She - An Inside Look at What It's Like to Have PMDD

I can sense she is coming, as my world starts to blur, she climbs into my body and claims it as hers.
Nobody sees her, she causes such pain.  She is nothing like me yet goes by my name.

It's like a possession no priest could exile, she's taken me over, she's stolen my smile.
My body is hurting, I'm wrecked and alone.  For two weeks a month, my body's her home.

Her rage has no limit, she's hurtful and cruel, she says things I wouldn't, and I look like a fool.
She drags me by force to the depths of despair, until I don't know myself, I am no longer there.

She damages my friendships and destructs my work, has me laid up in bed, exhausted and hurt.
And when I'm broken and lost and she's had her fun, she climbs right back out, I've survived another month.

And I take back my body, my mind and my heart, I repair all the damage, I make a new start.
I'm back and I'm happy, I'm thankful and free, though I know in good time she'll return for me.

Maybe one day I'll be free from her hell, she will no longer own me, and I will be well.
Until that day, I will swim the rough seas.
I won't let her drown me, for she isn't ME.

by Nicola James, 2016

Hello! It’s Not Just PMS. PMS and PMDD Are Not the Same Thing

Let's set the record straight once and for all, shall we? PMS and PMDD are not the same thing.

I remember PMS. I had it as a very young girl and woman. It was signified by the typical energy drop, irritability, cravings, weepiness, bloating and leaden legs that preceded my period. It was a pain in the...well, you know. It made it a challenge to go about life as usual, but I managed, because PMS is manageable. At least, it was for me. I have a huge pain tolerance!

At some point in my life, something switched on...or maybe off. Either way, PMS started to transform into something a lot less friendly. I was markedly becoming an entirely different person for several days before my period, changing back again as soon as the blood flowed. This wasn't about bloating and irritability. This was about marked personality changes characterized by extreme sensitivity to stimulus and anger. Simply put, I couldn't stand to be around people, and I couldn't handle the simplest of frustrations.

Enter peri-menopause. Now at age 48, PMDD has become an even bigger nightmare. With the shifting of my hormones comes a much more unpredictable barrage of cyclic symptoms including anxiety, rapid mood swings, rumination and self-sabotage the likes of which even years of extreme personal development can't help me tackle. Add to the mix suicidal fantasy, full-on rage, and an aversion to my partner with its characteristic withdrawal and silence that is completely destructive. Marked personality changes have become unrecognizable personality! Day-long crying jags have replaced weepiness. And bloating and cramping have morphed into days of constipation, muscle aches, headaches, and other inexplicable weirdness including strings of 12 hour naps! This ain't PMS, folks!

I wonder how many of my well-meaning associates who say they have or had PMDD really know what they are talking about. Did they have those simple cramps, bloating, and mood changes I recall from my youth? Do they think that is PMDD? Do they understand that PMDD is a life-altering, destructive, and altogether demonic monthly possession which leaves one feeling completely effed-up? I have to wonder. Because often, something in the way they say it or look at me or how they live their lives makes me think they don't. The dead give-away is of course, "It went away with exercise and dietary changes" or "You just have to think more positively".

These two female "things," PMS and PMDD, are often lumped together. There is no harm in that, necessarily. The problem arises when everything that is generally known about PMS is transferred to PMDD and an assumption is made that they are in fact the same thing or so closely associated as to be kissing cousins. In actuality, they are entirely different races. And speaking of races, it's a lot easier to run the PMS race, let me tell you. The PMDD race? Honey, it's a never-ending marathon of trials over which a woman has very little control, no matter the extent of her efforts.

Are you suffering from PMS or PMDD? Learning the difference can make a world of difference in understanding yourself and your symptoms. For more information, visit the National Association for PMDD/Gia Allemand Foundation website. 

Liana's note:  The above guest post was written by the blogger Cheekyminx. With her permission, several posts she has written about PMDD will be featured on this blog in the months to come. In the meantime, to find out more about her work as a PMDD Advocate, please visit her Facebook page, PMDD Life Support.

