A little something extra today in honor of Halloween. PMDD is not a new condition. It's been around in one form or another since at least the time of Hippocrates. Back then it, and just about any other condition relating to women's hormones, was called hysteria, hystera being the Greek name for uterus.
This is why anyone with a uterus is considered hysterical at times, and why they call the removal of your uterus a hysterectomy.
But I digress. PMDD is not, as some believe, a disorder made up by the drug companies to sell more drugs. It's a condition happily exploited by drug and supplement companies, to be sure, and even some doctors (more on this in a future post), but it's far from a made up condition. You know it, and I know it, and anyone who has ever lived with a woman who has PMDD knows it.
That doesn't mean we're not accountable for our actions. PMDD is an explanation--not an excuse, or free pass--for bad behavior. We owe it to ourselves to understand the condition (and therefore ourselves) as fully as we can, and to then promote a positive awareness of PMDD everywhere we go. It's only by focusing on the positive--what works, what helps, what provides solid help and answers--and not the negative--the fear, the stereotyping, the ridicule--that we will get mainstream medicine to pay any genuine attention to PMDD and other women's health issues.
That said, today I thought I'd offer up a special post on women and insanity, to let us know where we might have ended up, had we been born in another time.
Please welcome my guest blogger, Wild Rose Press author Loretta Rogers.
Because divorce was a rarity during the pioneer/frontier days, men devised other ways to get rid of unwanted wives and children, and that was by declaring them insane and placing this unwanted loved one in an insane asylum. Actually these early asylums were in reality prisons and not medical centers. These institutions were filthy, dark places where people were treated more like animals than human beings. The asylums usually provided only the basic necessities of life. Food was poor, cleanliness was not stressed and the rooms were often very cold. Diseases were quick to spread throughout the asylum.
Some of the reasons women were institutionalized are unbelievable. In the early 1800’s wives and daughters were often committed for not being obedient enough to their husbands or fathers. You’ve heard the term, “children are to be seen and not heard.” This applied to wives as well. If a woman spoke out and went against the “norm” she could be committed.
With no birth control, it wasn’t unusual for a woman to give birth to another baby while still nursing her last child. And a brood of six to twelve children wasn’t unusual either. With her body no longer firm and supple, her energy level somewhere between zero and double zero, and with the daily routine of cooking, cleaning, plowing, and all the other demands, a woman was run ragged. It’s no wonder she grew old long before her time.
All the husband and/or father had to do was simply write the word “lunacy” on the admission form. Lunacy was an acceptable reason for divorce. The woman’s husband would declare her insane, put her in the asylum and then file for the divorce. A few months later, his marriage records to a younger bride usually showed up.
Other reasons to be “put away”, were depression, alcoholism, just being a little different from the norm, and even going through menopause. Doctors just didn’t know how to deal with mental issues and the result was to put their patients in the asylum. These women were locked up and forgotten by their loved ones. The fathers/husbands often forbid the family members to visit. It was as if the wife or daughter had simply died. Most of these women did stay at the insane asylum until their death.
If a father had no sons, but didn’t want his daughter to inherit his fortune or worldly goods, he could have her declared insane, institutionalized, and leave his money to a favorite nephew or his ranch to a ranch hand he considered as a son. If a man’s wife had died in child birth and he couldn’t find a woman to wed who was willing to become a stepmother to his large brood, or if he couldn’t marry off any of his eligible daughters, he simply declared them as lunatics and placed them in an asylum. Sometimes daughters were committed for unwanted pregnancies. Other children were committed for being disobedient or for illnesses such as Down’s Syndrome or Autism. Being born deaf or mute, retarded or physically disfigured was another reason a child might be committed.
Oftentimes, the husband might tell others that his wife or child had died. If a newspaper office was available, he might even have an obituary printed. Yet the person was very much alive at the asylum. While it was rare for a sane person to be released from an asylum, it did happen. Imagine what it was like for this woman. Having been declared dead, she had no identity.
Some of these asylums were built next to, or part of, the prison system. This was to help cut back costs of care, food and facilities. Rape was prevalent in asylums. Because women had been declared insane, it was deemed they had no powers of reasoning, no feelings or emotions. In other words, they were considered walking zombies. Because of this deranged thinking, (no pun intended) prisoners and even asylum employees used the women for their own pleasures.
If you are into genealogy and have run into a brick wall trying to locate a female relative, the US census has a place on some of their census, example 1850, that had a place to mark if deaf, dumb or insane. The probate section may carry Lunacy Record Books at the county courthouses. Some Wills will declare if someone is insane or having lunacy. If someone seems to have disappeared, they may have been “sent away.”
Therefore, when we refer to the ‘good old’ days, we might remember these women and their lives, and be thankful that they paved the way for us.
Loretta C. Rogers, Isabelle and the Outlaw.
Sunday, October 31, 2010
Wednesday, October 27, 2010
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.
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.
Wednesday, October 20, 2010
Overcoming Your PMDD Starts With Being Good To Yourself
I am a work in progress. One thing I have that a lot of people don’t have, or don’t make the time for, is self-awareness. I’ve been digging into this PMDD thing for so long that I’ve finally learned how to separate my real self from my PMDD self. How do I do this? I’m constantly checking in with myself to see how I am feeling, and trying to determine the reasons for why I am feeling the way I am—if it could possibly be my PMDD (based on where I am in my cycle) or if it’s something else.
In doing this, I’ve learned I’m super sensitive to just about everything I eat, drink, and breathe in. For instance, yesterday I went to get my hair cut. This morning I woke up with a sore throat and congested cough. Am I coming down with something? No. It’s a reaction to all the chemicals I inhaled while getting my hair cut. All I have to do is drink plenty of fluids today and I will be fine.
So I’m constantly weighing, measuring, sifting, adjusting. If I feel a little off, I ask myself—what’s new? What did I do differently today or yesterday? Where did I go that I don’t usually go? What did I eat or drink that I don’t usually eat or drink? What stresses did I encounter that I don’t usually encounter?
By constantly doing this, I’m able to detect patterns, and learn what (and who) to avoid. For instance, just going to church gets my sinuses flowing. I can smell the cloud of perfume ten feet away from the front door. The same thing can happen in restaurants, theatres, sporting or music events. This doesn’t mean I don’t go to those things. It just means I’m aware of what can happen, and if I feel a little funky afterwards, I know why.
I’m determined to live my life drug free. Because I feel this way, even taking two ibuprofen affects me as much as say, taking a narcotic painkiller would affect someone who isn’t used to it. Oddly enough, since the birth of my son--a major hormonal event--anything I take that is supposed to make me drowsy tends to have the opposite effect. I can’t take decongestants at all. Narcotics, like Tylenol with codeine, forget it. I’ll be up all night.
I’ve gotten so sensitive that even certain foods affect me strangely. It sounds crazy, I know, but what’s really happening is just a strong bio-chemical reaction that when processed in my brain affects my moods. So what is a natural physiological reaction to a substance, because of the imbalance in my hormones, manifests itself as a mood symptom. This can include irritability, weepiness, anxiety, lethargy, depression, or even euphoria.
I believe there are many women out there just like me. Women who perhaps aren’t blessed with the time and opportunities I have had to really sit down and be still long enough to try and figure out just what in the world is going on in their bodies and brains. We live in such busy times, running from one commitment to another, taking care of the loved ones in our lives, conditioned by our culture, society, and religious beliefs to serve others and place our own selves last.
This drastically affects our health and well-being, but since we are so busy all the time, we don’t have the time (or energy) to figure out what’s wrong, why we are feeling so out of kilter, maybe even miserable most of the time. And then our cycle kicks in, with our PMDD, and everything really goes haywire. We scream, we yell, we snap, and have wild mood swings. We lash out at loved ones and coworkers and store clerks and other drivers, and then, if we haven’t found a way or two to numb our conscience, we feel badly about our behavior and find ways to beat ourselves up and/or try to make amends if we can. We spend so much time trying to make it right with people, or beating ourselves up and engaging in even more destructive behavior, that we get even further run down and behind.
And then the cycle begins again. So we look for quick fixes, anything that will keep us in motion, fulfilling our commitments and obligations, keep us awake and moving long enough to get everything we need to get done in any given day done before we crash in front of the TV or into bed, exhausted, grateful that another day has ended and we have somehow survived.
It’s no way to live. So several years ago I made the effort to strip my life down to what’s important to me, and just focus on that. One of those things was my physical health and well-being. I figured if I could just take care of that—the rest of it would take care of itself.
Little did I know how difficult just doing that would be. It’s no wonder more people don’t take time out to do the same.
But I’m a persistent soul, and determined to figure this thing out. What I present here are things I have learned along the way. They might apply to you, they might not. Every woman is different, and due to her menstrual cycle, every woman is just a little bit different every day. That makes us mysterious and exciting, not bitchy and crazy. That makes us worth taking the time to get to know.
I’d like to take the time to get to know you, to hear your story, and find out what works and doesn’t work for you. I’d like to share those stories here and try to find common ground so that we can help each other to feel better if we can.
It can be done. It’s just that the information out there is so confusing and so conflicting. And we’re all so busy. It would be heaven if we could just Google PMDD and get the answers we need, find the quick fix, and get on with our lives.
But it doesn’t work that way. The first step, I have found, is to take the time to get to know yourself, physically, mentally, and emotionally. Emotionally, because you have to know what emotions are being caused by your PMDD, and what emotions are normal and natural for you to be feeling. Contrary to popular belief, women are allowed to get upset, become irritated, annoyed, and angry. It doesn’t always have to be PMS or PMDD causing it, and we shouldn’t have to put up with snide comments about it being “that” time again, every time someone doesn’t hold up their end of the bargain and we express our disappointment in that.
It’s about accountability, and knowing yourself enough to know when it’s your fault, and when it’s not. I don’t know about you, but I’m not interested in taking the blame for things that aren’t of my doing. I make enough mistakes on my own, without that added burden, thank you.
That said, I’ve come to realize that PMDD is an explanation, not an excuse, for why I do the things I do when I’m having an episode, and I still need to be held accountable for those things, to take responsibility for myself and my actions, no matter how badly I may be feeling. It’s up to me, and me alone, to sort out what’s the real me, and what’s my PMDD, and keep the two as separate as I can. You know how you feel like you’re a totally different person when you’re having an episode. You know that’s not you. It takes a lot of strength, determination and willpower to separate the two, and the effort can be exhausting. But it can be done.
For example, the past few weeks I’ve been feeling just plain blah. No energy, no willpower, no motivation. I wondered if it was my PMDD, just come to roost for a while, but no, PMDD comes in cycles. This had to be something else. My thoughts were validated when my PMDD did arrive, and whew! It was like the difference between night and day. For just a couple of days, I sank into that abyss, and knew the difference. Clearly, on those other days, there was something missing in my diet that needed to be boosted…what that is I’m still sorting out, but I now know that lethargy is not my PMDD.
