May is Mental Health Month - A Primer on PMDD

The following guest post was written by the blogger Cheekyminx. With her permission, several of her posts about PMDD are being featured on this blog. To find out more about her work as a PMDD Advocate, please visit her Facebook page, PMDD Life Support.

Many women the world over experience the usual discomforts associated with the premenstrual cycle. PMS is a well-known condition that often includes irritability, bloating, and physical pain. But if you feel like PMS takes you out of commission every month, there may be more to it for you. Could you be one of the growing numbers of women who realize they are suffering from Premenstrual Dysphoric Disorder, or PMDD? What many women, and indeed many doctors, do not know is that in 2013, PMDD was officially recognized as a mood disorder (this classification will have to do for now) experienced by about 10% of all women who menstruate.

Now word is getting out. So how do women who have PMDD discover they have it? PMDD is caused by a sensitivity to normal hormone fluctuations rather than a hormonal imbalance, and getting tested for hormone levels usually reveals nothing. Many women discover it when they are at their wit’s end, having tried birth control, antidepressants, and other treatments to target symptoms they often think are the result of something else…like bipolar disorder or depression. In fact, many women with PMDD report not only PMS-like symptoms that are extreme and debilitating, but also much more dramatic and difficult-to-manage changes in mood and thought patterns, often leading to misdiagnosis. But intuitively, they know there’s something about their monthly cycle that seems to be playing a role, so they begin to chart their symptoms.

These symptoms are numerous and vary from person to person but generally involve anxiety, increasing irritability, hypersensitivity of the senses, depression, rage and other uncontrollable emotions. Thoughts can become insistent and feel “uncharacteristic” to the person having them. It is as though the mind becomes polluted, distorting everything. PMDD also seems to exacerbate underlying medical conditions, making it unique to every woman and can include dizziness, sluggishness, bloating, heavy bleeding, and sore muscles. But by and large, it is the increasing loss of patience and intensifying irrationality that makes PMDD such a nightmare, not only for the women, but for the people they love.

In fact, many find that during the 10-15 days of their hormonal sensitivity, they lose interest in their partners…not just sexually, but often to the extent of detesting them altogether. Some report regularly breaking up with their partners on a monthly basis. This Jekyll and Hyde transformation wrecks havoc on relationships of all kinds, not just romantic ones. It’s difficult for mothers to parent and for employees to continue with duties as usual. Overwhelmed by fatigue, cravings, paranoia, or even suicidal thoughts, normal life remains out of reach until the sensitivity ends, usually with the onset of menses–though there is debate the sensitivity fluctuates for some women at other times in their cycle. What’s important to realize is that the symptoms do disappear, sometimes instantaneously, whether it is the day the menstrual cycle starts or several days later. And suddenly, things are back to normal…but often leaving a great deal of destruction behind. In fact, women with PMDD often feel as though they spend two or more weeks a month in hell and the other two or less making up for it.

Think you might have PMDD? Here’s what you’ll want to do:

1. Start by paying attention to your cycle and taking notes. Get yourself a pocket calendar or use and app like iPeriod or PMS Tracker. Then start keeping track. When do symptoms hit? When do they stop? What are the main symptoms and to what degree are they experienced? Do they progressively get worse? Think not just of physical symptoms. Consider your emotional and mental states as well. Are you more prone to tears or anxiety? Is it more difficult to think positively? Have others commented about a change in your mood?

2. Take several months of your notes with you to your doctor if you decide to take a Western approach. Explain that you think you may have PMDD. If he or she dismisses you, find another doctor–one who will help you determine whether or not you have it, explain your options (they aren’t all that great at the moment and there is no known cure), and work with you to help you cope.

3. Educate yourself and find additional support. As a relatively new disorder, there is still much to be discussed and researched about PMDD. Read up on it online and talk to others who have it. Women who realize they have a condition with a name to it are usually very relieved when they realize they are not alone…and not crazy! Facebook has several groups, both open and closed, including a support group for family members of PMDD sufferers that offer insight, coping strategies, the latest science, and a safe place to vent.

