I have been taking the highest dose of Sertraline for over 3 years now, so why is it then, that every few weeks or so, I feel DREADFUL? And by dreadful, I mean so low that I slip back into that dark hole of despair and the suicidal ideations come creeping in like poison and I am unable to function. My motivation, energy and enthusiasm for anything becomes non-existent and I feel so exhausted that I can barely open my eyes in the morning. I am sad and tearful and lose the ability to rationalise my thoughts and everything seems bleak. Oh and the physical pain. The debilitating migraines, the swollen joints, the bloated and gaseous stomach, the sickness and nausea, the huge bruises that appear for no reason! Is it any wonder that when all of this comes along and hits me at the same time, all I want to do is disappear off the face of the earth?
Why do I feel like this when I am already being treated for depression and anxiety? PMDD. That’s why.
If you thought that PMS was bad (which it is) then I hope to God that you are never unfortunate enough to meet it’s very evil big sister, PMDD.
PMDD stands for Pre-menstrual Dysphoric Disorder and according to Mind, ‘It is a very severe form of premenstrual syndrome (PMS), which can cause many emotional and physical symptoms every month during the week or two before you start your period. It is sometimes referred to as ‘severe PMS’.’
While many people who are able to have periods may experience some mild symptoms of PMS, if you have PMDD these symptoms are much worse and can have a serious impact on your life. Experiencing PMDD can make it difficult to work, socialise and have healthy relationships. In some cases, it can also lead to suicidal thoughts.
Like many others, I had never heard of it. I just thought that I was a lost cause. Someone who despite her many, many efforts to manage mental illness, would just simply, always battle with it.
‘What an exhausting life ahead of me’ I thought. ‘Do I really want to live this way?’ No. No I did not. I knew that something was wrong with me but despite numerous visits to the GP, many blood tests and lots of experimenting with cutting out various foods…everything always came down to ‘you’re just stressed, there’s nothing physically wrong with you.’
Great. Thanks then.
I was exercising, getting fresh air, eating well…I didn’t feel particularly stressed?! I took it upon myself to do some research into possible diagnoses and came across the PMDD page on Mind’s website. I couldn’t believe what I was reading. I ticked every single box for PMDD. That’s when I decided to go back to the GP armed with this knowledge and get them to finally listen. The GP looked at me like I had 5 heads when I told her about PMDD and said she’d never heard of it! I’d been writing a journal of my symptoms for the previous 6 months prior to my appointment and upon reading this, she agreed that the pattern formed around my menstrual cycle. She wanted to make my periods go away full stop so recommended trying the Depo injection. Which I did. And I hated it! My periods didn’t stop, they became worse! As did the PMDD symptoms! So I gave up on that option.
I decided to try a more holistic approach and invested in some essential oils. I add these to warm baths, put a few drops on my lava bead bracelet and also inhale gently by placing some on a cotton wool ball. I also have a humidifier which I add oils to.
These are the oils that I have found to be the most helpful:
- chamomile to promote relaxation and sleep
- clary sage to relieve menstrual cramps and anxiety
- lavender to experience a calming effect
- neroli to ease anxiety and relieve PMS
- rose to reduce stress and relieve PMS
I also try to maintain some sort of exercise routine during hell week (the 7-10 days prior to my period) even though it is HARD to muster the energy! Something gentle like a walk or some simple yoga moves such as ‘bridge’ or ‘downward facing dog’ can really help.
I also researched supplements and these are the ones that I find help me the most: (recommended by Mayo Clinic)
- Calcium. 1,200 milligrams (mg) calcium daily can help ease physical and emotional symptoms.
- Magnesium. 360 mg can help ease breast soreness and bloating.
- Vitamin E. 400 international units (IU) daily can help reduce prostaglandins in the body. Prostaglandins are known to cause pain.
- Vitamin B-6. 50 to 100 mg daily can help ease fatigue, irritability, and insomnia.
There are plenty of other methods to try but some more expensive than others. I’ve heard that acupuncture can be really helpful but am yet to try it.
I would say that the best thing for me BY FAR has been to have regular B12 injections. These were recommended to me by a fellow PMDD sufferer on Instagram and I now have regular shots from a lovely B12 technician called Tracey. She comes to my office or home so it’s really convenient. Since having these on a regular basis, I have noticed a rise in my energy levels and my overall wellness.
Of course, as with most illnesses and conditions, diet plays a massive part. When you are in the midst of PMDD, the last thing you feel like doing is cooking a healthy meal from scratch and the food cravings make it even harder to reach for the celery instead of the chocolate. HOWEVER, eating the right foods is critical to managing PMS/PMDD. Eating salty foods increases bloating so ditch the salt and vinegar crisps! Sugar may cause drastic blood sugar fluctuations which worsens fatigue and mood swings (I know, I’m sorry…easier said than done to banish the sugar!) and meat/high fat foods tend to increase the severity of menstrual cramps. The thing to do is eat small and often. This helps to combat stomach upset and bloating. Eating lots of fruits and vegetables and avoiding processed carbs, salty snacks, alcohol and…this is the killer for me…caffeine will also work wonders. Coffee is life for me so instead of avoiding it completely, I drastically cut back to one cup a day which I look forward to each morning. If I am meeting friends for a coffee I stick to decaf.
Another trick is to make extra when preparing food during your good days/weeks of the month. I have lots of old takeaway containers (no judging please!) that I use to portion up and freeze. These come in VERY handy when I don’t have the energy or motivation to cook and it means that my kitchen-shy husband can just pop them in the microwave! It also means that you are less tempted to eat badly or reach for the takeaway leaflet!
Despite doing all of these things, some months still hit harder than others and when that happens, I have to admit defeat and hide away in my room until Auntie Flo pays her visit. It’s a battle when your mind is telling you to reach for the pills and end it all but reminding yourself that it’s the hormones talking helps pull you through. It’s a bloody rubbish thing to go through each month and I feel for all of my fellow sufferers. But each month we DO come through it and are rewarded with a couple of weeks (if we’re lucky) of relative normalcy.
I continue to research and experiment with treatment methods but one day, I hope to have a hysterectomy to completely eradicate the symptoms. Of course, this may bring on early menopause and cause a whole host of other issues but that is a risk I’d be willing to take.
If you have read this and though to yourself ‘that’s me!’ then I would recommend starting a journal of your symptoms/feelings/thoughts right away.
I also highly recommend visiting https://www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/about-pmdd/ which is jam packed full of information on PMDD, treatments and how to go about getting a diagnosis.
My collection of bruises.