PMDD and Your Brain

A while ago, I read the book Women’s Moods: What Every Woman Must Know about Hormones, the Brain, and Emotional Health. It was a great book about overall hormonal health and described how hormonal issues are physiological occurrences in the brain that manifest as emotional behavior, because the hormones involved affect the areas of the brain that regulate our emotions.

On the one hand, I wished I’d read this book years earlier than I did, as it was first published in 1999. On the other, I’m glad I didn’t. While the authors completely explain the devastating effects women's hormones can have on your emotional life, they are firmly in the camp of using medication to treat these brain disorders that affect women throughout our reproductive years.

That’s fine if you want to go that route, but there are other options available now to women who suffer from hormonal issues. In 1999, these options were given a cursory mention and dismissed. Which means if I’d read the book any earlier than I did, I would have come to the conclusion that there was no alternative to my PMDD, short of medication.

That, for me, would have been very depressing indeed.

I know there are millions of women out there who have severe hormonal issues that may well require medication to control them—notice I say control them—not manage them. Me, I manage my symptoms through nutrition and exercise and positive lifestyle choices. If I took medication I wouldn’t need to be so vigilant about my health—the medication would theoretically handle the problem for me. But in my case, with the PMDD, I can’t see taking medication every day for something that only occurs a few days a month.

Still, there are days when the thought of it tempts me. But most days it does not.

As I said, to have read this book any earlier would have been devastating for me. Because the authors insist over and over that without treatment, your hormonal issues will only get worse. That there is no light at the end of the tunnel without treatment—this is absolutely true--but their treatment of choice is not mine.

That aside, I was able to read the book and learn much about the causes of hormonal issues and how and why these issues can and do get worse later in life without some type of intervention.

Hormonal issues are a very serious and practically rampant problem for women. Yet some days it seems like the only people paying any attention to us are those who can profit from our condition(s). Most of the information women receive regarding "hormonal imbalances" (a term I take exception to) comes from companies whose drugs have been approved for treatment of these "imbalances."

We need more than to be told a certain medication (or two, or three) can solve  our problems. We need to understand the underlying causes of our hormonal issues and find ways to heal ourselves from within and prevent the need for chemical solutions. We need to understand the unique female brain/body connection and how it makes us vulnerable to mood problems at the most challenging times in our lives. Puberty, pregnancy, post-partum, peri-menopause, menopause, and post menopause.

Every time you have a child, your hormones undergo an enormous amount of stress, and yet society acts as if there’s nothing to it. Life goes on and you cope.

But what happens when your ability to cope fails you? What happens when, as these authors aptly describe it, you have an internal “earthquake” and mood disorders erupt?

All this attention is given to heart health, but brain health is equally important. We need to learn to care for our brain as diligently as we do our heart. Not only the heart can be compromised by a woman’s genetic make up, life experiences, and stress load, but so can the brain.

If our brain doesn’t work right, we don’t work right, and all sorts of life-chaos can happen. No amount of "being strong" or "powering through" is going to re-regulate a brain that has gone askew. It just isn’t going to happen.

The way this book and many others describe it, our brains have neurological pathways that become worn over time like ruts in a road. When any situation arises, our brains immediately locate the memory of how we dealt with that situation in the past, so that we can effectively do so again. And each time we deal with that situation again, a new pathway is created over the old pathway.

This works fine if your brain is healthy, or operating at optimum level. But what if your brain is not? Then your brain is creating new pathways over damaged roads, and only more damage ensues.

Genetics plays a factor in this, of course, but so do your thought processes. In short, how we deal with stress affects our hormones, which in turn affects our brain. This stress can come from any and all sources, trauma from an accident or abuse, be it physical, emotional, sexual, mental, spiritual, financial, you name it, or from naturally occurring life events such as birth, death, marriage, divorce, loss of a job or health or relationship, to name just a few.

When your hormones are doing what they should, your body deals with these stresses in a normal and healthy way. When your hormones are compromised, your body and brain do not. Little stresses can be magnified into big stresses, completely out of proportion to the situation. When your hormones are compromised and your brain is dysregulated, you can feel like you are under attack 24/7. Your brain makes no distinction between the threat of an oncoming car or someone who simply disagrees with your point of view. Both, to your dysregulated brain, are threats to your very existence.