If you do indeed have PMDD, now that you know, you can give yourself the support you need to get through it. It may call for changes in your diet, supplements, exercise and meditation, or even medication. And if you don’t have it? Chances are you know someone who does, and she might not realize what it is. So share what you’ve learned with others and help spread the word about PMDD.

PMDD Awareness Month Ends, But the Struggle Continues

Today wraps up the end of PMDD Awareness Month.  I've spent the month sharing on Facebook and Twitter several posts from my Voices of PMDD series, where women with PMDD and their partners have shared their stories.  The quotes that follow come from Hormone Hell, the personal journey blog of a fellow PMDD Advocate, Jarrah, who asked her readers to describe what PMDD feels like to them.  I've chosen several responses that I fear we can all relate to in some way.  Please read on, and, if nothing else, know that you are far from alone in your struggles with the demon that is PMDD.  Perhaps one or more of these descriptions will help you to put into words for a loved one what it's like for you, each and every month, and raise awareness in your own way.

On my bad days it feels like my nerves are on the outside, that everything hurts, and there’s a heavy blanket on me that I can’t get out from.

It feels like nails in my brain that prevent me from thinking correctly. The nails stay in my skull for about 2 weeks and then they finally go away and I can think again.

Your brain feels like mush, your memory is poor. You're actually scared that one day you’re going to wake up and forget who you are. Your digestive system is going crazy, you’re constipated one minute, rushing to the toilet the next. Your bladder needs to empty itself 6 times in a single hour. You're hot, no you’re cold, umm, you’re hot again. You love your husband one minute and consider filing for divorce the next. If one more person chews, breathes or coughs, there will be bloodshed.

I’m angry, I’m sad, I’m laughing…now I’m crying. My joints ache. I am only 29 but I feel 99. My hair is thinning; it’s so dry it feels like straw. I have permanent dark circles under my eyes. My skin is so dry it’s flaking.

You’re so tired but no matter how much sleep you get, you still wake feeling tired. You’re hungry one minute, you’re nauseous the next. You can’t breathe; your heart races and you can’t stop sweating. You don’t want to be touched, you feel suffocated if someone sits close to you.

Overthinking is an everyday occurrence and often your head is swimming with thoughts that leave you feeling terribly anxious. You no longer look forward to anything, as each day is just a matter of survival. You have no passion and no longer think about the future. You hate this empty person you have become.

You start daydreaming about dying. Deep down, you know there’s a part of you that definitely does not want to die. You know that, logically, things are fine and you will be okay. But you can’t FEEL that. All you feel is despair, hopelessness, and a suddenly strong urge to leave this world.

Worthless. Empty. Angry. Bloated. Exhausted. Sometimes I just wish I could disappear…just lay down in the grass and get absorbed in to the earth somehow. Oh yeah, and Crazy. I know what I feel isn’t normal, but I can’t change it…at least until my period comes and then I’m right as rain.

Anticipation for hell week becomes a hell week in itself. I can’t control the choking wave of anxiety or the rage of this demon but I have changed my outlook. It will not own me.  I will not let it drown me.  I will swim and swim until I come up for air. Until the next storm. There have been a few hell weeks where no matter how hard I swam I could not escape the urge to let it pull me under and take me in its entirety. Those days and those times I don’t know how anyone makes it out alive.  

Rage, anxiety, mind going crazy, all of those things attacking you all at once. You wish it was over and the sad thing is you have no control over it. You see yourself doing all these dumb things and you try and stop it but it’s so hard to control. But you keep fighting because you love your family and you love yourself too much to give up!

Like a tightness of the skull above the eyes, like my skin and hearing is super sensitive, so I have a headache and am easily overwhelmed. This coupled with lowered patience and attention span means I’m really short-tempered. Sometimes that results in a snappy comment and then unreasonable crying (e.g. about burnt pine nuts), but other times it’s disproportionate rage. Sometimes it’s just a brain fog, where I sit and stare at the work computer, trying to figure what I’m supposed to be doing, and how someone is paying me to sit and feel like my powers of logic and reason have been pulled out through my eye sockets.

