World Health Organization Validates Premenstrual Disorder as a Global Health Concern

BOSTON, MA, 14 June 2019 --  In a landmark decision, the World Health Organization (WHO) has added Premenstrual Dysphoric Disorder (PMDD) to the International Statistical Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11), validating PMDD as a medical diagnosis worldwide and confirming the growing scientific and medical understanding of this little known, debilitating and life-threatening condition.

This groundbreaking move gives PMDD its own ICD code (GA34.41), which will help drive diagnosis, treatment, reimbursement, and research. A staggering 60 million people globally, 1 in 20 people with menstrual cycles, suffer from PMDD, caused by an increased sensitivity to reproductive hormones during the luteal phase between ovulation and menstruation. This sensitivity leads to alterations in the brain chemicals and pathways that control mood and well-being. Symptoms include severe depression, mood swings, irritability or anxiety, and drastically increases the risk of suicidal behaviors. Appropriate diagnosis and treatment of PMDD are therefore important not only for reducing suffering but also for saving lives.

“This decision is a game changer for PMDD,” according to Sandi MacDonald, Board President of the International Association for Premenstrual Disorders (IAPMD).  “The WHO has officially classified PMDD as a true and diagnosable disorder, and differentiated it from the wide collection of premenstrual symptoms commonly known as PMS.”

Historically, PMDD has been studied and treated by both (1) nervous system (brain) experts (neuroscientists and psychiatrists) and (2) reproductive system experts (reproductive endocrinologists, obstetrician-gynecologists). This multi-specialty approach has been reinforced by PMDD’s ICD-11 cross-listing in multiple chapters; the chapter on mental, behavioral, and neurodevelopmental disorders, as well as the chapter on diseases of the genitourinary system (system of the reproductive organs and the urinary system). This will foster more effective collaboration between these specialties.

“Given that evidence-based treatment algorithms for PMDD require a broad set of clinical expertise and skills, it is becoming increasingly clear that multiple providers with different specialties are required to offer truly comprehensive care for PMDD,” according to Tory Eisenlohr-Moul, PhD, IAPMD Clinical Advisory Board Chair and Associate Director of Translational Research in Women’s Mental Health at the University of Illinois at Chicago.

“The IAPMD recommends that clinicians build collaborative, multidisciplinary treatment teams for PMDD patients in order to facilitate patient access to the full range of evidence-based treatments. It is our hope that the inclusion of PMDD in ICD-11 will facilitate greater collaboration among treatment providers of differing specialties,” added Eisenlohr-Moul.

The ICD is published by the WHO and used worldwide for morbidity and mortality statistics, reimbursement systems, and automated decision support in health care. In May 2019, member states agreed to adopt the ICD-11, to come into effect on 1 January 2022. The system is designed to promote international comparability in the collection, processing, classification, and presentation of these statistics. Like the analogous DSM (which is limited to psychiatric disorders and almost exclusive to the United States), the ICD provides a common language that allows health professionals to compare and share health information across the globe.

The International Association for Premenstrual Disorders (IAPMD) is the leading voluntary health organization which aspires to create a world where people with Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Exacerbation (PME) can survive and thrive. Our mission is to inspire hope and end suffering in those affected by Premenstrual Disorders (PMDs) through peer support, education, research, and advocacy. What began as a collective of fellow suffers in 2013 has grown into a global movement accelerating the progress being made around the world.

My First Memory of Having PMDD

It’s hard to pinpoint my first true memory of having PMDD. I think I struggled against my PMDD for so long, denying that I had a problem, that it manifested long before I admitted there was something wrong with me. No one else I knew went through these struggles, or if they did, they didn’t talk about it. They managed, they coped…why couldn’t I? What was wrong with me that I was fine one day, and could barely get out of bed the next? I think I blamed it on everything and anything else but me, sources outside myself, school, work, friends, family, whoever I was in a relationship with at the time--because I was young and healthy and mental-type problems only happened to other people.

The first episode I can remember which I would now attribute to PMDD was a two-week period in my freshman year of college, toward the end of the semester and year, when I simply didn’t get out of bed except to go to class. I was doing well in my classes, not having any problems to speak of, and then suddenly this period of total sadness and hopelessness and lethargy hit, and I had no motivation to do anything or go anywhere. Then just as suddenly it lifted, and for the remaining weeks of the semester I raced around like a madwoman, trying to catch up and make sure my grades didn’t suffer.  I was eighteen years old.

Now, looking back, I can see countless repetitions of this scenario, where I’m sailing along, and life is fine, and then suddenly...it isn’t. When all indications are that I should be happy beyond measure--having achieved every goal I’d set for myself to that date--but I wasn’t. I used to think there was just something inside of me that liked to make life a little more challenging. Something that liked to let me fall behind, just so I could prove that I could catch up and still come out ahead. Now I realize it was the PMDD dragging me down. Now I think about how much I could have accomplished, had I known what was happening and learned to manage my PMDD, like I eventually did.

But I don’t dwell on those thoughts, because those opportunities have come and gone, and negative thoughts will bring anybody down, not just a woman with PMDD. There’s no sense in feeding the fire. What’s come and gone has done just that…come and gone. The only moment we can do anything about is the moment we’re in right now. And right now, I know that most, if all negative thoughts I have stem from my PMDD and I’m just not going to give them any more air time. I’m still as stubborn as I was as a teenager, still as determined not to let the sadness and negativity get me down, only this time I know what I’m dealing with. Now I’m able to separate the two, my usual self and my PMDD self, and when my PMDD hits, I’m able to label my self-defeating thoughts as PMDD thoughts and just set them on a mental shelf to be dealt with later.

The beauty of this tactic? When later comes, those thoughts are no longer relevant. Mostly because they weren’t true to start with. On PMDD days now I rest and take it easy. I find something positive and uplifting to read or watch or listen to, and focus on small, sometimes mindless tasks that I know need to be done and have been saving up for just such a day. Organizing receipts or CDs or books on a shelf. Folding the laundry. Nothing heavy, nothing demanding either physically, mentally, or emotionally. For instance, sorting through old photographs probably wouldn’t be a good job for a PMDD day. The emotions they dredge up might not be positive, might make you miss someone or someplace or stir up regrets. Or they might remind you of a happier time, and instead of making you smile, might make you feel like you’ll never be happy again. That’s the PMDD brain talking, not you. And whatever it is saying is certainly not coming from God.

I bring God into this because my faith was and is a big part of my experience with PMDD. Without faith in something bigger than myself, I never would have come to have faith in myself. I can’t tell you how many times I thought there has to be a way to make this madness stop. The first book I picked up was Prayer, Faith and Healing: Cure Your Body, Heal Your Mind, and Restore Your Soul. I’d tried everything else. Maybe it was time to give prayer a chance. And so I started. With baby steps. One by one, one day at a time, learning how to listen to something positive outside myself for a change, until I learned that God was inside of me, too, and I could go within for the answers I needed. They didn’t have to come from outside sources.

