A PMDD Crisis Guide, Guest Blogger Cat Stone

I figured you might be getting tired of me going on and on about relationships and such, so fellow PMDD blogger Cat Stone has graciously agreed to step in and do some guest posts, starting today with her PMDD Crisis guide. Please help me welcome Cat to Living on A Prayer, Living with PMDD...

Recently, I have been feeling much better. This is a real turnaround after many years of feeling like a pendulum swinging back and forth. I feel I have more control. I am coping with my bad days more effectively and achieving more on my good days... AND it's winter!

Up until now, it has been hard to write without getting too emotionally involved, and that's no good if you are trying to help others in an emotional state. I finally feel that I can share some practical advice, and I really hope it helps other women cope with PMDD.

Firstly, here's a little about what I have learned and coped with over the years. I'm not a Doctor, but I am an Aromatherapist, and have researched many therapies and theories over the years. I have also had PMDD for 20 years... since I was 13. I have lived with this disorder all my adult life. I don't remember a time when I wasn't feeling crazy and out of control on a regular basis. I used to believe I was really mentally ill. I just wanted to be taken away and put in a padded cell.

When I look back at this, the desire to be taken away, away from my kids and life, stemmed from the overwhelming feeling of being unable to cope. A week or month in a psychiatric ward looked more like a holiday. A break from the pressure, the relentless cycle of life, bills, kids, shopping, etc.

That never happened. They never took me away. I was a single mum with a 3 year old. No family or friends as I'd just moved to a new area after separating from my adulterous husband and being homeless. I would hit crisis every month. Crisis at this time in my life was volatile... I had been through so much emotional trauma by this time that I was reacting to everything, and was feeling more and more suicidal.

Screaming, frustration, anger, rage and shouting. Throwing things, kicking things, punching, scratching my arms with my own nails, drinking, sobbing, weeping, and suicidal feelings.

I would lose all control over myself. An ex-boyfriend said once that I made no sense while I was having an episode. Words would come out, but he couldn't understand me. I figured I was a raving lunatic. I feared for my daughter. I thought I was an inadequate mother. I felt she should be taken away from me. I digress.... I know that ladies reading this who have PMDD can relate to my story, and those people who don't suffer, will never be able to truly understand how it feels.

The point to my story is that I have been in crisis more times than I care to remember. It's taken me years to understand, years to develop ways of coping, years of trying different meds... I grieve the years I have lost to PMDD, the opportunities lost and the events I've missed.

In everything I study, there are different realms... We live in physical, mental, emotional and spiritual realms. In holistic therapy, we can become unwell or suffer dis-ease in any of the realms. I believe in the theory that everything is interconnected. An illness in the mind can become an illness in the body, and PMDD is a disorder in the body that causes a disorder in the mind.

PMDD is an invisible disorder. Women that suffer look no different to women that don't (unless you count the extra grey hairs and bags under the eyes!). PMDD dis-ables women. It robs them of approximately two thirds of their life, every month, without fail.

PMDD often gets misdiagnosed as Bi-Polar. I asked my Psychiatrist what the difference between the two is, and he said 'Bi-polar sufferers will have periods of time (weeks, sometimes months) when they function normally. Life is relatively normal. Then they will swing, either up or down, again for a longer period of time, and the cycle continues.

PMDD works on a much faster cycle. The ups and the downs can be weekly, sometimes even daily, and there is no long period of normal, functioning time.' PMDD sufferers may get a few days in a row of feeling OK, and believe me, there is MUCH to do during those days... sort out problems, fill in forms, do the shopping, clean the house, catch up on work. It all too quickly deteriorates and jobs end up having to wait again till the turmoil is over.

If you can get to the point when you know you're about to explode, when you can recognise the feelings building, when you are aware of your actions, then you have half a chance of diverting disaster. In my next few posts, I will be looking at each 'realm' in turn, and how PMDD affects you on different levels.

This is my interpretation, my opinions, theories and my experiences. One thing is for sure.. although there are a lot of commonalities between PMDD sufferers, what works as a treatment, what helps you get through and survive is usually very different. There is no one way to treat PMDD. I am just sharing my way, in the hope I might be able to help others find their own path through PMDD.

My next post.... PMDD and the physical realm: Looking after the body to look after the mind.

Relationships and PMDD -- Doing Your Part

Last week I posted 20 tips for partners who live with women who have PMDD. While it would be ideal if your partner did all of these things, that’s still only 50% of the equation. You’ve got to bring something to the party as well. As any relationship book will tell you, it takes two to make a relationship—any relationship—work.

So if you’re thinking, “If I just love him enough,” or “If I just (do anything) enough,” it’s not going to work—not without you running yourself into the ground. Relationships are full of give and take, and only work well when each partner gives as much as he or she takes.

Even if you’ve got the best partner in the world, there are still things you can do to make your PMDD episodes run more smoothly. And if your partner is not supportive—then do it for you…because you’re worth it.

1. Chart your symptoms daily. It doesn’t have to be elaborate, one of those pocket calendars will do. Just write a few words each day: anxious, crabby, sad, sleepy, achy, bloated, cravings, weepy, snapped at __________. Use this to get in touch with your feelings and your body. Eventually you’ll discover patterns of symptoms.

2. Consult your chart/PMDD calendar when considering social events, activities, creative or household projects, vacations and such. Making major decisions comes under this heading, too. Don’t set yourself up for failure by taking on something big when you know you won’t be feeling up to it. Don’t just try to slog through your life the best that you can…be pro-active!

3. Learn to recognize when you are symptomatic, and consciously postpone thinking about anything that needs serious thought until you are feeling better. If you don’t, your decisions will be colored by your PMDD, and you may well end up asking yourself, “What the hell was I thinking when I decided to do this?”

