Most women experience some sort of emotional disturbance and irregularity shortly before and after their menstrual cycle. However, about 5 percent of women experience premenstrual symptoms so severe that they can have detrimental effects on mental health, work, school, and relationships. Irritability, depression, anxiety, anger, self-deprecating thoughts, difficulty concentrating, and decreased interest in regular activities are among the symptoms. These symptoms fall under the diagnosis of premenstrual dysphoric disorder, or PMDD, as listed in “The Diagnostic and Statistical Manual of Mental Disorders,” Fifth Edition (DSM-5). PMDD, a severe form of Premenstrual Syndrome (PMS) that occurs the week before menstruation and tapers off a few days after it ends, is a debilitating reality that not many people know about. Yet many of us live with it.
It was initially diagnosed in the DSM-IV as a “depressive disorder not otherwise specified” with similar symptoms to Major Depressive Disorder, the difference being that PMDD symptoms are cyclical. It has been found that a major impact of PMDD in a woman’s life is on personal relationships. There are feminist psychologists who believe that the language surrounding PMDD and PMS stigmatize women’s suffering. They have argued that the equation of female anguish with mental illness bolsters female stereotypes and undermines real issues. I do believe women should be careful not to use the diagnosis as a safety deposit box. It’s easy to dismiss all of our unbecoming behaviors as a separate self, the “PMS Self.”
I started to notice a pattern in myself over the past year. It was always around the seventh of the month. I noticed it after entering into a new relationship that suffered tremendously during that time. I felt cold and disconnected. My sex drive was nonexistent and I found myself unable to connect emotionally. The day-to-day felt like phlegmatic auto-pilot and more than anything, I would find myself extremely irritable. I couldn’t believe how differently I felt during that time at the beginning of the month. The scary thing is it still felt like me, but with the lights off. I started to do research to see if I could better understand what was going on with me—to see if there might be something hormonal going on to explain the inconsistencies.
I began to pay more attention to my body and my mind. I traced back about six months to look for patterns. It became pretty evident to me that there was some kind of dramatic shift going on. I never went to a doctor or sought a diagnosis. I don’t want to compartmentalize my emotions or lean on the condition too much, because there are always other factors at play. But I am far more aware now and find I have a better handle on my impulsive behavior. When I find myself in a low, I try to “wait it out,” especially avoiding making any big decisions during premenstruation. I’ve also read of homeopathic remedies that I try to stick with, such as avoiding sugar, caffeine, and alcohol during the week before menstruation, and eating smaller meals throughout the day to avoid spiking blood sugar levels. Aerobic exercise is also a strong defense in the fight against depression and this helps me more than anything, coupled with getting a full night’s sleep.
The hardest part for me was that I truly didn’t know which feelings to trust. I grievously questioned if the times I felt wholesome and balanced were an illusion. But I forced myself to contemplate and reflect. I told myself to think of it like seeing during the day versus the night. I know that I see with far more lucidity in light, so that must be the vision less likely to misconstrue the contours of my reality. This is the truth I hold on to as a guiding principle as I move forward.
This feature originally appeared in the Madness issue. Find more inspiring stories from the Madness issue here.