The stronger I became on the inside, the more those negative external voices dimmed to background noise. Such as well-meaning friends and family with unsolicited advice, and not-so-well-meaning friends and family with selfish needs and demands.  Not to mention well-crafted advertisements pointing out all the areas in which I was lacking in my life, or organizations with agendas on how I needed to live my life, and countless books, magazines, radio and television programs telling me I could have it all, while at the same time measuring me by artificial standards no one person could ever hope to attain.

It’s hard enough navigating life with all your faculties intact. But when you’re a woman with PMDD, operating on half power or less half the time or more, life gets really challenging. So don’t beat yourself up. The world is more than happy to do that for you. Accept that you’re not perfect and you’re never going to get there, then relax and enjoy your life. When you’re feeling good, take on all you want to, and when you’re not—take time out to take care of you.

If you take nothing else from this post, take this: Don’t spend another day beating yourself up for something you have no control over. Do start listening to your body, and giving it--and yourself--the respect you deserve. If you don’t know how to do that, if you’re scratching your head at the very thought of it,  like I once was, then check out my blog, my Living with PMDD Facebook page, or my book, PMDD and Relationships, for more information on how to better manage your PMDD, as well as support, encouragement, and tips on how to be a better you…all month long.

Today is World Mental Health Day - PMDD

This from the Gia Allemand Foundation:

Today is #WorldMentalHealthDay and this year's #WorldMentalHealthDay focuses on mental health in the workplace. Coping with PMDD in any aspect of your life is a challenge. Dealing with PMDD at work can be especially difficult.

Maintaining a business demeanor when you are experiencing violent mood swings, fatigue, anxiety, and often physical pain related to PMDD can seem an impossible thing to do. You may find that you need to be absent from work while your PMDD symptoms are at their most severe. You may wonder if you can do that without losing your job. Thankfully, in the United States, there are some measures you can take to ensure that you can take the time off work that you need in order to cope with your PMDD symptoms without losing your job.

For more information, and for access to valuable tools that may be helpful to you in your journey no matter were you live, please visit this Gia Allemand Foundation page.

Liana adds:  Remember, PMDD is an explanation, not an excuse, and is something that happens to you that you don't have any control over it happening. The only thing you can control is how you respond to your PMDD.  Just know you are not crazy, and that you are never alone.  Even though, I know, it totally feels like you are.  But you are not.  Help is available.  

PMDD and the MTHFR Gene

Today's gift is a post by PMDD Advocate Danielle Lasher Bosley, which helps to explain the mysterious MTHFR gene we have often read about.  

What is MTHFR? It's an enzyme that can be mutated. Women with PMDD don't all have the mutation, but it is assumed the vast majority of us do. If I had to personally estimate based on women I know who have been tested already, I would say above 90%.

MTHFR is highly linked to mood disorders, autoimmune issues, and many, MANY other things. Heart disease, PCOS, cancer, thyroid issues, addiction, miscarriage, fibromyalgia, IBS, bipolar, chronic fatigue syndrome, asthma, MS, cervical dysplasia and much, much more...

People with the MTHFR mutation cannot properly methylate. When methylation is impaired, they can't detox properly, among other things. Birth control, any synthetic hormones, prescription drugs overall are riskier for us. They essentially get us further away from being better while making us feel better temporarily. 

People with MTHFR should NEVER use acetaminophen (stick with bioron or ibuprofen if needed). We also should not be vaccinated. Many of us in the PMDD community who have researched this illness for many years and have also researched vaccines are confident there are potential links and that for some of us, vaccines contributed to or outright caused the start of this illness.

The two most common forms of MTHFR we know of are c677t and a1298c. Heterozygous MTHFR means you have one copy of one of these. That is the least serious form, but it still predisposes the individual to more risks than someone without MTHFR. Compound heterozygous means you have one copy of each form. This is more severe than the first form I mentioned. The most serious form of MTHFR is homozygous. Homozygous c677t is the worst one. This means you have two copies of the 677 form. Methylation is decreased to an estimated rate of just 30% of what the body should be doing in these cases. 

People affected by the MTHFR mutation need methyl folate. They also need to avoid folic acid. Folic acid is the synthetic form of folate (Liana adds: and is promoted heavily by the media to all women of childbearing age.) With MTHFR mutations, only methyl folate can be received and processed by the body. Synthetic folic acid actually builds up on receptors and blocks natural methyl folate from getting through. This makes us sicker.

Keep in mind this goes beyond vitamins. Folic acid is added to a TON of processed foods. Breads, cakes, potato chips, etc... This is part of the reason we improve when we cut out these foods. You might have heard women speak about their PMDD improving when they go Paleo, etc.... It's not merely because they cut out processed food. It's because in that step, they removed the folic acid from their diet and started consuming methyl folate. Their body is finally able to start working properly and detoxing well.

Vitamin B is also important and majorly impacts our moods. We must avoid cyanocobalamin and only use methylcobalamin. (Liana adds: Read the label on your bottle.)

Synthetic hormones and birth control are not only a risk for us because we have higher risks of heart issues, stroke, and pulmonary embolism, but because the synthetic hormones reduce folate! The hormone part makes you feel better today, but the damage its doing underneath the surface will make this illness, as a whole, harder to treat.

We are also at high risk of vaccine injury. Many of us are confident PMDD may be the result of vaccine injury itself. If you've never researched vaccines, they do indeed cause injuries. Many of them are brain injuries and issues that have led to the development of neurological disorders. As of this date, $3 billion has been paid out to victims of vaccine injuries through the federal vaccine court. The numbers continue to grow.

Vaccines are dangerous for us because they contain adjuvants we can't properly detox from when we have either the MTHFR and/or COMT* gene. MTHFR also inhibits our bodies from removing the toxins that vaccines inject. Just some vaccine ingredients include:

Formaldehyde, aluminum, mercury, aborted fetal cells, cow and monkey DNA, glycophosphate, polysorbate 80 (carcinogenic preservative), neurotoxins like ammonium sulfate, antibiotics (more harm to our guts), phenoxyethanol (antifreeze), and more.

Hope you're all hanging in. We ARE going to resolve this illness. ~Danielle

*Catechol-O-methyltransferase (COMT) is one of several enzymes that degrade catecholamines (such as dopamine, epinephrine, and norepinephrine), catecholestrogens, and various drugs and substances having a catechol structure. In humans, catechol-O-methyltransferase protein is encoded by the COMT gene.

Five Secrets for Surviving PMDD

Sometimes when we’re on the edge, a little dose of truth is all we need to keep from toppling over. Here are 5 secrets that can make surviving PMDD a lot easier.

1. Resistance creates suffering. Yes, PMDD causes unbelievable discomfort and mental agony. But were you aware that when you resist that discomfort and agony, you are actually creating MORE of the same? The human race is quite masterful at wanting things to be different. We’ve gotten quite adept at overanalyzing, strategizing, manipulating, denying, oppressing, and yes, even brooding over what is. But what is, still is. With or without all the energy we expend pushing things away, blaming ourselves or others, and replaying events of the past or imagining disasters in our future, reality is still reality. The trick, and I tell you true, is to use that very same energy you’ve been wasting on what you cannot change and divert it into new channels that actually make you feel better. It’s so flippin’ simple and obvious, and yet doing it takes tremendous energy and refocus.  

