10 Ways PMDD Can Ruin Your Relationships

I’m sorry for the things I said when I was suffering

In late-2019, I began to suspect something was wrong with me. It was an internal change that I found difficult to articulate to anyone else. Efforts to explain what was happening to my then-partner failed spectacularly. There was no way for me to communicate what was going on — or for him to understand what I was trying to say when I didn’t understand it myself.

I can’t credit PMDD entirely with ruining that relationship, but it certainly didn’t help. Premenstrual Dysphoric Disorder (PMDD) can ruin lives and relationships, and yet, it’s often dismissed as female histrionics rather than a real and debilitating chronic illness.

PMDD has changed my life, and I’ve begun to openly talk about how. It’s under-researched and under-funded and will remain that way until there’s a better understanding of how this disorder is harming women.

It’s not just harming women though. It also negatively impacts our relationships with partners and children, our workplace relationships, and every other important relationship in our lives. Here are 10 ways that PMDD is wrecking our relationships.

#1 PMDD sufferers are easily irritated.

PMDD is a cyclical disorder that usually begins on the 14th day of the 28-day menstrual cycle each month. It can last about 10 days on average. During this time, people who suffer from PMDD are easily irritated.

It’s easy to see how this can impact relationships. During a PMDD phase, things that would normally not bother me at all become intensely irritating. It can cause a bad mood and be unpleasant to be around. I often feel like my absolute worst self during this time.

#2 PMDD sufferers can be cyclically suicidal.

PMDD is often mistaken for severe PMS, but it’s so much worse than that. People with PMDD are often suicidal during their cycle. Think about that: it’s a disorder that causes suicide ideation every single month. This can be a devastating part of the disease for both the person dealing with it and their friends and family.

I wasn’t suicidal before my PMDD began. I had the normal, rare thought of suicide, but when my PMDD began, I wanted to die. I had no hope, no ability to change my perspective, and every desire to cease to exist. I’ve never experienced anything like it. Now, I get to experience this once a month when unmanaged.

#3 PMDD sufferers lack impulse control.

Greater irritability, cyclical suicide ideation, and a lack of impulse control make a terrible combination. It’s not a stretch to see how this could ruin relationships. One feature of PMDD is lowered impulse control. Where we can usually hold back a thought or comment, we might be more likely to speak and act before thinking, impulsively giving into the mood.

I have experienced so much shame on the other side of a PMDD cycle. Shame for my emotions, shame for things I said, shame for the ways I overreacted. Yet, every month brings with it the same symptoms and the same struggle. The shame, too, is cyclical.

#4 PMDD sufferers have heightened sensitivity to rejection.

To make matters worse, people with PMDD are more sensitive than usual to rejection. Many words and actions can be interpreted as rejection when someone is in a PMDD cycle, so partners should take note. It may not seem rational. That’s because it’s not. It’s a part of the disorder and one that may have us overreacting to situations that normally wouldn’t bother us.

I can definitely see how this heightened sensitivity played out in my own relationship. I would reach out for a connection, and my former partner’s busy day could feel like a rejection rather than a scheduling issue. While that might not bother me on a normal day, it would feel like the end of the world (and the relationship) on a PMDD day. It can be embarrassing to reflect on, but the more I understand the disorder, the more self-forgiving I am.

#5 PMDD sufferers experience debilitating pain.

I can’t ever decide if the moods are worse than the pain or if it’s the other way around. Both are equally awful. Once a month, I become a person who has no energy, no motivation, and no ability to tolerate the pain my body feels. I spend several days curled up around a heating pad popping over-the-counter pain relievers in hopes of experiencing some relief.

This pain can impact relationships, too. It’s not easy to partner with someone with chronic pain. We’re put in the position of having to prioritize our pain and moods, and as a result, we can often fail to show up for others in the way that they need.

#6 PMDD sufferers often experience brain fog.

While brain fog doesn’t seem as serious as suicide ideation, it can also contribute to ruining relationships. When we have a hard time thinking straight or focusing, it can be tough to be a good listener in relationships. As a result, other people may feel invalidated or unheard.

During these times of the month, our care becomes very specific. I have certain routines to take care of my mental and physical health. Self-care is the order of each day, and I try to minimize my interactions with others when brain fog is present. Most of the people who know me understand this happens sometimes, but it can be hard for a newer relationship to understand there are times I need to check out and care for myself.

#7 PMDD sufferers can experience a loss of interest in their usual activities.

PMDD’s mood disturbances can create a lack of interest in the activities we usually find pleasurable. When I’m experiencing a PMDD cycle, I don’t want to watch TV or read or go out with friends or do any of the things I normally love. I want to sleep. I want to find a way to get through the depression and pain.

