PMDD Symptom Play by Play Number 1

The following guest post was written by the blogger Cheekyminx. With her permission, several of her posts about PMDD are being featured on this blog. To find out more about her work as a PMDD Advocate, please visit her Facebook page, PMDD Life Support.

Talking and writing openly about Premenstrual Dysphoric Disorder is something I'm compelled to do, both for myself, other women, and the people who love us. I'm trying to understand myself and this very complicated phenomenon that seems to slip and shift into unrecognizable forms within a recognizable framework every month. Since learning about PMDD, I am now free to witness the cyclical changes taking place in my body and mind with some objectivity. As my body becomes more and more sensitive to the hormones surging through it, I'm less fearful about why I'm suddenly losing control, wondering how much worse it will get. It's easier to pay attention to the process, fascinated and taking notes.

Truly, as hard as it is to understand, things can be very different month to month. What I've done here is journal some of my symptoms in the days leading up to one period a few months ago. Were I to do this monthly, no doubt the expression of symptoms could be different each time. Typically, women begin to experience symptoms 14 to 11 days out from menstruation. The actual period tends to bring relief either instantly or within a couple of days. But again, this is only generally speaking. What I have garnered on the forums and from my own experience is there are exceptions to this rule, and a woman should not rule out PMDD just because she doesn't fit some erroneous profile that was originally established on a very small base of women. And if, like me, your hormones are in flux anyway due to perimenopause, you might indeed be a bit all over the symptom map!

With 11 days to go...The first thing I notice is an almost instant loss of my sense of humor. It was there one second, gone the next. My husband noticed it since we had been laughing for days prior. It isn't that things have ceased being humorous so much as that I have stopped being able to find humor in them. Even my face feels like it has forgotten how to move upward into a smile. The next thing I finally notice is growing fatigue. In fact, I'd slept 12 hours for two nights in three days. This is an absurdly long amount for me to sleep. I didn't even wake to relieve my bladder which is a common occurrence during a night of much less sleep. I gave into this need for sleep instead of fighting it off, and I think it did me a world of good. I also notice my body feeling colder. I wear a sweater and my hands ache with cold even though the temperature isn't that different from weeks prior. Then there's the hunger. I'd probably be eating all day long if I could. The menu? Salty chips, roasted nuts, dark chocolate, and butter on all manner of cakey-bready things. Unfortunately, the baker where we used to get our organic sourdough stopped taking orders, so I'm left with unfulfilled pangs and cravings for hot buttered toast or French toast. When it comes to food, I know I can't give into every craving anyway. I'd be the size of a buffalo. So, I balance things as best I can eating oat crackers and high-quality chocolate along with the grapefruit and parsley juice and salad and fruit. For the weeks leading up to this time, I was making banana shakes using almond milk, including the spices turmeric, cardamom, and cinnamon...each known to alleviate various PMDD symptoms like depression. I've also started taking magnesium which is supposed to help with symptoms. We'll see if I notice anything.

With 6 or 7 days to go...I felt like I was doing better this time around contrasted with last month. Is it the spices? The magnesium? Luck? I've noticed that, generally, I have good months and bad months. This makes the whole concept of PMDD even harder to understand and, for some, to believe. And yet, other women express the same experience. Some say every third period is the worst. I seem to have three on, three off...way off. Will this be a good month? Weepiness has set in and my legs are starting to feel like two leaden logs, so maybe it is too soon to tell. (Note from Liana: this good month/bad month pattern has been explained by whether or not the woman is ovulating.  If  you ovulate, you will experience PMDD symptoms.  As we enter perimenopause, we have fewer and fewer ovulations.  No ovulation = no symptoms.)

5 days and my mind is off and racing. I can't stop over-analyzing, over-thinking, and over-compensating. Some who know me might say I'm always like that. Okay, so, imagine that ramped up by 10. I've become afraid of the world, and what were merely challenges have become insurmountable obstacles. My husband is doing his best to distract me and also to listen to me without himself becoming depressed and defeated. Somehow, I've managed to regain my sense of humor, and this is really saving the day. Squirrel! 

4-2 days: Could I actually get through this month without losing it completely? I've had three social obligations in the last three days, and though as an introvert I'm feeling the drain, it isn't debilitating. The fact that I could even be social just a few days before my period is somewhat of a miracle.

1 day to go and everything I thought I'd managed to escape this cycle has come down full-force. The internal pressure I feel...how to describe it...has increased dramatically, making me very antsy...agitated. I feel like a combustible material. Pour the wrong remark over me and I will blow up.