2. Build your energy. Okay, so now you know. You’ve got to spend the energy you have differently and also increase your energy enough to be able to break out of old habits. So, you have to identify all the ways you waste or leak energy. It could be through crappy relationships, through poor diet, not getting enough sleep, and the less obvious ways of stuffing emotions, harboring negative thoughts, or denying yourself as a matter of habit everything you truly want in life (by, for example, not even asking for it!). And here’s another tip: the more comfortable you can become with your discomfort, the more energy you will reserve and build. When you want to flee or fight, but there’s no imminent threat, stop. Feel. Breathe, woman! I promise it will pass. 

3. You don’t need to fix yourself. I know. It’s hard to believe. But it is true. You don’t NEED to be any different than you are…no matter what you or anyone else has been telling you. I know PMDD sucks. I know it can turn you from sweet and loving to bitter and hateful in under 3 seconds. But the thing is, neither of those personalities is you. You are a deep and beautiful mystery created by Life, infused by life, and guided by life. Flawless! Next time you get the message that you suck, duck! Let that bullshit ride the airwaves right over your head and out the window. There’s nothing you can do to change what is until Life decides it’s time. And then all you have to do is not resist! So until then, dream a better life but without the underlying judgment that says, “I am not doing enough.” 

4. Let yourself off the hook. The nature of PMDD ensures you’re going to have bad days. Why beat yourself up about them? Why bash yourself with judgments and shame or guilt over what you thought or felt or did? Make reparations if you can, of course. But it is actually a complete waste of energy to chastise yourself for losing your temper or getting depressed again. It is useless to tell yourself to get a grip or get over it. And you certainly wouldn’t appreciate hearing that from someone else, so why do it to yourself? Accept that in every moment, you unquestionably do the best you can. If you could do any better, you would. Allow yourself your mistakes, forgetfulness, reactions… Whatever thoughts or feelings or emotions you experience, they really aren’t personal. They pass and evaporate, eventually. They aren’t YOU. 

5. Stop believing your complaints. PMDD causes sufficient misery to provoke numerous complaints. You’ve earned the right to complain. So if you need to vent, vent! It’s healthy! But that doesn’t mean you have to believe your complaints or use other people like sponges to absorb all of your problems. Whatever you need to express, do it with people who aren’t going to buy into and reinforce the story. But take care you don’t reach out to people who are going to devalue your experience either. What you feel is real. What you believe about it…not so much. It is a delicate balance, and it starts with you. Recognize that sensations arise in consciousness. You will never be able to control them, so don’t waste that precious energy trying so hard. Instead, learn to doubt them. Learn to see them for what they are. You’re not broken, doomed, hopeless, or useless and life hasn’t handed you an impenetrable bum deal. The truth is, life is so much easier than we make it…if we’re willing to let it be.

Liana's note:  The above 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.

Sharing the Sisterly Love - A Report From the 2nd Annual National Association for PMDD Conference in Philadelphia

The 2nd annual National Association forPre-Menstrual Dysphoric Disorder (NAPMDD) conference was like no other, ever, anywhere. Since continuing medical education credits were offered this year, they had a wide array of medical professionals present, both at the podium and among the attendees—all of them discussing Premenstrual Dysphoric Disorder, a disorder that affects women around the world with life-altering symptoms that revolve around their menstrual cycles.  Clinicians from all fields of PMDD treatment shared what they knew, what they believed, what they had discovered, what could be proven, and what worked for their patients.

For a research geek like me, it was sheer heaven. Nowhere else on earth would I find one location with so many dimensions of medical care for PMDD represented—and openly exchanging ideas, some of them rather heatedly. But to witness a public forum of medical professionals discussing the disorder I have suffered from for over forty years was a dream come true.

My deepest gratitude and admiration goes out to NAPMDD Executive Director Amanda LaFleur and her tireless board of women determined and dedicated to doing all they can to promote awareness and open discussion of a disorder we have suffered from in silence, confusion and neglect for more than the 70 years since it was discovered. In Philadelphia, on the 51st floor of a building overlooking the beautiful City of Brotherly Love, psychologists, psychiatrists, social workers, endocrinologists, gynecologists, medical researchers, reproductive hormone specialists and other PMDD advocates gathered. Several speakers commented that they’d only seen PMDD from their specialty’s perspective until this conference, and they appreciated the opportunity to hear other points of view, as it brought up ideas they had never before considered, and made their PMDD picture more complete.

Surprisingly enough, one thing everyone in the room during a particularly dynamic discussion of treatment options agreed on—the name needs to be changed and the designation of ‘dysphoric’ dropped, to remove PMDD from the realm of mental illness. PMDD is a biological disorder, not a mental one, and needs to be treated as such, and not with the current cache of psychotropic drugs designed to alter the mind.

That was my major takeaway from the conference. No, you are not crazy. That alone made it worth the price of admission.

I also attended last year’s NAPMDD conference in Denver. I would say the major takeaway from that conference was: You are not alone. Between the two conferences, I now have something I didn’t have the first forty years of my life with PMDD: Hope—if not for a cure in my lifetime, then at least for a reliable answer as to what causes PMDD and the best way to treat it. Nearly everyone I heard speaking on the subject, with only one notable exception, said antidepressants and/or birth control were not the answer for treating PMDD, but merely band-aids used to mask the symptoms, which can (and do) rebound worse than ever when this faux treatment stops.

But take heart. Caring professionals are out there studying PMDD diligently. Others want to learn all they can about PMDD, to be able to treat their patients correctly and with compassion. This is progress like my generation merely dreamed of. I am truly energized with hope for the growing number of women still in their childbearing years, struggling with this debilitating disorder. Now, thanks to NAPMDD, there’s a chance you won’t have to suffer like so many women who have come before you, shuttling from doctor to doctor to doctor, being misdiagnosed and mistreated, being told “It’s all in your head” or having your concerns completely dismissed because the doctor had no clue what you were talking about. Not to mention being used as a human guinea pig for countless medications we now know don’t work for PMDD, because while they may aid in suppressing some symptoms, they do not address the root biological cause of what is happening to you.

The second part of the conference was all about support and social networking. Last year, I think we were all simply relieved to meet “other people like us.” This year, we had many return attendees. Instead of anxious, relieved and emotional women dominating the conference landscape like last year, this year we had a strong squad of empowered women who returned to speak about their successes (and failures) in managing their PMDD, and to provide support and resources to those attending for the first time. Many new attendees brought mothers, sisters, friends or partners for support, and it was beautiful to see. The atmosphere was just as warm and welcoming as last year, if not more so. The Gia Allemand Foundation Reception Friday night was open to the public, and provided a fantastic opportunity to meet and mingle with both attendees and speakers. 

