I recently passed my one year anniversary of being diagnosed with PMDD. It is crazy to think back and reflect on all the ways I have tried to handle this condition. I have tried every diet, workout, supplement and lifestyle in the book. I have handled the frustration of well intentioned people telling me to ‘try working out more’, or ‘maybe you just need to get outside’, or my favorite, ‘just decide to be happy today!!!(??)’. And I have also learned to handle the days where I just cannot go on. The days where I am afraid of my shadow, where my husband looks like a stranger and all I can do is hide. Because the truth is, my condition has morphed. It has taken a lot of love and respect, but I am slowly starting to make good friends with me. Slowly being the operative word in all of this.
For those of you who may be new to the blog and need a little background, I have previously spoken about the early days of living with this condition here.
PMDD is a condition like no other. It is a terrifying, faceless disorder that apparently affects 3-8% of women. However, I am sure that that percentage is much higher. We as a society still have to work to free ourselves of dangerous stereotypes about hormonal women. I believe that there are a lot of women who have to deal with the mental struggles of this condition whilst being labelled as ‘crazy’ and ‘PMS-ing’. I am here to say that it is not normal to lose a third of your time to mental darkness. You are not just a ‘crazy woman’ if your periods cyclically deliver you a new, terrified personality. There is something deeper going on that needs to be understood.
By far the most terrifying part of PMDD is how poorly this condition is understood. I have learned to explain it as an intolerance to my natural hormonal swings, because that is about the extent of the research done on it. I recently read a systematic review of studies done on the effect of cognitive behavioral therapy on PMDD. It was found that the body of work was not rigorous enough to conclude anything solid.
The lack of research done in this condition has stalled many women’s recovery. I remember finding a paper on taking an off label medication for PMDD that had overwhelmingly positive results, but a small study cohort. Because of that, my doctor was understandably not comfortable putting me on that medication.
Personally, the only thing that has ever helped my PMDD has been getting on antidepressants. I trialed a few SSRI’s before I landed on my current one, and it has completely saved my life. I went from having ten day long stretches of major depression, anxiety and lethargy, to no extreme mental fluctuations. I still get mild PMS and all the feels. But that is a welcome change to what I used to go through. I no longer have to count the days before I ovulate to know exactly when I will need to go into hiding, and stop living freely. My life is far less scary.
This is not to say that I am cured. I just came out of a bad cycle, my first in six months. There are a few reasons for this, but the key one was that I got complacent. Even though my life has been saved by getting on a low dose of SSRI, I still have to fight those voices in my head (and in the world at large) that tell me I should get off my meds. The stigma attached to taking antidepressants drives me insane, and I have fallen prey to it at times. I take my medications year round, and after I ovulate I increase the dose until I am out of my danger zone. This cycling takes the edge off my worst days, and allows me the mental space to see the forest for the trees. But for the last couple of cycles I chose to not increase the dose. I wanted to see if could handle my condition on the lowest dose possible, with the intention to taper off completely.
It didn’t work. Each cycle got progressively harder to handle, but I managed to work through the pain. Until three weeks ago, when all hell broke loose in my head.
One morning I woke up and went to a group meeting. When I went to speak, I just cried for two minutes straight instead. I left the meeting, and sat in the street bawling. I then went home to my husband, and cried for the rest of the day. I had to spend the next three days keeping an anxiety attack at bay, hiding in my house. If I did anything that required me to show up in any way, I would panic. My body in the mirror ballooned. I stopped wanting to eat.
So, I increased my dose, as my doctor had prescribed for me. And in a couple of days, I got that wonderful mental space from PMDD.
Antidepressants have saved my life. They have not taken away any of the emotions I normally feel, nor have they made me a zombie. All they did was give me the space to show up to my life. I am eternally grateful that they work so well for me. I know that this is not the case for everyone. However, alongside exercise and a careful diet, I can keep the worst of my condition at bay.
But it is still an un-researched and un-heard of condition. I think the biggest blessing of my life with PMDD is acceptance. I am fully aware that I may not be able to go off my medication until I finish going through menopause. And that the time between now and then will cyclically get rough. I am also aware that everything changes, and I may improve over time. With this acceptance has come comfort in talking about my experiences. Last week when I was having a bad time of it, I was able to reach out to everyone who needed something from me and explain that I could not step up until I got my period. Definitely a strange thing to hear from a business partner.
But you know what?
Everyone met me with love and understanding, and gave me my space. I was able to recover much faster, and return to my life with strength.
PMDD has really cemented my beliefs that I am the luckiest person in the world. I get to be surrounded by people who love, support and respect me. In a way, it is my burn out indicator. I go hard in all aspects of my life. When my heart starts to pound over what I want to eat for breakfast, and that voice tells me I am worthless, I know that it is time to step back. The world won’t stop spinning. I can go to bed and get 12 hours of sleep. I can watch bad TV.
Basically, there is space for me to recover. Being open and honest about my struggles has created that space. I am so eternally grateful for that. Because I know that I am not alone. And that is the biggest gift of all.
Peace and love to you all.