But I also know my PMDD is not me. And so I’ve learned to separate the two, and set the PMDD aside when it comes. I know it’s there, and it would very much like to take over and run (ruin) my day, but I won’t let it. I acknowledge that it’s present, and that I’m not crazy, and I warn my loved ones that I’m having a bad day and it has nothing to do with them, but it would be best to avoid me for a day or two.
With that in place, I go about my business, and get as much done as my energy level allows. If I need to take a nap, I do it. If I need some quiet time, I take it. If I need to eat some carbs…I do it. Guilt-free. That’s the key. Never feel guilty about taking time to care for yourself. Would you feel guilty about taking care of someone else? Then why don’t you deserve as much care and comfort as they do?
I listen to my body and give it what it needs, without giving in to the wild emotional swings that wait in the wings, and without giving any air time at all to the negative thoughts swirling in my brain. That’s just my PMDD talking, I tell myself, and I refuse to listen to it.
So the next time it happens to you, give it a shot. Just take a deep breath and refuse to give in. You are stronger than your PMDD, and it’s time you let your PMDD know it. You can channel your rage and anxiety and depression into strength and calm and control with simple awareness and practice. It won’t be easy, not at first. It’s a lot easier to just give in and go with the flow. But where has that gotten you?
Think about it, and you’ll know.
Any time you’re feeling out of control, just go to any number of PMDD sites and vent. We know. We care. We understand. We won’t take it personally. We’ll help you through it…because really, we know all you want to do is vent and be heard.
And then, maybe, while you’re visiting one of the message boards, or blogs, you’ll come across a bit of info that makes the next time a little easier to handle.
Baby steps, is all I can say. Be good to yourself, and things will get better. I promise.
In doing this, I’ve learned I’m super sensitive to just about everything I eat, drink, and breathe in. For instance, yesterday I went to get my hair cut. This morning I woke up with a sore throat and congested cough. Am I coming down with something? No. It’s a reaction to all the chemicals I inhaled while getting my hair cut. All I have to do is drink plenty of fluids today and I will be fine.
So I’m constantly weighing, measuring, sifting, adjusting. If I feel a little off, I ask myself—what’s new? What did I do differently today or yesterday? Where did I go that I don’t usually go? What did I eat or drink that I don’t usually eat or drink? What stresses did I encounter that I don’t usually encounter?
By constantly doing this, I’m able to detect patterns, and learn what (and who) to avoid. For instance, just going to church gets my sinuses flowing. I can smell the cloud of perfume ten feet away from the front door. The same thing can happen in restaurants, theatres, sporting or music events. This doesn’t mean I don’t go to those things. It just means I’m aware of what can happen, and if I feel a little funky afterwards, I know why.
I’m determined to live my life drug free. Because I feel this way, even taking two ibuprofen affects me as much as say, taking a narcotic painkiller would affect someone who isn’t used to it. Oddly enough, since the birth of my son--a major hormonal event--anything I take that is supposed to make me drowsy tends to have the opposite effect. I can’t take decongestants at all. Narcotics, like Tylenol with codeine, forget it. I’ll be up all night.
I’ve gotten so sensitive that even certain foods affect me strangely. It sounds crazy, I know, but what’s really happening is just a strong bio-chemical reaction that when processed in my brain affects my moods. So what is a natural physiological reaction to a substance, because of the imbalance in my hormones, manifests itself as a mood symptom. This can include irritability, weepiness, anxiety, lethargy, depression, or even euphoria.
I believe there are many women out there just like me. Women who perhaps aren’t blessed with the time and opportunities I have had to really sit down and be still long enough to try and figure out just what in the world is going on in their bodies and brains. We live in such busy times, running from one commitment to another, taking care of the loved ones in our lives, conditioned by our culture, society, and religious beliefs to serve others and place our own selves last.
This drastically affects our health and well-being, but since we are so busy all the time, we don’t have the time (or energy) to figure out what’s wrong, why we are feeling so out of kilter, maybe even miserable most of the time. And then our cycle kicks in, with our PMDD, and everything really goes haywire. We scream, we yell, we snap, and have wild mood swings. We lash out at loved ones and coworkers and store clerks and other drivers, and then, if we haven’t found a way or two to numb our conscience, we feel badly about our behavior and find ways to beat ourselves up and/or try to make amends if we can. We spend so much time trying to make it right with people, or beating ourselves up and engaging in even more destructive behavior, that we get even further run down and behind.
And then the cycle begins again. So we look for quick fixes, anything that will keep us in motion, fulfilling our commitments and obligations, keep us awake and moving long enough to get everything we need to get done in any given day done before we crash in front of the TV or into bed, exhausted, grateful that another day has ended and we have somehow survived.
It’s no way to live. So several years ago I made the effort to strip my life down to what’s important to me, and just focus on that. One of those things was my physical health and well-being. I figured if I could just take care of that—the rest of it would take care of itself.
Little did I know how difficult just doing that would be. It’s no wonder more people don’t take time out to do the same.
But I’m a persistent soul, and determined to figure this thing out. What I present here are things I have learned along the way. They might apply to you, they might not. Every woman is different, and due to her menstrual cycle, every woman is just a little bit different every day. That makes us mysterious and exciting, not bitchy and crazy. That makes us worth taking the time to get to know.
I’d like to take the time to get to know you, to hear your story, and find out what works and doesn’t work for you. I’d like to share those stories here and try to find common ground so that we can help each other to feel better if we can.
It can be done. It’s just that the information out there is so confusing and so conflicting. And we’re all so busy. It would be heaven if we could just Google PMDD and get the answers we need, find the quick fix, and get on with our lives.
But it doesn’t work that way. The first step, I have found, is to take the time to get to know yourself, physically, mentally, and emotionally. Emotionally, because you have to know what emotions are being caused by your PMDD, and what emotions are normal and natural for you to be feeling. Contrary to popular belief, women are allowed to get upset, become irritated, annoyed, and angry. It doesn’t always have to be PMS or PMDD causing it, and we shouldn’t have to put up with snide comments about it being “that” time again, every time someone doesn’t hold up their end of the bargain and we express our disappointment in that.
It’s about accountability, and knowing yourself enough to know when it’s your fault, and when it’s not. I don’t know about you, but I’m not interested in taking the blame for things that aren’t of my doing. I make enough mistakes on my own, without that added burden, thank you.
That said, I’ve come to realize that PMDD is an explanation, not an excuse, for why I do the things I do when I’m having an episode, and I still need to be held accountable for those things, to take responsibility for myself and my actions, no matter how badly I may be feeling. It’s up to me, and me alone, to sort out what’s the real me, and what’s my PMDD, and keep the two as separate as I can. You know how you feel like you’re a totally different person when you’re having an episode. You know that’s not you. It takes a lot of strength, determination and willpower to separate the two, and the effort can be exhausting. But it can be done.
For example, the past few weeks I’ve been feeling just plain blah. No energy, no willpower, no motivation. I wondered if it was my PMDD, just come to roost for a while, but no, PMDD comes in cycles. This had to be something else. My thoughts were validated when my PMDD did arrive, and whew! It was like the difference between night and day. For just a couple of days, I sank into that abyss, and knew the difference. Clearly, on those other days, there was something missing in my diet that needed to be boosted…what that is I’m still sorting out, but I now know that lethargy is not my PMDD.
But I also know my PMDD is not me. And so I’ve learned to separate the two, and set the PMDD aside when it comes. I know it’s there, and it would very much like to take over and run (ruin) my day, but I won’t let it. I acknowledge that it’s present, and that I’m not crazy, and I warn my loved ones that I’m having a bad day and it has nothing to do with them, but it would be best to avoid me for a day or two.
With that in place, I go about my business, and get as much done as my energy level allows. If I need to take a nap, I do it. If I need some quiet time, I take it. If I need to eat some carbs…I do it. Guilt-free. That’s the key. Never feel guilty about taking time to care for yourself. Would you feel guilty about taking care of someone else? Then why don’t you deserve as much care and comfort as they do?
I listen to my body and give it what it needs, without giving in to the wild emotional swings that wait in the wings, and without giving any air time at all to the negative thoughts swirling in my brain. That’s just my PMDD talking, I tell myself, and I refuse to listen to it.
So the next time it happens to you, give it a shot. Just take a deep breath and refuse to give in. You are stronger than your PMDD, and it’s time you let your PMDD know it. You can channel your rage and anxiety and depression into strength and calm and control with simple awareness and practice. It won’t be easy, not at first. It’s a lot easier to just give in and go with the flow. But where has that gotten you?
Think about it, and you’ll know.
Any time you’re feeling out of control, just go to any number of PMDD sites and vent. We know. We care. We understand. We won’t take it personally. We’ll help you through it…because really, we know all you want to do is vent and be heard.
And then, maybe, while you’re visiting one of the message boards, or blogs, you’ll come across a bit of info that makes the next time a little easier to handle.
Baby steps, is all I can say. Be good to yourself, and things will get better. I promise.
Wednesday, October 13, 2010
Confusion City
This post was completely updated September 23, 2015
One of the main problems I find in researching PMDD is that every woman’s hormones fluctuate daily in concert with her menstrual cycle, so it’s hard to separate what’s caused by normal female hormonal fluctuations and what’s caused by PMS or PMDD. To be clear: PMS and PMDD are not the same. PMDD is *not* PMS on steroids, although it can feel like it when you’re having an episode.
There is a definite brain component to PMDD that is not present in PMS. PMS mostly deals with physical symptoms (aches, pains, tenderness, cramps, bloating, etc.), with some minor mood fluctuations…a little irritability, a lack of energy or motivation, some weepiness, maybe more anxiety than usual.
PMDD ratchets these symptoms up a few hundred notches, to the point that these mood disturbances affect your ability to function and maintain stable relationships.
A lot of books and websites discuss the more mild symptoms of PMS, and then simply transfer the same thoughts and theories to PMDD. A lot of these sources even call PMDD a more severe version of PMS. This is not true. They are two separate conditions that unfortunately have enough in common to confuse everybody. But in the end, they take two different paths.
One of the main problems I find in researching PMDD is that every woman’s hormones fluctuate daily in concert with her menstrual cycle, so it’s hard to separate what’s caused by normal female hormonal fluctuations and what’s caused by PMS or PMDD. To be clear: PMS and PMDD are not the same. PMDD is *not* PMS on steroids, although it can feel like it when you’re having an episode.
There is a definite brain component to PMDD that is not present in PMS. PMS mostly deals with physical symptoms (aches, pains, tenderness, cramps, bloating, etc.), with some minor mood fluctuations…a little irritability, a lack of energy or motivation, some weepiness, maybe more anxiety than usual.