At the reception I had a fangirl moment when a PMDD researcher I’ve admired for years sat at our table and I told her, “I have a special binder full of all of your studies.” In exchange, she told us how she got into PMDD research and how inspired she is by the increasing awareness of PMDD in the medical community. Other highlights of the weekend include a tour of Philadelphia on a double-decker bus with ten other conference participants, exchanging ideas over breakfast with fellow speakers and drinks and snacks at the Tap House with Executive Director Amanda and our wonderful videography team at BKN Creative. I returned home with friendships I know will last a lifetime.

So the conference is not just about exciting news and taking notes. It’s also about having fun with friends and creating a network of support and resources you can count on during the hard times.

If you missed the conference this year, join NAPMDD to stay in the know, which will provide you with access to the videotaped presentations of both the first and second national conferences, to discover this information for yourself. The cost is $36 and well worth the price of admission. There is also a free membership, but that does not provide access to the videotapes; you’d have to buy them separately.

Knowledge is power, and knowing all of your options can empower you to seek proper treatment for your PMDD, and to stand up for yourself when you meet a medical professional that refuses to believe or work with you to find the individual solution that works best for you. With the information from these videos, you have the tools you need to be your own best advocate.

For more information on NAPMDD and how to attend their next conference, go to NAPMDD.org.

The Voices of PMDD - Battling the Darkness

Today's powerful guest post was written by Amanda Van Slyke, Founder and Editor-in-Chief of Flurt Magazine.  For more information, please visit Flurt's Facebook Page.

Every month around this time the darkness swallows me up. It seems to happen in an instant, where I previously felt more creative and fulfilled than I've felt in a long time. Just before the lights go out, I climb mountains of work that I've been trying to reach for weeks. I write essays full of passion and reach out to others for emotional connection. I walk down the street smiling ear to ear, thinking that maybe – hopefully, this time – I've escaped the torture I see others endure online. They post about how they can't do this anymore – about how it happens every month, and every month like clockwork it's the same thing – feelings of hopelessness, loneliness and isolation. But I am happy. I eat well and do yoga and meditate and run – everything you're supposed to do to get rid of the darkness. I think that if only people did what I did, they'd feel just as great as I do. I am the exception to the rule.

When I was younger, I came to a point where I'd felt like I had already died. I was a shell of a person, barely leaving my bed because of the fatigue and depression, stuffing my face with whatever temporarily took away the pain. I barely escaped to the west coast to get away from the darkness before it swallowed me whole – and I saw a lifestyle that could make me feel better. I stopped drinking, stopped eating sugar and dairy and gluten – and I know how you all feel about gluten, but it worked. For the first time in my life, my face cleared up. My bloated belly flattened. When I filled my body with fuel instead of poison, my energy started to come back. My depression started to lift. I could feel the oxygen coming back into my bloodstream. The more I took care of my body, the more I saw God through me – and I was an atheist.

I know that sometimes people take medication – SSRIs mixed with therapeutic conversation – and believe me, I've been on so many pills I considered swallowing them all at once. But pills took away something far deeper than the darkness – they took away my ability to feel your toes tingle and your whole body remember what spirituality feels like. And for me, I'm not willing to give up my God – the one that speaks to me through my own moans and screams. To me, feeling that numbness inside me might as well as be the death of me. So I tapered off my medication – well, after I tried to go cold turkey, and my boyfriend almost broke up with me. When I finally felt I was myself again – the one I had been searching for and didn't know could exist – I wanted everyone to know about the revolution.

And the revolution came in a plant based crusade. I felt like I had finally found a cure for the darkness. I went two years without eating meat, and I was so skinny my panties fell to the floor. But I still said that I was part of the movement. I shared photos of my recipes online, and talked about how well I was doing. But away from the limelight my diet fluctuated just as much as much as my mood. Just like I'd tapered off my medication, I tapered off fuel for my body, replacing it with poison – processed foods that were easy, thinking that just a little bit of junk food would make the pain go away. Because the pain never did, regardless of what I was eating. If I gave in and reached for the poison, it would spread throughout my body and the pain would inflate my belly and the lights would go out. And then I would say, "Screw it," like the people online that I thought just needed to be more like me.

I know now the darkness is inevitable. I know I need to do my best to choose the light – and that I won't choose it every day, nor will anyone else – even the gurus on Instagram who post photos of food I don't have the money to make. Because the darkness isn't a place where you only go when you're weak. Diet and exercise and medication is for the privileged – and I'm privileged enough – but sometimes I don't have much money for food or the will to leave my apartment, so I reach for something I know will be easy but harder in the long run. And then I spiral down – feeling hopeless, lonely, and isolated – where my only friend is the poison that I know will kill me. Because people die from this.

The darkness leaves you feeling like there's a hole where your heart should be – where you try to fill it with things to make the pain subside. Junk food, alcohol, sex, and drugs. But the real misery comes when you realize these things are never going to be enough. It comes from the knowledge that only finding self love can fill that hole – and trying to love yourself is hard when you never did. Once you see it's just you and the darkness, you can either stay up til morning or go to sleep. And while it's easy to say some are weak for not fighting, I don't blame them.

Because right now, I am unhappy. I walk around my apartment with swollen eyes, moping about how I'm just like everyone else, posting online about how I can't do this anymore, about how it happens every month, and every month like clockwork the darkness returns. But I know that soon the light will appear – so for today, I eat well, do yoga, meditate and run. I know it isn't a “cure,” but I know the more I take care of my body the more I'll see God through me. And maybe she can give me strength so I can see the light another day and remember what it's like to be happy – to smile ear to ear, thinking that maybe – hopefully, this time – I've escaped the darkness.

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

PMDD Quote of the Week

~I can feel the PMDD approaching, hovering, waiting. It feels like another presence, a shadow, that lives inside me and it's slowly making its way to my mind where it can take over my thoughts and emotions. It's behind me where I can sense it but not see it. I'm aware of it there and can push it back a little, but I can't stop it and it slowly creeps forward closer and further than it was before. I try to prepare for the inevitable, knowing that I can never really prepare myself for what's to come.~ JP

Declare Your Independence from PMDD - Nutrition Matters

Today we offer a two-for-one post, with a guest segment from Julie, a woman who, like me, has taken the responsibility for management of her PMDD symptoms into her own hands.  Read on to find out how and why. 

Let food be thy medicine and medicine be thy food. ~Hippocrates, founder of the Hippocratic School of Medicine

Julie starts:  Over a decade ago, I sat down with a doctor and burst into tears. Literally within moments, I had a prescription for an antidepressant.

I left feeling ashamed and deficient somehow. The drug didn't help at all and I was cycled through various others to see if one would finally work for me. When I decided to quit the search, I was tapered off of everything and felt like bolts of lightning were jolting through my body for weeks.

Nobody ever asked about my diet.

I've had three idiopathic blood clots. That means doctors can't identify what caused them. But now I take an anticoagulant for the rest of my life. For years, I've had to be careful about which foods I ate because certain foods could interfere with the medicine.

I even saw a gastroenterologist who wrote me a prescription for an anti-anxiety drug before printing me a list of foods that might be the culprit behind my constantly upset belly. There was no real plan, no follow-through. Just a drug to treat the symptoms.

