PMDD - Premenstrual Dysphoric Disorder

I was diagnosed with PMDD in 2019. I’d lived with this condition for most of my life, but unfortunately, it went undiagnosed due to a lack of information and understanding. Since my diagnosis, however, I have been working on building myself up to be able to live the life that I deserve to have.

What is PMDD?

Premenstrual Dysphoric Disorder is a premenstrual condition that affects 1 in 20 cycling individuals (anyone who ovulates). 

  • Premenstrual - before the period

  • Dysphoric - the opposite of euphoric and means a state of difficulty

  • Disorder - defined by Google as “a confused or messy state” (which I actually think is very accurate!)

    So PMDD = a difficult, confused and messy state before a period!

You’ve probably heard of PMS (premenstrual syndrome) – that time of the month when a person may feel more emotional than usual, suffer from stomach cramps and so on. PMS is not thought to be debilitating - but PMDD can be disabling. 

Being cyclical, symptoms of PMDD generally begin shortly after ovulation – (around day 14 of the menstrual cycle) and tend to stay until around day 1-3 of the next period. However, this will vary from person to person.


Symptoms:

The main symptoms of PMDD fall under the emotional or mental bracket, and they can include anxiety, depression, tension, feelings of despair and hopelessness, and sometimes, suicidal ideation. 

Some people will also suffer from physical symptoms, including headache, sickness, bloating and breast tenderness. Other symptoms can include brain fog, exhaustion, insomnia, and binge eating.

PMDD AND ME:

I was asked recently what my first experience with PMDD was, and honestly, I have no idea! For lots of people, there’s a huge moment when they experience symptoms for the first time and know straight away that something isn’t right, but because I’ve been battling PMDD for half of my life, I guess I never knew what was normal and what wasn’t for hormonal health. 

There was a time when I wondered if I had Bipolar Disorder, as I couldn’t work out why my symptoms came and went, but after doing some research, I knew that Bipolar Disorder wasn’t quite the right fit for what I was experiencing. At this point, I started to blame myself for my fluctuating mental health and would blame my harder days on my increased binge eating or my lack of exercise, telling myself that I was being an attention seeker and a drama queen.

My symptoms can range from impulsivity to binge eating, to depression, to a feeling of grief. No two months are the same, but one stand-out symptom for me that occurs each time is I am always self-deprecating and so unbelievably hard on myself - “there’s nothing even wrong, you’re just being dramatic…” and, “Maybe if I had kept up with my running, and ate healthier, I wouldn’t be feeling like this….”


I had my “PMDD lightbulb moment” in 2019 when I stumbled across a post about it on social media. I related to all of the symptoms listed in the post, and after doing some research and keeping a journal for six months, I was finally diagnosed with PMDD. Knowing that, actually, it isn’t your fault and that there are other people out there who understand wasn’t just life-changing. It was life-saving.

My Toolkit:

There is currently no ‘cure’ for PMDD, but there are lots of treatments/interventions that can help reduce symptoms or make them more manageable - I recommend visiting IAPMD - The International Association of Premenstrual Disorders to read about this in more depth, and you should always speak to a medical professional before you consider altering your medication.


Treatments for PMDD can be traditional “Western” medical approaches like certain hormonal contraceptives and antidepressants, lifestyle and holistic approaches, and at a later stage, more invasive treatments (for those who have not responded to the ‘first line’ treatments) - such as chemical menopause or even surgery to remove the ovaries.

There is no ‘one size fits all’ approach or solution, and everyone will react differently to these options - as well, of course, as having their personal preferences. 


Personally, I don’t believe we have to choose one approach and stick firmly within its boundary. What suits me is having a whole toolkit available to support me through my symptoms and through the ‘putting-myself-back-together-again’ phase afterwards. Here are some of the steps I use that I currently find help me live through a life with PMDD:

  • Ownership and accountability - I have a chronic medical health condition. It’s real, and I did nothing to deserve to have it….that doesn’t make me a victim. It means that I have to manage my condition if I want to enjoy my life.

  • Antidepressants - specifically luteal phase dosing of fluoxetine.

  • Fresh air - Getting outside every day, especially first thing in the morning. I have two dogs which help me get out and about!

  • Gratitude - practising gratitude regularly makes it easier to dig deeper on the hard days.

  • An overall healthy lifestyle - without putting pressure on myself, I know that if I eat well and keep relatively active, it has a positive impact - especially on my physical symptoms.

  • Cyclical Living - I’m so lucky with my work that I get to choose what days I work. That means not taking on work on the days when I know I’m most likely to struggle and, instead, approaching those days with a “low-battery mode” approach.


But the main one I have to make sure I practise is self-compassion - none of the things above will work if the self-compassion isn’t there. And when you live with a mind that wants to destroy you for half of each month, a little self-compassion goes a long way.


This is just an introduction to PMDD and my experience of living with it. If you’d like to hear more about then give the My Hormones My Health podcast a listen, or get in touch. For more in-depth information, go to iapmd.org.