Differences Between PMDD and Bipolar Disorder

The following is a guest post inspired by fellow PMDD advocate Danielle Lasher Bosley, who answers countless questions in Facebook groups regarding what she's learned about PMDD.  Today's topic is about the differences between bipolar disorder and PMDD, which are commonly confused in the medical arena.  Welcome, Danielle!
I've had a few women message me lately about the tangled web of bipolar disorder and PMDD and how to tell the difference between them. This is a question that pops up more and more. And the answer is tricky, but I'm going to try to address it since it keeps coming up.
One thing I've noticed is most women who ask me about this do so privately. So many seem ashamed over the idea they could have bipolar disorder (which affects up to 3% of the population). I get it. Having PMDD - an autoimmune hormonal issue - seems a lot less stigmatized than saying you have a well-known mental health disorder people make fun of and mock all the time. So yes, I get it.
Buuuut... The longer you go treating one disorder (like PMDD) when you may not even have it and ignore the other (like bipolar), the worse it gets.  Liana adds: The reverse is also true—you could be taking medications for bipolar disorder when you actually have PMDD. Either way, The treatment plans and medications are not the same. Something to think about.
So... The diagnostic criteria for PMDD and bipolar disorder are different. There are different types of bipolar, too. I'm not gonna get into all of that right now. What I will say is - in the majority of cases with bipolar, there is some level of mania. Yes, there is one type that doesn't have mania. There is also hypomania which is milder. These cases are not the majority of bipolar cases. Most will have mania. Bipolar disorder also brings with it certain typical behaviors: reckless behaviors like frequent sexual partners and impulsive spending. These are not typical of PMDD. Do they exist with PMDD? Sure, they can because we are all different and have differing personalities, but as a whole, it's not a commonly recognized symptom like it is with bipolar.  Liana adds: PMDD impulse control issues generally have to do with mood swings and saying things we don't mean. That doesn't mean we don't indulge in a little retail therapy now and then, but not to the scale of shopping sprees during manic episodes of bipolar.
Most importantly: PMDD doesn't happen outside the luteal phase (the last two weeks of your menstrual cycle). Yes, stress and surprises and emotional upset are still hard for a woman with PMDD to handle. But the depressive lows or extreme highs will not suddenly hit you on Day 8 of your cycle. That's not PMDD.
Now, there is also PME, which throws many with bipolar disorder off track and onto PMDD. Women with PME experience prominent symptoms in their luteal phase because the fluctuating hormones worsen the underlying bipolar disorder. But the difference is that bipolar symptoms are still present outside of the luteal phase. Bipolar disorder is not predictable like PMDD symptoms are and with bipolar disorder it's not happening during the same timeframe month to month.

With bipolar disorder... your depressive state may lead to suicidal thoughts that change over to feelings of euphoria  and endless energy. These extreme mood swings can occur more frequently – such as every week – or show up more sporadically – maybe just twice a year. There is also no defined pattern to the mood swings. One does not always occur before the other – and the length of time you are in one state or the other varies as well... 

Also, and this is the most important part: if you don't have physical symptoms, it's very likely not PMDD. The diagnostic criteria for PMDD is used to emphasize this better. Since it was tweaked in 2013, we are seeing more women with bipolar disorder being misdiagnosed or self-diagnosing with PMDD. Traditionally, the most common physical symptoms of PMDD are extreme bloating, an all over heaviness, joint and muscle aching, acne, lethargy and fatigue, weight gain, and food cravings... And most with PMDD have more than one or two of these physical symptoms. If you're dealing mostly with mild mood changes and the physical stuff is more along the lines of PMS, the issue may actually be bipolar with PMS, not PMDD.
Substance abuse (whether it's pills and needles or you're the woman who "needs" wine every day) is also far more common in women with bipolar disorder than PMDD.
Danielle sums up: This is how I differentiate between bipolar and PMDD. You don't have to agree, but I think the differences need to be mentioned and that women who suffer with either PMDD or bipolar disorder need to recognize what exactly they have, own it, and get the help they need. As we well know, doctors haven't been the most helpful in this regard over the years. So we need to be our own best advocate. We need to be  honest with ourselves about what's going on.  Liana chimes in: I agree.  We need to do our own research.  With just a little effort, you *can* figure out the difference for yourself.  The tools are available and the information is out there.  And we deserve better than to spend years taking the wrong medication for something we don't have.
As always, get your hormones and thyroid tested annually (if only to find out what you don't have). Chart your cycles.  It's the best way to determine whether you have PMDD or not.
But most of all: Don't give up. ❤ The answer that is right for you is out there somewhere.

PMDD Quote of the Week

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

PMDD Quote to Reflect On

From a participant in the Facebook groups...

~I came to the realization that PMDD is as much of a spectrum disorder as autism is. Everything is different for each of us, severity so different, that there is no real way to pin it down. Maybe that's why treatment is so elusive. We are trying to classify it to fit in a single box, and it simply can't. In other diseases there are finite ways to tackle it. That is just not so with any spectrum disorder.~ 

Declare Your Independence from PMDD - Nutrition Matters

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

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

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

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

Nobody ever asked about my diet.

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

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

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

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

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

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

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

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

And this happened after only two weeks!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

And wouldn't that be something to celebrate?

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

PMDD Quote of the Week

~Just yesterday I could not stop eating.  It was like I was keeping myself from being dragged under.~