I was told that my symptoms were all in my head and just manifesting themselves in my gut. I felt broken and shamed again.

Yoga was my first step in recovering from depression. I'm now a registered yoga teacher and practice almost daily. I meditate and take long walks to soothe my nervous anxiety. I have been gluten-free for years and until recently ate what I thought to be a fairly healthy diet. I don't drink or smoke or even drink caffeine. Most people who know me would probably consider me somewhat of a health nut.

One day it occurred to me that I would never just "open my medicine cabinet and start swallowing random handfuls of drugs." I don't even take Tylenol without checking to see if it's safe with anything else I have to take. But I do this with food. I open the refrigerator and...

I [finally realized that I] paid more attention to the appetizing picture on the package than to what was actually in the package. I finally understood that FOOD IS MEDICINE and that literally every single cell in my body was made of the food I chose to eat.

For the past several weeks, I've been eating nothing but clean food. I've removed all dairy, grains, legumes, soy, and sugar from my diet. I have piled my plate with veggies, fruit, and protein. Everything has been delicious and satisfying. I've definitely lost weight, and I've never felt deprived or gone to bed hungry.

But I've also gained strength and endurance. My sleep has improved. My skin is happy. And my resting heart rate has dropped steadily.

And this happened after only two weeks!

I'm much happier these days than I was a decade ago. I've fought for my own happiness. I now know who I am and what I need to feel like me. Antidepressants and anti-anxiety drugs are helpful to many and there's no shame in taking them—none—but they've become so stigmatized that we sometimes get defensive about them instead of fairly examining the whole picture.

None of the doctors I met ever asked me about my diet. I was told that my symptoms were all in my head. Who cares that my head happens to be connected to the rest of my body?

What we eat matters and affects our entire being, not just our physical body.

Did you know that body fat secretes hormones? It works like an organ. If any other organ were enlarged and throwing the rest of your system out of whack, you'd probably consider that a problem.

Food is comforting. These past weeks have been emotionally exhausting. I got a call from the vet who has been treating our beloved dog for his leukemia. When they diagnosed him, they said he had 7-60 days left. He fought for more than six months! Even so, the vet confirmed that we had to say goodbye. He suggested euthanasia was the most compassionate response. It was gut-wrenching. I was standing in Target sobbing and calling around looking for someone to come to the house that night to help my dog transition in peace.

During that situation and other, equally stressful situations, I found myself face to face with the reality that I use food to comfort myself. I longed for sugar, cream, grains... Cookies, basically. I stared at the brightly colored bags of treats and imagined what it would be like to eat them. To feel their crunch and sweetness and melting chocolate. I felt alarms going off in my head like an addict fighting to stay clean amid temptation. I pushed my cart through the store with eyes red from crying and left with my commitment to a clean diet intact.

Once at home, I made myself a bowl of chia seed pudding with coconut milk and cream, bananas, blueberries, and love. It satisfied and comforted me. It nourished me instead of making me feel sick and sad.

It's okay and good and right to feel comforted by your food. Food is medicine. Food is one of the truest joys in life. Learning to see food for what it really is has been an intense and eye-opening experience.

If you're looking to learn more about all of this, please go find a copy of the book, It Starts with Food. Written by a certified sports nutritionist, it's an absolutely fascinating and inspiring read.

Liana adds:  So make today the day you declare your independence from PMDD.  In addition to whatever treatment plan you are following, take a good, hard look at your food habits.  What you eat, when you eat, where you eat, and why you eat.  Read up on food and nutrition and how it all works to support and sustain your brain and body.  Do what you can to eat clean(er)—and feel the difference for yourself.  Become more body aware as you start to feel healthier. 

Make changes in small increments if that's the only way you can stick to a plan.  Baby steps. 

That's the way I did it, and, like Julie, my symptoms have eased to barely worth mentioning in the year and a half  I have been eating cleaner.  So much so that I haven't needed to take anything for anger, irritability, depression, mood swings or anxiety other than an extra 100mg of progesterone as needed.  (I wear an estrogen patch (.75.mg) and take 100 mg progesterone capsule at bedtime daily.  I take an added dose of progesterone (either via a second 100 mg capsule or a dime-size dollop of progesterone cream) on days when I feel symptomatic.)

Nutrition matters.  And you deserve to be nourished, not pacified.  So give cleaning up your diet a sincere effort, like Julie and I have.  There's nobody out there who can or even will do it for you.  It has to come from you.

Then, once you, too, feel stronger and have more stamina and energy—mentally, emotionally, and physically—you may be able, with the supervision of your medical practitioner, to be weaned from any substances (or situations) you have determined are making you feel worse...instead of better. 

And wouldn't that be something to celebrate?

Readers can find Julie on Instagram @hideadollar and can reach Liana either through posting a comment here or by emailing her at info (at) livingwithpmdd (dot) com.

PMDD Awareness Month, April 2016

A PMDD Valentine: Not All Chocolates Are Equal

For Valentine's Day, a post about chocolate (and a few other things), first written in 2009, but updated and still relevant today.

Having come freshly off a week of spending up close and personal time with my evil twin, who kicked my butt so badly the last day she was here I had to take a three-hour nap in the middle of the day, on top of getting a full night's sleep, today I feel uber-qualified to write about how it feels to experience PMDD. The thing is, now that the episode (aka her latest visit) is over, it's the last thing I want to think about.

I look around and see all that didn't get done over the week, the laundry piling up, the floors that need to be cleaned, the clutter of all I didn't feel up to coping with and simply set aside, and would much rather regain some semblance of control over my life—if only its external appearance—than write about the dark place I inhabited for eight full days and change this time around.

Why such a long visit this time? I think I know. I think it had something to do with my recent road trip: the stress of travel, the staying up later than usual, sleeping in strange environments, the change in diet, the miniscule amount of alcohol consumed, although in comparison to my usual alcohol intake, it was a big jump. Add that to the copious amounts of caffeine I consumed while on the road, the pasta-heavy fare at the conference, and I think I'm getting the picture. At home, I'm usually alcohol and caffeine free-or close to it. An occasional cup of coffee, usually one cup of caffeinated tea in the morning, if I feel the need, and chocolate only when "the cravings" come.  I hadn't had pasta or bread in weeks before the conference.

Why? All of these are bad for women with PMDD. Caffeine, alcohol, sugar, flour, hence the bread and pasta. But why am I so sensitive to their effects? I know women who practically live on caffeine and sugar, others who drink freely, others who love their bread and pasta. Is it possible they feel as miserable as I do, or more so, but deny their misery and continue to self-medicate with food and drink?

Because attempts to self-medicate is what these addictions (for lack of a better word) are. My research is showing there are very few true physical addictions in life. Most compulsions are emotionally or psychologically based. Only in rare cases is an addiction physiological.

That's not to say we can't get cravings. But cravings are cravings, temporary urges for some kind of substance to relieve our mental, emotional, or physical discomfort. Cravings are not addictions, although when you are in the throes of one, it can feel like an addiction. But as someone writing a book on dealing with addiction recently pointed out to me, "You're not going to stick a gun in someone's face for a piece of cake."