PMDD ratchets these symptoms up a few hundred notches, to the point that these mood disturbances affect your ability to function and maintain stable relationships.
A lot of books and websites discuss the more mild symptoms of PMS, and then simply transfer the same thoughts and theories to PMDD. A lot of these sources even call PMDD a more severe version of PMS. This is not true. They are two separate conditions that unfortunately have enough in common to confuse everybody. But in the end, they take two different paths.
However, since they are often treated as similar, even
interchangeable, by many media, for years I thought I had PMS, and couldn’t
figure out why—if more than 80% of all women experience some form of PMS—why
couldn’t I cope like everyone else did?
Because it wasn’t the
same thing, and I didn’t know that.
So, while PMS affects (mostly) your body and (mildly) your mind on more or less a regular cycle, with more or less the same cluster of mind/body symptoms each month (specific to you as an individual), PMDD affects your brain’s ability to regulate itself, and therefore affects just about every other hormone in your body, too.
This is why you often feel as if something or someone else has taken over your body. You think one thing, and something totally different comes out of your mouth. You think you’re eating right, getting enough sleep and exercise, and suddenly one day you have no energy and your body simply won’t cooperate. There’s a missed connection there, and while it’s not “all in your head,” as many friends, relatives, co-workers, and even medical personnel would have you believe, it is happening in your brain.
So what are some of these hormones, and what do they do?
Here (in alphabetic order) are the ones most likely to affect your levels of PMDD.
Aldosterone – Never heard of it? Doesn’t matter. It still contributes to excess water weight gain when your progesterone levels are high, like in the second half of your menstrual cycle, when you feel all fat and bloated. Now you know (in part) why you get that way, and why (short of diuretics) there’s really nothing you can do about it but avoid salt, celebrate the fact that you’re a woman, and know that this, too, shall pass…
Androgens (DHEA and others) – When levels of these are too high they enhance your sex drive and aggressive tendencies, produce unwanted facial hair and apple vs. pear-shaped bodies in women, stimulate your appetite and contribute to waistline weight gain.
Cortisol – This affects your metabolism and tells your body to store more (more! more!) body fat, and is produced in even higher amounts under stress. (Remember, a woman with PMDD is more sensitive to stress to start with, so don’t be surprised if your levels are off the charts.)
Think about this: Our bodies have not changed much biologically since prehistoric times, and so are designed to respond to stress in a certain way that back then was perfectly normal and balanced. But stress back then might be due to a natural disaster, imminent death or starvation, attack by a wild animal, or, in later times, attack from a warring tribe.
Now our stress comes from sources like electronic devices, over-commitment, dashed hopes and unmet expectations, financial strain, unsafe drivers, emotional upsets, and major life changes like birth, death, marriage, divorce, surgery, change in employment or living location, to name just a few.
But our bodies still react in the same way they did in prehistoric times to these threats and upsets—as if we were literally under physical attack.
So up goes your cortisol, which, among other things, suppresses your normal immune functions, leaving you susceptible to every cold and flu that comes your way. In time your body can get so run down that you develop something serious, even terminal.
The Estrogens – Estradiol, Estrone, and Estriol These three wonder hormones are involved in over 400 crucial functions throughout your body and brain, including your metabolism, moods, body heat regulation, insulin sensitivity, pain levels (think muscle and joint pain, and headaches), and carbohydrate tolerance. Both too much and too little estrogen are bad for you, in ways too numerous to go into here. But know this—you have estrogen receptors in your brain, bladder, bones, muscles, blood vessels, skin, breasts, uterus, eyes, heart, and colon. It’s not just about sex anymore. With all those receptors, you can easily take in too much estrogen—or, more appropriately, too much of the WRONG kind of estrogen (aka xenoestrogens).
Insulin – Lowers your blood sugar, stimulates fat storage.
Melatonin – Regulates your sleep cycles and body rhythms, promotes fat storage for hibernation (remember those cave dwellers) and increases your appetite for carbs. Melatonin also plays a role in Seasonal Affective Disorder (SAD) syndromes that affect your energy levels, weight gain, daytime sleepiness, and depressed moods.
Norepinephrine and Epinephrine – aka your Adrenaline Hormones. These govern your “fight or flight” responses. They increase your heart rate, lift your mood (or in excess cause anxiety), increase alertness, and dilate your arteries to provide more oxygen, glucose, and nutrients to your key organs in times of distress.
Remember what I said about how our bodies were initially designed to respond to threats and the differences between threats then and threats now? Some of us are living in a nearly constant state of fight or flight simply due to the lifestyles we live. But on top of that, when a woman enters her PMDD zone, her fight or flight switch comes on, but because of some missed connection in the brain—it does not shut off.
So, while PMS affects (mostly) your body and (mildly) your mind on more or less a regular cycle, with more or less the same cluster of mind/body symptoms each month (specific to you as an individual), PMDD affects your brain’s ability to regulate itself, and therefore affects just about every other hormone in your body, too.
This is why you often feel as if something or someone else has taken over your body. You think one thing, and something totally different comes out of your mouth. You think you’re eating right, getting enough sleep and exercise, and suddenly one day you have no energy and your body simply won’t cooperate. There’s a missed connection there, and while it’s not “all in your head,” as many friends, relatives, co-workers, and even medical personnel would have you believe, it is happening in your brain.
So what are some of these hormones, and what do they do?
Here (in alphabetic order) are the ones most likely to affect your levels of PMDD.
Aldosterone – Never heard of it? Doesn’t matter. It still contributes to excess water weight gain when your progesterone levels are high, like in the second half of your menstrual cycle, when you feel all fat and bloated. Now you know (in part) why you get that way, and why (short of diuretics) there’s really nothing you can do about it but avoid salt, celebrate the fact that you’re a woman, and know that this, too, shall pass…
Androgens (DHEA and others) – When levels of these are too high they enhance your sex drive and aggressive tendencies, produce unwanted facial hair and apple vs. pear-shaped bodies in women, stimulate your appetite and contribute to waistline weight gain.
Cortisol – This affects your metabolism and tells your body to store more (more! more!) body fat, and is produced in even higher amounts under stress. (Remember, a woman with PMDD is more sensitive to stress to start with, so don’t be surprised if your levels are off the charts.)
Think about this: Our bodies have not changed much biologically since prehistoric times, and so are designed to respond to stress in a certain way that back then was perfectly normal and balanced. But stress back then might be due to a natural disaster, imminent death or starvation, attack by a wild animal, or, in later times, attack from a warring tribe.
Now our stress comes from sources like electronic devices, over-commitment, dashed hopes and unmet expectations, financial strain, unsafe drivers, emotional upsets, and major life changes like birth, death, marriage, divorce, surgery, change in employment or living location, to name just a few.
But our bodies still react in the same way they did in prehistoric times to these threats and upsets—as if we were literally under physical attack.
So up goes your cortisol, which, among other things, suppresses your normal immune functions, leaving you susceptible to every cold and flu that comes your way. In time your body can get so run down that you develop something serious, even terminal.
The Estrogens – Estradiol, Estrone, and Estriol These three wonder hormones are involved in over 400 crucial functions throughout your body and brain, including your metabolism, moods, body heat regulation, insulin sensitivity, pain levels (think muscle and joint pain, and headaches), and carbohydrate tolerance. Both too much and too little estrogen are bad for you, in ways too numerous to go into here. But know this—you have estrogen receptors in your brain, bladder, bones, muscles, blood vessels, skin, breasts, uterus, eyes, heart, and colon. It’s not just about sex anymore. With all those receptors, you can easily take in too much estrogen—or, more appropriately, too much of the WRONG kind of estrogen (aka xenoestrogens).
Insulin – Lowers your blood sugar, stimulates fat storage.
Melatonin – Regulates your sleep cycles and body rhythms, promotes fat storage for hibernation (remember those cave dwellers) and increases your appetite for carbs. Melatonin also plays a role in Seasonal Affective Disorder (SAD) syndromes that affect your energy levels, weight gain, daytime sleepiness, and depressed moods.
Norepinephrine and Epinephrine – aka your Adrenaline Hormones. These govern your “fight or flight” responses. They increase your heart rate, lift your mood (or in excess cause anxiety), increase alertness, and dilate your arteries to provide more oxygen, glucose, and nutrients to your key organs in times of distress.
Remember what I said about how our bodies were initially designed to respond to threats and the differences between threats then and threats now? Some of us are living in a nearly constant state of fight or flight simply due to the lifestyles we live. But on top of that, when a woman enters her PMDD zone, her fight or flight switch comes on, but because of some missed connection in the brain—it does not shut off.
Until her period comes. That
can last up to three weeks in the worst cases.
Being trapped in that fight or flight state is exhausting, to
say the least. You know how you feel when you're exhausted...apply that to a
woman with PMDD ten-fold and you may begin to understand her emotional
instability during her episodes.
Progesterone –
The jury is still out on this one. Some sources say too much progesterone can increase your appetite, increase
fat storage, reduce insulin sensitivity, make you sleepy, depressed, and
depress your sex drive. Fatigue, breast
tenderness, bloating, and vaginal dryness are also symptoms. Other sources say too little progesterone can cause many of these same symptoms—in
addition to anxiety attacks, insomnia, dizziness, irritability, difficulty
concentrating, extreme changes in mood, muscle pain, joint pain, and urinary
incontinence.
Who to believe? All I
know is progesterone supplementation is something that needs to be fine-tuned
over the course of your cycle . I have found that, much like an upside-down
U-curve, there seems—for me—to be a sort of sweet spot at the top of the curve;
too little progesterone creates symptoms, too much progesterone creates
symptoms. The dosage needed can vary
daily. I have to constantly adjust and
readjust my progesterone intake, using supplementation and nutrition.
So be wary of progesterone creams, especially over-the-counter
brands. Depending on what else is in
them, you can get too much, too little, or none at all. They are not regulated. Other ingredients in the creams can also clog
your pores and provide added fake estrogens if you do not read the label carefully. Only a precious few progesterone creams perform
the way they are intended to. I use a cream
when symptoms are particularly bad, but for the most part I take a 100 mg
capsule of micronized progesterone daily, and double that on symptomatic
days. If you would like to know which
brands I use, contact me directly. (info (at) livingwithpmdd (dot) com.)
Testosterone – It’s not just for guys. Too little testosterone can negatively affect your bone and muscle growth, metabolism, mood, energy level, and sex drive.
Thymosin – This little-known hormone plays a major role in the development of your immune system. Be good to it or be betrayed by it.
Thyroid – Affects your metabolism, nervous system, muscles and bones, energy levels, heart rate, body heat production, and brain activity. (Hello? Brain activity? Remember this.)
