I cancel coffee dates, go two weeks without answering my phone, drop out of obligations I make during my good weeks.  I’ve since learned the crash will come and I have no business volunteering, working, serving or reaching out to anyone.

I’ve lost jobs, quit jobs, started and quit businesses, started and quit homeschooling over and over, lost friends, went on uncontrolled spending sprees, started arguments and walked away from relationships to save them from myself.

I wish at times, I had a physical ailment.  A limp, a scar, a broken bone or even cancer.  At least then, when someone met me they would have evidence of my disease.  They would be able empathize and process the injury in their own mind.

Instead, the injury is inside my mind.  It is not visible unless you live under the same roof.
It is hidden behind a mask I wear everywhere I go.  I can’t escape from the betrayal of my mind and body every month.  It is always taunting me…always waiting silently to paralyze me yet again and destroy everything I begin to build.

I’ve learned not to build anymore.  That is what hurts the most.

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.

PMDD, Prostaglandins, Pain, and YOU

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

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

Sounds simple, right?  It is.

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

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

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

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

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

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

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

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

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

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

Prostaglandins help with many things, such as:

Blood vessel dilation

Muscle contractions

Inhibition and promotion of blood clotting

Regulation of secretions, including digestive hormones

Cell division and growth

Body temperature regulation

Lowering (or raising) blood pressure

Immune system responses

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

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

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

Tell me something good about prostaglandins, then.

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

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

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

 Series 2 Prostaglandins (the Bad Guys)

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

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

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

Series 1 Prostaglandins  (Our Heroes)

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

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

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

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

and

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

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

 

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

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

evening primrose oil

naturally fermented fish oil

flaxseed oil

borage oil

starflower oil

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

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

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

Other ways to combat Bad Guy Prostaglandins:

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

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

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

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

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

So, to recap:

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

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

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

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

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

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

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

Avoid these top ten culprits.

1.  Sugar

2.  Wheat

3.  Caffeine

4.  Soy

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

6.  Dairy products, especially milk and cheese. 

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

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

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

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

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

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

Taken By Surprise...

This has been an odd month for me. After a couple of years of only experiencing PMDD symptoms every few months--due to the onset of menopause--for the past two cycles I’ve been back to my regular clockwork schedule of symptoms and a refresher course of how miserable PMDD can be.

But now, I also know how to manage and minimize it. I now know I am not my PMDD, and my PMDD is not me. After nearly forty years of cycling through it, being buffeted by first regular, then random storms of PMDD, I have finally learned to separate myself from my PMDD.

To do that, however, takes a great deal of self-attention and self-awareness. You have to listen to everything your body tells you. The body never lies.

But a PMDD body does lie. Imagine that. Your own body lies to you.

No wonder you feel like you’re going crazy sometimes.

I am a very much a positive thinker. Calm, creative, goal-oriented, and optimistic. Generally I sail through my days without a problem. I don’t sweat the small stuff, and half the time don’t even sweat the big stuff. Life has a way of working out for me, and for that, I am grateful. The more it happens, the more I learn to trust—to trust in myself and my higher power—that all choices made from that quiet place within me can be trusted and will lead me to good and positive outcomes.

So imagine my surprise last week, when a day I had willingly chosen to give over to helping a loved one get the medical help he needed, for me turned into an endless loop of mental frustration. What is this? I kept asking myself. This day is no surprise, and I chose to spend it this way, and yet….

And yet I can’t seem to stop the thoughts of anger, resentment, and frustration from welling up inside of me.

I did not let them out. I knew well enough that the person I was spending the day with was not the problem. But Lord, how I wanted to. Just wanted to let loose with every negative thought on my mind. We even joked about it.

Did you catch that? I was able to joke about my feelings in the midst of a PMDD episode.

And I didn’t even know I was having one. I just knew something was “off.”

It wasn’t until the following afternoon that I began to suspect it was PMDD. Thursday morning I procrastinated until it was too late to leave for my Qigong class, which I absolutely love. There’s no reason for me to miss the class, as everyone there knows about my PMDD and accepts me as I am. They welcome my arrival no matter what my mood, which I often announce upon coming in the door.

“Brain’s not working right today,” I will say, and everyone will know I’m a little off my stride.

So I skipped class—all the while asking myself, “Why would you skip something that brings such good things into your life?”

Remember, PMDD doesn’t make sense. It just is.

That afternoon, I found myself unable to focus on what I needed to be doing. My handwriting was off, and I kept getting distracted by the latest shiny thing—a new email, a new link to explore, a phone call to answer, a note to write, a snack to make.

Speaking of snacks, suddenly, for the first time in weeks, I wanted chocolate.

Should have been another clue, but I wasn’t thinking PMDD yet.

Not until the next morning, Friday morning, when I literally did not want to wake up. I swear to you, it felt exactly like when I woke up to a carbon monoxide leak in my house last November. Debilitating, bone deep lack of motivation and fatigue. All I wanted to do was sleep.