Cravings are the body's signals that some physiological need is not being met. You're low on some vital nutrient, to be exact. Your body is saying, for instance, "I'm low on magnesium," and you feel a sudden urge to eat a banana, or some almonds, maybe some oatmeal, or, yes, some chocolate.

Chocolate is one of the best known substances we crave. What confuses the issue with chocolate is not only its physical healing properties (of which there are many), but its emotional associations. We associate chocolate with feeling good. But not all chocolate is equal. Some are better for us than others. Much better. Others are almost useless, physiologically speaking. In the example above, a banana would provide as much magnesium as a 1.5 ounce chocolate candy bar, but a handful of almonds or cashews would provide almost three times as much magnesium as either the banana or candy bar.

So why do we reach for chocolate? It's as much for the emotional fix as the nutrients needed. More confusion arises when we don't know the difference between types of chocolate, due to the marketing and advertising claims of their manufacturers. Manufacturers is the key word here. Quality chocolates from true chocolatiers abound with the beneficial properties of chocolate. True dark chocolate is a rich source of flavanoids and antioxidants, with the cacao bean containing more than twice as many antioxidants the so-called superfoods like blueberries, kale, spinach, or broccoli.

It's the cheap, mass-marketed brands that—while they may contain tiny amounts of chocolate's beneficial properties—have processed most of the antioxidants and flavanoids right out of the chocolate. To derive any benefit from eating these lower quality chocolates, you need to eat way more than is healthy for you. When this happens, the negatives outweigh the positives—and you could end up outweighing all your friends.

If that's not enough, did you know that adding milk to your chocolate, or even drinking milk with your chocolate can negate its good effects?

Meanwhile you're bewildered, thinking, "Chocolate is supposed to be good for me, right? Milk is supposed to be healthy for me. Isn't that what the ads say? By eating chocolate and drinking milk, I'm doing something good for my body, right? So why do I feel so miserable?"

Because all the chocolate in the world isn't going to solve your problems, honey, and while I may crave it like mad at times, neither is it going to make my PMDD go away. For all its mood-enhancing abilities, even the finest Belgian chocolate won't "cure" dysphoria.

Dysphoric is the opposite of euphoric. Euphoric means happy, dysphoric means depressed. As in depression. But only pre-menstrually, which I suppose can be considered a blessing.

In some atypical cases, however, the dysphoria can come AFTER a woman begins her period. Lucky me, I'm atypical. Mine usually starts on Day 3, if it's going to come. It doesn't always come. Which is what drives me batty, trying to keep on top of what I need to do—or to avoid—to keep it from returning.

I lead too full and rich a life to keep being knocked flat by this unwelcome change in my body. It makes me feel like I'm constantly behind—on everything.

As women, we all know "it will never get done," but to have something come along and steal a full week or more out of your month, something that no matter what you do or don't do seems to be totally beyond your control...it's more than frustrating. It's crazymaking.

I'm here to tell you you're not crazy. I'm here to tell you there are scientifically proven physiological reasons for why you crave the things you do—like carbs—and what happens to your body as a result of that. I'm here to tell you there's help, and hope, but it's far from easy, living in a body that seems to have a will of its own at times, and a manufacturing and marketing culture that promotes unhealthy foods as healthy because of their base ingredients, while completely ignoring the toxic effects of their processing processes.

That said, the first step is to forgive yourself for falling short of your own expectations, and to understand that what is happening to you is as involuntary a response as an allergic reaction. You cannot control it. You can try to soften it, to be sure, by living a universally healthy lifestyle (once you understand what that truly is) but you cannot control it.

Nor can you deny it and simply plow through it, as most women do. We have commitments, responsibilities, schedules, and deadlines. We have people counting on us to be there for them.

But first, we have to learn how to be there for ourselves. My book PMDD and Relationships, addresses this topic in detail. I can hit on a subject here and there in a blog post, but the book...the book covers it all, from start to finish. And if you are a partner here looking for information about PMDD and how to live with the woman you love: PMDD: A Handbook for Partners is for you. Click on the book covers in the sidebar for more information.

So be good to yourself today, and every day, and when it comes to chocolate—insist on the good stuff. 

Because you are most definitely worth it.

Happy Valentine's Day, all!

Remember: When it comes to chocolate, the darker, the better.  You might have to work your way up to it (I'm now at 70% cacao), as it can taste bitter at first.  But the darker it is, the better it is for you (and your blood pressure!).  And don't drink milk with it because that interferes with your body's ability to absorb the antioxidants in the chocolate and therefore dims its beneficial/healing effects.

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 this blog. Both books are also an excellent resource for understanding your PMDD and for starting a meaningful conversation with loved ones who want to know more about this debilitating disorder we live with daily.   More information on PMDD can also be found on Liana's Facebook page, Living with PMDD.

PMDD Quote of the Week

Women with PMDD want to feel normal,  We don't want to admit there's something going on in our brain that isn't right.  Something that even the medical professionals can't agree on, much less define.  We can find a thousand excuses for why we are so clumsy at times, or so ravenous, or irritable, edgy, disoriented, anxious, or weepy.  We deny and deny and deny there is anything wrong with us, or that we are in any way acting strangely, because to admit that we are doing so means we will have to stop and deal with it somehow, and how can you deal with something that defies description?

Sometimes it's a battle you just don't want to fight. 

From my books, PMDD and Relationships and PMDD: A Handbook for Partners  

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:

PMDD, A Conversation with Someone Who KNOWS

Trust the process that got you here to get you through.

For today's post, I have taken a rather lengthy reader comment from one of my previous posts and re-formatted my reply to resemble a question and answer session, because, as you will see, the original comment touched on several  questions/ideas many of us have wondered about over time. 

By answering the reader here, I can reach more people.  So here goes:

Hello, Liana, 

I can't thank you enough for having the courage to put this blog out there and then be honest and specific about your symptoms and coping mechanisms as it relates to them. You wrote "No egg, no sadness. Woo hoo! Party time!" which just explained to me why some months feel suicidal and some months LIFE IS WONDERFUL!

Hard not to think one is crazy when all of this bullshit is happening.

Hello, T!  Welcome to my blog, and thank you for taking the time to write, especially in such detail.  I appreciate your affirmation and support.  And yes, the "no released egg, no symptoms" aspect of PMDD tends to throw just about everybody off and make countless women doubt their sanity.  Especially in our later years, as we begin to release fewer and fewer eggs.

It would almost make it bearable if there was a higher purpose to it, a reason why.

I've thought that same thing many times.  One day I decided the higher purpose to my PMDD is to write about it.  I spent many years thinking I was crazy, and then, finally, it hit me that "Surely there must be others out there like me, who think they are crazy.  I need to let them know (through writing about my PMDD experiences and research) that they are not."

So my blog was born during a five month period when my book editing business was slow.  I had three website pages completed before I realized the website was too static, and I needed to do a blog.  20 blog posts later my business picked up again and it's been a struggle to find time for my PMDD research and writing ever since. 

