For many women, the monthly menstrual cycle is a manageable part of life, but for those with premenstrual dysphoric disorder (PMDD), it becomes a debilitating ordeal that disrupts every aspect of existence. One 32-year-old individual, recently diagnosed after suspecting she had the condition for around five years, describes how PMDD severely impacts her life, leading to feelings of being utterly stuck and isolated.
The Monthly Struggle with PMDD Symptoms
For approximately ten days each month, during the luteal phase after ovulation, she experiences intense irritability, impatience, and a crippling brain fog that makes daily tasks feel insurmountable. At its worst, the condition plunges her into deep depression, accompanied by uncontrollable crying and suicidal thoughts. Despite maintaining a healthy lifestyle—including weekly therapy sessions, a balanced diet, regular exercise, and minimal alcohol consumption—these positive habits often become impossible to uphold during this challenging phase.
The Emotional Rollercoaster of PMDD
When not in her luteal phase, she embraces life with joy and enthusiasm. However, as the countdown to the next cycle begins, everything crashes down: she contemplates leaving her job, ending her relationship, and withdrawing from friends. This cyclical pattern creates a sense of hopelessness, leading her to question how she can endure another two decades under such conditions. The lack of recognition and research into PMDD only compounds her struggle, making it difficult to share her experience or ask for help, and sometimes even causing her to doubt the reality of her own suffering.
Expert Insights into PMDD
Dr Sophie Behrman, a psychiatrist who established an NHS menopause and menstrual health clinic in Oxford, sheds light on this often-overlooked disorder. She explains that PMDD affects an estimated 1-3% of women and can occur at any point during their menstrual lives. Contrary to common misconceptions, it is not caused by abnormal hormone levels but by how the brain reacts to hormonal fluctuations, particularly the drop in progesterone before a period. This reaction triggers severe psychological symptoms, such as anxiety, depression, and impulsivity, which the patient aptly describes as feeling like a "brain transplant" after her period arrives.
Managing PMDD: Steps Forward
Dr Behrman emphasises that the individual is already on the right track with her current efforts. A nutritious, wholefood diet and regular exercise have been shown to offer significant benefits, though maintaining these during symptomatic phases can be challenging. Supplements may also provide relief, but it is crucial to consult a healthcare professional before making any changes. Cognitive behavioural therapy (CBT) is recommended as a helpful tool, and peer support through resources like the website iapmd.org can offer valuable community and information.
Having a diagnosis is a positive step, as PMDD is a relatively newly classified disorder, meaning many women must advocate for themselves with research in hand when seeking medical help. While the patient has a supportive partner, expanding her support network to include other trusted individuals can alleviate the burden. Educating others about PMDD, though tiring, is sometimes necessary to foster understanding and assistance.
Seeking Help and Support
For those struggling with PMDD or similar mental health issues, reaching out is essential. In the UK and Ireland, the Samaritans offer confidential support via freephone at 116 123 or email at jo@samaritans.org. In the US, the 988 Suicide & Crisis Lifeline is available at 988, and in Australia, Lifeline can be contacted at 13 11 14. Additional international resources are accessible through befrienders.org.
This personal account highlights the urgent need for greater awareness and research into PMDD, a condition that profoundly affects women's health and wellbeing. By sharing stories and expert advice, we can move towards better support and understanding for those living with this challenging disorder.