It’s like a switch that is flicked inside me as soon as ovulation begins. From that point on I become the opposite of what I consider to be my “normal” self. I’m suddenly extremely anxious, paranoid, worried, irritable and I can snap at the smallest things. The rages are life-destroying. They hurt everyone I care for, and scare off anyone else. My period finally begins and within a day or two, my mood lifts. The anxiety goes away, the paranoia is no longer there. I can think rationally and logically. I have energy to do anything I want, and sadly most of that time is spent picking up the pieces of the storm that lives inside of me, and has--for now--disappeared.  

At the start depression starts to set in, aching body, foggy head, headaches, high anxiety, pains in the stomach, sweating, panic attacks when I go in public, hysterical crying, at my worst, thoughts of suicide. Then my period arrives...all those feelings and thoughts are gone just like that…I’m back, me again, I’m back to normal. I can go to work with ease (if I still have a job). I can go out anywhere with no panic attacks, anxiety (what anxiety?) I am fun, I enjoy being around people and they enjoy being around me. I wish I could be this person all the time, I hate knowing it is short lived and the devil lady will be back again soon.

Sensitivity to light and sound…my son talks and talks and I just want to curl in a ball to escape. That’s horrible to say…but I just can’t handle it.

I always wonder if this mental illness will kill me one day—I’m sure it will. The brightest days are good. I enjoy them. The darkest days however, seem like I won’t ever escape them. Each time it feels like maybe this could be it, the one that I don’t come back from. But somehow I make it through. PMDD is cruel. It’s like every month, sanity is dangled in front of me and I have to hold onto it. There’s a glimmer of hope that this month I’ll be cured, then suddenly it’s ripped away.

I was sitting in my seat watching a movie, my whole body was tense, I was clenching my teeth, my heart was racing, and I was swallowing back the nausea I felt…I tried to push all those feelings out of my head so I could try to enjoy the movie. As I sat there I couldn’t help but think…So this is what my life has come to? It’s a movie for goodness' sake and my body is acting like I need to be on alert just in case at any second someone might try and kill me.

I ended up going for a walk to try to clear my head. My legs would only carry me half way around the block, my whole body was so fatigued and I was so nauseous the symptoms reminded me of how I felt when I was in the first trimester of pregnancy.

PMDD….a war you’re constantly fighting that no one else can see.

PMDD: Into Me See

The following is a guest post by the blgger Cheekyminx. With her permission, several of her posts about PMDD are being featured on this blog. To find out more about her work as a PMDD Advocate, please visit her Facebook page, PMDD Life Support.

I've said I wanted to write about some of the things that help me to cope with PMDD. Maybe another day. Right now, NOTHING is helping. In fact, everything is just making it worse! I suspect, hell, I know from reading the forums, that this is pretty common. Nothing helps, at least it seems that way, and everything is an irritation. A speck of dust in the wrong place can make me want to jump out the window. Yes, it’s irrational. That’s kind of the point, and I don’t need to be reminded of it…  At least I have some control over a speck of dust.

The reason nothing helps is because nothing makes this chemical shit-storm of body and mind go away. It is still there, demanding attention, making me behave in ways I cannot stand. But there are things that do bring modicums of comfort. I can take a bath. Sitting in the sunshine smelling the grass helps, too. There are also my standbys of yoga and meditation. I would be lost without them, but sometimes, they aren’t enough. Really, they’re never enough…not during PMDD. They just offer a bit of relief and keep me as stable as possible.

The saddest thing may just be that so many of us have to get through this pretty much unsupported and alone. Very few people get it enough to be of help. The fact is, if you don’t have it, you just don’t get it. This includes friends, roommates and partners who, needless to say, have a very hard time of it, and often wind up making everything worse, even if they don’t intend to. Even if it was me on the receiving end of this phenomenon, I don’t know how I would respond. I guess it would depend on my own mental state that day. Sadly, PMDD ruins plenty of relationships.

But one can dream that suddenly, it wasn’t such a horrible thing for others to cope with…

Dream Sequence

I wake up and I can feel the stirring of hormonal reaction inside my body. The good days have passed. Shit! Here we go again. Two weeks until my period when I can think and act straight again and not detest myself for having no control.