For a few years, I let my research slide.  No time.  Then, when I was ready to start up again, I had to re-do all of my research, in case new information had surfaced while I was busy doing other things.

And it had.  In the past two years, the news about PMDD has increased exponentially.  I get a Google alert every other day about someone writing something about PMDD.  So I go there to check it out.  Because, as many of us have learned the hard way, you can't trust just anything you read on the internet.  There are a LOT of supposed health sites that have jumped on the PMDD bandwagon, just to pull in readers.  Sites that I can now pick out when (because I've been researching PMDD for over a decade) they don't understand the first thing about PMDD.  Old information recycled as new, some information slanted to achieve a certain goal or just plain false, but enough of the article close enough to known facts to confuse someone new to the subject....

Anyway, I decided my mission/higher purpose would be to sort out the fact from fiction, and publish my findings here and elsewhere.

I haven't gotten to the elsewhere part yet, due to family and work obligations, and then, in 2013, there was my surprise brain surgery. 

But back to your comments:  I don't see a lot of people mentioning ANXIETY! as a symptom but it sure is one of mine, a surge of cortisol and other hormones so big it triggers obsessive violent thoughts and then it all subsides once period time gets here.

Anxiety is a huge problem for a lot of people.  I'm not sure if I'm one of them, mostly because I manage my environment around my PMDD,  so I don't put myself in situations that feed my anxiety.  But my anxieties are different from those of others, because there are a LOT of things I think nothing of, that terrify others.  And some things that terrify me, that don't bother others at all.

Educate yourself, learn to love yourself in spite of all the shit your head comes up with; there is some putting up with [this shit] that goes along with [PMDD].

I couldn't agree more, and that is what my blog is about.  I've sifted through probably 90% of the current information on the internet and in books relevant to PMDD and put the best of it on my blog.  If not in the posts, then on the sidebars, where there are links to all sorts of good resources.

For the men, if you love the woman, get educated about this as much as you can, I strongly recommend reading "Female Brain Gone Insane" by Mia Lundin.

I agree completely, and have a link to that same book in the sidebar of my blog.  Another excellent read is The Female Brain, by Dr. Louann Brizendine.

In it [Ms. Lundin] sheds tremendous light on this subject and offers great natural suggestions for relief,  but the only way out [of PMDD] is [to go] through it. [That] doesn't mean you guys take any abuse, but for the love of everything that is holy do not get confrontational—rather go for a walk or something.

Again, I agree 100% and have written three blog posts specifically for the partners of women with PMDD. 

For the ladies thinking hysterectomy as an end to this, PLEASE DON'T DO IT.  It is the easy way out and when the storm-tsunami-holocaust of this mess passes you will need those eggs!  Hysterectomy is the first thing OBGYN offers because it is a money maker.

I agree in that I believe most hysterectomies to lessen the horror of PMDD are unnecessary, and find it very saddening that there are so many women willing to die early (because hysterectomies do shorten your life span), risk their lives with major surgery, and take the very real chance that the operation won't help your PMDD symptoms at all if they don't take out your ovaries as well.  Also, when you get a hysterectomy, you go on hormone replacement therapy afterward, which just messes with your hormones all over again.  I would LOVE to hear from women who have had a hysterectomy for PMDD (not any other reason) and found it to be worth the risk, cost, lost time, health complications, and shortened life span in the end. 

I know your PMDD symptoms make you feel desperate, but I do not believe a hysterectomy is the answer.  Neither does Winnifed B. Cutler, PhD, and her reasons why are outlined in her book, Hormones and Your Health, also pictured in the sidebar of this blog. 

Please, please, ladies, do your research before you make this life altering decision.  Don't let emotion guide you, but rather the facts.

Of course all I have said is from personal experience and is easier said than done. So  please, please, please, take what you like and leave the rest.

To that I add, if you have already had a hysterectomy for your PMDD, just start where you are with improving your health and living the best and fullest life you can for the rest of your days.  Good nutrition, rest, exercise, and lowering stress are a recipe for better health for everyone, not just those of us with PMDD or hormonal mood disorders.

Pray a lot! Talk it out, DO NOT ISOLATE. This monster wants you in a corner and it wants you dead or to make you hurt someone else and usually that someone else is a loved one, although strangers can get a backlash too.

She nails it, don't you think?  PMDD is a monster determined to bend you to its will, and do as much damage as it can to your world along the way. 

I take megadoses of vitamin C, to bowel tolerance and after a few months, something inside is building back up, [and my] energy is slowly starting to come back, [but] JUST FOR TODAY.

One day at a time.  It's all any of us can do.  But vitamin C is a great place to start. 

I am 48 now. Something new is I get my period twice a month for the last two months and I feel my ovaries churning when an egg is released. I also feel hard in the lower belly before [my] period starts (something new).

I, too, get my period more often now.  Every three weeks instead of four. And I can feel when I ovulate as well.

In addition I want to shed some light from another blog I read, women who go through this, usually have had some early trauma in their lives (even or especially if they don't consciously remember) and then, spiritually speaking, the pain (stuck energy) is trying to work itself out of your body through the horrors of PMDD (just something to think about).

Don't sell yourself short, T.  I believe this can be the case as well.  And there have been scientific studies that prove a correlation between a traumatic childhood, childhood trauma in general, and sexual abuse and PMDD.  I plan to write more about it one day.  But for now I will say that for me personally, my PMDD and then period at the end of the cycle is like a huge purging of all that has distressed me in life and not yet been dealt with.  I used to let it take control.  No more.  Now I basically make note of what comes up during that time and deal with it when I'm feeling strong enough to handle it like a responsible adult. 

As for you Liana, you are the first person [to] have actually made feel and believe to the core of my being that this is not forever, that in fact "this too shall pass" and that I am not bad or crazy or being punished by the gods for all of my sins of being an imperfect human.

You are correct.  PMDD does not last forever.  It ends with menopause.  (It does, however, get worse during perimenopause if left untreated.)

You are not bad.

You are not crazy.

And you are not being punished for any sins.

I can't thank you enough and these posts in and of themselves are very cathartic. This is such an amazing twisted, enlightening, terrifying process, that I even wrote poetry a few years back and I never wrote a poem in my life...it is as if the garbage [we] accumulate over a lifetime is trying to get out of you and your true beautiful Self is trying to shine through.

Every woman's experience is different, but yes, writing or journaling about your PMDD can be extremely cathartic, and like I said above, I have long felt that my PMDD brings to the surface many things I tend overlook/avoid/suppress during my "good" times... either out of fear, denial, or the desire to avoid a confrontation.  I have read so many Facebook posts where women describe having a meltdown and then take the blame for the entire incident and don't even realize or acknowledge that the other person was yes, indeed, being a jerk.  (And that anyone in that same situation would have a right to be upset.)  It's always the PMDD that takes 100% of the blame, and not the 50% actions of the other party. 

Ladies, it takes two to make a relationship and it takes two to break one.  It's that simple.

So stop blaming your PMDD for every confrontation/mishap that happens in your life.  Other people do mean and stupid things too...what is their explanation?

