I often joke that it’s hard to know what to place the blame of my emotional ups and downs on: My personality disorder, my zodiac sign, or my period? Most people with a uterus can agree, periods are physically exhausting. Cramps suck. Bloating sucks. Frequent visits to the bathroom suck. But for me and others who have Premenstrual Dysphoria Disorder (PMDD), the body dysmorphia, extreme sensitivity, feelings of depression and hopelessness, and suicidal idealizations suck a whole lot more. Not only is my body interrupted five days a month; my self-confidence, my brain, and my happiness are put on hold too.
So what exactly is PMDD and what are it’s symptoms? According to MoodDisorders.ca
PMDD is a condition associated with predominantly severe psychological symptoms which cause disruption of the daily lives of affected women. Dysphoria is derived from the Greek word dusphoros, which means hard to bear. The symptoms of PMDD are recurrent. They usually start seven to 10 days before menstruation and decrease within a few days of the onset of menstrual flow. Then, they disappear completely until the next premenstrual phase.
PMS is present in about 30% of women in their child bearing years and studies have found that up to 8% of women with PMS meet the criteria for PMDD.
- Very depressed mood, feelings of hopelessness
- Marked anxiety, tension, feelings of being “on edge”
- Marked mood shifts (e.g., suddenly feeling tearful extremely sensitive)
- Persistent or marked anger or irritability or increased interpersonal conflicts
- Decreased interest in usual activities (e.g., work, school, friends, hobbies)
- Difficulty concentrating
- Fatigue, tiredness, loss of energy
- Marked change in appetite, overeating, food cravings
- Insomnia (difficulty sleeping) or sleeping too much
- Feeling out of control or overwhelmed
- Physical symptoms such as breast tenderness or swelling, headaches, joint or muscle pain, “bloating”, weight gain
Up until this past year I had never considered the idea that I might have PMDD. Probably because I didn’t know it existed, and believed Premenstrual Syndrome (PMS) to be the default. Long before I got my first period, I had been warned that those of us with uteruses are “crazy” once a month, and once I joined the club, I accepted that it was normal to not be normal for a few days.
This summer, my struggle with depression seemed to finally be at an end (or at least a hiatus). I went off my anti-depressants, my thoughts of suicide decreased, and my therapist seemed to be nodding her head at a frequent pace whenever I talked. I felt mindful. I felt in control of my emotions and moods. My personailty disorder and my depression were no longer influencing every action and behaviour. But then came the week before my period. The feelings that had been routine for years were now designated to five days instead. It was incredibly defeating. It seemed like no matter what I did, I was destined to be a sad girl.
Frustrated, I went to Twitter and ranted about my woes. Luckily for me other people with uteruses recognized my experience and difficulties. For the first time I was introduced to the term PMDD and it was suggested that I speak to my doctor about it. And so I did. I was switched to different birth control, a pill with a higher hormone balance, I was also prescribed an anti-depressant. I was directed to take it once a day, and then twice a day during menstruation. But I didn’t want to be (nor could I afford) to be on an anti-depressant any longer. I’m lucky enough to have an aunt who is a pharmacist so I called her before starting the medication. I asked her if it was possible for the medication to work if I just take it during my period, or if it was impossible because the chemicals hadn’t had time to be built up. She did her research and called me back a few hours later. It was safe to try, and so far it hasn’t solved everything, but I do feel like it helps.
So if we can’t control our uteruses and the effects they have on our brains, what can we do? Here’s a list of activities and tips I’ve found to be helpful.
- Avoid mirrors & embrace snapchat filters: Body dysmorphia may be triggered by PMDD. So try not to pick yourself apart in the mirror. I can’t count how many times I’ve destroyed my face from picking and squeezing. That face you’ve grown comfortable with will eventually return to you, but the longer you stare at the PMDD version of it, the longer you’ll indulge in self-hate. During the next few days scroll through your Snapchat filters and have some fun.
2. Call a friend: PMDD is my favourite time to remember what the original function of my phone is. During the next few days, my body is sore, my brain is sad, and I’m struggling to be around others because I’m convinced that I’m the ugliest person in the world. Laying down on my bed, staring at the ceiling, and talking to a friend on speakerphone has been one of the most effective ways to keep myself from becoming isolated and alone, all the while remaining at a distance where I can remain comfortable.
3. Don’t text or call a flakey friend: Besides worrying about how everyone sees me, I’m worried about how everyone perceives me. Trying to get in touch with a friend who has been distant or cold, prior to effects of PMDD is absolute self-inflicted torture. Do not seek out attention from those who cannot even provide you with support and love when things are fine.
4. Stock up on ready-made food: I don’t like telling people what to eat. But I want you to know that if you do not have the energy to cook an elaborate three-course meal during this week, that is okay. If you break your diet while working through your PMDD symptoms, that is okay.
5. It’s okay to nap: Please don’t feel guilty if you allow yourself more time to sleep during this week. The reality is, PMDD isn’t fun. Your dreams may provide you with a temporary escape to somewhere better, and you deserve that.
6. Listen to an audio-book: Again, this is a hard week. A week where your thoughts may not reflect who you usually are. Your mind might be consumed of sad, bad, not so rad thoughts. Put in your headphones and let someone else’s voice, someone else’s story drown out whatever it is you’re tired of hearing.
7. Colouring: Get yourself a colouring book, and keep your hands busy. I often experience dysphoria, suicidal and self-harm idealizations during the week of my symptoms. It can be hard not to pick at yourself, or even more seriously it can be hard not to harm yourself. Colouring not only keeps your hands busy but often you end up with a creative and beautiful result. It feels a million times better to look down at a colourful piece of paper than a blotchy red face that's been squeezed and irritated.
8. Avoid music that will enable your sadness: I love Elliott Smith, but I know Elliott Smith is not good for me during this week. Turn your Spotify session to private and allow yourself to listen to the cheesy pop of your youth. Or even better, turn on some rap that will boost your ego and remind you of the confidence you’re used to outside of this week.
9. Talk to your doctor about anti-depressants or changing birth control: What you’re experiencing is valid, it’s real and it’s hard. You deserve support not only from your family and your friends but also your doctor. The first method might not work, finding an effective treatment and/or medication can take time. Don’t doubt yourself, and if you find your concerns being dismissed ask for a second opinion. This illness is just as legitimate as any other. You, your brain, and your uterus deserve to be happy every week of the month. PMS may not be covered by insurance, but PMDD should be.