4. Understand that if it is not treated, your PMDD will only get worse. It could end up a major depressive disorder and who wants that when you know it can be avoided?

5. Find a doctor who will listen to you. If the doctor won’t listen, change doctors. It’s your life at stake here. No one has as much to gain from finding the right treatment for you as you do. So take an active part in your own health and well being. Don’t just do what the doctor says because “the doctor knows best.” The doctor knows what the doctor knows, and if the doctor doesn’t know anything about PMDD, you need to find one who does.

6. Try whatever you need to try to feel better. If you don’t feel better, then stop whatever makes you feel worse, and try something else. This goes for both medical and natural treatments. If medication works for you, go for it. If it doesn’t, don’t keep hanging in there, thinking it will get better. Your doctor is not you. Your doctor can’t feel what you feel or experience what you experience. Only you can know what works for you and what doesn’t.

7. Do not let anyone make you feel inadequate because something that works for others is not working for you. There is nothing wrong with you if this treatment or that treatment doesn’t work. All it means is you haven’t found the right solution for you yet. PMDD is not a one-size-fits-all disorder.

8. Move your body. Fit exercise in whatever you can, whenever you can. Isn’t a healthy you worth it? Find a few kinds of exercise you enjoy and mix it up so it doesn’t get boring fast. A class here, a walk there, maybe Tai Chi today and Zumba tomorrow. Just put on some music and dance around the house with the kids or by yourself for a song or two. See if that doesn’t put some energy in your step. Park your car a few spaces away from the door instead of in the closest spot. 30 minutes of some sort of aerobic activity a day is best, even if it’s just cleaning the bathroom or carting laundry up and down the stairs, but if you have to start with 5 or 10 minute increments, then start there. Anything is better than nothing.

9. It is essential that you get enough rest. Sleep is when your body re-regulates itself and if you don’t get enough sleep, your body doesn’t have the time it needs to complete its repair job from whatever abuses you subjected it to during the day. (aka substance abuse, smoking, stress, overexertion, poor diet). The more sleep you lose, the harder it is for your body to catch up, and you fall further and further behind each day. This explains why you are so exhausted.

10. Eat healthy. Whole foods, as close to their natural state as possible. Avoid alcohol, caffeine, sugar, sugar substitutes, anything made with high fructose corn syrup (yes, you might have to start reading labels), white rice and white flour, for starters. Start being aware of what you eat, and as you pour that cup of coffee, know you are contributing to your PMDD, and know that you are choosing to do so. Ask yourself, is this candy bar, energy drink, glass of wine, piece of cake worth feeling miserable two weeks from now?

11. Get yourself some high quality dark chocolate for when the cravings come. Not that mass-produced stuff that comes in a bag. No matter how good it tastes, it’s not going to help you like true chocolates from a chocolate store will. There are plenty online to choose from if your town doesn’t have a chocolate store. A bonus is you’ll need less of the high quality stuff to feel better, so you might even lose some weight.

12. If you snap out at someone, stop, apologize, and explain to them that it’s not them, it’s your PMDD. Don’t let hurt feelings fester, on either side of the relationship. If they’re not open to an explanation of PMDD, just say, “I’m sorry, I’m having a bad day,” and leave it at that. Everybody has bad days now and then.

13. If somebody is trying to bait you, walk away. Don’t let their bad mood spark yours. Tell them you’ll be back or continue this conversation when you’re both in a better mood.

14. Ask for help when you need it. If you don’t have anyone in your life who is willing or capable of doing this, find new friends who will be supportive and encouraging. Even if they’re just online. PMDD forums and discussion groups abound. You don’t need to go through any of this alone.

15. Do not let your negative thoughts and feelings get the better of you. Every day, all day long, our minds run rampant with thoughts. Good ones, bad ones, even strange ones. One way to get a handle on this is to learn how to still your mind. But that takes dedicated time and effort. If you’re not at a place in your life where you can take the time out to meditate or practice some form of deep breathing exercise that stills the mind, at the very least, when the negative thoughts come, push them right back out of your mind and refuse to dwell on them. Say to yourself, “That’s my PMDD talking, not me,” and consciously change the subject.

Remember (as long as PMDD is your only problem), you are in control of your mind…your mind is not in control of you (even though it very much feels like it). You need to refuse to give those negative thoughts any air time, because if you don’t, they will loop endlessly through your mind, creating deeper and deeper ruts, until negative thoughts are all you know and you end up with major depressive disorder. This is how PMDD women become suicidal.

Some wonderful ideas on how to mentally shift gears are in this article from Women to Women. The article is about perimenopause, but unless you die first or have your ovaries surgically removed, thus throwing you into instant menopause, you’re headed for perimenopause anyway. Why not learn how to deal with it in advance?

Be blessed, and keep me posted on your progress!

Top 20 Tips for Partners Dealing With PMDD

What follows is my most widely-read blog post, completely updated in December 2015 and included in my book, PMDD: A Handbook for Partners. That said, here is the post that inspired the book.