In walks my husband with a bouquet of flowers. “Good morning, sunshine!” he says.

“Drop dead.” Shit, I think to myself. Did that just come out? Oh, crap, oh crap, oh crap. I want to enjoy the flowers. They are so beautiful. Please, please, please let me just enjoy the flowers. How did he know how much they would mean to me? And yet, I can’t express it. The only words out of my mouth are “drop dead?” What is wrong with me?

“Honey, I won’t take what you said to mean anything,” he says. “I know what day this is…um…I know any day now I’ll be losing you for a week or two to that whatever it is…but I just want you to know, I’m going to do everything I can to make it easier for you this time.”

Really? I think, heart melting inside while I roll my eyes on the outside thinking of what a damned irritating [insert cuss word] he usually is at this time. How does he intend to do that? Go on vacation for two weeks without me? He would abandon me like that!

I go down to the kitchen expecting crumbs on the cutting board, knowing I’m about to get all wound up, and what’s this? The kitchen has been cleaned! I mean, really cleaned! The floor actually sparkles. It’s a miracle!

“Do you want breakfast?”

“Just leave me alone,” comes out of my mouth while "Yes, please make me your lovely eggs" never leaves my lips.

“I’ll make some eggs. If you don’t want them, you don’t have to eat them. If you do, I’ll leave them here for you.”

Hmm…what’s gotten into him? I start to think paranoid and judgmental thoughts. I just manage to hold back the bitter words that want to exert my independence, “I can make my own eggs!”

“Oh, by the way, I know how much it’s been bothering you that I hadn’t fixed that sink since we moved in two months ago, so guess what?”

What? Another empty promise to fix it…someday…next year? I’m biting my tongue because I KNOW I’m thinking with way too much exaggeration. Words start leaking out…words I KNOW will only do more harm than good…

“I called the plumber. He’ll be here next week when you feel better.”

He… I can’t help but smile. The tension in my body that usually just gets tighter and tighter is starting to untwine. This is all getting to be too much.

“I also tidied my room just so you won’t have to be repeatedly irritated by the disorder in there. I know it affects you and makes things worse. In fact, I’ve decided to take care of everything on this here list that I normally force you to tolerate and remind me of month after month like I’m deaf. I may let things slide at other times, but I realize it just makes things worse once your cycle again. Besides, it really is my responsibility…”

Oh, my God! I just want to cry now. I have to cry. So out it comes. I am sobbing uncontrollably. Great. Now he’ll take it personally and the world falls to shit.

He doesn’t say anything. He gets a pained look on his face…and then, it happens. Another miracle. He takes me by the hand, leads me upstairs, and holds me on the bed while I finish crying. At first, I push him away. I can’t bear to be touched. It actually hurts. But he holds me even tighter. He isn’t trying to get me to stop crying, or offering me Kleenex, or asking me what’s wrong. He’s just there. Strong. Reassuring. And I feel safe for what feels like the first time in my life.

When I stop, I feel stupid. I feel embarrassed. And I push him away. He doesn’t say, “I can never do anything right.” He doesn’t throw up his hands. He doesn’t call me crazy or make me feel worse than I already do. He just says, “Honey, I love you. I’ll give you some time and space. I’ll go get some groceries because I know we are out of bananas and chocolate…and frankly, that scares me right now.”

I want to say, “and we need lettuce” but I can’t get it out my mouth. Why the fuck can’t he remember the fucking lettuce? And then I cry some more, ashamed of my ridiculous thoughts but also, feeling a strange sweetness inside. I think I’ll bake him some cookies.

I know. It’s just a dream. Maybe it is too much to ask. Is it catering and kowtowing? Is it just too utopian? To expect another person to be able to behave this way when faced with judgment, contempt, rage, and the other unpleasantries that consume a woman in PMDD? Is it too much to expect someone not to take such seemingly personal attacks personally? To be able to be in our heads knowing what it is we need or want when it is suddenly impossible for us to just speak it? To be able to set aside their own discomforts with whatever has taken us over to wonder, my God, what is it like for her?

