Premenstrual Dysphoric Disorder Is More Than A Bellyache And A Bad Mood

flickr/Evil Erin

When I was in college, a friend told me that she didn’t get menstrual cramps because she exercised. As she spoke those words, I pictured high school me running an eight-mile race on the cross country team, blood spilling into my giant pad while I tried to ignore the pulsing uterine pain that made me want to double over right there on the trail.

High school me wanted to reach into the future and punch this friend in the face.

I can’t remember exactly when I got diagnosed with premenstrual dysphoric disorder, also known as PMDD. But I do know that out of all my mental health issues, PMDD is the one that brings me the most internal shame. This is largely due to misinformation about what exactly it entails. It also has to do with the taboo subject of periods themselves.

Many menstruating people get PMS to varying degrees. This of course includes bloating, cramps, and some irritability. With PMDD, however, these symptoms are on overdrive. One woman I spoke with says of her symptoms, “The week before my period every month, I feel like I am losing my grasp on reality. It feels like the whole world is out to get me and everything possible goes wrong. I’m anxious and clumsy. I make stupid mistakes and I feel like everyone hates me.” Another says, “It’s more debilitating than people imagine. It’s not just a little bit of a bellyache and a bad mood.”

I began noticing my symptoms when I was about 19. Every month like clockwork, I’d fill with despair and start sobbing uncontrollably about the thought of losing my then-boyfriend. Month after month, year after year, I wasn’t able to control these emotions, even though I knew what caused them and exactly when they’d arrive. I’d often sabotage friendships and make a myriad of work-related faux pas. And with the advent of the internet, my paranoia wasn’t just limited to internal melancholy or face-to-face interactions. I’d start emailing whomever I was “sure” I was about to lose that month. After each email, I’d email again, caught up in a vicious cycle with no end (that is, until my hormones finally subsided):

2 p.m.: “I’m feeling anxious about our friendship / our relationship / my job.”
4 p.m.: “Are you mad at me? I’m sorry if I upset you.”
4:15 p.m.: “I realized I shouldn’t have brought anything up. I get like that sometimes.”
4:45 p.m.: “The thing is, I have anxiety.”
6 p.m.: “That was probably too much information. Just forget I said anything.”
7 p.m.: “I’m really sorry about bombarding you with all these emails.”
7:15 p.m.: “I really do have anxiety though.”
7:45 p.m.: “Are you still there?”

Of course, many of these emails would be paragraphs in length. Sometimes the friend, potential partner, or business associate would start to see me through pitying eyes. Sometimes they’d walk away for good.

At the height of my PMDD paranoia, I walked to the grocery store in my small college town and saw the truck of a love interest who had played hot — but mostly cold — for months. Sane me would have read his silence as disinterest. Paranoid me was desperate to reconnect in any way possible. So I sat on a bench near his truck for what seemed like an eternity, then I left a note on the windshield and continued on my way to the store. On the way back, I saw his truck turn left and ramble down the road. With arms full of groceries, I ran as fast as I could and screamed his name in desperation. I never heard from him again.

My PMDD isn’t as bad as it used to be, largely due to the wonder of antidepressants and the hormonally stabilizing effects of birth control. But while I don’t agonize much over connections anymore — and don’t find myself wanting to randomly drive off a bridge — my brain still changes in other ways. Whatever room I’m in seems darker, even though it’s just as lit as it’s always been. My legs and arms get sluggish, and I see the world through slightly blurry vision. Oftentimes it feels as though a Mack Truck is sitting on my forehead, and I can’t read anything unless it involves simple language. I’m a hazard on the road. I sleep 12 hours at a time. I speak in a monotone and strangers on business calls have no idea what I’m saying. They ask me to repeat my words until I give up and hang up the phone.

When I worked normal jobs, the PMDD would, as the above might suggest, often interfere with my performance. I’d have to call in sick at least once a month — usually more — as my symptoms also come with ovulation (which occurs two weeks before menstruation). It’s a difficult task to tell a male employer that the blood getting ready to rush out of your body is making it difficult to come in to work. It’s hard to step into a room of 15 middle schoolers and not get overwhelmed by the motion and noise, when even one-on-one conversation seems like too much auditory stimulation.

After missing too much work at my last job, I turned in my resignation and started freelancing from home. It’s amazing how not having to apologize for my body on a regular basis has transformed my self-worth. One woman with PMDD tells me, “I work from home as a freelance writer, which makes it a little easier. I would very much struggle to be in an office environment with PMDD and then during periods (which are very heavy and uncomfortable). I am almost entirely unproductive during the week leading up to my period — now that I understand and recognize that I don’t fight it. I use that time for admin tasks, filing, and being kind to myself rather than trying to complete big projects or be creative.”

Of course, it’s not just work that can be difficult during this time. My friendships also go through a period of stages — pun intended. If it’s a new friend and plans fall on a bad day of my cycle, I’ll tell her I’m sick, or that I have sleep apnea, which is also true and also impacts my energy. As I begin to test the waters of our friendship, I’ll eventually tell her when I’m in a “zombie” state due to my period. Once she gets into my inner circle, I’ll explain that my body doesn’t work like most others. Even then, friends don’t really grasp the extent of my transformation unless they see me in person when I’m on the verge of keeling over.

One woman says about her own struggles with transparency, “I don’t want to feed into that stereotype of women being moody around their periods, so often I use other excuses for why I’m not feeling well. Which isn’t difficult because I have chronic health conditions that I can always blame instead of talking about my period or my mental health.”

On a monthly — and sometimes daily — basis, I struggle between transparency and shame. Like the woman above, I too fear that my symptoms perpetuate the “weak female” stereotype. That friend of mine from college who “doesn’t get cramps” because she exercises most definitely believes that women have control over the physical pain they’re willing to endure. However, those of us with the “gift” of heavy periods and their accompanying complications know there’s no easy way out of our experiences, no matter how many miles we run in an effort to escape them.

And the truth is, it is a gift. Or at least it does me no good to think otherwise. My body is a feminist body. I ride the waves of the ebb and flow, nurturing it during times of needed rest and channeling its powers during times of strength. I’m not less than the male body. I’m not a dysfunction of the female one. I am someone who lives, works, and loves to the beat of her cycle. It’s a requirement — but it’s also beautiful.

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