Understanding PMDD
So what is PMDD? So let me start with a definition from the International Association For Premenstrual Disorders.
“Premenstrual Dysphoric Disorder (PMDD) is a cyclical, hormone-based mood disorder with symptoms arising during the premenstrual, or luteal phase of the menstrual cycle and subsiding within a few days of menstruation.”
In other words, if you have PMDD, your symptoms are present and really, at its worse during the 10-14 days before your period. Once your period starts, though, the symptoms tend to go away either immediately or within a few days of your period starting.
Now there’s no test to diagnose PMDD and it’s important to see a doctor if you might think you have PMDD because they are able to run tests to rule out any underlying causes.
To really diagnose the condition, you will need to track your symptoms daily for at least 2 menstrual cycles. And then, you’ve got to meet the criteria for the diagnosis as well.
Info on Diagnosis & DSM-5 Diagnostic Criteria
A common way that PMDD is described is that it is a severe form of PMS. Is it the same thing though? The simple answer is no. Many of the symptoms of PMDD is like PMS. However, if you have PMS, the symptoms are typically less severe than that of PMDD. Now about 80% of women experience some forms of PMS and that is more common than PMDD which affects about 5% of women. PMDD is also classified as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders also known as the DSM-5 for short.
How I was diagnosed with PMDD
I really started noticing my periods getting really bad in my early to mid-twenties. The cramps were debilitating to the point where I could not get out of bed if I did not take any ibuprofen or something to manage the pain. I’d literally be curled up in a ball, balling my eyes off. And I remember, I just felt one, very alone in my pain. I felt that, although logically I knew I was not alone, I still couldn’t help feeling that way. I also oftentimes felt like a crazy person – not really sure how else to describe it – because I knew I felt terrible, depressed, hopeless, and just all of these things for a certain amount of time and then next thing I knew, I felt better and this was before I knew it was cyclical and before I made those connections. I didn’t understand what was going on at the time.
Like others with PMDD, it was like 1 week was excruciatingly difficult while the other weeks felt like cleaning up after the mess/fallout of what happened in what others describe as the “hell week” to only repeat it every single month. For others, I know suicidal ideation or thoughts come up and fortunately for me, that was not the case.
At work, I noticed that I would start to get anxious. I started having panic attacks when I had no prior history of them. I was starting to have trouble focusing and concentrating at work. Issues that would not normally set me off, would. If anything stirred me up emotionally where I would end up crying, it would be these crying spells that I could not stop which made it difficult to pick myself up, compartmentalize, or keep it together.
One day, I just about had enough. I was sick of feeling the way that I did and was so exhausted. Honestly, I wanted to take more control of my situation and life. One of my biggest motivating factors is this sense of responsibility to myself, but to the relationships I have in my life and owning a business and having all these people depend and rely on me. Something that is said in the Maxwell Leadership community is that everyone deserves to be led well and that is something I believe in. And so, I wanted to become the leader I knew I could be and that my team deserved. So, something needed to change.
I started to do a bit more research about what I could possibly be experiencing. I came across PMDD, after going down the rabbit hole of every diagnosis possible, and definitely resonated with what I learned about it; however, I didn’t really know much about it yet and I knew I had to be sure and went to see a doctor. I was fortunate to have a doctor at the time who was familiar with PMDD and was able to diagnose me with it. I felt a tremendous sense of relief. Because then I knew. I knew I wasn’t crazy and could explain what I was experiencing a bit better. And with a diagnosis, it felt like I had a place to start tackling the problem. There’s a framework of what is happening and gave me more to work with.
Treatment options for PMDD
First-line of treatment for PMDD includes oral contraceptives/birth control pills and SSRIs. Those two options were the only ones presented to me as well. So I wasn’t aware of what else could have been effective and there also weren’t a lot of studies or resources back then either. I do notice there is a lot more information now and more studies are being done.
I started off with Birth Control Pills for about 1 year to 1 year and a half. I noticed it wasn’t as effective when I was sick or if I forgot to take a pill, symptoms took a little bit to subside again.