I suppose so. People are people after all. There no such thing as a Stepford Husband.

Then again, maybe this is all it would take to change the patterns and break the cycles. Maybe, PMDD is a dis-ease in consciousness designed to make us learn things we never would have otherwise about ourselves and each other, given the compassion and support to get through it. What are the lessons? If we knew that, we wouldn’t be going through it. Maybe learning them would be the difference between escalation and management.

Or is it just spiritual bullshit to think there are lessons. And even if there are, what if they aren’t being learned?

If nothing else, maybe this little dream illuminates the secret machinations of the very complicated and unsettling PMDD mind.

I hope so.

Postscript: I shared this with my husband who said it helped him understand me better. I told him I wasn’t going to post it because it just felt too exposing. But then, on one of the Facebook forums, I read a post from a young woman who had just had a blowout with her boyfriend. She was so upset, and I could feel the shaking in my own body…  I thought about what my husband said, that this helped him understand. I thought about what he did for me after reading this: fixed the sink, took me grocery shopping, didn’t walk away when I was emotionally over-stimulated but held me instead. He just wants me to be happy. Given a little information, he actually wants to put it into practice. So, I’m getting over my damned self and sharing this now because it just may help someone else.

PMDD, From One Man to Another, Part 2

How do I survive? If I'm doing all of this, what am I doing for me? Well, it's taken a long time but, I've accepted the fact that it's not about me. It's not even about her. It's about the boys. If she's in a state, I trust her to handle it. I deal with the dudes.

WHAT ABOUT ME?

Don't get me wrong. I do things for me. I'm not talking about drinking or smoking or drugs (though my alcohol intake does increase on those PMDD days). For me, it's cooking. Something that has a beginning, middle, end. Something that involves the boys (so they don't bug mommy on the couch or in bed). Something that satisfies us. Something that's controllable by me. Something that's as challenging as I want to make it. Something that allows me to express myself to others. I can immerse myself in the process, pushing the stresses of the day to the side (at least temporarily).

Recently, I've been writing. I write how I'm feeling when she ups and leaves the dinner table or lashes out at me or tries to pick a fight just because she wants to argue. I keep track of the number of days she sleeps downstairs, while I deal with the boys through the night. I write lists (bucket, shopping, chores). I write quotes or words of wisdom and inspiration (to remind myself that I'm not alone...though it often feels like I am.)

My big one, though, is music. No, I don't write it or sing it or perform it. I listen to it. I have my 'mood music' to centre me. And, like her needs during her PMDD spells, what I need varies each time. It could be punk or rap or chillout or metal or classic rock or country...but when it's on, I'm in the zone, in the moment and in the mood. When I'm cooking, there's ALWAYS music on. Again, it shifts with my moods.

I'll say it: PMDD can be a selfish disorder if your partner blames every given frustration or moodiness or anxieties on it. And, trust me, it can go there. She will do what she needs to do for her when she needs to do it. Regardless of your intentions, there's very little you can do. She's been dealing with it, coping with it, handling it well before you entered the picture. She's dealt with it on her own and will continue to do so...ON HER OWN. Get over it. Seriously.

WHAT CAN YOU DO?

For the love of humanity, when she says to leave her alone, LEAVE HER ALONE.

When you're trying to decide what to make for supper, avoid at all costs, asking question after question after question. Stick to one simple question with a yes or no answer. Most likely, she won't eat any food anyway so it doesn't matter what you make!

Please ask her, once, "is there anything you need" or "can I get you anything" or "is there anything I can do?" - but do NOT ask every few minutes.

Be prepared. It's the scout's motto. It's important here, too. Have her comfort foods on hand: perhaps it's a particular chocolate bar (Lindt dark chocolate with hot peppers for my wife) or salty snacks (chips? nachos?) - don't be surprised if they disappear during her moments of deep darkness. Even if you wanted some, you can buy more. Again, this can lead down the road of selfishness but get over it.