So what happened next? I was attempting to control an out-of-hand ant problem (yes, ironic...me being antsy and all). My husband was pressuring me to leave for grocery shopping because the stores would close soon. He wasn't helping or taking part in what I saw as a near-disaster. Yes, I realize ants are not a near-disaster, but PMDD magnifies everything by about 1000. Couldn't he see what I was dealing with? I became furious.

So my husband asks, "Why are you acting like an asshole?"

Wrong move. That was it. The end of marital bliss. I may well have been an asshole, but I didn't need anyone pointing it out to me, thank you very much. I tore the shopping list in two, gave him his half and wished him luck. Despite wanting to call a truce in the market, I couldn't bring myself to do it because of the way he was now behaving...like an asshole.

The thing is, if I act like a big-enough asshole, then eventually, so does my husband. And then, we're lost. We're lost for an hour, a day, a week...hard to tell. But I know I can't engage with him AT ALL if he's also going to be a two-year old. And then I hate him because he doesn't have a "hormotional" excuse and could be making all this so much easier for us both.  (emphasis added)

Why couldn't he just have grabbed me, hugged me, and told me the ants were a little problem and that if I could just walk away I would feel better? Herein lies the greatest PMDD difficulty for me and countless others. Our behavior becomes exceedingly difficult if not impossible to control. (Liana adds: and once we have reached that tipping point, we are literally unable to go back, to retreat, to regain control.  All our efforts to soften our PMDD symptoms (meditation, herbs, vitamins, exercise, rest, nutrition, mantras, art or music therapy) are done in an effort to not reach that tipping point.  Because once we have, all is lost for that day or that PMDD episode. This is what most people do not understand.  We can't stop, once the emotional cascade begins.)

We're not doing it to be difficult. We're not doing it because we like throwing tantrums. We don't even get any pleasure out of it. Well, maybe some do. I don't. Mostly, I see a madwoman taking over my body and wonder how on earth to reach her, calm her, and love her. It is no easier for our significant others who try desperately to understand us as we're suddenly shooting daggers at them when five minutes ago they could do no wrong.

My husband and I talk about this stuff when we can. When I'm back to my old self again and after he's recovered, we talk about this funny thing called PMDD. We strategize and decide we can handle it. We make-up and go about our lives...laughing, loving, sometimes bugging each other, but getting over it. But then, when it rolls around again, it seems neither one of us remembers what to do. It's a common amnesia.

When I can, I will do another symptom play by play post. In the meantime, have you noticed similar symptoms in your own or a loved one's life?

PMDD Wisdom for the Holidays and Beyond

I received two excellent comments from readers this week, both of them spot on, and rather than leave this straightforward wisdom buried in the comments section at the end of an older post, I thought I'd bring it front and center for your consideration.  Please keep these comments in mind as we move into the craziest and most emotion-filled time of the year, and may your next six weeks be filled with more peace and understanding because of it:

Here’s some advice for anybody who lives with a woman experiencing PMDD from somebody who has it herself: If you suddenly find that the woman you live with is irritable, seems distant, or has actually left to be by herself, leave her alone! She’s not mad at you, you didn’t do anything wrong. If you follow her around, touch her, stare at her, and ask her questions when all she needs is to be by herself for a bit, you’re going to piss her off. Look at the calendar. Is she premenstrual? Yes? Then that is your explanation for her behavior. She doesn’t need to explain it to you every month. She doesn’t want to talk about it. This is super predictable, guys. I know you may see her not feeling well and worry about her and your natural reaction is to touch and comfort and find out what’s wrong. For the love of all that is holy, just leave her alone. She can’t control how she feels and she doesn’t like it either. Don’t make it worse. She most likely already feels terrible you have to deal with her. :(  ~Anonymous comment on my post, Dealing with PMDD - Advice for Men