It’s not logical, in fact it is completely irrational, but that’s what it is. Your dysregulated brain is not properly processing the threat.

This is why women with mood disorders like PMDD or even simple hormonal fluctuations seem so irrational at times.

But we’re not crazy, or imbalanced--far from it. Rather, something has compromised our hormonal system, something that has yet to be scientifically identified and verified, something we have no more control over than we do an allergic reaction.

This is not to say there is nothing we can do to prevent our hormonal eruptions.  We all know that once one begins, it is unstoppable, because the PMDD brain is out to win at all costs.  But there are ways to minimize our eruptions, and this blog* is full of tips for that.  If you're looking for the information all in one place, try my book, PMDD and Relationships, or, for the supportive partner, PMDD: A Handbook for Partners.   Both are based on the posts in this blog.

*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.

Readers Speak Out: Advice for Partners of Women with PMDD

Today I uncovered another gem of wisdom from a reader on how to approach your partner's PMDD.  Rather than leaving it buried in the comments section of another post, I've decided to feature it here:

I just found this blog searching for something to help my husband know what to do with me. I feel better now, but I fear I'll regress and we'll struggle again as a family. I have PMDD. I say DO NOT bring it up when she is at her worst. She is completely irrational and doesn't want to answer stupid questions or talk about how she is feeling. [In that moment] it seems so obvious to her that you should know how she is doing. Don't bring it up on a date or otherwise special time between you two. It is better to ruin a good day or week to get her help, than to keep living like how you are and end up divorced.

First, you need to get your wife medical help. When you have an opportunity to talk—not in public—ask her if she's ever had PMS. She may not have realized her moods are associated with her cycle. You're either going to get a "Yes, dumb***" answer or a "No, not really, I don't think so."

Depending on how that goes, tell her you've done some research, you think her moods might be associated to her cycle, or, if she knows she has PMS, that it might be something more serious. Tell her about PMDD. Read her the symptoms. Ask her if this is how she feels sometimes. Feel bad for her, say you're sorry she has to endure that every month. Let her know there is help available.

I know it sounds insane. I know you shouldn't have to put up with it. I also know how well I'm doing now and wonder how much better last year could have been for my marriage if my husband would have reacted to me differently. If he could have said, "How are you doing? Not well? Let's get you to the doctor," instead of "You're so mean and I don’t have to put up with this." I think I would have felt better. I was already on an antidepressant. It wasn't working.

What I need to feel better is a new prescription and a husband who will back off when I'm irritable and take care of the kids. When I have a bad day, I need him to think, "She's mad, hmm, let's look at the calendar, yep, she's pre-menstrual, I'm going to leave her alone, not mention PMS, and take care of the kids until she feels better."

It might be a few hours, it might be a few days, but it won't be a few weeks like it was last year when he was mad at me for having a bad day; then I felt worse, then there was a fear he'd leave me. I get it, I wanted to leave me, too, but women with PMDD, I'll speak for myself at least, need to feel wanted and loved and worth it to help.

So that is my advice, stranger. Ruin a good day to get her the medical help she needs. Say, "I took next Thursday off work, would you like me to take you to the doctor?" If you have kids, arrange babysitting. It's so hard for moms to find an hour to go to the doctor, especially if she doesn't feel she's worth helping. Even if it's not PMDD she has, make sure she gets bloodwork done. They should be testing her thyroid to make sure there aren't issues there.

Either way, good luck, and from the wife's perspective, thank you husbands who stick it out and deal with us. Some of these marriages seem beyond repair, but husbands can do so much to help. Think of how she is doing and what you can do to help, even if that means just leaving her alone for a bit. She’s not rejecting you. She feels like s***. Unless she comes to you, your touch will be repulsive. It’s not personal, it’s just how she feels. Know that she cannot help how she feels when she is pre-menstrual. For me, I feel angry, tired, sad, and irritable so I am distant to try to protect the ones I love most (from me).

Perhaps your wife [doesn't] care so much if she is mean, but I care. I bet deep down she cares too because she loved you enough to marry you and doesn’t want to be mean to you. You don't have to understand it, you won't ever. You just have to love her through it. Hopefully she's worth it to you.

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.