Okay, now I’m no doctor, but if you take the major symptoms of PMDD and bump them up against these hormones, you’ll find that too much or too little of eight of them can lead to weight gain, five of them can cause problems with your metabolism, five of them can affect mood disorders, six can cause problems with your energy levels, two can make you anxious, two can make you aggressive, three affect your sex drive, two reduce insulin sensitivity, two affect sleep cycles, two can depress your immune system, and two can affect your brain function…which can affect all of the above.
Let’s break that down into something more understandable.
Imbalances (for lack of a better word) in the following can cause weight gain:
Androgens
Cortisol
Insulin
Melatonin
Progesterone
Testosterone
Thyroid
Aldosterone (water weight gain)
Imbalances in the following can cause metabolism problems:
Cortisol
Estrogen
Testosterone
Thyroid
Imbalances in the following can cause mood disturbances:
Estrogen
Progesterone
Melatonin
Testosterone
Thyroid
Imbalances in the following can cause your energy levels to plummet:
Estrogen
Insulin
Melatonin
Progesterone
Testosterone
Thyroid
Imbalances in the following can compromise your immune system:
Cortisol
Thymosin
Imbalances in the following can reduce insulin sensitivity:
Estrogen
Progesterone
Imbalances in the following can cause problems with brain function:
Estrogen
Thyroid
Or, to cross-match it another way…
DSM-V Symptoms of PMDD affected by hormone levels:
Markedly Depressed Mood (feelings of hopelessness, or self-deprecating thoughts)
Estrogen
Progesterone
Melatonin
Testosterone
Thyroid
Marked Anxiety, Tension, Feeling Keyed-up or On Edge
DHEA
Norepinephrine
Epinephrine
Thyroid
Marked Affective Lability (feeling suddenly sad or tearful or increased sensitivity to rejection)
Estrogen
Progesterone
Persistent and Marked Anger, Irritability, or Increased Interpersonal Conflicts
DHEA and other Androgens
Testosterone
Thyroid
Decreased Interest in Usual Activities (work, school, friends, hobbies)
Estrogen
Insulin
Melatonin
Progesterone
Testosterone
Thyroid
Subjective Sense of Difficulty in Concentrating
Estrogen
Progesterone
Thyroid
Decreased Interest in Usual Activities (work, school, friends, hobbies)
Estrogen
Insulin
Melatonin
Progesterone
Testosterone
Thyroid
Subjective Sense of Difficulty in Concentrating
Estrogen
Progesterone
Testosterone
Thyroid
Lethargy, Easy Fatigability, Marked Lack of Energy
Estrogen
Insulin
Melatonin
Progesterone
Testosterone
Thyroid
Marked Change in Appetite, Overeating, or Specific Food Cravings
DHEA
Cortisol
Insulin
Melatonin
Progesterone
Testosterone
Thyroid
Hypersomnia or Insomnia
Estrogen
Melatonin
Thyroid
Subjective Sense of Feeling Overwhelmed or Out of Control
Estrogen
Progesterone
Thyroid
Lethargy, Easy Fatigability, Marked Lack of Energy
Estrogen
Insulin
Melatonin
Progesterone
Testosterone
Thyroid
Marked Change in Appetite, Overeating, or Specific Food Cravings
DHEA
Cortisol
Insulin
Melatonin
Progesterone
Testosterone
Thyroid
Hypersomnia or Insomnia
Estrogen
Melatonin
Thyroid
Subjective Sense of Feeling Overwhelmed or Out of Control
Estrogen
Progesterone
Thyroid
Physical Symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, or weight gain.
Aldosterone (water weight gain)
Estrogen
Progesterone
Cortisol
Insulin
Melatonin
Testosterone
Thyroid
Do you see where I’m going with this? You could have PMDD, or you could have some kind of hormonal excess or deficiency that is exacerbated pre-menstrually (called Pre-Menstrual Exacerbation). It might actually be an insulin problem, or a thyroid problem, an auto-immune system problem, and not PMDD at all. Some doctors have been making great strides with theories of inflammation. Your problem might be PMDD or it might be something entirely different.
Physical Symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, or weight gain.
Aldosterone (water weight gain)
Estrogen
Progesterone
Cortisol
Insulin
Melatonin
Testosterone
Thyroid
Do you see where I’m going with this? You could have PMDD, or you could have some kind of hormonal excess or deficiency that is exacerbated pre-menstrually (called Pre-Menstrual Exacerbation). It might actually be an insulin problem, or a thyroid problem, an auto-immune system problem, and not PMDD at all. Some doctors have been making great strides with theories of inflammation. Your problem might be PMDD or it might be something entirely different.
The reason to get a diagnosis of PMDD is not to brand you with
the PMDD label, but rather to rule out any other treatable causes for your
symptoms.
Once you get that something else identified and dealt with, you
might be left with only PMS to deal with.
And wouldn't that be wonderful?
The bottom line is only you and a caring, knowledgeable, and
forward-thinking medical professional will be able to identify and separate the
many connected hormonal threads in your body and figure out what's working
right and what is not.
You are a beautiful, complex system of individual ups and downs, highs and
lows, checks and balances. Don’t let medical
professionals simply hand you prescriptions for one-size-fits-all blanket treatments
and/or try to make you feel to blame or as if you are not trying hard enough when
they don't work.
And most of all, don't let anybody tell you you’re crazy.
Because the only things out of kilter here are your hormones.
Keep searching until you find the right practitioner and answers
for YOU.
Wednesday, October 6, 2010
PMDD and Maple Syrup
Okay, time to check in again. One of the things I make a point of here is to be as honest with you as I possibly can. But my information is only as good as what I have personally experienced, so I can’t—and won’t--recommend things I haven’t tried. I’m just as eager—and sometimes just as desperate—as the next woman to find a way to feel well all the time, but I’m not one to just throw things out there to see if they stick. I’ve chased enough dream cures for PMDD in my forty years to know I don’t want to send any of you down the same road of futility and despair.
Because every time one of these so-called “miracle cures” fails to take away our PMDD, we tend to blame ourselves, and not the product we just spent another $20, $50, or $100 on. The problem must be with us, right?---not the stuff in the pretty package with all the glowing testimonials of how it worked for other women.
Wrong. The only problem here is you fell prey to hope.
That said, the only thing I know for sure is a woman with PMDD needs to pay careful attention to what she eats and drinks, and needs to listen to the signals her body sends her about whatever she is putting into her body, be it food, drink, supplements, creams, hormones, or medication of any sort. It’s only through this total body awareness that we’ll be able to get a handle on our PMDD.
Our bodies are amazing, and communicate with us constantly. Think aches, pains, tingles, queasiness, sleepiness, nervousness, whatever. Unfortunately, we’ve been conditioned to ignore these distress signals from bodies, and therefore our health and well-being, as long as we are able to get done all the things we need to do. It’s this ignoring of our bodies that leaves us wide open to using and abusing them in ways that invariably come back to haunt us, via cravings and weight gain, irritability and mood swings, and susceptibility to illnesses of all sorts, both physical and mental.
So the number one thing you need to do is take the time to get to know your body, what nourishes and sustains it, and what sends it, and therefore you and your life, out of kilter.
Last week I thought it was the cottage cheese bringing me down. I’ve since figured out that it was--and it wasn’t. It wasn’t bringing me down in the way I thought it was. As most women with PMDD, I need a certain level of carbs to be functional. Carbs are the precursor to making serotonin, which is a hormone a woman with PMDD lacks during certain times of the month.
There aren’t a lot of carbs in cottage cheese :). So after coming off the fast, which was a cleansing fast, and not one I would recommend for everybody (which is why I’m not openly promoting it here), I was (and still am) determined to watch my calories. Not count them—never again will I count calories—but I am determined in general to stick to a reasonable level of healthy fuel for my body intake.
Full fat cottage cheese is 30% fat—that’s what makes it so tasty. But by eating the cottage cheese, I was putting something in my body that wasn’t going to help improve my mood. What I should have been eating was something that would provide some healthy carbs to fuel my serotonin production.
In short, I substituted fat for carbs. And while it satisfied my hunger and the pleasure/reward area of my brain, it did nothing to improve my mood, or sense of mental clarity and well being. The key, in my case, is to keep a steady supply of carbs in my system, so my body has enough resources to make the level of serotonin I need to stay happy and focused. There are a few ways to do this. One, by eating some dense, healthy carbs—like oatmeal, or multi-grain toast with no sugar added preserves, or even bananas, grapes, apples, or oranges. (But you have to be careful about eating too much fruit if you have problems with insulin resistance.)
Another way to boost your serotonin levels is by exercising moderately. Too much exercise, and you deplete your body’s stores of carbs, therefore defeating the whole purpose. So a nice, moderate, 2-mile walk really helps. Maybe a some kind of dance (Zumba is great for this) or Pilates class. But if you don’t have time for that, even 10-20 minutes of walking or light aerobic exercise will help—just enough to get your heart rate up and break a light sweat.
A third alternative is to take some 5-HTP. I have two kinds here…one with 37 grams per capsule, and one with 100 grams per capsule. That way I can take whatever I need, based on whether I feel like I need a big boost in mood and focus or a small one. However, it is not recommended that you take 5-HTP if you are already taking any MAOI drugs or SSRI anti-depressants. The main reason being that they accomplish the same purpose so you could easily overdose by taking both. For more information on Serotonin Syndrome, go here.
An alternative to 5-HTP is to take a SSRI-type antidepressant—but only while you are feeling symptomatic. There’s no need to take any kind of drug every single day, day in and day out, for something that troubles you only part of the month. SSRIs have been proven to help with symptoms of PMDD in 60% of the women who take them. You won’t know if you’re one of the 60% unless you try. But what they don’t tell you is that for PMDD, you only need to take them when you are feeling symptomatic. It’s just easier to prescribe one for you to take all the time, and when it starts to fail, up the dosage (and all the unpleasant side effects). It’s like we can’t be trusted to know when we need a boost and when we don’t.
But while an anti-depressant takes a few weeks to kick in for those who are truly depressed, if you have PMDD, a SSRI can somehow affect the part of your brain that boosts your serotonin level within hours. So yes, I have a 10 mg prescription handy for those days when nothing else seems to work. But those days are few and far between, Thank God (in six months I’ve taken them three times, for 2-3 days each time), and I much prefer to use the natural methods of treatment available.
Other options are to increase your intake of Vitamin D, or to simply get more sleep. I realize that this last one is the least simple of the options available, but sometimes nothing less will do. For it's when we sleep that our body has a chance to re-set itself, and put everything back into balance if it can.
I did mention that while on the cleansing fast, I had no symptoms of PMDD. My guess is this was due to the maple syrup component of the fast, which kept a slow, steady supply of carbs circulating through my body and brain all day long. One serving of maple syrup contains 53 grams of sugar, 10 more grams than a can of regular soda. But all sugars are not alike. Sodas not only don’t add anything to your body but calories, they actually rob your of vitality and nutrition, and leave you dehydrated, to boot.