Unfortunately, my research has uncovered a complete lack
of serious information for men on the subject of PMDD, so here
it is, short and sweet, a list of the top 20 things you can do for
your partner with PMDD.
1. Believe her. When she tells you what she’s
experiencing, believe her. Even if it doesn’t make sense.
Because PMDD doesn’t make sense. The symptoms are as
unique and individual as the woman having them.
2. Do not tease her. Do not make fun of her, as this is a
serious and often debilitating condition. Would you tease a
combat veteran for having PTSD? During an episode, a PET
scan of a woman with PMDDʼs brain shows the exact same
configuration as that of a vet with PTSD. This womanʼs brain
truly believes she is under attack, and will respond accordingly.
(This will cause her to do and say things she would never even
consider during her non-PMDD days.)
3. Chart her symptoms daily, either together or on
your own. If she refuses to admit there’s a problem, then do it
on your own so that you can be prepared for when the storm
hits.
4. Consult your chart or app when considering social
events, activities, or vacations and such. Surprises and big
decisions come under this heading, too.
5. Learn as much information as you can about
PMDD from reliable resources. If they have a product to sell
you, any type of product, proceed with caution.
6. Understand that if it is not treated, her PMDD can
only get worse. It could end up as Major Depressive Disorder.
7. Help her to find a doctor who will listen to her and
help her. This may take several tries, as most doctors are not
trained in the treatment of PMDD. Traditionally trained
medical doctors will only offer you birth control or
antidepressants, since they are the only drugs medically approved
for treatment of PMDD by the FDA. Your best bet is to find a
naturopathic doctor or nurse practitioner.
8. Don’t let her negative thoughts and feelings get the
better of her—or you. If she shares them with you, gently
remind her it’s the PMDD talking, not her, and postpone any
major changes or discussions/decision making for a few days.
9. Be supportive and encouraging as she tries different
things to feel better. Make a note of what works and what
doesn’t. Share this with her doctor. Do not blame her if any
medication she is prescribed does not work. It does not work for
most women. Science does not yet understand the brain well
enough to know what is biologically going on during an episode
of PMDD, despite what the television ads tell you.
10. Help her to get enough rest. Sleep is when our
bodies re-regulate themselves. If we don’t have enough (sleep)
time to do the work needed, we start the day at a disadvantage.
11. Join her for moderate exercise. Exercise is always
more fun with a friend. I have found a walk of 45 minutes can
buy me up to two hours of PMDD-free time.
12. Encourage her to eat healthy. (Avoid alcohol,
caffeine, sugar, sugar substitutes, energy drinks, anything made
with high fructose corn syrup, and white rice and flour, for
starters.)
13. Buy her some high quality dark chocolate. Keep it
on hand for the bad days.
14. Do what you can to keep stressful situations to a
minimum. PMDD feeds on stress.
15. Do not accept any behavior that is abusive. Ever.
16. Do not return such behavior if it happens. Calmly
walk away and resume your conversation when she is more in
control of herself. Be firm about refusing to engage when she is
out of control or abusive. When she gets this way, the PMDD
bully in her brain is in full control, and determined to destroy
whatever it can.
17. Remember that she literally is not herself during
an episode of PMDD. Try not to hold the things she says and
does against her. It’s not personal, and it’s not about you. It’s the
bully that has taken over her brain egging her on.
18. Be as comforting as she will allow you to. If she
won’t let you near her, let her know you will be nearby if she
needs you. To her brain during this time, allowing comfort
equals weakness. Weakness equals vulnerability. Vulnerability is
dangerous to the PMDD brain.
19. Don’t expect her to be full of sunshine and
laughter when she’s not having a PMDD episode. A
healthy, balanced, and emotionally well-rounded woman feels
every emotion—not just the good ones.
20. Last, but not least: Do not blame every time she
becomes irritated, annoyed, angry, afraid, or upset on her
PMDD. Nothing is more irritating than having a genuine
concern or grievance, and being told, “It’s your PMDD again,
isn’t it?”
Maybe it is, and maybe it isn’t. Take the time to check her
chart to see if she’s supposed to be having an episode, and then
carefully sort through (usually by talking it out) and separate
what is her PMDD and what is a genuine fear or concern on her
part. Encourage her to feel and express the full range of
emotions, just like people without PMDD do.
More than anything, a woman with PMDD just wants to
feel normal. These 20 tips will go a long way toward helping
your partner do just that.

Note:  PMDD: A Handbook for Partners, and its sister book, PMDD and Relationships, are available in both ebook and print.  If you participate in the Amazon Smile program, please consider designating the National Association for Premenstrual Dysphoric Disorder (NAPMDD) as your chosen charity.  You can also buy these (print) books on the NAPMDD website, where $1 from each purchase goes to support the NAPMDD Awareness Fund.

More Tips For Partners Dealing With PMDD

Last week’s post, while it will go a long way toward stabilizing your relationship with a woman in the throes of a PMDD episode, was barely the tip of the iceberg. So this week I thought I’d continue with some tips and information on how to cope with your partner when she’s feeling her worst.

Once again, most articles I read in researching this post were about how awful it is for the partner, who has to deal with all sorts of aberrant behavior on the part of his or her loved one. In these articles, there doesn’t seem to be much understanding or empathy for the woman actually going through the brain changes over which she has no control.

So the first thing I want to emphasize once again is empathy. Put yourself in her place, and my guess is you’ll discover you wouldn’t want to have a body and brain you have no control over for several days a month. How would you feel if your thoughts—due to a biological disconnect between your brain and your mouth—came out as something else entirely—something actually hurtful to those you love the most? How would you feel if no matter how hard you tried to eat right and/or stay in shape, your body suddenly just wouldn’t cooperate? What if it actually undermined all your best efforts by bringing on intense cravings for things you know you shouldn’t eat, cravings for things that actually make your condition worse?

How would you feel if for up to half of your life, nothing you thought or said or did made sense?

One article I read said women could be touchy—touchy!—about being labeled as a raving lunatic for a few days a month. As if the women involved had no business being so sensitive. Who wants to be called insane? Do you?

It also said very few women will admit they’re affected by PMDD. Again, would you feel comfortable telling people, “Oh, don’t mind me, my mind just goes berserk every now and then?” Would you want the strange looks that come with such a statement, would you want people steering a wide path around you because you just admitted there’s something not quite right about you?