Because PMDD is an explanation, not an excuse.  If you take nothing more away from this blog post than that, you will be doing something positive for yourself in 2015.

And now, a fitting farewell from our special guest interviewer, which I think sums up what many of us are feeling and experiencing.

Because [of] ALL OF YOU, I feel less alone, less insane and more hopeful. Something that comes HARD to me, but that I am working on is: SURRENDER, ACCEPTANCE AND TRUST.

As are we all; me, as well.  At the moment, I am working on exactly those three things.  Starting January 1, I've taken a 6-month hiatus from my income-generating work to focus on my PMDD blog and books, and it's going to take a lot of surrender, acceptance, and trust to see this whole thing through.

But letters like T's have convinced me it's the right thing to do.

That said, I join T. in wishing you all love and light and tons of resilience, faith, and strength in the coming year.  Happy 2015, ladies, and may it be the year YOUR beautiful Self shines through!
Blessings,

Liana

PMDD, the Holidays, and Relationships

Going into the holiday season, often a time of stress in general, but especially so for PMDD women, who often can not predict how we will feel or how much energy or motivation we will have from day to day, I thought I'd revisit a few posts on relationships to remind us of what's important, what's not, and what we can do about it.

Here are the links to my series of posts about all sorts of relationships, because between now and when life settles down again in January, we'll most likely be dealing with more people than we do the rest of the year combined. So feel free to bookmark this page, and refer to it as needed :)

Relationships Begin With You

Learning to Treat Yourself Like a Friend

HOW to be a Friend to Yourself

Choosing Your Friends Wisely

Choosing Your Family

How to Survive Family Gatherings

It's Not Personal, It's Just Your PMDD

Finding the Right Partner

Dealing with PMDD - Advice for Men

and, as a gentle reminder,

They Only See Our Failures

Take care, God Bless, and may your holidays be happy.

PMDD and Making Hard Choices, a Guest Post by Kit

In my Voices of PMDD series, we spent the summer of 2014 hearing from women with PMDD and their partners, through blogposts describing the struggles and challenges they face monthly.  Going into fall, I'd like to focus on some solutions various women with PMDD have found.  Since every woman's PMDD is different in the symptoms she feels and the severity of those symptoms, not every suggestion regarding relief will work, but I offer these posts in the hopes that something will strike a chord somewhere, and at least put you on the path to lessening your PMDD pain, be it physical, mental, emotional, or spiritual.

Today's guest post is written by Kit, and comes filled with great wisdom, and several positive choices for feeling better.  That said, here's Kit: 

Apart from feeling a little tense/dramatic during ovulation weekend and a little teary the day before my period began, this month has been so easy. My symptoms have been getting better over the last two years. When I look back to how badly PMDD used to affect me (3 out of 4 weeks), chronically suicidal most months, I just can't believe how it is now...

Here is how I choose to live now compared to before.

BEFORE

Chose boyfriends who didn't understand, sympathise, and had their own crazy issues going on — boyfriends I chose, so I'd feel less F'd up and—ironically—more equal.

Had friends that took from me and drained me because PMDD makes it hard to create continuity of self and therefore friendships can be tricky. So when they took, drained, and crossed boundaries ... I rolled with it—thinking I should be grateful for their friendship. 

Thought of myself as having this big secret from the world that I couldn't control and was ashamed of. I spent a fair amount of time thinking about what others would think, especially when I was ill.

Shut myself away for weeks on end to protect the life I had just spent weeks building again.

Tried hormonal medications, anti-depressants, and supplements, all of which gave me side effects and changed the flavour of the PMDD to the point of not being worth it.

Worked 9-5 in a high-powered job, with a boss with questionable ethics, which made me ill via the ethical distress and stress of my workload, while spending 4 weeks a month trying to be the same person every day.

Generally believed I couldn't make a change from any of these because it would be impossible. How could I maintain my relationships, jobs, family, etc. if I tried to change all the above?

NOW

I chose a partner with understanding, tolerance and, most importantly the willingness to co-manage my PMDD with me—what a difference that one makes!

I chose a partner who is as self-aware as I am when it comes to his own journey.

My attitude is : I am a good catch; if I get ill, I am ill, if my partner started to be unsupportive I would wait until I was in my good time, and then talk from a point of grounded logic, explaining that I need someone who can give me support and understanding and that's what I deserve and if that's not him, he can leave now. 

I now offer Zero Tolerance to anyone who's going to risk making me ill by their own silliness.

I now only have friends who respect my boundaries; I phased out those that didn't.  It wasn't easy but, wow, has it made a difference in my life and in my PMDD.

I no longer have a 'secret' but I don't choose to tell others unless we're close ... I tell them what PMDD is but don't go into details. I don't care what others think. I know what I have, I know it is real. I do not need to communicate it, or hear their acceptance to accept myself. I have worked hard on accepting myself as I am, PMDD and ADHD warts and all, using the Strong Notes app.

I am still careful about planning social occasions around my bad times. I don't feel badly about saying 'No' — it's what I have to do to be kind to myself. Unnecessary stress that you choose to opt out of, no matter what others may think, can reduce your PMDD symptoms.

I am on Methylphenidate for my ADHD, and so far taking a really low amount, but it works wonders with my ADHD and could be having an effect on my PMDD, too. I would love for others to try it and see how it quiets the inner thoughts and mind tumble dryers we all get stuck in during PMDD mode. 

Using an app called Strong Notes, I send myself accepting/loving messages from my 'well self' to read on my bad days, feeding my strength back to myself on days I can't access it from within.

I have separated my 'well self' from my 'ill self' in my mind so I don't brand the 'true well me' with an ill tarnish. It helps to be sympathetic to my 'ill self' when well, and remember my 'well self' when ill. 

This is so important : I now identify when ill that how I'm feeling is real and not just my imagination.

I quit my ego stroking 9-5, 4 weeks a month job to pursue another working model that allows me to be ill when ill and kick ass when well.

I sought help from a mental health charity that supports people trying to make life work for them while struggling with a mental health problem. Successfully got a government business loan to start a business. I was honest about the PMDD and it was never even brought up as an issue.

I now believe that I am worth drastically changing my life for. I don't put myself in situations where I am stressed, and in turn my PMDD is at rest rather than flared up. I still know it's there but it's controllable.

I've read and live by Eckhart Tolle's book The Power of Now.

I eat foods with high nutrients but also still eat crap (sugar, etc.) when I want to, and for me it makes no difference. Food diets aren't ever as impactful as emotional diets in my opinion.

Signed up for all business/mental health support organisations to have mentors to keep me on track and to keep reminding myself that I am worth the hassle.

This is all just one story but I thought I would share it with you in case any of you are feeling ready to go on an emotional diet, too, or should I call it a MIND DETOX. I stayed in bad situations, feeling like a victim, for too long. I missed out on my teens and twenties for sure, but I am no longer going to be a victim to society's views, or the acceptance of others. 

I have PMDD. It means I must live accordingly. I choose to make my life better by taking the actions needed to protect and progress myself.

Love to you all.  I know we know each other's darkness all too well. I hope some of this helps.

K xxx