Guys. I’m a wife. I’m a mom. I have PMDD. I get how you would think that if your wife/girlfriend can keep it together at work that you would think you are not her top priority. But, consider this. What if she is a mess around you because you and your kids are everything to her? Think about it. Work is important, but it’s just a job. Friends are important, but they are just friends. Wanting to be a good wife and mom is everything to most women I know. Personally, I find it challenging, if not impossible, to be a good wife and a good mom at the same time. Both roles require completely different demands. This is stressful. So then, take into account that when your wife is premenstrual, she has lost her ability to cope. She’s so stressed out and so overwhelmed she cannot deal with anything. It’s upsetting when the toast is taking too long to pop up let alone the child who is screaming because she said he can’t play with the electrical cords. So, it’s hard. We care so much about being a good wife and mom, that when we can’t be, we feel incredible guilt. We are incapable of being loving, fun and efficient all time and feel so bad about it that we think you and the kids would be better off without us. These feelings can affect us physically to the point that we can’t fulfill any of our roles. If we didn’t care about being a good wife and mom, it wouldn’t stress us out. When we’re premenstrual, we can’t handle the stress.
If that’s not the case with your wife, there’s another explanation. If she’s at work all day and comes home to you and the kids at night, that means she has spent the whole day trying so hard to not be a monster. This is exhausting. There is so much she wants to do and say, but she can’t. She holds it in. Coming home to the demands of being a wife and mom put her over the top, she has nothing left. She just can’t deal with it anymore. It’s not that you aren’t her top priority, it’s that when she has time with you, she literally has nothing left to offer.
Another reason would be that work is validating for her. She's probably good at what she does, and she gets a paycheck for it. There's a reward and purpose and it feels good to be a good employee. There is not much that makes you feel good about being a wife and mom. If the house is messy, you don't know what to make for dinner, dinner sucks, laundry isn't done, etc., it's easy to feel like a subpar wife. If your 3 year old isn't potty trained, your 15 year old doesn't know how to load a dishwasher, your kids watch too much t.v., your kids eat nothing but junk, your kids fight, your kids don't obey, you forgot your tooth fairy duties, etc., it's easy to feel like a failure as a mom. It's not hard to feel inadequate at home. Maybe the "needed benefit" for her going to work is that she feels good about herself the 8 hours she's there, and that 8 hours is what gets her through the other 16 every day.
There you have three explanations. I hope this gives you insight on what you’re wife might be thinking. We’re all different, but it was sad for me to hear you think you’re not a priority or of less importance to your wife because for me, it’s the opposite. It’s the anger and frustration and questioning of our love for you that gets us stuck in depression. Try responding to her with love. If she comes home from work a crazy angry person, or if you come home from work and she’s clearly irritable, that would be a good time for you to say, “Kids, Mom doesn’t feel well. Come to me for everything you need. Let’s clean up your toys, I’ll help with homework, I’ll feed you dinner, I’ll give you baths, I’ll put you to bed.” Just try it. See how much sooner she feels better. She needs to know you love her even though she’s having a bad day. I know it’s a lot of work to do everything at home after you’ve worked so hard all day, but contemplate this: If you get divorced or she kills herself, which is something women with PMDD think of often, you’re going to be doing everything every day anyway for the rest of time. ~Anonymous comment on my post, Dealing with PMDD - Advice for Men

A Perfect Storm of PMDD

Unfortunately, I’m one of those atypical types who has my PMDD served up in three different courses, which is one big reason it took me so long to get diagnosed. All the sites and information said specifically that for it to be PMDD, all symptoms must abate at the onset of menses, or when your period begins.

But mine never did. Mine came in three separate stages. Which I finally learned is possible as well. God knew I’d been living it long enough—but to see it actually mentioned in a book? Finally I could go to my doctor in confidence and get diagnosed.

I often compare my symptoms of PMDD to the course of a hurricane. Prior to the onset of my period is the building storm, the wind and the rain, with symptoms of irritability, edginess, an inexplicable, almost ravenous hunger, and cravings for salt and three specific foods---cheese, chocolate, and oranges. I have yet to figure out why, although occasionally I get glimmers of understanding and I am sure I will find the answer some day. But for now it’s enough to know that that’s what I crave, and when I find myself reaching for nothing but those three things, I know a storm is about to blow in.

On my pre-period days I also get jittery, clumsy, confused, and distracted, unable to focus on any one task for any length of time. My handwriting even changes. Usually, it’s comfortable, loose, flowing. When I’m having an episode of PMDD, it’s spiky, jerky, and messy. At times it looks like the handwriting of a much older woman. I’m always startled to see it come out that way, but not totally surprised, because as I’m writing, my hand doesn’t seem to work properly—which might also account for my tendency to drop things more than usual during those periods of time.

Anyway, the unfamiliar handwriting is generally one clue that something is happening in my brain. My typing is also affected. I have a friend who pointed out that I don’t bother to capitalize in my emails when I am having an episode of PMDD and I don’t do a lot of smiley faces. It’s as if to do either would take too much effort.

So in my case first comes the storm of irritability, anger, and rage. Snapping out at the drop of a hat. Lashing out at someone who didn’t say anything out of the ordinary, but just struck me as wrong. Feeling under attack and wanting to hit someone, anyone. Just give me a chance. Not a reason, but a chance. I call these my wanting to “drink, smoke, and be bad” days. Impulsive behavior does its best to take over, and I can fully understand in those days why some women go out and do completely irresponsible things they later regret. I’ve felt like doing so more times than I can count, and have complete empathy for those who give in to these bizarre urges. If I didn’t have a core of responsibility inside me that keeps me anchored in good times and bad, I would go out and do the same.