But since I was using organic Grade B maple syrup, I was getting all of the nutritional benefits (Grade B organic maple syrup is filled with all sorts of vitamins and minerals), without any negative side effects. However, at one point I was running out of Grade B syrup, and since the Whole Foods store was on the other side of town, I went to the grocery store instead to find a replacement to get me through the weekend.
No dice. All I could find was 100% pure Grade A maple syrup (not organic). One serving of that, and I had an immediate headache and was sick to my stomach. I went to the internet to find out why, and learned that non-organic Grade A maple syrup is sometimes processed with formaldehyde.
My body was letting me know I was not giving it something that was good and healthy. Back to the Whole Foods store I went, and the problem immediately went away.
So now I sweeten my tea with a little Grade B organic syrup, and it does wonders to keep the healthy carbs flowing.
Because every time one of these so-called “miracle cures” fails to take away our PMDD, we tend to blame ourselves, and not the product we just spent another $20, $50, or $100 on. The problem must be with us, right?---not the stuff in the pretty package with all the glowing testimonials of how it worked for other women.
Wrong. The only problem here is you fell prey to hope.
That said, the only thing I know for sure is a woman with PMDD needs to pay careful attention to what she eats and drinks, and needs to listen to the signals her body sends her about whatever she is putting into her body, be it food, drink, supplements, creams, hormones, or medication of any sort. It’s only through this total body awareness that we’ll be able to get a handle on our PMDD.
Our bodies are amazing, and communicate with us constantly. Think aches, pains, tingles, queasiness, sleepiness, nervousness, whatever. Unfortunately, we’ve been conditioned to ignore these distress signals from bodies, and therefore our health and well-being, as long as we are able to get done all the things we need to do. It’s this ignoring of our bodies that leaves us wide open to using and abusing them in ways that invariably come back to haunt us, via cravings and weight gain, irritability and mood swings, and susceptibility to illnesses of all sorts, both physical and mental.
So the number one thing you need to do is take the time to get to know your body, what nourishes and sustains it, and what sends it, and therefore you and your life, out of kilter.
Last week I thought it was the cottage cheese bringing me down. I’ve since figured out that it was--and it wasn’t. It wasn’t bringing me down in the way I thought it was. As most women with PMDD, I need a certain level of carbs to be functional. Carbs are the precursor to making serotonin, which is a hormone a woman with PMDD lacks during certain times of the month.
There aren’t a lot of carbs in cottage cheese :). So after coming off the fast, which was a cleansing fast, and not one I would recommend for everybody (which is why I’m not openly promoting it here), I was (and still am) determined to watch my calories. Not count them—never again will I count calories—but I am determined in general to stick to a reasonable level of healthy fuel for my body intake.
Full fat cottage cheese is 30% fat—that’s what makes it so tasty. But by eating the cottage cheese, I was putting something in my body that wasn’t going to help improve my mood. What I should have been eating was something that would provide some healthy carbs to fuel my serotonin production.
In short, I substituted fat for carbs. And while it satisfied my hunger and the pleasure/reward area of my brain, it did nothing to improve my mood, or sense of mental clarity and well being. The key, in my case, is to keep a steady supply of carbs in my system, so my body has enough resources to make the level of serotonin I need to stay happy and focused. There are a few ways to do this. One, by eating some dense, healthy carbs—like oatmeal, or multi-grain toast with no sugar added preserves, or even bananas, grapes, apples, or oranges. (But you have to be careful about eating too much fruit if you have problems with insulin resistance.)
Another way to boost your serotonin levels is by exercising moderately. Too much exercise, and you deplete your body’s stores of carbs, therefore defeating the whole purpose. So a nice, moderate, 2-mile walk really helps. Maybe a some kind of dance (Zumba is great for this) or Pilates class. But if you don’t have time for that, even 10-20 minutes of walking or light aerobic exercise will help—just enough to get your heart rate up and break a light sweat.
A third alternative is to take some 5-HTP. I have two kinds here…one with 37 grams per capsule, and one with 100 grams per capsule. That way I can take whatever I need, based on whether I feel like I need a big boost in mood and focus or a small one. However, it is not recommended that you take 5-HTP if you are already taking any MAOI drugs or SSRI anti-depressants. The main reason being that they accomplish the same purpose so you could easily overdose by taking both. For more information on Serotonin Syndrome, go here.
An alternative to 5-HTP is to take a SSRI-type antidepressant—but only while you are feeling symptomatic. There’s no need to take any kind of drug every single day, day in and day out, for something that troubles you only part of the month. SSRIs have been proven to help with symptoms of PMDD in 60% of the women who take them. You won’t know if you’re one of the 60% unless you try. But what they don’t tell you is that for PMDD, you only need to take them when you are feeling symptomatic. It’s just easier to prescribe one for you to take all the time, and when it starts to fail, up the dosage (and all the unpleasant side effects). It’s like we can’t be trusted to know when we need a boost and when we don’t.
But while an anti-depressant takes a few weeks to kick in for those who are truly depressed, if you have PMDD, a SSRI can somehow affect the part of your brain that boosts your serotonin level within hours. So yes, I have a 10 mg prescription handy for those days when nothing else seems to work. But those days are few and far between, Thank God (in six months I’ve taken them three times, for 2-3 days each time), and I much prefer to use the natural methods of treatment available.
Other options are to increase your intake of Vitamin D, or to simply get more sleep. I realize that this last one is the least simple of the options available, but sometimes nothing less will do. For it's when we sleep that our body has a chance to re-set itself, and put everything back into balance if it can.
I did mention that while on the cleansing fast, I had no symptoms of PMDD. My guess is this was due to the maple syrup component of the fast, which kept a slow, steady supply of carbs circulating through my body and brain all day long. One serving of maple syrup contains 53 grams of sugar, 10 more grams than a can of regular soda. But all sugars are not alike. Sodas not only don’t add anything to your body but calories, they actually rob your of vitality and nutrition, and leave you dehydrated, to boot.
But since I was using organic Grade B maple syrup, I was getting all of the nutritional benefits (Grade B organic maple syrup is filled with all sorts of vitamins and minerals), without any negative side effects. However, at one point I was running out of Grade B syrup, and since the Whole Foods store was on the other side of town, I went to the grocery store instead to find a replacement to get me through the weekend.
No dice. All I could find was 100% pure Grade A maple syrup (not organic). One serving of that, and I had an immediate headache and was sick to my stomach. I went to the internet to find out why, and learned that non-organic Grade A maple syrup is sometimes processed with formaldehyde.
My body was letting me know I was not giving it something that was good and healthy. Back to the Whole Foods store I went, and the problem immediately went away.
So now I sweeten my tea with a little Grade B organic syrup, and it does wonders to keep the healthy carbs flowing.
Wednesday, September 29, 2010
PMDD and Nutrition
Okay, after all those posts telling you what you need to avoid, I promised to take a break and tell you some of the good and positive things you can do to lessen and help manage your PMDD. Because there is no cure for PMDD. Get that straight in your head right now--no matter what anybody on the internet or on television promises you. There is no cure. Period. You can make it go away for a while by either masking it with a various assortment of drugs, or by making positive lifestyle changes and treating yourself the way you deserve to be treated.
But if you don’t keep up indefinitely whichever path you choose, day in and day out, the PMDD will be back—and most times with a vengeance.
One of the best natural things you can do to manage your PMDD (in addition to reducing the stress in your life, exercising regularly, and getting enough rest) is to pay very close attention to what you eat. Nutrition, nutrition, nutrition. Any body responds well to good nutrition, but a woman with PMDD in particular needs to pay attention to her nutritional needs if she wants to keep her hormones functioning at optimal levels and in balance.
Recently I attempted a ten-day detoxification fast, with the goal of ridding my body of accumulated toxins, re-setting my metabolism, and re-establishing my hormonal balance. I went eight days without solid food, and would have gone longer, if I didn’t have a four-hour community service commitment I had to go to. I wasn’t sure what would be involved, or if we would be eating, and I decided I’d rather go off the fast than have to explain what I was doing and why I wasn’t eating. People can be so touchy about that, if they offer you food and you don’t eat it.
I needed a day to switch gears before going on this outing with my church, so I stopped the fast at the end of day eight.
While I was on the fast, I felt great hormonally. Never better. No mood swings, lots of energy, an amazing clarity of mind, and all sorts of warm, fuzzy feelings of well-being.
I went off the fast, and the very next day, my PMDD returned. My first thought was it was because of something I was eating. My best guess is that something is meat and dairy products. Why? Because unless you go specifically hunting for sources of meat and dairy products that are antibiotic and hormone-free…which I do most of the time but didn’t take the time to last week…you’re going to get some of those substances in the meat and dairy products you consume (including cheese, cream, butter, yogurt and milk), and it’s going to affect your own delicate hormonal balance.
And boy, did it, in my case. Why? Because those first couple of days off the fast, I treated myself to a big bowl of cottage cheese and tomatoes, using the last home-grown tomatoes of the season. I’ve always considered real cottage cheese (the full fat kind, not that low fat stuff) more tasty than ice cream…so it’s my special treat, and when the home grown tomatoes are in season…I can’t resist.
But after two days of feeling like my old PMDD self, I started resisting. And when I started resisting, I started feeling better. Then, two days ago, I went on a road trip, where for the most part, only fast food and vending machine food was available. The next morning, I couldn’t seem to wake up, couldn’t get my day started at all. I was in a total fog and couldn’t shake it to save myself.
The culprits? Coffee, cheese and crackers, and (even though the fast food place said it was home made) a very tasty Sloppy Joe.
So in an attempt to revive the energy and clarity of my food fast, I went back to the basics—oatmeal, fresh fruits and vegetables, seeds, nuts and other whole foods. I ended the day by making a very tasty and filling vegetable soup, with no interest at all in my usual accompanying cheese and crackers.
Today I feel 100% better. We’ll see what happens in the days to come as I continue to eat no meat that isn’t hormone-free, no cheese, and drink no milk.
I’m not saying this will work for you, but it’s definitely something I am willing to try, after having felt so good and energetic those eight days I didn’t eat or drink any of the above. The only things I actually missed in those eight days were fruit, salad, and nuts.
How interesting, that given the chance to strip things down to the bare bones, by eating no solid food for over a week, that the things my body craved were all good and healthy foods. Proof positive that if you just listen to your body--not your emotions, as in emotional eating--it will steer you to the right kinds of fuel. The only reason I went after the cottage cheese, was because I knew my days for eating the last fresh tomatoes of the season were limited.
I also found it interesting that while fasting I didn’t give chocolate a second thought. Wanting some never entered my mind. I also had absolutely no desire to eat anything made with refined sugar or flour—and still don’t. It totally amazes me. The fast was drastic, yes, but in a sense it did reset my hunger mechanisms. And I did ease into it by eating mostly salads for a few days before I began.
