For Better or Worse: Life with PMDD

I’ve had to learn self-compassion for me at my worst

I remember exactly when it all began. I was at the ballet, and everything shifted. I knew that something was wrong, but I had no words to adequately describe it. Still, I tried. I called my then-partner and tried to find the words to describe what was happening — how one moment I was perfectly content and the next the joy leached out of the room and took me out of myself. He didn’t understand, and I couldn’t explain it.

This was very likely the first sign of Premenstrual Dysphoric Disorder (PMDD).

Over the next year, I would continue to struggle with monthly occurrences of pain, depression, anxiety, and suicide ideation. I had gotten everything I wanted from my life. I had the career of my dreams, two beautiful children, and a partner I loved deeply. But the bottom had fallen out and kept falling, and I couldn’t understand why.

In a plot twist I didn’t see coming, it was a subscription box that helped me solve the mystery. Therabox, a self-care subscription box company that sends wellness and beauty products, included a mood tracking journal in one of their boxes. What made this journal different was that it required that I color in spaces based on each day’s mood. Soon, a pattern emerged. After three months of tracking, I could clearly see a 10-day period where my joy simply evaporated, leaving me in despair. Every month, repeating exactly like the month before. In full color, the pattern was easier to see, and it pointed me directly toward the diagnosis.

Of course, I had a full range of other PMDD symptoms. I would have angry outbursts, poor impulse control, a loss of interest in my life, cramps, severe bleeding during menstrual cycles, bloating, irritation, anxiety, difficulty concentrating, sleep disturbances, forgetfulness, headaches, and appetite changes.

Even though I recognized the symptoms and identified their connection to my menstrual cycle, I still had trouble obtaining a diagnosis. The first gynecologist I talked to dismissed my concerns, pointing to my mental health instead. Since he also expressed the opinion that women don’t struggle with hormonal issues, I sought a second opinion — and walked out of that second appointment with the right diagnosis.

By that point, I’d been suffering for well over a year. I had spent a year as my absolute worst self. My emotions were unstable, my anger was often palpable, and I found myself in therapy when I knew I could no longer manage on my own. My relationship had ended, and the suicide ideation was still a regular feature in my mood changes. I was barely holding it together, and yet I functioned on the outside as if everything was as it always had been.

It can be difficult for anyone on the outside looking in to see that we’re struggling when we keep functioning in many of the same ways we did before. My work got done, and my children were taken care of. Yet, I had moments of standing in my house screaming because I had a buildup of pressure with no release. I had evenings where I stared blankly at walls because I couldn’t summon interest in any of the normal activities I enjoyed and patiently waited for an hour late enough to go to sleep. I cried more than I ever have, and sometimes, all hope left me. I minimized social interactions and just kept moving, hoping that things would get better.

I’ve had to learn self-compassion for the version of me that was suffering from something as-yet undiagnosed. I knew that something was very wrong, but I didn’t have the language to adequately describe it or the tools to help myself manage it. I didn’t even know how to ask for help — or what help I really needed. I did the best I could, but I spent the whole time feeling like my best fell far short of what was needed.

PMDD is treatable, but there’s not a cure. I’ve taken a holistic approach to my care. There’s not one single treatment that has been entirely effective. Instead, I’ve had to address individual symptoms in hopes of feeling better.

Nutritional Support

I’m still learning about how to support my diagnosis with nutrition. I’ve read that decreasing caffeine, salt, sugar, alcohol, and processed carbs can help while adding complex carbs, small meals, and more fruit and vegetables to the diet. Because appetite fluctuations come with PMDD, I’ve started with drinking more water and making healthier food choices. Figuring out which foods help and which hurt will be an ongoing process.

Nutritional Supplements

There is some evidence to suggest that taking Vitamin B6, Magnesium, Calcium, and Vitamin E can help ease the symptoms of PMDD. My gynecologist recommended each of these as being potentially helpful in treating my symptoms. Suggestions for dosage vary, and it’s best to consult a doctor before beginning new supplements.

Herbal Remedies

Herbal remedies like evening primrose oil, chasteberry, and ginkgo have been shown to support PMDD symptoms. Other recommendations like St. John’s Wort can have negative interactions with the SSRIs recommended for PMDD treatment.

Therapy

I still see a therapist. I would absolutely recommend this treatment for anyone suffering from PMDD, particularly when it presents with depression, anxiety, and/or suicide ideation. Therapy is an effective treatment and can be paired with any of the other treatments for PMDD.

Antidepressants

SSRIs are often recommended as treatments. I take Zoloft only during my monthly cycle. Some doctors will recommend a daily antidepressant, but some studies have shown a dose during the cycle to be just as effective. Consult a doctor to see which treatment may work best for you.

Chiropractic Adjustments

Regular chiropractic adjustments have helped with some of the cramping, lower back pain, and headaches I experience with PMDD. I’ve experienced less pain and discomfort since I began getting regular chiropractic adjustments. While this isn’t always covered by insurance, it can be a good way to treat many symptoms of PMDD.

Thai Massage

Thai massage is also used to help manage cramping, lower back pain, headaches, and stress of the condition. Studies have shown that massage therapy can help manage symptoms of PMS and PMDD.

Birth Control

An IUD or hormonal contraceptive pills can help address heavy bleeding and debilitating cramps. I opted for the IUD for many reasons after discussing my issues with a doctor. A birth control prescription is one of the many common treatments for PMDD.

Exercise

Exercise can help ease symptoms, and I have continued to maintain an active lifestyle throughout the diagnosis process. On some days, the best I can do is walking, stretching, or other low-impact workout. When possible, I try to engage in my normal level of exercise. Staying active can decrease the pain of PMDD.

I’m only in my second month of treatment, and already I feel more myself than I have in a long time. I’m not without pain, but I’ve had so much relief. It’s not just the physical relief of no longer suffering as severely as I did before. There’s also the emotional validation of having a professional confirm a suspected diagnosis. No, I am not crazy. I have simply been managing the changes in my body to the best of my ability.

I have so much love for the people who stayed with me when I was at my worst. So often, we think of “for better or worse” as being marriage vows, but all the relationships in our lives will see us at different stages. Some go the distance. Some quietly exit stage right.

I wasn’t at my best self over the last couple of years, and yet people loved me through it. It’s taken me a little longer to love myself through it. Every month, I experience moving from peace and joy to a mutiny within my body. It’s uncomfortable, but by managing the symptoms, I’m able to get through to the other side in a cycle sure to repeat itself until my body eventually goes into menopause.

It is discouraging at times, but I have a team of professionals currently providing treatment. I’m also doing what I can to take good care of myself through the ups and downs of PMDD. I still have days that are tough, but I don’t feel alone in it anymore. I know that there’s a real problem — just as I first suspected when I had the feeling but no words to describe what was happening. I trusted myself, and even though it took a while to get a diagnosis, I kept going until I got help.

Help will be ongoing. I’m grateful to have it. I’m learning to be more mindful of what my body needs as I experience the fluctuations that come with PMDD. I’ll keep being proactive with self-care and loving myself through the process — for better or worse.

The above information is for educational purposes only and does not constitute medical advice. If these symptoms are familiar to you, please consult a healthcare provider.