The phone rang and I dragged myself out of bed. An hour and a half later, I’m still yawning, yawning, yawning. It took extreme effort to keep my eyes open. Coffee didn’t help. At all. I don’t normally drink coffee, so if I do have a cup, the effect is immediate.

Not today. Not a blip of relief. I felt like I had an iron band around my head, my tongue was made of cotton and was also thick and swollen (which is one of my PMDD symptoms—allergy aggravation), I couldn’t get enough water to drink, and I was ravenous both before breakfast and less than an hour after.

I finally realized I wasn’t truly hungry…I just wanted to eat. Believe it or not, there is a difference. My stomach was full. But my brain was sending distress messages. What those messages were, I have no clue, because there was nothing distressing that I know of going on in my life—you know, like the kind of situation that spurs emotional eating…

I just know the signals my brain was sending were manifesting as a nearly overwhelming desire to eat.

It was hard, but I didn’t succumb. My food charting (another experiment I hope to share the details of some day) told me I had already eaten as much as, if not a little more than, I had on any other day. So this was not true hunger. This was my PMDD talking, not me. I was not hungry. The chart clearly showed that on any other day, I wouldn’t have been the least bit hungry…and believe me, I am not one to deprive myself of basic nutrition, because I learned long ago that it will only make my PMDD worse.

So I compromised with my PMDD, and spent the day sipping my favorite chocolate drink, because suddenly all I wanted was chocolate.

I did, however, go to bed really early that evening, in deference to my fatigue. Added to that was now a strange aching in my legs, all the way down into my arches.

What had happened? Had I pulled/strained a muscle somewhere? Somehow? How could I, when I’d skipped class on Thursday? It didn’t make sense.

I woke up 12 hours later, still sleepy. Still ravenous. Still wanting chocolate. Still aching.

Okay…by now I am beginning to realize what is happening here. It must be my PMDD. By noon it was confirmed. I started spotting.

Suddenly everything that happened the previous three days made complete sense. The strange and unreasonable irritability on Wednesday, the clumsiness, disorientation, and inability to stay focused on Thursday, the lack of motivation, intense lethargy, fatigue, and ravenous appetite on Friday. The chocolate craving, the sensation of an iron band tightening around my head, the urge to weep, the dull ache in my legs.

I continued to eat normally, despite the ravenous hunger, sip my favorite chocolate drink, and headed off to the gym to walk around the track, even knowing it was the last thing I wanted to do. But exercise had helped before, and I wanted to experiment, wanted to see if there was actually something I could DO to make it better.

The first twenty minutes I felt like I wanted to vomit. No lie. Around the half hour mark, I started to feel a little better. By the 45 minute mark I was heading back toward an even keel. Came home, made a healthy, carb-laden supper, then went to church.

Things weren’t completely right, however, until I went out for a salty bowl of chicken noodle soup afterward.

Go figure. But for some reason, after the soup, I came home full of more energy than I’d had in three days. I was psyched, ready to take on the world.

Instead I rested and read and had a cup of tea. The storm wasn’t over yet; that was just the eye of it. Been here, done this enough times to know this thing comes in waves.

Sunday morning I was dozing again when the phone rang and woke me up. I didn’t have nearly as tough a time waking up as I had on Friday morning. Huge difference between then and now.

Why? The menstrual blood was flowing.

And because of that, I made it to my next Qigong class and the grocery store and was able to focus on a couple of creative projects I needed to complete.

The first wave of the storm had hit, and I weathered it. Mostly by repeating this is not me, this is my PMDD. I am not angry, resentful, mad—that’s my PMDD talking. I am not hungry, that’s my PMDD talking. I have no reason to cry—that’s my PMDD talking.

Unfortunately, there was not much I could do about the fatigue. But getting out for a walk definitely helped with that.

The good news is (except for one cup of coffee) I managed to avoid the quick-fix stimulants that so many of us use to get past our fatigue, stimulants that only make our PMDD hit back even harder. Tobacco, alcohol, caffeine, sugar, energy drinks.

You, too, can weather the storm, whether yours comes in waves, or all at once. It just takes an enormous amount of effort to do so. Not everyone has the time or energy or circumstances to be able to do it. I understand that. I accept that. You need to accept that too, and simply start wherever you are right now.

Start with what you have, start with whatever symptoms present themselves. Try to sort them out like tangled threads. This part is me, this part is my PMDD. I am not my PMDD. I am better than my PMDD. I am stronger than my PMDD. I will not allow my PMDD to define me.

And I will not allow anyone else to define me by it, either.

Because they have never slogged through the storm in my shoes.

Until you know how it feels to have a brain and body that sends basic biological signals contrary to all conventional wisdom and common sense, you will never understand.

To those who do, you deserve to be congratulated and applauded--not dismissed, discounted, and ridiculed.

We are the strong ones, we are the survivors, and we are not our PMDD.