Premenstrual dysphoric disorder, commonly known as PMDD, is a severe condition that profoundly impacts the lives of those affected. For one 32-year-old individual, recently diagnosed after suspecting its presence for around five years, PMDD has become a monthly battle that disrupts every aspect of daily life.
The Personal Impact of PMDD
For approximately ten days each month, during the luteal phase after ovulation, this individual experiences debilitating symptoms. These include intense irritability, impatience, and a crippling brain fog that hampers cognitive function. At its worst, the condition leads to deep depression, uncontrollable crying episodes, and even suicidal thoughts.
Despite maintaining a healthy lifestyle with regular exercise, a balanced diet, minimal alcohol consumption, and weekly therapy sessions, these efforts often become nearly impossible to sustain during the symptomatic phase. The individual describes feeling completely stuck, as if trapped in a cycle that repeats relentlessly.
The Emotional Rollercoaster
When not in the luteal phase, life is embraced with joy and enthusiasm. However, this positivity is abruptly shattered as symptoms emerge, leading to desires to quit jobs, end relationships, and withdraw from social connections. The struggle to share this experience is compounded by the condition's chronic under-recognition and lack of research, sometimes causing self-doubt about its reality.
The individual expresses concern about burdening their partner, who serves as a primary source of support. The dramatic shift upon menstruation is likened to a "brain transplant," offering temporary relief before the countdown to the next episode begins, raising fears about enduring this pattern for decades.
Expert Insights from Dr. Sophie Behrman
Dr. Sophie Behrman, a psychiatrist who established an NHS menopause and menstrual health clinic in Oxford, provides valuable context. PMDD is estimated to affect 1-3% of women and can occur at any point during their menstrual life. It is classified as a mental disorder that triggers severe psychological and sometimes physical symptoms in the luteal phase.
Dr. Behrman explains that PMDD is not due to abnormal hormone levels but rather how the brain reacts to them, particularly the decline in progesterone before a period. This reaction results in feelings of irritability, anxiety, depression, and impulsivity.
Management Strategies and Support
While the individual is already implementing beneficial practices such as a wholefood diet, exercise, and supplements, Dr. Behrman emphasises the importance of seeking further medical advice if symptoms persist. Cognitive behavioural therapy can be particularly helpful, and peer support is crucial for coping.
Resources like the website iapmd.org offer additional information and community connections. Having a diagnosis is a positive step, as many women must advocate for themselves due to the disorder's relatively recent classification.
The Importance of Sharing and Seeking Help
Gently, it is encouraged to share the condition with trusted others to build a broader support network. While educating people can be tiring, it is often necessary to foster understanding and assistance.
For those in crisis, helplines are available: in the UK and Ireland, Samaritans can be contacted on freephone 116 123; in the US, the 988 Suicide & Crisis Lifeline at 988; and in Australia, Lifeline at 13 11 14. International options can be found at befrienders.org.
PMDD is a real and challenging condition, but with proper management, support, and increased awareness, individuals can navigate its complexities more effectively.