This loss of interest can even extend to talking to other people. In my last severe cycle, I didn’t want to speak to anyone for days beyond what was absolutely necessary to live. I self-isolated — in part because of the depressive nature of the mood but in part because I just lost interest in trying to communicate and didn’t have the energy to summon it.

#8 PMDD sufferers may experience periods of low self-worth.

It’s taken much of my adult life to develop truly healthy self-esteem and self-worth, but a PMDD cycle can wreck all of that. It was one of the more notable symptoms in the beginning. I went from loving myself to hating everything about the body I’m living in.

It goes beyond the physical. During this low self-worth period, we can often feel like we aren’t worthy of love, deserving of affection, or even considered a good person. Reason doesn’t even come into the picture. It’s pure feeling, and it doesn’t help that the other symptoms can push away our closest relationships.

#9 PMDD has no cure and occurs every single month.

One of the worst ways that PMDD ruins relationships is that it’s incurable and occurs monthly. Our worst selves keep coming back no matter how much we want them to go away. I’ve found I have severe anxiety right before the onset because I know what’s coming, and even with treatment, I can’t make it stop.

Sadly, the medical community seems satisfied with the “wait until menopause” mentality. Of course, it’s not impacting their relationships and day-to-day life. This chronic illness is extremely debilitating, and it can be a lot for partners, friends, and family to handle. It takes love, patience, and a willingness to understand that the disordered behavior is often beyond our control.

#10 Many PMDD sufferers are unaware of the condition and remain undiagnosed and untreated.

Premenstrual Dysphoric Disorder affects 3–8% of menstruators, but that number is likely a low estimation, as many people who suffer from PMDD are not diagnosed. People who remain undiagnosed and untreated are likely sabotaging their relationships without even knowing it. The symptoms are severe and shouldn’t be mistaken for PMS.

My treatment consists of antidepressants taken cyclically, vitamin and herbal supplements, chiropractic care, mental health therapy, and monthly massage for my pain. Of these treatments, my insurance only covers the medication and related doctor’s visits. I understand that it’s a privilege to be able to pay out of pocket for the remaining expenses only because I was not able to do so for the first two years of my disorder.

While these treatment options certainly help, they don’t stop the PMDD from coming. I don’t feel suicidal when I take my antidepressants, but I still have some depression, anxiety, and low energy. I go to therapy, but I still have periods of low self-worth. Chiropractic and massage care are much needed, but I still experience pain. PMDD continues, and I must continue, too.

What To Do If You Suspect You Have PMDD

Chart your daily moods for a period of 2–3 months. This will help determine if there is a pattern. This is one of the primary ways PMDD is diagnosed. I tracked mine by coloring days on a calendar to represent mood. After two months, a clear, cyclical pattern emerged.
Make an appointment with a gynecologist who can assess your symptoms and rule out other factors. My gynecologist took me through an extensive differential diagnosis to explain how she arrived at this conclusion.
Make an appointment with a therapist, if possible. Therapy is one of the most impactful choices I made for myself during this time. Having someone to listen and help support the journey was essential. I began seeing a therapist even before I was formally diagnosed.

What To Do If You’re In a Relationship With Someone With PMDD

Be patient. The symptoms usually pass around the onset of the period. Understand that these aren’t behavioral choices as much as massive mood disturbances that are difficult to control.
Communicate. Learning to be an effective communicator is important for the person with PMDD and the person who chooses to partner with them. Being able to talk through what’s happening can help alleviate some of the anxiety.
Offer comfort. While some sufferers want space to isolate themselves, others want as much comfort and reassurance as possible. If you’re not sure, ask what they need and how you can help.
Take what we say with a grain of salt … and shot of tequila. We’re going to be more emotional during this time, which means overreactions aren’t just possible but probable. Never be dismissive of these feelings but remember that they don’t represent how we really feel most of the time. Rather than getting defensive or responding in kind, try to be aware of the extreme emotional highs and lows that come with the illness.
Just be there. One of the worst feelings was trying to communicate the problem to a partner who thought I was just being self-centered while he was having a bad day. He would distance himself at times that I was desperately seeking affection and reassurance. While neither of us realized the underlying factors, I can look back and see how this illness undermined the health of that relationship. The most impactful thing a partner or even friend can do is to be there for us when we feel like our worst selves and don’t even want to exist anymore. Remind us of who we are until we can be that person again.

PMDD is a debilitating condition that can wreck our mood and also our relationships. It’s a devastating chronic illness that is often dismissed as run-of-the-mill PMS. It’s like self-sabotaging our relationships when we don’t even feel like ourselves. With a better understanding of the illness, there’s hope for our relationships. Maybe one day, there will even be hope for a cure.