When I decided to go on an SSRI, I stopped Birth Control Pills. The SSRI has been the most effective for me in being able to regain stability and consistency in my life again.
I went on medication with the intent that I would eventually get off of it one day. Being on medication allowed me to focus on areas of my life, one at a time, without being overwhelmed by all the PMDD symptoms that would hold me back.
I am currently OFF of medication. The weening off process and withdrawals is a whole other experience of its own, so I do caution to think about your long-term plan of being on medication and if you have a plan for coming off of medication. That itself can take a toll on your body.
My Lifestyle Changes & Habits to Treat PMDD Naturally
I do quite a bit and this is what feels right for me and has been working so far for me. All of this did not happen overnight. Slow, consistent and sustainable changes is what I aim for! I’m also still working closely with a doctor for guidance & assistance in my health journey.
SLEEP - working on good sleep hygiene. Sleep has a huge impact on your MOOD, brain health, & overall health really! Getting enough rest is vital! I supplement with Magnesium (this is the one I take, not sponsored or an affiliate) & L-theanine 1 hour before bed to help relax.
HYDRATE - sounds easy enough, however, I always struggled with drinking enough water and even when I do, I don’t always feel hydrated. So the key is to make sure you’re getting electrolytes as well! I try to make sure I drink water first thing in the morning BEFORE my morning drink (which for me is a chai tea latte.) For electrolytes, I add in either lemon juice & Himalayan pink salt OR electrolytes from GOODONYA. Their electrolytes are organic, clean ingredients, & glyphosate-free!
REDUCING TOXIC LOAD - being more aware of what I put into my body, on my body, and the environment. Some things I do is open the windows in my house for some fresh air, use air filters, vacuum frequently to get rid of dust, use toxic-free cleaning products when possible. I am not perfect and I already have a bunch of products already, so after finishing a product and then opting to purchase a better, cleaner product next time is what I’ve been doing. All my skin care and hair products are clean and now I am working on my make-up!
SUPPLEMENTS - Magnesium is huge one for me that has helped with my migraines/headaches among sleep as well. I take that DAILY as well as a good multivitamin. Other things I take: probiotic, ashwagandha, Vitamin D + K2.
DIET - No ultra-processed foods. Processed foods occasionally as a treat. Reduced sugar intake or added sugars. Avoid anything with fructose corn syrup or sucralose. Reduced dairy intake. Incorporated more vegetables into my meals. I try to make sure each meal has some sort of vegetables. When I can, I try to change it up and go for different colors or kinds to get in different phytonutrients and benefits. I follow Glucose Goddess’s protocol in eating foods in the right order to prevent spiking your blood sugar levels.
DE-STRESS - reducing stress loads is important for activating your parasympathetic nervous system and getting your body out of survival mode. Looking at stress from a wider perspective of physical, mental, and environmental stressors and reducing the stress from all aspects. How to regulate my emotions. My favorite daily practice is mindfulness & breathwork! One of my favorite treatments to the physical stressors in my body is chiropractic care at Apex Chiropractic!
MINDSET - looking at and working through insecurities, especially the ones brought up during my PMDD, and working through those. Understanding my self-limiting beliefs and how to grow from them. Applying techniques learned through therapy like Cognitive Behavioral Therapy.
Final Thoughts
The experiences of PMDD differs from each individual to the next. For some people, they’ve actually been misdiagnosed as having Bipolar Disorder. For others, they have other health conditions on top of PMDD which makes things even more complicated to address. Some have lost their jobs, are constantly questioning the validity of their feelings, or this conditions just prevents them from showing up fully as themselves.
It seems that more information is coming out and more resources are becoming available though! That makes me so hopeful for those who are just getting diagnosed with this condition or may be currently struggling with it.
More resources to learn about PMDD & other people’s stories:
11 Women With PMDD Share What It's Really Like
Treating premenstrual dysphoric disorder
PMDD Almost Ruined My Life Before I Found out What It Was
PMDD AND WORK: ONE SUFFERERS STORY
