M. K. Fain
Oct 8 · 5 min read
Photo by Pixabay on Pexels

I’ve struggled with my mental health since I was young. For me, it seems like there’s a strong genetic component — all of my biological siblings suffered from depression when they hit puberty, while my adopted siblings did not. My mental illness has been exacerbated by trauma, abuse, and sexual assault.

At various periods (no pun intended) in my life, mental illness has shown up in different ways. During my early teen years, it was depression and self-harm. In college, I was briefly diagnosed with Borderline Personality Disorder. As an adult, it’s manifested as anxiety and PTSD.

For me, mental illness is both something I’ve come to live with and worked incredibly hard to overcome. I’ve gone through years of therapy, and after finally finding someone who genuinely helped me rather than enabled me, I’m doing much better. I haven’t self-harmed in over five years, I rarely feel suicidal any more, and I’ve learned how to have healthy relationships and manage my emotions.

But once a month, like clockwork, it all comes flowing back to me like a bad memory. My emotions start raging again, and I can feel all my progress start to slip away as my mind starts telling me everything I’ve fought so hard to quiet. I feel like I am going crazy; I wonder what happened to cause such a sudden downturn when everything was going fine. Then, sure enough, three or four days later, my monthly gift arrives as a little red stain.

Oh,” I think, letting out a small sigh of relief, “That’s why.

Except, it’s not really once a month and there’s very little clockwork involved — that would be too easy.

Like 60% of American women of “reproductive age,” I use a contraceptive. As someone who hates taking pills and is averse to unnecessary pain, “the implant” is my preferred method. The subdermal hormonal implant is placed into the underside of your upper arm. It is a painless procedure (especially compared to the incredibly painful IUD procedure) and lasts up to five years.

Nexplanon implant, Herald Bulletin via AP

While every woman’s body is different, one of the benefits of the implant is that it can eliminate periods (or severely reduce them). The first time I got the implant I had light spotting in the early months and then would go for stretches as long as six or eight months without any bleeding at all. When I would bleed, I didn’t have any of the cramps or pain that used to be associated with that time of the month. My periods were lighter and much more manageable. They passed faster, too, often in only three days.

When my first implant expired a few months ago, my periods returned. After getting a new implant inserted, they are starting to become irregular again. I imagine eventually they’ll go away entirely again, but until then, I’m stuck with sporadic and unpredictable periods.

If it were just about the bleeding, I would be totally fine with that. But it’s not.


A couple of nights ago, I started having the beginnings of a panic attack while I laid in bed next to my sleeping partner. I imagined waking up to his cold body, blood spilling out of his ear. “What would I do? What would I tell his family? Would they think I killed him?

I finally coaxed myself to sleep, only to wake up crying from a nightmare a few hours later. I don’t even remember what the nightmare was about, but nightmares are a common symptom I experience when my PTSD flares up.

I’ve had nightmares three nights in a row now.

During the day, I feel anxious, scared, and emotional about everything. Yesterday, I remembered The Hunger Games and started crying about that — the idea that someone could hijack your memories and turn your own brain against you has always deeply disturbing to me.

Real or not real?” whispered the voice in my head.

I could feel myself slipping.

My partner could tell and finally asked me what was wrong.

I don’t know if I’m going crazy, or if I’m just about to get my period,” I shamefully admitted to him.

I hoped to wake up to blood this morning — an explanation, a sign that my madness was coming to an end and everything would be alright soon.

But there was no blood today.

It always comes eventually. Rarely, if ever now, does my mental health slip so drastically for no apparent reason besides when I’m PMS-ing. It’s the obvious explanation, but without a predictable monthly cycle, I really have no idea. Each time it happens, I’m convinced I’m losing it. Each time, the feelings leave with the tide and I am returned to normal a few days later. My cycle is as mental as it is physical.


Despite the fact that half of the world is female, our health and biology are still considered “different” — male bodies are the default, and women are ignored by medicine.

Clinical trials for medicine often exclude women entirely. The reason, according to Dr. Natalie DiPietro Mager, is because women are considered too hard to study.

“It was also far easier, many scientists believed, to design and conduct a study composed of only or mostly males, being easier to study because, unlike women, they weren’t subject to frequent hormonal changes.”

Yet, these differences in women’s hormone cycles have real consequences.

Why, as someone with a degree in psychology, did I never learn about how my reproductive cycle could influence mental (and, therefore, physical) health?

Why did none of my therapists ever try to help me learn to address this?

Why did I have to figure this pattern out on my own?

Why am I still stuck wondering every time if these feelings are “real or not real?

Of course, feelings are “real” if you have them and the same coping mechanisms and skills I learned in therapy apply when I’m PMS-ing, too.

Yet, this experience should be talked about. There shouldn’t be shame in admitting that I struggle with my mental health when I PMS. Women’s hormonal cycles are an intimate part of our lives, deeply connected to our daily experiences. We can’t afford to ignore this piece of data.

Women need to be able to not only talk about these experiences but have medical professionals who are equipped with answers — because women’s bodies are real.

Fearless She Wrote

This is a space to empower differences, tell our stories, and share our lives together. We will not be silenced. We will be fearless. And we will write.

M. K. Fain

Written by

M. K. is a feminist writer with a background in grassroots activism and psychology. http://marykatefain.com Support on Patreon: https://www.patreon.com/mkfain

Fearless She Wrote

This is a space to empower differences, tell our stories, and share our lives together. We will not be silenced. We will be fearless. And we will write.

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