So don’t try to be helpful (or antagonistic) by pointing out her PMDD symptoms. She’s well aware of what she is feeling. Anxious, edgy, jittery, depressed, clumsy, fat, foolish, frightened, sleepy, weepy, ravenous, disorganized, out of control…the list goes on.

Even more important is that you don’t make fun of her for any of the above.

Again, if you knew people were going to ridicule you for something you have no control over, would you openly admit to having such a problem? How can any woman win the admiration and respect of the friends and family she loves and respects in such an antagonistic enviroment?

Your best bet is to save your meant-to-be-funny comments and war stories for your friends, to be shared privately, and simply act like nothing out of the ordinary is happening when the PMDD is in effect. Help to make your partner feel as accepted and normal as possible.

This does not mean you have to accept any kind of behavior she throws at you. Abuse is abuse, whether your partner means it or not. PMDD is an explanation, not an excuse, and you don’t have to accept abusive behavior under any conditions. For more on this, go to last week’s post.

Don’t spring any big surprises on her. Remember she’s doing everything she can just to cope with her everyday life, to stay on an even keel in a body emotionally tilting one way and then the other, just to get through the day without being labeled crazy. Big news, big plans, big surprises can wait for a day when she’s better equipped to handle them.

Besides, you should never trust any big decisions made while she is under the influence of her PMDD. This includes decisions she may come to regarding your relationship. If she says she wants out…do what you can to stay calm, and wait until the storm passes. If when it does she still wants out…then you have a different problem, and one that is beyond the scope of this blog.

Take it easy on social activities. If you felt like a beached whale and couldn’t seem to control what you put in your mouth, would you want to go to a party and spend it stuffing your face at the food table? A food binge can be great fun, if that’s what you want to be doing—if that’s your way of celebrating good times or good news. But if you’re watching your weight—and what woman isn’t at one point or another?—taking her food binge show on the road is the last thing she wants to be doing.

The same goes for her emotional outbursts. It’s hard enough to keep a lid on things at home. Do you really want to put her in a situation where she spends the evening either snarling at your friends and family or weeping at every little misinterpreted comment? Because during a PMDD episode, the PMDD brain will focus on the negative, and even if you didn’t say or mean anything negative at all, even if you compliment your partner, her brain is being flooded with negative thoughts and images, and eventually the dam will burst—putting a huge damper on your evening out.

And then she’ll feel miserable about it. About ruining your plans/evening/event. Whether she did or did not, and whether she admits it or not, she will blame herself for anything that goes wrong during these dark periods of time in her cycle.

So remember to track her symptoms and plan social events to avoid head-to-head conflicts with her PMDD episodes if at all possible. She’ll appreciate you all the more for your understanding.

Be understanding of her cravings. Both men and women seek comfort food when they are feeling miserable. During a PMDD episode, a woman will especially seek carbs. Doing so is a natural way to boost, for instance, the level of serotonin* in her body, and she knows this on a subconscious level. Where it gets confusing is the food and advertisement industries have done their best to convince us certain foods and drinks are healthy when they are not. So while on a very primitive level, your partner is craving something to boost any number of feel-good hormones in her body and make her feel better, what manifests is a desire to eat everything in sight in the hopes of finding that magic solution.

It’s best to have good quality carbs already on hand for when these cravings strike. I find that multi-grain toast with no-added sugar jam (not artificial sweeteners, as they can make PMDD symptoms worse), a bowl of whole or multi-grain cereal with almond or cashew milk, or a bit of good quality dark chocolate does the trick. When we consume large amounts of cheap chocolate candy (or cereal) we are looking for the same effect, but in the wrong place. The added calories from the sugar and fat that come along with the added amount of chocolate needed to reach the same feel-good hormone boost as a good quality piece of chocolate only cause our PMDD symptoms to worsen. They also cause us to gain weight.

But sometimes, the woman’s level of feel-good hormones dips so low that nothing short of a pizza will do. If that’s the case, then go for it guilt free. You might even plan pizza night around her cycle, and see if that improves things.

Take on some of her workload. Whatever you can do to help out, do it with an attitude of love, not resentment. If she asks you to help around the house, do what she asks. If she wants you to run an errand, please do the same. The slightest bit of effort to appreciate what she’s going through will go a long way toward soothing her, and is it really worth the effort to argue over whose turn it is to take out the trash?

It’s true that things that don’t usually bother her will bother her greatly when she’s having an episode. Just keep in mind who your real partner is, and go along with what she says. The sooner you do, the sooner her episode will pass.

That’s right, stress will prolong her episode, so if you want it to end sooner, the best thing you can do is to go along to get along, as long as it’s a reasonable request.

If you’re a mature adult, you know what reasonable and unreasonable is. We don’t need to go into it here.

Treat her like you appreciate her. Every woman loves to be appreciated, no matter what mood she’s in. During an episode of PMDD, with all those negative thoughts running an endless loop inside her head, your partner needs extra special care. Reassurance is always nice, but might not be believed or accepted. Understand that the negative thoughts in her brain are overwhelming the positive ones you’re trying to get across. Be patient. Be persistent. Let her know you care, and you’re there for her if she needs you. She’ll meet you more than half way if she possibly can.

If she doesn’t, it’s because she can’t, or doesn’t understand enough about what’s happening to stop the train of negative thoughts in her mind. It’s not because she doesn’t want to, or doesn’t love you. It’s not about you at all. So remember that, and try not to take the things she says and does personally. In a few days time, the woman you love will return, and when she does, it would be a good time to discuss what may have gone wrong during her most recent episode.

A lot of women will want to forget what happened, pretend it didn’t happen at all, and that’s quite normal, but not the best way to deal with it. Talking it out with your partner when she’s feeling herself is the best way to prevent unwanted behaviors and situations in the future.