This is a disorder requiring frequent, unexpected sacrifice. You're going to need to give up stuff - she may need your attention...ooooooooorrrrrrrr....she may tell you to 'get the f--- out' meaning you need to find somewhere else to be (pub? friend's place? ANYWHERE but home). The nice thing is that, if she's coming out of her state, she'll text you to come home. When you do go home, say very little. Maybe a 'how are you feeling?' but don't you dare overwhelm her with story after story about what you saw, did, or heard. It's not - and never will be - about you during these times.

One more thing. YOU. CAN'T. FIX. HER. Don't try. Don't tell her to 'go for a walk' or ask to go out for dinner or sex. Don't even consider telling her to 'get over it' or 'snap out of it' or tell her that it's nothing. It's everything. It's all consuming and all encompassing. It is a deep, dark hole that she's allowed herself to explore and it's scary as fu--. She doesn't want you down there with her. This is her own hell. You cannot and will not be her tour guide. Trust me. I've had my nuts in a sling one too many times thinking I could be the fixer...like I could be the solution to her problems. It sucks to not be able to solve a problem for her. I love my wife, but not having the tools to fix her hurts like hell. She's stronger than words can express...and it'll make you stronger the moment you accept the fact that you are not her knight in shining armor, rescuing her from a pit of despair.

So what are the solutions? There aren't any. Every month may be a different hell. Every time it rears its ugly head, it may be a different stimulus that exacerbates her anxiety. You can usually predict when the darkness may arise but be prepared for spontaneous combustion.

There are medications (my wife's on Cipralex). Does it help? Yes. Is it a cure? No. Her PMDD still comes...but not as frequently. We're down to ~8-10 days a month now. It lowers sex drive. Decreases appetite (with sporadic bouts of gorging). Ironically, it CAN increase anxiety (!) which, I thought, it was supposed to minimize...but, whatever.

There's therapy. I'm sure there is. We just haven't explored it. Yet.

There's exercise or yoga...something that centers the mind and body. But, dear man, don't suggest she work out while she's in the middle of an episode. You're likely to have a rolled up exercise mat shoved deep inside you through a very tiny orifice. 

Why don't I go out more? Because I never know when the PMDD will kick in or when the depression or anxiety will hit. I never know, going to get groceries, if I'll come home to find her on the floor. I fear leaving her with the boys on 'bad' days because I never know what to expect when I come home - will they be trying to wake her up? will she be locked in her bedroom, sobbing? will she be unleashing her fury on the boys as they wildly chase each other through the house? It's the fear of the unknown.

Don't be surprised if you slip into your own funk after a particular bout of PMDD. It's draining. It's exhausting. You'll be physically, mentally and emotionally wiped. You'll be worrying about her, questioning yourself, wishing you could do more (once you've accepted you can't), wondering if she's ok...it's a whirlwind that is uncontrollable. It keeps you on edge. She may have said something particularly hurtful or mean (just to get you going). That sucks big time. Then, when the dark clouds pass, when she's all kinds of relieved and 'nice again', you may be relieved...but you'll be mentally overwhelmed. You'll want to talk to her...and, perhaps, she'll want to share her thoughts (what you did right, what you did wrong) and that, in itself, further drains you. You don't want to hear all the things you did wrong (or didn't do at all) do you?

It sounds mean or cruel or insensitive but, guys, suck it up. Man up and accept that your wife or partner or lover has PMDD. The more you learn about her & how she handles it the better off your relationship will be. It is an ongoing process, kind of like the Hobbits on their quest for the ring. It's an adventure but one fraught with chaos, insanity, danger and doubt.

What can you do? What can you say? It's easier said than done.

When she's not in a PMDD state, (and, please, don't inundate her with all of these questions at one time!)

~Ask her what you can have on hand for her (salty? sweet? Sex & the City box set?)

~Ask what you can do to help (tell her to be specific in what she wants from you - rub her lower back, check in without saying a word, hand her a cup of tea and walk out, etc)

~Ask her what, specifically, she needs from you (a conversation afterwards? a walk? etc)

 ~If you think medication is needed, tread carefully - choosing a safe time to mention intervention is paramount.