Usually the worst thing I ever did was go shopping and buy all sorts of things I didn’t need or never wore. If I were to look at my credit card statements for those time periods I’m sure I would see a pattern of spending that coincides with the pre-menstrual portion of my PMDD episodes. Fortunately, now I understand what is happening and stay home on those days instead of going shopping. Because inevitably the bill would come, and I would wonder why on earth I had done such a thing.

When I worked as an analyst for the government, on my pre-menstrual days I would suddenly notice that I hadn’t received a response on this project or the other, and would call up the parties in question and remind them I was waiting to hear from them. On any other day it wouldn’t have bothered me. People get busy, people go on vacation, people have priorities, people forget. In the overall scheme of things, my projects were never that vital. Most of the time, I was tolerant and flexible.

But on a PMDD day, everyone I came across was either incompetent or personally holding me back from untold success. I might not rant at them directly--after all, even on my worst days I knew you catch more flies with honey than vinegar--but I would complain to anyone else who would listen about how I seemed to be the only person around who could get things done and do them right. I had no tolerance for even the slightest delay or mistake. On those days, you didn’t want to mess with me.

Then my period would come and I’d be miserable in a new way for a couple of days. Cramps, backaches, and pain that sometimes radiated as far down as my knees, and made me feel like I wanted to throw up. Breathing hurt. I would lie very still, hot pack pressed to my lower abdomen, which felt like someone was slowly trying to pull my insides out with a three pronged gardening tool. Every single month. That, if you want to believe it, was the eye of the hurricane. The first two days of my period.

Then the sadness kicked in. On Day Three. Always on Day Three. If it was going to come, that would be the day. It didn’t always come, still doesn’t. Now I know it has to do with whether I release an egg or not that month. No egg, no sadness. Woo hoo! Party time.

Not quite. But at least it’s a lot more pleasant around here when the sadness doesn’t come. Because when it does, I’m tired all the time, my head feels like it has an iron band around it, I sigh incessantly, big, deep sighs like the weight of the world is on my shoulders—and for me, it is. Most everything looks hopeless, every good idea I had during the month goes to s***, I want to weep at every turn, you don’t dare tell me a joke or tease me, and I spend a lot of time wondering why I even bother.

During this phase of my PMDD, I used to beat myself up incessantly over the people I had snapped out at the week before. Now, at least, I don’t do that any more. I know I didn’t mean it, and in most cases it doesn’t get that far anymore, because I have a much deeper awareness of what is going on and can catch myself in counterproductive behavior.

Now, when I catch myself starting to snap out, I apologize and explain I am having a bad day. Most of my friends know what that means. If the person isn’t my friend, it’s okay to leave it at an apology without an explanation. By all means, if at all possible, never ruin a perfectly good apology with an explanation. You don’t need to justify yourself or your behavior. You just need to acknowledge it, apologize for it if the incident warrants an apology, and move on.

But back then, as I said, I would beat myself up incessantly. Which only intensified my sadness and made me feel like a totally worthless human being. My friends couldn’t possibly be my friends. They wouldn’t be my friends if they knew the real me. How would I ever find anybody to love me if I was so impossible to be around. Yada yada yada. You know how it goes.

The bottom line is the first part of my personal hurricane is the moody, bitchy, out of control part. Then would come the eye of pain and two days of solid pain but surprisingly clear thinking. Fortunately, now, as I begin to enter menopause, it’s just the clear thinking part, and a huge surge of positive energy. It’s a definite reprieve in the storm.

Then the sadness comes. The first D in PMDD. My depression. Or The Fog, as I call it. Back then it was devastating. How could anybody not hate me? Now I am able to separate myself from it and while it is still not pleasant, I know I am not my depression. I rest, relax, take it easy, spend time reading or listening to music or doing something quiet and non-demanding, secure in the knowledge that it will pass. I do what I can to help it pass sooner. I take walks, take naps, eat right and take supplements. I do not allow my negative thoughts to take over. In fact, I smile at them, knowing I know better. God does love me and so do the people in my life. My ideas are good ones and I am full of creativity. I am strong, capable, and competent. Just running a little slower than usual today. Just a tad off my stride. It will pass and I will be fine.

And I am.

One day The Fog lifts, and its back to the torrid pace of my life as usual—until the next wave of cravings and irritability hits.