The bible says it best : Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres. ~ 1 Corinthians 13

All a woman with PMDD is looking for is the same thing everyone wants—love and acceptance.

The more you accept, the less you’ll have to. What we resist persists. So don’t fight your partner’s PMDD. Go with it, roll with it--and watch the waves grow smaller over time. 

For more information, check out my book, specifically written for partners of women with PMDD. 

*Serotonin is only ONE of several feel-good hormones in our body.  The serotonin-deficiency theory highly touted as the answer to PMDD has never been proven, but has been marketed heavily to women with PMDD.  More on this in another post.

Dealing With PMDD - Advice for Men

I’ve spent quite a bit of time searching the internet for Resources and Advice for men dealing with a woman who suffers from PMDD. Unfortunately, most articles lump PMS and PMDD together, which does a great disservice to women with PMDD. In the comment sections of these articles both men and women express anger and resentment toward the women who experience true PMDD: the men claiming the articles give women a license to behave badly two weeks out of the month, and the women claiming the women with extreme mood swings give all women a bad name.

So, to clear a few things up…

20% of women suffer no pre-menstrual symptoms at all
80% of women suffer from some combination of pre-menstrual symptoms
20-40% experience moderate discomfort pre-menstrually
Up to 10% of women suffer from PMDD

This post is written for the men who have partners in the last category.

But before we get started, a quick primer on the differences between PMS and PMDD.

PMS deals primarily with physical symptoms. Bloating, aching, cramping, tenderness, fatigue, headaches, food cravings, and mild mood swings are the most well-known of the more than 150 symptoms possible. A little irritability, tension, sadness, weepiness, or any combination thereof is par for the course.

The major component of PMDD is mood swings in the extreme. PMDD actually affects your brain’s capability to regulate itself, and therefore affects just about every other hormone in your body. That’s not to say a woman can’t have the bloating, aching, cramping, fatigue, cravings, and other physical symptoms. If she does, it may well be that she suffers from both PMDD and PMS, and once she gets her PMDD under control, all she’ll be left with is some PMS.

Frankly, I think most women with PMDD would be happy to simply suffer some form of PMS. Because PMS is to PMDD what a headache is to a migraine. There is a distinct difference, and that difference is biological—not mental. The biology of PMS and PMDD share many similarities, but at some point they split into completely different paths. An explanation of that is beyond the scope of this post, but I’ll be happy to write about it some other time.

For now, it’s enough to know that PMS and PMDD are two completely different things.

That’s not to say your relationship won’t benefit from the advice in this post if your partner simply has PMS. But we’re not talking about PMS here today, we’re talking full-blown PMDD.

1. Both you and your partner should mark the time on a calendar when you expect her to be pre-menstrual. This can be hard if her cycle is not regular, but do the best you can to identify patterns. An explanation of my pattern is here, and can give you an idea of what symptoms to look for.

If your partner is in denial, and claims there’s nothing wrong with her—mark your own calendar separately. In many cases, the man can tell before the woman that she’s entering into her pre-menstrual phase, because he’s watching from the outside, while she’s busy trying to cope—either consciously or sub-consciously--with the unwanted changes going on in her brain and body.

Please note: There are women who are in complete denial that anything different is happening to them, and then there are women who know what’s happening, but “really don’t want to deal with this right now” because they are too busy to, and so they pretend nothing is happening, and they really aren’t feeling any differently, until it’s too late to do anything about it, and the episode erupts full force.

Determine which type of woman you are living with, and keep track accordingly. Apparently there are several applications available on the iPhone and Android phones to help you track her cycle, but an old-fashioned calendar will do just as well.

2. If she’s indicated that this is what she would prefer, try to stay clear of her until the episode passes. This has nothing to do with you, or her love for you. It’s simply due to her heightened sensitivity to any combination of the five senses. She literally can’t handle any more sensory input—be it bright lights, loud noises, touch of any kind, strong smells, or even certain foods. If a PMDD woman has allergies of any kind, they can be exacerbated pre-menstrually. If she has any another condition, such as arthritis, diabetes, or fibromyalgia, they can be exacerbated as well.

Even if she’s otherwise healthy, during an episode of PMDD a woman is literally is a walking bundle of nerves. Unfortunately for both of you, this heightened sensitivity and discomfort can be so distracting that it causes her an inability to focus on things like questions, requests, conversations, or simple instructions. (Now you know why she forgot to pick up your suit at the cleaners.)

Take the first one, for example: You have a question that requires more than minimal thought and consideration.
Examples would be:
Major purchases—car, appliances, maybe that boat/motorcycle/sportscar you’ve always wanted (not a good time to bring it up)
Health decisions
Financial decisions
Employment decisions
Decisions involving having or raising children
Vacation plans
Any change of routine or structure in your life

Why? Because during a PMDD episode a woman’s brain is not functioning properly. This has nothing to do with how smart or intelligent she is. This is her brain chemistry being disrupted due to the hormonal shifts taking place in her body. During a PMDD episode it can take all of her concentration simply to focus on the basics of getting through each day. If you come at her with anything resembling a major decision, it could overload her brain and cause a meltdown.

So if she asks for space during that time, please give it to her.

3. Be patient. Dealing with anybody on a short fuse can be challenging. If she snaps at you, or does something that irritates you, don't lose your temper and fight back. It won't do any good, and in most cases will only make things worse. Just (discreetly) take a deep breath, maybe say a prayer, and ignore whatever she just did that bothered you. Remember that she's not normally like this and she’ll be herself again soon.