 If asking her to seek treatment is tricky, wait until you mention 'therapy'...that's another whole kettle of fish.

There's more, I'm sure...but if you have any questions, comments, ideas, suggestions, tips or stories to share, please do so...though it may feel like you're alone, know you're not...the fact you're exploring how you can help your partner demonstrates your strength and resolve.

Well done.

The above is a guest post in two parts by Chef Jay, who has decided to help raise PMDD awareness  by starting a blog for men about PMDD.  You can find his original post, and others, here.

PMDD, From One Man to Another, Part 1

What follows is a guest post in two parts by Chef Jay, who has decided to help raise PMDD awareness  by starting a blog for men about PMDD.  You can find his original post, and others, here.

Why am I writing this dissertation on PMDD? Simple. I need to. There aren't many resources out there for guys. There isn't a strong support system - the number of comments I've seen by guys saying "run away" or "get the F out of the relationship" or "she's crazy" are overwhelming, insulting and, at the very least, a disappointing commentary on the state of men.

Living with a wife with PMDD (who's had it most of her life) and growing up with a sister who, looking back, had something along the same lines, I can say the following: It's worse that what's described. Does it need to be said that PMDD is NOT PMS? Duh.

"...symptoms begin 7 to 10 days" - not always. It can hit at a moment's notice. The anxieties can skyrocket in a heartbeat. The moodiness can take over without warning...a sound, a question, proximity to other humans...anything. One moment, she's sitting at the dining room table, the next, she's heading to the basement to burrow into pillows and blankets, watching Downton Abbey (or whichever show makes her feel better).

If your partner, wife, girlfriend, significant other is anything like my wife (who, according to her doctor, is a textbook case for PMDD), hopefully my words might help, enlighten or support you in your relationship. It's not easy. I feel for you. Really. It's hard as hell. You can do this.

Let me say this first (and I'll say it a couple more times before this is through):

YOU ARE NOT ALONE.

Family is key. Hers, Yours...they need to understand what you're going through, why she couldn't make it to Thanksgiving supper or church or your nephew's recital. She probably doesn't want to be around people. Including you. Your life must continue.

But here's the tough part: she will take it out on you. Why? Because she loves you. If she's letting loose her irritations, her tirades, her anger, her frustrations upon you, it means she trusts you. She's let you behind the curtain. But what sucks is that you will be yelled at, loathed, be the focal point of her ire. And, most likely, she won't want to talk about it. She won't want to dwell on it. Once its passed, she's done with it, not wanting to recall the dark place she endured. Why? Because it's over...and, most likely, she won't want to consider how her words or actions (which she may or may not remember expressing) affect you or those around her. It makes matters worse. Or, at least, that's what I've learned. Often, picking fights is an outlet for the tension in her mind and body. My wife says it's because she loves me. It's hard as hell, but don't give into the temptation to engage in an argument when she's PMDD-y. Walk away. Seriously. She will, likely, say things to get you going, get under your skin or piss you off. Walk away. She's only doing it to drag you down. It'll make things so much worse because, likely, she won't recall engaging you in a volatile discussion and you will. And, if you're like me, you'll hold it against her. Remember, dysphoria is 'a state of unease or generalized dissatisfaction with life' - compounded with her anxiety, depression, restlessness, agitation and irritation...it's like a tornado within her body and her words are letting some of the destructive forces out, wrecking you in the process. The tornado knows not what it destroys. Walk away.

Here's the best way my wife described it: She's in a deep, dark hole. There's only one way out and, to get there, she has to go through the darkness. She said, 'when I come out, into the light, it helps if you're there waiting for me...it makes things easier.' - that, for her, for our family, I can do.

We have 2 kids. They're realising (at the ages of 4 & 6) that "mommy doesn't feel very good" rather often. Until medication entered our house, her PMDD symptoms were, on average, 16 out of 30 days. Things are getting better...the boys are well versed in the "don't wake mommy" talk...or "mommy's very tired today" chat...my 4 y/o will come into our bedroom to sleep with me when mommy stays downstairs. As he puts it "I'll sleep with you, daddy, so you don't get sad". 

