By Jolie Day
You’ve probably heard of PMS, but may not be aware of another severe type of premenstrual condition known as PMDD, or premenstrual dysphoric disorder. Approximately 3%- 10% of menstruating girls and women are affected by this condition, which can lead to severe mood swings, deep depression, feelings of anxiety, a sense of hopelessness—all of which can immensely affect one’s ability to perform their normal daily routine and feel like themselves. I know these feelings well because I have experienced this firsthand and it wreaked havoc on my life.
Around 3 million cases are reported in the U.S. each year. Although the exact cause of PMDD is still undiscovered, it has been proposed to be drastic changes in Serotonin levels in the brain during different stages of the menstrual cycle. Serotonin is responsible for mood regulation, sleep, appetite, memory, and libido. The effects are cyclical, as hormone changes occur after ovulation and may act as a trigger for the brain and cause imbalances. According to WebMD, a person may be diagnosed with PMDD if they experience symptoms such as: mood swings, depressed mood or feelings of hopelessness, feeling out of control or overwhelmed, marked anger, increased interpersonal conflicts, sleep problems, as well as other symptoms related to PMS such as fatigue, bloating, breast tenderness, and headaches.
Although a lot of these symptoms share similarities with clinical depression, PMDD is different from Major Depressive Disorder and Anxiety Disorder in that the symptoms only show up during certain parts of the menstrual cycle. Symptoms appear after ovulation and usually subside shortly after menstruation begins. It is important to note if symptoms occur throughout the entire month, it might be an indication that the condition is related to chronic depression and anxiety, rather than PMDD. However, it is extremely important for the patient and medical professional to work together in order to receive proper diagnosis and treatment.
Treatment options for PMDD include:
- Naturally: Medical professionals believe that PMDD may be benefitted by a change in diet that includes limiting consumption of alcohol, caffeine, and salt. Alcohol acts as a depressant that can worsen these symptoms. Caffeine acts similarly with heightening feelings of anxiety. Regular exercise is strongly recommended, as well as the adoption of stress relieving practices like meditation and yoga.
- Medication: The use of antidepressants that are SSRI’s, or selective serotonin re-uptake inhibitors, such as Paxil, Prozac, and Zoloft are an option that helps alleviate a lot of the common symptoms of PMDD. It is important that the patient and doctor communicate regularly if this is the chosen method of treatment, so as to make sure it is the best fit for the patient, as every medication has differing reactions to our individual chemical makeup.
- Hormone regulation: A medical professional may also prescribe that the patient use a method of hormone regulation, such as estrogen or progesterone or use of birth control, that may help with the imbalances caused during ovulation.
- Counseling: Having someone to help sift through the effects of PMDD may be extremely helpful as well. A professional would be able to give the recommendations and support that the patient needs.
PMDD affects how the person thinks and feels and in no way should be treated as anything less than a serious medical condition. According to a guide for patients and families: “PMDD is not the fault of the woman suffering from it or the result of a ‘weak’ or unstable personality. It is not something that is ‘all in the woman’s head.’” The implications of our society treating women as though their problems are “not real” or “exaggerated” is extremely dangerous to woman’s health, so it is necessary for all of those surrounding a person that may have this condition to listen and take what they have to say seriously.
My little sister and I are part of the group of people affected by PMDD. I was diagnosed when I was 16, and she was diagnosed this year. I remember suddenly feeling lost in a whirlwind of emotions and feeling like I had no way to ground myself. It felt like my head was in a thunderstorm of negative thoughts and unreasonable rationale. I had the worst anxiety that would leave me bed ridden. I was completely frustrated. I distanced myself from others. I felt unstable and not like myself—but this would only be some of the time, so I wasn’t sure what was going on. I knew that my PMS seemed to be more severe in comparison, but I hadn’t thought that it was capable of making me feel like that. My family started to express concern about the way it affected my relationships with them and my friends. I resented the stereotypes surrounding PMS and pushed back against it for a while. But I deep down I knew they were right. It came to a point where I could no longer ignore it and I started working with my physician and a gynecologist to find a way to regulate my hormones and manage my symptoms.
I wasn’t sure how I felt about antidepressants at the time, so I decided to try Mirena IUD and have seen such positive results. Over the past years I have noticed a dramatic improvement in my mood and sense of clarity. I no longer feel dread and hopelessness every few weeks like I used to. I regained who I am and it has changed my life for the better. Although my particular treatment won’t work for everyone, it is important to try and seek out what works best for each individual. PMDD and PMS shouldn’t be taboo, and I feel that it is really important that we take these kinds of symptoms seriously so that people receive the help that they deserve.