Although yesterday (with my PMDD going on) I did crave chocolate, but since the fast I find I don’t care for the taste of solid chocolate, and so instead of eating my regular brand of chocolate, I switched to drinking more of the healthy Mocha Cappuccino drink I have recommended before, from Bolthouse Farms.
It’s doing the trick, so as long as that works, I am a happy camper.
But, like I said, this is only what is working for me, and I am, as always, a work in progress. According to Ann Louise Gittleman, who wrote Super Nutrition for Women: A Food-Wise Guide for Health, Beauty, Energy and Immunity, particularly good nutritional choices for women who have PMDD include:
Blackstrap molasses
Broccoli
Lentils
Sea vegetables (check out your local health foods store)
Sesame Seeds
Sunflower seeds
Whole brown rice
What about Vitamins and Supplements?
Supplements can help, but should never replace food. The body works best with healthy food. By healthy I mean whole, natural, nutrient-rich foods. Not processed foods of any kind (like my beloved cheese). Vitamin and mineral supplementation can quickly send you into imbalance if you use them to try to make up for eating a nutrient-poor diet—meaning lots of processed food and fast food on the run--especially if you take more of any vitamin or mineral than you need.
More does not equal better in most, if not all cases of vitamin supplementation.
Beyond a daily pharmaceutical grade multi-vitamin (not just something off the shelf at your local discount store—sorry!), or daily pharmaceutical grade multi-vitamin pack, and some added calcium and magnesium, maybe some extra vitamin C during cold season, you need to get most, if not all of your PMDD nutritional needs from the foods you eat. The benefit of a daily multi-vitamin is to offset the daily depletion of nutrients from our bodies due to environmental pollutants such as smoke, carbon dioxide, pesticides, chemical-based cleaners, perfumes, deodorizers, air fresheners and the like, and medications of any kind, over the counter or prescription, including birth control pills (which cause deficiencies of folic acid and vitamins B 6 and B 12—both integral to mood stability).
In short, with all the toxins we are exposed to daily, a good multi-vitamin just keeps you from ending your day in the negative column. It gives you a good baseline to start from, but you still need to eat right to feel strong and healthy.
Our bodies know best. We need to learn to listen to them carefully and treat them well, so that they can do the same in return. Only when we choose to take charge of our health--when we decide to take control of our diets and make good and healthy food choices--will we have any hope of getting off the PMDD Not-So-Merry-go-round, and finally managing our unruly hormones.
Short version: Eat whole, natural foods as close to the source as possible; go organic whenever you can afford it; avoid all processed foods and as many medications as you can, both over the counter and prescription; take a daily pharmaceutical grade multi-vitamin or vitamin pack; make sure you get some added calcium and magnesium; minimize the environmental toxins in your home and work space; exercise regularly; get plenty of rest; and de-stress your life as much as possible.
A more detailed breakdown of each of these items will appear in blog posts to come.
But if you don’t keep up indefinitely whichever path you choose, day in and day out, the PMDD will be back—and most times with a vengeance.
One of the best natural things you can do to manage your PMDD (in addition to reducing the stress in your life, exercising regularly, and getting enough rest) is to pay very close attention to what you eat. Nutrition, nutrition, nutrition. Any body responds well to good nutrition, but a woman with PMDD in particular needs to pay attention to her nutritional needs if she wants to keep her hormones functioning at optimal levels and in balance.
Recently I attempted a ten-day detoxification fast, with the goal of ridding my body of accumulated toxins, re-setting my metabolism, and re-establishing my hormonal balance. I went eight days without solid food, and would have gone longer, if I didn’t have a four-hour community service commitment I had to go to. I wasn’t sure what would be involved, or if we would be eating, and I decided I’d rather go off the fast than have to explain what I was doing and why I wasn’t eating. People can be so touchy about that, if they offer you food and you don’t eat it.
I needed a day to switch gears before going on this outing with my church, so I stopped the fast at the end of day eight.
While I was on the fast, I felt great hormonally. Never better. No mood swings, lots of energy, an amazing clarity of mind, and all sorts of warm, fuzzy feelings of well-being.
I went off the fast, and the very next day, my PMDD returned. My first thought was it was because of something I was eating. My best guess is that something is meat and dairy products. Why? Because unless you go specifically hunting for sources of meat and dairy products that are antibiotic and hormone-free…which I do most of the time but didn’t take the time to last week…you’re going to get some of those substances in the meat and dairy products you consume (including cheese, cream, butter, yogurt and milk), and it’s going to affect your own delicate hormonal balance.
And boy, did it, in my case. Why? Because those first couple of days off the fast, I treated myself to a big bowl of cottage cheese and tomatoes, using the last home-grown tomatoes of the season. I’ve always considered real cottage cheese (the full fat kind, not that low fat stuff) more tasty than ice cream…so it’s my special treat, and when the home grown tomatoes are in season…I can’t resist.
But after two days of feeling like my old PMDD self, I started resisting. And when I started resisting, I started feeling better. Then, two days ago, I went on a road trip, where for the most part, only fast food and vending machine food was available. The next morning, I couldn’t seem to wake up, couldn’t get my day started at all. I was in a total fog and couldn’t shake it to save myself.
The culprits? Coffee, cheese and crackers, and (even though the fast food place said it was home made) a very tasty Sloppy Joe.
So in an attempt to revive the energy and clarity of my food fast, I went back to the basics—oatmeal, fresh fruits and vegetables, seeds, nuts and other whole foods. I ended the day by making a very tasty and filling vegetable soup, with no interest at all in my usual accompanying cheese and crackers.
Today I feel 100% better. We’ll see what happens in the days to come as I continue to eat no meat that isn’t hormone-free, no cheese, and drink no milk.
I’m not saying this will work for you, but it’s definitely something I am willing to try, after having felt so good and energetic those eight days I didn’t eat or drink any of the above. The only things I actually missed in those eight days were fruit, salad, and nuts.
How interesting, that given the chance to strip things down to the bare bones, by eating no solid food for over a week, that the things my body craved were all good and healthy foods. Proof positive that if you just listen to your body--not your emotions, as in emotional eating--it will steer you to the right kinds of fuel. The only reason I went after the cottage cheese, was because I knew my days for eating the last fresh tomatoes of the season were limited.
I also found it interesting that while fasting I didn’t give chocolate a second thought. Wanting some never entered my mind. I also had absolutely no desire to eat anything made with refined sugar or flour—and still don’t. It totally amazes me. The fast was drastic, yes, but in a sense it did reset my hunger mechanisms. And I did ease into it by eating mostly salads for a few days before I began.
Although yesterday (with my PMDD going on) I did crave chocolate, but since the fast I find I don’t care for the taste of solid chocolate, and so instead of eating my regular brand of chocolate, I switched to drinking more of the healthy Mocha Cappuccino drink I have recommended before, from Bolthouse Farms.
It’s doing the trick, so as long as that works, I am a happy camper.
But, like I said, this is only what is working for me, and I am, as always, a work in progress. According to Ann Louise Gittleman, who wrote Super Nutrition for Women: A Food-Wise Guide for Health, Beauty, Energy and Immunity, particularly good nutritional choices for women who have PMDD include:
Blackstrap molasses
Broccoli
Lentils
Sea vegetables (check out your local health foods store)
Sesame Seeds
Sunflower seeds
Whole brown rice
What about Vitamins and Supplements?
Supplements can help, but should never replace food. The body works best with healthy food. By healthy I mean whole, natural, nutrient-rich foods. Not processed foods of any kind (like my beloved cheese). Vitamin and mineral supplementation can quickly send you into imbalance if you use them to try to make up for eating a nutrient-poor diet—meaning lots of processed food and fast food on the run--especially if you take more of any vitamin or mineral than you need.
More does not equal better in most, if not all cases of vitamin supplementation.
Beyond a daily pharmaceutical grade multi-vitamin (not just something off the shelf at your local discount store—sorry!), or daily pharmaceutical grade multi-vitamin pack, and some added calcium and magnesium, maybe some extra vitamin C during cold season, you need to get most, if not all of your PMDD nutritional needs from the foods you eat. The benefit of a daily multi-vitamin is to offset the daily depletion of nutrients from our bodies due to environmental pollutants such as smoke, carbon dioxide, pesticides, chemical-based cleaners, perfumes, deodorizers, air fresheners and the like, and medications of any kind, over the counter or prescription, including birth control pills (which cause deficiencies of folic acid and vitamins B 6 and B 12—both integral to mood stability).
In short, with all the toxins we are exposed to daily, a good multi-vitamin just keeps you from ending your day in the negative column. It gives you a good baseline to start from, but you still need to eat right to feel strong and healthy.
Our bodies know best. We need to learn to listen to them carefully and treat them well, so that they can do the same in return. Only when we choose to take charge of our health--when we decide to take control of our diets and make good and healthy food choices--will we have any hope of getting off the PMDD Not-So-Merry-go-round, and finally managing our unruly hormones.
Short version: Eat whole, natural foods as close to the source as possible; go organic whenever you can afford it; avoid all processed foods and as many medications as you can, both over the counter and prescription; take a daily pharmaceutical grade multi-vitamin or vitamin pack; make sure you get some added calcium and magnesium; minimize the environmental toxins in your home and work space; exercise regularly; get plenty of rest; and de-stress your life as much as possible.
A more detailed breakdown of each of these items will appear in blog posts to come.
Wednesday, September 15, 2010
Finding a Doctor to Help You With Your PMDD
Update: March 2018...I have been getting a lot of requests for names of naturopathic doctors lately...I refer everyone to the American Association of Naturopathic Physicians. A good nurse practitioner in your area can also be of great help. I realize these links are for Americans, but perhaps you can find a similar organization in your country. I wish you all the best and let me know how you make out! In the meantime, here is my original post, written just over two years ago:
Someone had asked if I’d ever looked into saliva hormone testing, and the answer is yes. Once, last summer and fall. This post will be long, but I hope it will be of some help and consolation to those who are meeting dead end after dead end in your own search for relief from your PMDD.
Imagine my joy last summer when I opened my local paper to find a special supplement for women, and discovered, after all my years of searching, that my town had a genuine hormone specialist.
Or at least that’s what the ad said. My experience, unfortunately, didn’t bear that claim out.
My first visit to this woman was a resounding disappointment. I’d waited until I was in the throes of an episode to call for an appointment, so that she could see for herself what I was dealing with, but was told I’d have to wait several weeks for an appointment.
Once I finally got there, symptom-free, the upshot was she wasn’t at all familiar with PMDD, had no idea what I was talking about, and when I tried to describe it to her, how I am perfectly fine and happy most days of the month, but then there is that one week that everything goes awry emotionally, in conjunction with my menstrual cycles, she just looked at me and asked, “Have you talked with a psychiatrist about this?”