One thing that's not often identified when discussing symptoms of PMDD is suicidal fantasies. I learned, quickly, that the fantasies are VERY different from tendencies. I was told, "hide the pain pills away from me because that's the way I'd probably do it...less mess for you to clean up". WTF? Nobody prepares you for that mindset.

So...What do I do? How do I cope? What keeps me grounded? Why do I stay in a relationship that, clearly, is emotionally volatile?

First off, the boys. Dude & Lil Dude. I'm there for them. I take them away, keep them occupied, keep them entertained, keep them busy...but I also get their meals, make their lunches, do their laundry, bathe them and put them to bed...and I wake them up, make them breakfast, get them ready for school...it's not an equal division of labor, I know...but it's what needs to be done.

Why do I do all that? Why do I also do the groceries and the laundry and make suppers? Simple. I don't know if it's going to be one of THOSE days. I made a promise to myself that I'd do what I could to start the day off positively and easily for her. I anticipate the worst (it's gotten to the point where I have a 50/50 chance of  being right). I try and do everything I can so her anxiety is lessened. I can't get rid of it...but I can lower it. She calls me a martyr. So be it. I'd rather do that than be one of the guys who, at the first sign of adversity, turns tail and runs.

Next Up:  PMDD  - From One Man to Another, Part 2 - How do I survive?

Great News! PMDD Tied to Sex-Hormone Reactive Genes

Today's guest post welcomes author Eryn Speers' unvarnished reaction to the news that National Institutes of Health (NIH) researchers have discovered molecular mechanisms that may underlie a woman’s susceptibility to disabling irritability, sadness, and anxiety in the days leading up to her menstrual period.  I couldn't have said it better myself, which is why I asked permission to reprint Eryn's original Facebook post here.  

The bottom line is this NIH discovery is good news for us all.  Please be sure to watch the five minute video (link provided) at the end.

I have been through the gambit, had my moments of doubt, and a few good months where I thought I was "free" of PMDD. Chalking it up to stress, or difficult times, only to have it return with a vengeance. In my frustration I began my research again, shaking my head every time I ended up down the same road: eat clean, eliminate sugar and caffeine, get your hormone levels checked, get acupuncture, see a naturopath, try anti-depressants and Cognitive Behavior Theory. The list goes on and on, as we know. What I, myself, have come to realize, is that all this conflicting information just makes it all worse. That's why I am taking this new research as a cue to stop blaming myself, and to stop listening to all the noise and babble about what the "correct" treatment of PMDD is. While it's a good idea for anyone to reduce sugar intake, exercise regularly, and investigate possible food sensitivities - these things will make anyone feel better in general, but to continue to go in circles just adds stress to what is already a stressful situation.

I hope this new research helps others to do the same. Yes, it means we still suffer until they find a way to use the info to come up with a therapy that targets the actual cause of the problem, as opposed to the symptoms. However, at least those of us who are desperate and tired of trying everything to no avail, can try to find some hope in knowing that they are really working on it.

This is a disorder on a cellular level, and I am ready to accept whatever treatments they come up with in order to get my life back. My hope is that those of you who are very anti-pharma will try to trust, for a while, and give yourself a break from feeling that the only one who can correct the problem is you.

This puts so much undo pressure on us, and also nurtures an environment of pessimism and fear. We deserve to feel better! This problem is not caused by us. This is not a matter of poor diet or lifestyle choices, or a hormonal imbalance. All we can do right now is cope as best we can, and we're all doing that.

We're here to support one another, and I feel that we should all encourage one another to stay open to the possibilities as the research advances. Please, I implore you to keep trying new therapies until you are finally free of this awful disease. If you want to take anti-depressants in the meantime because they help, great! If you want to take birth control, or stay 100% natural in your efforts to get through and lessen the severity of your symptoms - also great!

However, please don't let the way this disease makes you feel hopeless and useless allow others to tell you exactly how to approach your own health. Don't let the fear and skepticism of others stop you from trying a drug that has been specifically developed to treat this issue in the future. They ARE working on it.

Please watch the video, and find hope.

Have faith! ~ES