4. Do not enable immature behavior. I’ve said all along, PMDD is an explanation, not an excuse. Being emotional does not excuse inappropriate behavior, any more than being drunk excuses offensive behavior. If she’s being immature, yelling, shouting, stomping, snapping, cursing, slamming or throwing things, don’t respond with your own immature behavior. She at least has an explanation for it—a biological explanation. What’s your excuse?

Stay calm and leave the room if you have to, until she settles down. Let her know you love her and you’ll be nearby, but you can’t have a conversation with her when she’s being irrational. Believe me, she knows she’s being irrational. But without conscious effort at awareness, she can’t stop herself any more than she could stop an allergic reaction. If you calmly point out that she’s being immature or irrational and say you’ll be happy to continue this conversation another time, things will settle down a lot more quickly than if you respond with your own emotional outburst.

5. Listen to her, even if she’s not making any sense. Try to figure out what the REAL problem is. If she’s complaining about something that’s never bothered her before, or doesn’t usually bother her, most likely what she’s saying is “I feel miserable, and there’s nothing I can do about it, so I’m looking for something else to change and hoping that will make me feel better.” This is a time of true desperation for her. She’s looking for anything, rational or irrational, that will make her feel better. This is a good time to suggest she take some time out for herself, maybe a hot bath, or a cup of tea and a good book, or whatever soothes her soul. Let her know you support her need to have a little time to pamper herself in whatever way makes her the happiest.

But beware of sending her out on a shopping spree. Retail therapy will only make things worse when the mood has passed and the bills come in.

6. Don't take it personally. During an episode of PMDD, you can count on her emotions getting the best of her, and she'll probably question your relationship. She might question you. Might question her whole life and everything she believes or stands for. This is normal and natural for a woman during an episode of PMDD. As mentioned in Number 5 above, she's feeling helpless, and sometimes when people feel helpless they look for other things they can control, and that might mean bringing up topics or suggesting changes that trigger your emotions. Your best defense against this is to stay level-headed and calmly say, "Ok, I understand." What you really understand is that you're still the same person she loved before her PMDD episode kicked in, and her change in perception of you and her life overall is the PMDD talking, not her. For more information on this, see my post It’s Not Personal – It’s Just My PMDD.

7. Be compassionate. Think about a time when stress or physical changes made you hard to get along with. Have you ever been sleep-deprived? Maybe you had an accident or were the hospital, and the chronic pain made you want to lash out at everybody. Put yourself in her shoes. Not only is she experiencing uncomfortable physical symptoms, but her hormones also ebbing and flowing, making it almost impossible for her to know how she feels or what she wants. Think of the effect testosterone has had on you, like when you get sexually aroused, or on any occasion when you felt aggression or rage. You remember how you felt caught up in the emotion, how it made you want to say and do things you ordinarily wouldn’t say or do. That’s what’s happening to her.

8. Be forgiving and reassuring. Her insecurities will definitely come up during an episode of PMDD, and with her heightened sensitivity, every negative thought she has will be magnified ten times over. If she doesn’t consciously stop the negative thoughts, they will flow through her mind in an endless loop. If you can get her to talk about them, fine. Some women won’t want to, because they know the thoughts are irrational, even while they are having them, they just don’t know how to stop them. Nobody wants to share irrational thoughts, and then remember they did so when the episode is over—even if the only one remembering them is her.

If she feels unloved and insecure, she’ll probably act out, which will make you not want to be around her, which will "confirm" her negative thoughts. Most women feel insecure about their bodies to start with, maybe even their lovemaking, child-rearing, housekeeping, or professional skills, and if they’re in any way insecure about your feelings for them, this is when that insecurity will come out. So try to give her a few extra compliments (and don’t be offended if she doesn’t believe you, or snaps at you for it), and—if she’ll let you (remember those heightened sensory sensitivities)--be more affectionate. If she won’t let you near her, don’t make her feel badly by taking it personally. Guilt is the last thing she needs when she’s feeling unlovable. Tell her you understand and you’ll be around if she changes her mind. That could well be all it takes to melt her defenses.

More on this next week, as that’s enough for now. For more information, I invite you to scroll through my most popular posts, as indicated in the sidebar.

Take care, and good luck!