Yes, I said, I have, but it’s not a psychological problem, it’s a hormonal imbalance in the brain (ergo why I am here) due to a dip in serotonin (aka a mood-elevating hormone) on those days, that causes the D part of PMDD, or depression.
“Depression!” she says, her eyes practically lighting up. “Then what you need are anti-depressants.” No, I repeat, because it doesn’t happen but a few days a month. The rest of the month I am fine. Healthy, happy, whole, and sane.
I explain the situation to her again. She decides I must be in denial, puts Depression down as my diagnosis (which I discover after I go online to find out what the diagnostic codes she has written on my receipt and lab test requests mean) and hands me a home saliva hormone testing kit.
Send this in and call me to schedule an appointment to discuss the results, she says, practically shoving me out the door. Oh, and that will be $100. Next!
The thing is, I have to wait until I have another episode of PMDD to take the test, because I want to do the test while the PMDD is happening, and an episode has just passed, so it takes another month for me to even do the test.
In the interim, since it is clear that the true focus of this woman's practice is elsewhere, as in botox injections and chemical peels (both of which are truly hazardous to your hormones), and the hormone testing is apparently just some sort of sideline, I call all around town to find someone else to help me sort out my unruly hormones.
No deal. Only she and one other doctor in town are doing this kind of hormonal testing and the other one was a man and couldn't see me for at least three months.
So I do the test. I knew it was a mistake the minute I dropped the samples off at the UPS shipping post. The instructions had been so specific about keeping the saliva samples in the freezer and mailing them off THE NEXT MORNING. You could go with UPS or the postal service, but I knew the US mail didn’t go out before three around here anyway, so I opted for UPS.
I walk in with my little test kit, and the woman says, “Fine, just leave it on the counter.”
“When do they pick up?” I ask. “Oh, sometime this afternoon.”
In the meanwhile, my little kit sits out in the open on the counter of a store that has its front doors wide open to the fall sunshine. How could the samples not be corrupted?
I ask this of the doctor when I see her three weeks later, and she looks at me like I’ve grown two heads. “I don’t know,” she says. “It’s not a problem.”
Well, I see it as a problem, because my test results turned out to be totally unexpected and off the charts in some areas, and she can’t explain why. She just kept looking at the results, and circling them, and saying nothing more than, “Well, that’s what it is. As you can see, its…high.”
She drew in some upward arrows for effect.
It turns out, that according to the test results, instead of a deficiency in my hormones, I have an excess in some areas. This causes a problem for the doctor, because apparently the standard procedure is, she tells me I am low in this, this, and that, and then tells me I am in luck, as she has just the supplements I need on hand.
Be very wary of any kind of testing that comes complete with (their own) name brand products as the solution to your problems.
Fortunately, however, she was out of the one thing I was deficient in, Vitamin D. I told her that was okay, I’d manage to get some on my own (from a company I know and trust).
In the meantime, I ask the doctor, “How do you get rid of excess hormones?” She looks at me. “I don’t know.”
Well, I know the answer exists, because I read it somewhere, but I don’t remember where, because it was just something I'd read and had no idea I’d be needing.
“I’ll call the lab and see what’s going on with these results,” she says. “Why don’t you make an appointment for next week to come back and find out what they said?”
This time I looked at her. “Why don’t you just call me and tell me what they said?”
She agrees to do so. So I ask her what could possibly cause my hormone levels to be so high. I know the answer. I want to see if she does. After all, I’m the one paying her to tell me what the problem is. She fumbles badly until I give her a clue, then she takes off with it, all the while, asking, “You know what I mean?”
Yes, Doctor. I know what you mean. I also know that you’re winging it here and it shows.
In the end, she decides I need more testing, and bounds out of the room to figure out what test I need.
"Why do I need to take a different test?" I ask. "Because this one is better than the other one," she says, which leads me to wonder why she didn't give me the better test $500 ago.
No matter. No way am I doing this saliva test thing again, which several doctors in my research books have found to be unreliable. They recommend blood serum tests instead.
I ask her if there aren’t any blood serum tests I can take to get a better picture of what’s going on. “Why?” she asks. “It won’t do any good.”
This is the exact quote I have read over and over again in my books about women seeking help for hormonal issues, being shut down by their doctors who either have been trained to say or truly believe blood hormone tests aren’t reliable.
But how can the home-collected saliva tests be? It’s impossible. At least when you have samples taken at a lab, be they blood, urine, or saliva, they keep them refrigerated, and transport them in refrigerated containers. God only knows where my samples sat during the five days it took to get to the lab. I sent my samples off the morning of the 25th. They weren’t tested until the 29th.
To find out more about the subject, I went to what was billed as a seminar on saliva hormone testing, sponsored by a local pharmacy. A compounding pharmacy, one that can create individual prescriptions for women with hormonal imbalances, once the testing kits show where they are deficient. The room was filled with about forty women, all middle-aged.
The presentation was completely on target and informative. The information was correct. But it was a marketing presentation all the same. Go to your doctor, ask for these kits, get your hormones tested, then come back to us for a consult and we will mix up the perfect prescription for you.
Sounds like a dream come true to women who can’t sleep, can’t lose weight, are either bitchy or want to cry all the time or both at the same time, have hot flashes, headaches, backaches, swelling, cramping, bloating, joint pain and are either losing their hair or growing a moustache, just to name a few symptoms. And don’t forget, we’re all exhausted, and not interested in sex.
But they warn you the testing is imperfect, and it may take a few tests to get your prescription right, and you will need to be tested every three months thereafter to make sure the hormones they are giving you are the right ones for you.
They do not mention the cost, nor that it is not covered by insurance, nor that there are only two doctors in town who subscribe to this method of testing, and one of them is a woman who apparently doesn’t know the first thing about interpreting the results. All she knows is how to hand you a kit and say, “Call me for an appointment to get the results.”
This is the same woman who after speaking with me for 15 minutes, strongly suggested I go on anti-depressants as the solution to my hormonal problems, which I refused, because 1) I'm not depressed, and 2) countless case studies show that taking anti-depressants only makes your PMDD symptoms worse.
Hormonal imbalances are so individual, because each woman’s physical make up and life stressors are so different, that prescribing one pill to take care of them is like asking every woman to wear a one-size-fits-all-tent dress.
This time, after seeing the supposedly high levels of my hormones, in particular my serotonin level, which is what the SSRI anti-depressant would supposedly boost, the doctor did a complete 180 degree turn-around. As I was leaving, I asked her, just to make sure, “Now, you don’t recommend the anti-depressants any more, correct?” And she looked at me. “Well, you’re the one who said you wanted to go natural, right? You can’t do that if you’re on anti-depressants.”
A few weeks later I got a call from her office, informing me that the supplements for my depression that my test results indicated I needed were in and I could come in and pick them up.
I said, "I'm sorry, but I'm not depressed, and at this point I have lost all confidence in your office's ability to help me with my hormonal problem, so I won't be picking up any supplements."
I received a call from the doctor the next day, placing the blame on the receptionist, who obviously had "misunderstood my situation."
Professionalism at its finest. Blame someone else. The receptionist hadn't misunderstood anything. Not when I knew the doctor herself had diagnosed me with depression.
I then asked the doctor if she had called the testing company (as she had said she would when I was in her office) to find out why my results were so abnormally off the charts, and she said that no, she hadn't, because, well, "The results are the results."
And besides, she said, "I didn't give you all the results anyway."
"You didn't?" I asked, stunned.
"Well, no," she said impatiently, "because you wouldn't be able to handle all the information at once." These things take time, she insisted. It takes more than a couple of visits to sort everything out.
Needless to say, I never returned.
April 2012 Update: I recognized the "hormone specialist" I wrote about above in the check out line at our local whole foods co-op. The clerk was chatting about a television show she had watched the night before and the doctor asked, "Does it have to do with money? Because I only know about things that make money."
Everybody laughed.
But I knew she was telling the truth.
After my useless encounter with her, I went to an endocrinologist, for whom I had to wait several more months to see. She was a lovely woman, well-informed, empathetic and understanding, since she herself happened to be going through menopause.
However, she was not a fan of bio-identical hormones. We talked a while, and then, comfortably leaning back in her chair she said, "As a medically-trained doctor, I can only give you advice based on the information that has been clinically proven. Your choices are anti-depressants, birth control pills, or hormone replacement therapy."
(The HRT she was talking about, however, was the conjugated estrogen therapy proven to cause several potentially fatal side effects by the Women's Health Initiative Study. (More on this in another post, since this one is already so long).)
"But as a woman," she added, then leaned forward and looked me in the eye, "When you find the answer, call me." She held up her hand to her ear to mimic using the phone.
This are only two examples of how frustrating it can be to find answers for your PMDD. Some doctors claim to have the answers but don't, some can only speak to what they have been taught, others are willing to help, but don't know what to do.
Meanwhile, month after month rolls around, and we suffer.
I managed to talk her into doing some blood tests for my estrogen and progesterone levels. "I'll order the tests," she said, "but what are you going to do with the results?"
"I don't know yet," I said, "but I'll figure something out."
In the end it turned out the tests she ordered for me weren't quite what I needed, but I didn't know it at the time. I've since learned more on the subject, and after more than a year's worth of PMDD episodes later, I managed to get my primary physician to request the serum blood tests that I needed, per the instructions on page 385 in Dr. Elizabeth Vliet's book, It's My Ovaries, Stupid! We then started a bioidentical hormone regimen that finally saved my sanity.
Yes, in the end I was able to work with my primary care practitioner, who, per the instructions in Dr. Vliet's book, prescribed bioidentical hormones for me in the form of an estradiol patch (the right dosage for me was .075mg/day, but you can start at .0375 mg and go up to 2.0 mg), and 200 mg of prometrium (progesterone capsules), which I still take daily. For seven years, this bioidentical combination was a huge help with both my symptoms of perimenopause, and my PMDD. (March 2018: I have now reached menopause and reluctantly no longer use the patch.)
Other effective things I found to help ease my PMDD were all lifestyle changes - diet, exercise, self-awareness, self-care when an episode descended, and vitamin supplementation. For a list of what I took then and/or now take daily, please email me at info(at)livingwithpmdd(dot)com. I do not provide it here, because I am constantly fine-tuning my efforts to be well.
And that is all I want for you. To be well.
Someone had asked if I’d ever looked into saliva hormone testing, and the answer is yes. Once, last summer and fall. This post will be long, but I hope it will be of some help and consolation to those who are meeting dead end after dead end in your own search for relief from your PMDD.
Imagine my joy last summer when I opened my local paper to find a special supplement for women, and discovered, after all my years of searching, that my town had a genuine hormone specialist.
Or at least that’s what the ad said. My experience, unfortunately, didn’t bear that claim out.
