What is Premenstrual Dysphoric Disorder, and how can you manage it?
Written by Louise Hill. The following is a personal piece, featuring the lived experience of the writer. Everyone’s experience of mental health is different.
Warning: This blog post mentions alcohol and suicidal ideation.
Premenstrual dysphoric disorder (PMDD) is a very severe form of premenstrual syndrome (PMS). It causes a range of emotional and physical symptoms every month during the week or two before your period.
PMDD occurs during the luteal phase of your menstrual cycle. This is the time between when you ovulate and when your period starts. The luteal phase lasts approximately two weeks for most people but can be longer or shorter.
During this time you may experience PMDD symptoms every day, or for a few days within the phase.
My experience with Premenstrual dysphoric disorder
In 2020 I discovered that my brain reacts negatively to the fluctuation in hormones that happen every month. If I had learnt about this condition when I was 14 years old, it would have saved me a whole lot of pain.
In my teens it seemed that the way I was feeling was normal for a teenage girl, in my 20’s I drank quite a lot of alcohol so I put it down to having a perpetual hangover, while in my thirties it became so debilitating that I couldn’t work for months at a time. By the time I reached my 40’s I had given up all stimulants like alcohol, sugar and caffeine, was practising yoga and meditation daily but the condition was getting worse, and had led to monthly suicide ideation.
All this time I didn’t realise I had developed a serious brain condition as a result of a childhood trauma. PMDD put me into a sustained state of fight or flight that I couldn’t escape.
By its very nature the fight or flight state is a frightening state to be in, and is only meant to be on for short bursts to help us escape from danger, but living in that state is unsustainable and debilitating. I would burn out quicker than my peers, and although I had so much passion for my work I was floored by the condition on a regular basis.
PMDD can significantly impact a person’s quality of life and should be taken seriously. If you think you or someone you know has this condition it’s important to seek professional help. Living with PMDD is hard but there are lots of things you can do to help. Here are the things that have helped me to manage it.
How I have managed living with Premenstrual dysphoric disorder
Yoga
Yoga has been my saviour, it’s my safe space where I can breathe deeply, stretch and hold empowering postures like warrior or superhero. For years I spent hours at the gym or forced myself to go running without knowing that I was perpetuating the fight or flight state.
For a traumatised brain having a safe space to go to is really important. Develop a regular practice that works for your body and brain, one that is compassionate, kind and nourishing, this will support and carry you through your most difficult months, and helps to calm the anxious brain down.
Avoid stimulants
Stimulants like alcohol, sugar and caffeine directly affect the brain’s neurotransmitters, which are chemicals responsible for transmitting signals between nerve cells. They increase the level of dopamine, norepinephrine, and serotonin in the brain, leading to increased activity and arousal.
While this may be good for some, if you have PMDD your brain will be highly sensitive to these, leading to agitation, anxiety and even psychosis. If you can, it’s best to avoid these, they can also have a cumulative effect over longer periods of time.
Move around
If PMDD is a result of early childhood trauma you may find yourself going into a freeze response. This is when our brain and body completely stops to cope with a threat in our environment. When this happens, there’s often lots of activity in the mind but no mobilisation in the body.
I’ve found the best thing for this is to move, one step at a time, no matter how much you don’t want to, walk, jog, stretch and while you’re at it, try to be aware of your surroundings. What do you see, hear, smell, taste and feel?
Often when we freeze we also dissociate, we go off in our head and are not present in our body or the moment. This simple grounding exercise will bring you back.
Practise self-compassion
The negativity with PMDD can be overwhelming, for some women it’s projected outwards whilst for others it’s directed inwards on ourselves.
Self-compassion is the practice of treating yourself with the same kindness, care, and understanding that you would offer to a good friend. It involves acknowledging your own suffering, understanding that it is a normal part of the human experience, and responding with warmth and kindness rather than self-criticism or judgement.
On your bad days be kind, have a warm bath, watch a movie, or read a book on the couch, we don’t have to be super productive every day. Try to take it easy on yourself.
Set boundaries
The upside of having PMDD is that I have had to be so acutely aware of what is and isn’t good for me. Knowing my limits and when to say no, when to bow out of something even if it’s something I really want to do has been an important hurdle for me to overcome.
My passion was driving me forward whilst PMDD was holding me back. It forced me to slow down and take care of my mental and physical health. Ultimately taking the necessary steps to manage PMDD has had positive impacts on many aspects of my life, including my relationship, my living and working environment, and has led me to find my purpose and a more meaningful life.
Read more lived experience pieces, or learn about the link between physical and mental health.
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Posted on: 18th May 2023