Liana Laverentz is the award-winning author of two books on PMDD, PMDD and Relationships, and PMDD: A Handbook for Partners.  Both books are based on the most asked questions by her readers, and therefore the most popular posts on her blog, Living on a Prayer, Living with PMDD.  Both books are also an excellent resource for understanding your PMDD from within and starting a conversation with loved ones who want to know more about this debilitating disorder we live with daily. 

Snapping Out with PMDD

Here’s but one small example of how PMDD can affect your life and or relationships. A few weeks ago, my teenage son mentioned a wildly popular movie he’d seen over the weekend, and asked if I wanted to watch it with him. I love watching movies, and love spending time with my son, and was thrilled that he’d thought enough of the movie (and me) to ask so even though I had already seen the movie years before and didn’t particularly care for it, I said, “Sure, honey, we can watch it this weekend.”

For the past twelve years, we’ve enjoyed Movie Night every Sunday evening, as a way to settle in and prepare for the week to come. So he got the movie, and brought it home. A few days later, movie in hand, he asks, “Do you want to watch the movie now?”

And I snapped out on him and told him in no uncertain terms that I did not.

I don’t recall doing it. This is not me. I mean, I’ve watched Winnie the Pooh and Thomas the Tank Engine and Theodore the Tugboat videos over and over and over again. I’ve seen most Disney animated videos at least twice, some several times. For a couple of years, I stopped what I was doing every afternoon to watch the Power Rangers.

I have watched a LOT of shows and movies I might not have felt like watching, but did so because they were age appropriate at the time.

But apparently I changed my mind this time, and I don’t even remember doing so.

A few weeks later, I innocently mentioned to my son in passing that we hadn’t watched the movie yet, and he looked at me and said, “That’s because you said, `I don’t see why I should have to sit through a movie I don’t even like just because you want me to watch it.'"

“I did?” I asked, feeling totally embarrassed. “When did I do that?” “A few days after I first asked you about it and you said it would be okay.” “I’m sorry,” I said. “I don’t remember doing that. What did you say or do when I did that?” He shrugged and said, “I just figured it was one of your PMDD days and left it alone.”

I’m glad he knew it wasn’t him that caused my snappishness, but still…

“Where’s the movie now?” I asked.

“In my room,” he says.

“You want to watch it?”

He did. We did. It was better than I remembered, but I also remembered why I didn’t like it, as it contained some subject matter I find unpleasant. In addition to that, it had a sad ending.

“You asked me to watch a movie that would make me cry?” I teasingly accused him afterwards, still sniffling.

But he was sniffling, too. It was a good movie, a good moment, and sparked a good conversation about life and death.

And I would have missed that chance to have that conversation with him because of my PMDD.

I try not to look back, but I wonder how many other opportunities like that were missed because of something sharp I said when I didn’t mean to. Worse yet, I wonder how many times I hurt someone’s feelings by snapping out and don’t even remember it.

Because that’s part of PMDD. You get irritable, you snap at people, and don’t even realize you’re doing it. You think you’re behaving normally, until something ugly happens, or someone who feels close enough to you or comfortable enough with you gently points out you may be having an episode. (Which nine times out of ten you will vehemently deny until you realize they are right.)

Or, before either you or they are aware that you have PMDD, they may be less gentle or understanding, and may simply shout, “What the hell is wrong with you?”

You don’t know, they don’t know, and the relationship starts to strain at the seams. If you don’t get help, unless your friend or partner is a total saint or a doormat, the relationship falls apart.

Sound familiar?

Well, take heart in knowing it takes two to make a relationship work and it takes two to bring one to an end. It isn’t and wasn’t completely your fault. When you’re having an episode of PMDD, certain factors are out of your control.

That’s an explanation, not an excuse. (You’ll hear me say this over and over and over again, so get used to it.) You still need to go back and make amends if you’ve hurt someone you care about while your brain was not firing properly. You don’t need to beat yourself up over it. Your rage and irritability and emotional outbursts during an episode of PMDD are as uncontrollable as an allergic reaction. That doesn’t make them or the consequences from them any less painful, but neither does it mean you have to drown yourself in guilt afterward. You simply apologize and do what you can to make up for it.

If your loved ones really love you, they will understand and accept that there are times when you just aren’t yourself.

If you really love them, you’ll do everything in your power to see that those episodes are few and far between.

Tips and hints on how to do that can be found in this blog*, and in my books, PMDD and Relationships, and PMDD: A Handbook for Partners.  Also, if you use Amazon Smile, you can choose the Gia Allemand Foundation and they will receive a donation from Amazon.  Win-Win!

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