My first visit to this woman was a resounding disappointment. I’d waited until I was in the throes of an episode to call for an appointment, so that she could see for herself what I was dealing with, but was told I’d have to wait several weeks for an appointment.
Once I finally got there, symptom-free, the upshot was she wasn’t at all familiar with PMDD, had no idea what I was talking about, and when I tried to describe it to her, how I am perfectly fine and happy most days of the month, but then there is that one week that everything goes awry emotionally, in conjunction with my menstrual cycles, she just looked at me and asked, “Have you talked with a psychiatrist about this?”
Yes, I said, I have, but it’s not a psychological problem, it’s a hormonal imbalance in the brain (ergo why I am here) due to a dip in serotonin (aka a mood-elevating hormone) on those days, that causes the D part of PMDD, or depression.
“Depression!” she says, her eyes practically lighting up. “Then what you need are anti-depressants.” No, I repeat, because it doesn’t happen but a few days a month. The rest of the month I am fine. Healthy, happy, whole, and sane.
I explain the situation to her again. She decides I must be in denial, puts Depression down as my diagnosis (which I discover after I go online to find out what the diagnostic codes she has written on my receipt and lab test requests mean) and hands me a home saliva hormone testing kit.
Send this in and call me to schedule an appointment to discuss the results, she says, practically shoving me out the door. Oh, and that will be $100. Next!
The thing is, I have to wait until I have another episode of PMDD to take the test, because I want to do the test while the PMDD is happening, and an episode has just passed, so it takes another month for me to even do the test.
In the interim, since it is clear that the true focus of this woman's practice is elsewhere, as in botox injections and chemical peels (both of which are truly hazardous to your hormones), and the hormone testing is apparently just some sort of sideline, I call all around town to find someone else to help me sort out my unruly hormones.
No deal. Only she and one other doctor in town are doing this kind of hormonal testing and the other one was a man and couldn't see me for at least three months.
So I do the test. I knew it was a mistake the minute I dropped the samples off at the UPS shipping post. The instructions had been so specific about keeping the saliva samples in the freezer and mailing them off THE NEXT MORNING. You could go with UPS or the postal service, but I knew the US mail didn’t go out before three around here anyway, so I opted for UPS.
I walk in with my little test kit, and the woman says, “Fine, just leave it on the counter.”
“When do they pick up?” I ask. “Oh, sometime this afternoon.”
In the meanwhile, my little kit sits out in the open on the counter of a store that has its front doors wide open to the fall sunshine. How could the samples not be corrupted?
I ask this of the doctor when I see her three weeks later, and she looks at me like I’ve grown two heads. “I don’t know,” she says. “It’s not a problem.”
Well, I see it as a problem, because my test results turned out to be totally unexpected and off the charts in some areas, and she can’t explain why. She just kept looking at the results, and circling them, and saying nothing more than, “Well, that’s what it is. As you can see, its…high.”
She drew in some upward arrows for effect.
It turns out, that according to the test results, instead of a deficiency in my hormones, I have an excess in some areas. This causes a problem for the doctor, because apparently the standard procedure is, she tells me I am low in this, this, and that, and then tells me I am in luck, as she has just the supplements I need on hand.
Be very wary of any kind of testing that comes complete with (their own) name brand products as the solution to your problems.
Fortunately, however, she was out of the one thing I was deficient in, Vitamin D. I told her that was okay, I’d manage to get some on my own (from a company I know and trust).
In the meantime, I ask the doctor, “How do you get rid of excess hormones?” She looks at me. “I don’t know.”
Well, I know the answer exists, because I read it somewhere, but I don’t remember where, because it was just something I'd read and had no idea I’d be needing.
“I’ll call the lab and see what’s going on with these results,” she says. “Why don’t you make an appointment for next week to come back and find out what they said?”
This time I looked at her. “Why don’t you just call me and tell me what they said?”
She agrees to do so. So I ask her what could possibly cause my hormone levels to be so high. I know the answer. I want to see if she does. After all, I’m the one paying her to tell me what the problem is. She fumbles badly until I give her a clue, then she takes off with it, all the while, asking, “You know what I mean?”
Yes, Doctor. I know what you mean. I also know that you’re winging it here and it shows.
In the end, she decides I need more testing, and bounds out of the room to figure out what test I need.
"Why do I need to take a different test?" I ask. "Because this one is better than the other one," she says, which leads me to wonder why she didn't give me the better test $500 ago.
No matter. No way am I doing this saliva test thing again, which several doctors in my research books have found to be unreliable. They recommend blood serum tests instead.
I ask her if there aren’t any blood serum tests I can take to get a better picture of what’s going on. “Why?” she asks. “It won’t do any good.”
This is the exact quote I have read over and over again in my books about women seeking help for hormonal issues, being shut down by their doctors who either have been trained to say or truly believe blood hormone tests aren’t reliable.
But how can the home-collected saliva tests be? It’s impossible. At least when you have samples taken at a lab, be they blood, urine, or saliva, they keep them refrigerated, and transport them in refrigerated containers. God only knows where my samples sat during the five days it took to get to the lab. I sent my samples off the morning of the 25th. They weren’t tested until the 29th.
To find out more about the subject, I went to what was billed as a seminar on saliva hormone testing, sponsored by a local pharmacy. A compounding pharmacy, one that can create individual prescriptions for women with hormonal imbalances, once the testing kits show where they are deficient. The room was filled with about forty women, all middle-aged.
The presentation was completely on target and informative. The information was correct. But it was a marketing presentation all the same. Go to your doctor, ask for these kits, get your hormones tested, then come back to us for a consult and we will mix up the perfect prescription for you.
Sounds like a dream come true to women who can’t sleep, can’t lose weight, are either bitchy or want to cry all the time or both at the same time, have hot flashes, headaches, backaches, swelling, cramping, bloating, joint pain and are either losing their hair or growing a moustache, just to name a few symptoms. And don’t forget, we’re all exhausted, and not interested in sex.
But they warn you the testing is imperfect, and it may take a few tests to get your prescription right, and you will need to be tested every three months thereafter to make sure the hormones they are giving you are the right ones for you.
They do not mention the cost, nor that it is not covered by insurance, nor that there are only two doctors in town who subscribe to this method of testing, and one of them is a woman who apparently doesn’t know the first thing about interpreting the results. All she knows is how to hand you a kit and say, “Call me for an appointment to get the results.”
This is the same woman who after speaking with me for 15 minutes, strongly suggested I go on anti-depressants as the solution to my hormonal problems, which I refused, because 1) I'm not depressed, and 2) countless case studies show that taking anti-depressants only makes your PMDD symptoms worse.
Hormonal imbalances are so individual, because each woman’s physical make up and life stressors are so different, that prescribing one pill to take care of them is like asking every woman to wear a one-size-fits-all-tent dress.
This time, after seeing the supposedly high levels of my hormones, in particular my serotonin level, which is what the SSRI anti-depressant would supposedly boost, the doctor did a complete 180 degree turn-around. As I was leaving, I asked her, just to make sure, “Now, you don’t recommend the anti-depressants any more, correct?” And she looked at me. “Well, you’re the one who said you wanted to go natural, right? You can’t do that if you’re on anti-depressants.”
A few weeks later I got a call from her office, informing me that the supplements for my depression that my test results indicated I needed were in and I could come in and pick them up.
I said, "I'm sorry, but I'm not depressed, and at this point I have lost all confidence in your office's ability to help me with my hormonal problem, so I won't be picking up any supplements."
I received a call from the doctor the next day, placing the blame on the receptionist, who obviously had "misunderstood my situation."
Professionalism at its finest. Blame someone else. The receptionist hadn't misunderstood anything. Not when I knew the doctor herself had diagnosed me with depression.
I then asked the doctor if she had called the testing company (as she had said she would when I was in her office) to find out why my results were so abnormally off the charts, and she said that no, she hadn't, because, well, "The results are the results."
And besides, she said, "I didn't give you all the results anyway."
"You didn't?" I asked, stunned.
"Well, no," she said impatiently, "because you wouldn't be able to handle all the information at once." These things take time, she insisted. It takes more than a couple of visits to sort everything out.
Needless to say, I never returned.
April 2012 Update: I recognized the "hormone specialist" I wrote about above in the check out line at our local whole foods co-op. The clerk was chatting about a television show she had watched the night before and the doctor asked, "Does it have to do with money? Because I only know about things that make money."
Everybody laughed.
But I knew she was telling the truth.
After my useless encounter with her, I went to an endocrinologist, for whom I had to wait several more months to see. She was a lovely woman, well-informed, empathetic and understanding, since she herself happened to be going through menopause.
However, she was not a fan of bio-identical hormones. We talked a while, and then, comfortably leaning back in her chair she said, "As a medically-trained doctor, I can only give you advice based on the information that has been clinically proven. Your choices are anti-depressants, birth control pills, or hormone replacement therapy."
(The HRT she was talking about, however, was the conjugated estrogen therapy proven to cause several potentially fatal side effects by the Women's Health Initiative Study. (More on this in another post, since this one is already so long).)
"But as a woman," she added, then leaned forward and looked me in the eye, "When you find the answer, call me." She held up her hand to her ear to mimic using the phone.
This are only two examples of how frustrating it can be to find answers for your PMDD. Some doctors claim to have the answers but don't, some can only speak to what they have been taught, others are willing to help, but don't know what to do.
Meanwhile, month after month rolls around, and we suffer.
I managed to talk her into doing some blood tests for my estrogen and progesterone levels. "I'll order the tests," she said, "but what are you going to do with the results?"
"I don't know yet," I said, "but I'll figure something out."
In the end it turned out the tests she ordered for me weren't quite what I needed, but I didn't know it at the time. I've since learned more on the subject, and after more than a year's worth of PMDD episodes later, I managed to get my primary physician to request the serum blood tests that I needed, per the instructions on page 385 in Dr. Elizabeth Vliet's book, It's My Ovaries, Stupid! We then started a bioidentical hormone regimen that finally saved my sanity.
Yes, in the end I was able to work with my primary care practitioner, who, per the instructions in Dr. Vliet's book, prescribed bioidentical hormones for me in the form of an estradiol patch (the right dosage for me was .075mg/day, but you can start at .0375 mg and go up to 2.0 mg), and 200 mg of prometrium (progesterone capsules), which I still take daily. For seven years, this bioidentical combination was a huge help with both my symptoms of perimenopause, and my PMDD. (March 2018: I have now reached menopause and reluctantly no longer use the patch.)
Other effective things I found to help ease my PMDD were all lifestyle changes - diet, exercise, self-awareness, self-care when an episode descended, and vitamin supplementation. For a list of what I took then and/or now take daily, please email me at info(at)livingwithpmdd(dot)com. I do not provide it here, because I am constantly fine-tuning my efforts to be well.
And that is all I want for you. To be well.
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