Living with PMDD
In March 2020 I was diagnosed with PMDD (Premenstrual Dysphoric Disorder). PMDD is similar to PMS, but more extreme. Symptoms can include irritability, depression and anxiety that start one or two weeks before the start of a period and then fade a few days after periods start. I lived with severely anxious and depressive episodes with no explanation for over a year. During those episodes I hated my life and had thoughts of running away and never coming back. When I started therapy in November 2019, my therapist and I started closely monitoring when my anxiety and depression were at their worst. We discovered a hormonal correlation and that I met all of the criteria for having PMDD. Officially knowing that I have PMDD and that I wasn’t just “crazy” changed my life. I felt empowered to manage my life again. I dove deep into understanding my body and emotions. Now, after a year of living with PMDD, I have an idea of when it is kicking in and I can prepare ahead of time. My PMDD still causes me to have depressive episodes with a lot of anxiety, but I’m able to give myself grace.
*Disclaimer! I am not a medical professional. If you believe you are struggling with PMDD or depression, talk to your doctor right away!*
My PMDD Diagnosis
I struggled quite a bit after my pregnancy with my second child in 2018. About 3 months after she was born I started to struggle with depressive episodes. I didn’t have energy to do anything. I’d barely get off the couch to go to the bathroom. I attributed my issues to postpartum blues and seasonal depression because it started in the fall and was worse throughout the winter. As the seasons changed to Spring and Summer my mood improved overall and I felt like I had more energy, but I was still having issues. I would go for a week or two of not getting off the couch and just hating my life. After struggling for over a year I decided that I needed to start seeing a therapist. I started therapy in November 2019 and went bi-weekly for the first few months. My therapist noticed that I was very different from session to session and had me start tracking exactly when I felt at my emotional worst. I’d already noticed that it seemed to correlate with my monthly cycle, but her encouragement to follow that gut validated that thought. After 3 months she and I sat down and went over the clinical symptoms for PMDD. Those symptoms, according to the National Institutes of Health, include: exaggerated changes in mood (mood swings, suddenly feeling sad/tearful), increased sensitivity to rejection, irritability or anger, depressed mood, feeling hopeless, self-deprecating thoughts, anxiety, feeling like you could crawl out of your skin, decreased interest in usual activities, difficulty concentrating, lack of energy, food cravings, insomnia, feeling overwhelmed or out of control and physical symptoms like breast tenderness or bloating. I had all of those symptoms (except one) about a week or two prior to my period almost every month.
My next course of action was to talk to my GYN about my symptoms. She sat down with me and went over all of the information that I had logged. She agreed with my therapist that I had PMDD and discussed a few options for treatment. I don’t take hormonal birth control, and wasn’t interested in starting it, so my GYN suggested that I try taking a calcium supplement. She also recommended daily aerobic activity. She said those were two of the most effective treatments that she had seen in her other patients with PMDD. My therapist also had a few treatment suggestions, like a light therapy lamp. I now take a daily calcium supplement and try to spend at least 20 minutes in front of my light therapy lamp, if I don’t go outside that day. I do not get my 45 minutes of aerobic activity in every day, but I do try to go for walks or workout a few times a week. I’ve noticed a huge difference since starting the calcium and it has also helped with my period cramps. I used to have the worst cramps before I started taking the calcium. (Talk to your doctor before starting any kind of supplement!)
Scheduling Life Around My PMDD
The biggest help for me in managing my PMDD though was when my therapist suggested that I schedule my life around my monthly cycle, since I roughly know when my PMDD symptoms will start. This suggestion came from me feeling utterly hopeless about accomplishing tasks or goals. This included DIY projects, time with my family and working on the blog. My therapist recommended that I schedule all of my blog writing, projects and creative endeavors for the time of the month when I wasn’t plagued with PMDD symptoms. That way when my symptoms started I could take the time I needed without feeling frustrated or behind. She also suggested that I spend my non-PMDD times taking the girls out places or doing activities with them. That way, when my PMDD kicked in, I could just watch movies on the couch with the girls (mostly) guilt-free. Activities like going out with friends, or having date night, helped my PMDD symptoms. Probably because I’m a very extroverted person. I schedule a lot of those events to happen when I’m usually feeling the most down, because they help me feel better. I also use that time to get sucked into a book, or binge a show. In fact, I now usually reserve reading for during my PMDD so that I can be productive the rest of the month.
The idea of scheduling your life around your period isn’t just for women with PMDD either. There is an amazing episode of the Live Free Creative podcast called Flowing with Your Seasons with April Davis of The Vagina Blog. In the episode, Davis talks about treating your monthly cycle like the yearly seasons. So the cycle starts with your period, that’s Winter. Winter is for resting, eating good food and being cozy. This could also be a time to plan for what the rest of the month will look like when you aren’t so tired. Then, your period ends and the season changes to Spring. You may have more energy during this time, so it’s a great time to tackle projects and work. Summer is full of more energy and is a great time to ramp up workouts or get moving in general. Then Fall starts and it’s time to prepare for Winter. Wrap up projects, buy some extra snacks and start slowing down. The first time I heard this it sounded a little Hippie-dippy to me, but as I thought about it the more I realized that it was true. While my body doesn’t honor the Winter, Spring, Summer, Fall order as far as energy and emotions are concerned, it does follow it’s own repeating cycle month after month. I know that about half-way through my period I start feeling energetic again. I want to work out, eat healthy food and get shit done! Then around Day 14 of my cycle I start feeling anxious and hard on myself. I follow my body’s lead and decide day-by-day what my evenings will look like. Some days I’m very productive during this time, but I also have days when I just watch a movie and go to bed early. Around Day 25 I start feeling very tired and extremely grumpy. Everything pisses me off. This is when I order all my favorite foods, buy a new book and make sure my blog content for the next week is on auto-pilot. When my period comes I just give myself permission to do nothing for a few days. The kids watch more TV, I eat a ton of junk food and I sleep a lot. Then a few days later, I’m me again.