For as long as I can remember, I have had a less than ideal menstrual cycle.
One of the strongest memories of my teen years is falling into a ball in the shower because the cramps in my lower abdomen felt like knives were repeatedly being shoved into me. My poor dad was the only one home. I couldn’t move. I screamed in agony for help but also screamed that he not look at me; because what teenage girl wants their father to see them naked? My dad successfully got me dressed (without looking at me) and took me to the emergency room. The message I received was that I would probably experience very painful menstrual cycles my whole life due to a problem with how my eggs traveled through my fallopian tube. Awesome. With the help of birth control, the pain was minimized and I didn’t have any more experiences where I was banished to the fetal position.
Then I had children.
My cycle was unchanged after my first child. After my second child, things changed in ways that I did not know were possible. While the physical properties of my cycle changed, they were manageable with over the counter options. My cycle is pretty regular and I track it to keep me prepared. I use an app on my phone called MyDaysX. I started to notice a pattern emerging with my moods the closer I got to my period. Of course, I questioned Dr. Google and found something called PMDD (Premenstral Dysphoric Disorder). I have a history of mental illness and see a therapist regularly. When I explained to my therapist the pattern I observed, she was pretty confident that it was indeed PMDD. She instructed me to start tracking my moods in my cycle tracker for 2-3 months and then bring it to the attention of my gynecologist.
What is PMDD
PMDD is similar to what you think of when you think of PMS. Most people associate moodiness with PMS and PMDD is like a very severe case of PMS. It happens 1-2 weeks before your period starts. It is different for everyone but is described as intense depression and anxiety. There is not a clear cause for PMDD but it is thought to be linked to hormone and/or serotonin level changes during the menstrual cycle. In my experience, I would feel myself starting to get depressed about a week before my period would start. I would use the coping skills learned over the years in therapy that usually get me through a “bad” day but they would have little to no effect on my mood. Then 24 hours before my period would start, the suicidal ideations would begin. I would get to the point where I would start making plans to end my life, then I would start my period and all of those feelings would disappear. It was as if someone turned a switch from “suicidal” to “non-suicidal”. This is one of the clearest symptoms of PMDD, although not all women with it will experience suicidal ideations.
Treatment for PMDD
If my experience sounds familiar, please talk to your doctor. They will have the best plan of action for you. My therapist and doctor recommended that I take an SSRI (selective serotonin reuptake inhibitor) during the week I normally experience the severe depression. Once my period starts, I can stop the meds. I was unaware that SSRIs could make an impact in such a short period of time but PMDD is its own breed and in my first month of taking them, I saw a huge improvement. I still experienced irritability but there were no (as in zero, zilch) suicidal thoughts.
Along with exercise and a healthy diet, my new medication regime should free me from the mental fetal position that PMDD put me in.
There is major stigma around mental illness and although PMDD is not considered a mental illness, it involves treating your mind. It’s easy to think that everyone feels how you’re feeling. Maybe it isn’t PMDD, maybe you need something else. Whatever it may be, feeling depressed on any consistent basis is worth bringing up to your doctor. You deserve peace of mind.
If you are feeling suicidal and need immediate help, 1-800-273-8255 is the National Suicide Prevention Hotline and is available 24/7 with immediate counseling.