Relationships and PMDD - Finding the Right Partner

Okay, today’s post begins the one I had in mind when I started this series on relationships. But once I started thinking about it, I realized that for any of us to have a successful relationship, we have to start with ourselves. We have to know ourselves, like ourselves, and be friends with ourselves before we can successfully have any sort of relationship with anyone else, be it friendship, a family relationship, or a relationship with a significant other.
People will only treat you as well as you treat yourself. If you don’t know yourself, don’t understand yourself, how can you explain your PMDD to anyone else? If you don’t treat yourself with kindness, care, and consideration, how can you expect anyone else to?
So I started with Relationships Begin With You, then emphasized the importance of getting to know yourself as well as you would a friend, and then offered some ideas on how to be a friend to yourself, or how to treat yourself the way you would a friend. Because, face it, most of us treat friends better than we do ourselves. We’re there for friends, but when it comes to taking care of ourselves…for any number of reasons, we drop the ball. Those issues go way beyond the subject of PMDD, so this is not the place to explore them.
I then tackled the topic of family—offered tips on how to get along with your family, especially during family gatherings--and if for reasons beyond your control, you just can’t get along with some family members—I wrote about how to “just say no” to family gatherings for your own peace of mind and well being. This is not opting out. This counts as being good to yourself, and treating yourself like a friend. If a friend came to you and said, “I just can’t deal with my family, family drama stresses me out, or I love them but they just plain make me feel crazy,” what would you tell that friend?
Then tell yourself the same thing. Do what you can to get along, and learn to let go of the rest. Take a break from the family if you need to, if you need some time to get your head together. The only person you have control over and are responsible for is yourself. If others behave badly, that’s not on you. But if you’re the one behaving badly, then you need to take a look at that, take some time out, and do your best to figure out what you could be doing differently. Be the change you want to see in your world. Start with taking care of yourself.
Many of us are already in relationships, and have children. Children who depend on us to be there for them, no matter what kind of day we are having. Taking care of ourselves helps us to be better able to take care of them. When we’re calm, relaxed, and happy, we’re much better able to weather the storms life brings into our days, and provide that emotional stability our children need to grow into happy, well-adjusted adults.
They can’t do that if we’re in a bad relationship, whatever the reason. So if you’re not willing to put forth the effort to find or create a healthy, stable, and supportive relationship for yourself, then do it for them—the kids who are counting on you to show them how to navigate life’s many challenges. If you don’t show them…who will?
To have a good relationship, you need a supportive partner. Period. If your partner isn’t supportive of your needs as a woman with PMDD, you might as well be a salmon swimming upstream. But for your partner to be supportive of those needs, you have to know what those needs are, yourself. When you’re having an episode, do you need calm and quiet, or do you need to be held? Do you need to be left alone, or do you want someone who can gently and lovingly help to ease you out of your negative mood? Will flowers and candy help? Do you just want to watch TV or read a book, or do you want to talk?
The answers are as varied as can be. But the key to any good relationship is communication. Maybe one month you’ll want to go out to dinner. Maybe another you’ll want to take a long bath. Maybe you’ll want to make some popcorn and watch a comedy. Maybe you’ll want to go for a walk. Maybe you just want to feel appreciated.
Whatever you want, you need to be able to communicate that to your partner. And if your partner won’t cooperate…is he or she the right partner for you? I’ve said all along, PMDD is an explanation, not an excuse. It’s not an excuse to behave badly. It’s not an excuse to take your anger, irritation, or sadness out on others. It’s not an excuse to withdraw and/or abandon your responsibilities.
But it is an explanation for why you feel tempted to do these things when having an episode of PMDD.
The first thing you need to do is chart your symptoms, to discover what your pattern is. I detailed mine in my post, A Perfect Storm of PMDD. Once you know what your pattern is, you need to let your partner know when your bad days are coming, and ask for some extra consideration on those days. If you have a really good relationship with your partner, he or she might be able to see the storm coming before it arrives. I know there have been many times in my life that I was completely unaware that I was starting to act out of character, until my best friend, a man, pointed it out. Then I had to decide if he was right or not, because nobody knows my mental, emotional, or physical state as well as I do.
Sometimes he’s right, and sometimes he’s wrong. When he’s right, we go into PMDD mode. When he’s wrong, I do my best to figure out what’s really bothering me, and if he’s involved, we talk about it. If he’s not, I might ask him to help me figure out ways to deal with the person or situation that is causing my anger and or tears.
Beware of partners who tell you that you must be having an episode just because you’re upset with them for one reason or another. There come times in everyone’s lives when we are genuine angry or upset with someone about something. And that’s okay. Anger and emotional upset are normal and natural signals that something is not going right in our lives. They’re like warning lights, letting us know that here is something going on that needs to be addressed. The key is to know the difference—are you genuinely angry, or has your PMDD kicked in?
If your PMDD has kicked in, revert to the list of phrases I mentioned in my last post. What works with children and family members works just as well with partners. Or make up your own list. Agree on these code phrases beforehand, when you are feeling well. Then, when the bad days come, you’ll have them ready to diffuse tense situations that arise.
A good relationship of any kind is based on mutual admiration and respect. If you’re in a good relationship, your partner will respect your need for space or extra attention when the bad days come. If you’re not, you will likely find yourself with a partner who ignores you, demeans you, eggs you on, refuses to believe you, and/or abandons you when you most need love and support. Partners like this only add to the problem, because they create stress. Stress exacerbates PMDD and PMDD causes stress.
So the best thing you can do for yourself is to find a partner who will not add to your stress when you are already stressed. If your partner simply won’t listen, then there’s more going on in your relationship than just your PMDD. Don’t let anyone blame you or your PMDD solely for the failures in a relationship, be they friends, family, or your significant other. It takes two people to have a relationship. If you’re trying, and the other party isn’t—it’s not just about your PMDD. They’re using your PMDD as an excuse to avoid looking at whatever else may be going wrong in the relationship.
I don’t know any gentler way to say it. If somebody loves you, truly loves you, they will work with you to find a way to make your life easier and your episodes more bearable. They will be open to information and resources on the subject, and will want to help you get better. They will not walk away, and they will not cast 100% of the blame on you. They may not be happy with you at times, but they will be there for you.
If they are not…then you need to start at the beginning again…and learn how to be there for yourself.

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 and starting a meaningful conversation with loved ones who want to know more about this debilitating disorder we live with daily.  More information on PMDD can also be found on Liana's Facebook page, Living with PMDD.

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

Okay, we’ve covered your relationship with you, learning to treat yourself as well as you would a friend, how exactly to have a relationship with yourself, choosing your friends wisely, avoiding relatives who are toxic to you if you can, and tips to get along with them if you do choose to attend family functions.

Now we’re going to look at your relationship with another aspect of your family—the people you live with every day.

This could be any combination of people and or ages. Mother/guardian and children; parents and/or siblings (you, living with your parents and siblings); adult woman living with parents; adult woman caring for parents; roommates; mother, partner, and children; childless couples; same sex couples, you name it. But these are the people we are closest to, physically, if not emotionally. It would be nice if we were as emotionally close to them as we are physically, but for any number of reasons that often isn’t the case.

Stress at home is bad enough, but for a PMDD woman, it can be the key element that keeps you from getting well, as any kind of strife at home only exacerbates a PMDD woman’s symptoms. During a PMDD episode, we are biologically sensitive creatures, as in sensitive to light, sound, touch, taste, and smells. This has been proven. A PMDD woman’s five senses can be enhanced during an episode, enhanced to the point of discomfort and beyond, which makes us react in ways not welcome or understood by those who do not suffer such on again, off again changes in sensitivity to light, sound, touch, taste, and/or smell.

Please understand this: It’s biological, this shift/change that is happening in our bodies, but we react to it/manifest it emotionally.

Anger has been a basic form of self defense since the cave dwellers. Our bodies are hardwired to react with some form of flight or fight (including anger and aggression) when we feel threatened.

You’re having a PMDD episode and the kids are being too loud? You snap and snarl to get them to quiet down. Your head is pounding with a PMDD migraine, you tell your beloved to shut up and turn out the lights. Both of these reactions are nothing more than self-preservation instincts kicking in. Too many flashing lights? Too much electronic noise? Same deal. Significant other giving you a hard time? Everybody wants a piece of you at the same time?

Your biological responses kick in, and you lash out in self defense.

The target of your attack responds with “What’s wrong with you? I was just…?”

They wonder if you’re crazy. You wonder if you’re crazy. Some are even so mean-spirited as to taunt you and make you do it again and again and again…because when you’re out of control, the focus is off of them. Just remember that.

The best way to fight this form of mean-spiritedness is to become your own best friend, get to know yourself better than anyone else knows you, sort through what is your fault and what is not, then amend your own behavior—such as catching yourself before you explode into anger or tears—and learn how to apologize when you don’t.

Never apologize for “being the way I am.” You are who you are. And God loves you just the way you are. If your family or partner doesn’t…you need to think about that. Think about some changes you might need to make before you can be well again.

But right now you need to focus on you, to get a handle on your PMDD.

If you don’t catch yourself in time, apologize immediately for the hurt you caused the other person. Not for being upset in the first place. When you snap out during an episode of PMDD, unless you are aware of what you are doing and actually feel it coming on, you have no more control over what you say and do than you would over an allergic reaction.

Because it’s biological in nature, and deals with, among other things, your stress responses.

Which came first, the chicken or the egg? Which came first, stress or PMDD? Stress contributes to PMDD, and PMDD causes stress. The only thing you can do to break the cycle (short of taking drugs that only mask your symptoms and give you various side effects to deal with) is to get to know yourself as well as you possibly can, and learn ways to head off these “natural as an allergic reaction” responses to stress.

If you chart your symptoms, which really is a must for a PMDD woman, you can tell when things are going to start getting dicey in your life. You can plan around those days, plan to take it easy on those days if at all possible, learn to pamper yourself a little. You can also warn those you live with that those days are coming.

If they are not sympathetic, do not explode. Simply be the change you want to see in the world. Model the type of behavior you would like to receive from them. Do unto others….

It all starts with you. Why? Because if you don’t take care of you, nobody else will. If you have to start being nicer to someone so that they will be nicer to you, then so be it. Give peace a chance. There are those who won’t respond positively, or who won’t respond at all. That does not matter. The only person whose behavior you are responsible for is you. And once you have a handle on your own behavior, they can’t use it against you any more.

So think about that.

My house is a haven. It’s where I go to find peace, to recharge, to rest and relax. It wasn’t always that way, and I had to make some serious choices and changes to get to where I am today. One baby step at a time.

But now, if I am having a bad day, all I have to do is say so, and everyone knows it has nothing to do with them and everything to do with me and my PMDD. The best course of action is to avoid me, make no demands, agree with me if I start something, and not take anything I say or do personally.

My job is to stay aware of what I am doing, go about my business quietly, gently remind people who forget and start to ask for something I can’t give at that moment that I am having a bad day, do my best not to start anything, and not take anything personally.

The best advice for everyone involved is to not to take anything personally on those days. This is not a license to freely do and say what you want to during that period, but an agreement that if things should go awry or even get out of hand—it’s not personal. It’s just your PMDD.

Remember, PMDD is an explanation, not an excuse.

And if others in your household are behaving badly when you are having an episode of PMDD, what is their explanation for it?

Think about that one for a while.

You’ll soon realize it’s not just you.

So stop taking the blame for everything that does wrong in your relationships. Recognize that it takes two to have a relationship and both parties have to want the relationship equally for it to work.

I’m talking about adults here.

When it comes to kids, it should be easier to simply explain to them that Mommy is having a bad day, and needs some quiet time, and it would be a really big help if they could find something quiet to do while Mommy rests so she can feel better sooner.

If your kids don’t understand or refuse to honor this simple request, then a parenting class might be in order. If your partner doesn’t understand or refuses to honor this simple request, a relationships class might be in order. There’s nothing wrong with asking for a little peace and quiet, a little time to yourself to regroup, especially when you are not feeling well.

Around here, we use words like…
I’m feeling fragile today.
I can’t handle too much information today.
I’m having a bad day.
I’m having a sad day.
Whatever you say or do today will be wrong, so it’s best to steer clear of me today.
It’s not personal.
It’s not you.
She’s baaaack! (Meaning my evil twin).
Guess who’s visiting? (The Alien, which is another name for her.)
All I want is chocolate.
Let’s go out to eat.
I can’t stay awake today.
I think I’ll just read a book for a while.
Not today, hon, I can’t seem to hold onto my thoughts for very long.
I think I’ll just end this day now and go to bed. (Usually said when I am extremely irritable, and no matter who says anything to me, they are likely to get blasted. I simply remove myself from the situation and temptation.)

That’s enough for today. I hope I’ve given you some food for thought.