For most women, the three or four days right before the arrival of their period are much like a trip to the dentist. Not entirely pleasant, but nothing they can't handle. At worst they may suffer some cramping, maybe they'll be slightly bloated, a little irritable. Some jerk at work may make a PMS joke about how she's on the rag and everyone should look out.
Roll your eyes at those kind of jokes, do you? I shudder. I'm the kind of woman those jokes were made about. But then, I don't just get PMS. I have pre-menstrual dysphoric disorder, or PMDD. I'm one of the approximately 5 percent of women of childbearing age who suffer from pre-menstrual symptoms so severe that they can affect our work and our relationships.
And when I say severe, I mean PMDD was added to the new Diagnostic and Statistical Manual, the DSM-5, last year. It's now recognized as a bona fide mental disorder.
So what makes it different from regular ol' PMS?
Well, for starters, I'm not just a little bitchy when my cycle nears its end. I'm Maleficent and Cruella de Vil and Ursula the Sea Witch all rolled into one.
Any little thing can set me off, and my reactions are extreme.
The Saturday before I was diagnosed three years ago, I became so enraged with my whining child that I had visions of putting her head through a wall. I stood, just feet away from her, and as she cried, I shook as my brain formed a picture of my hands wrapped 'round her small head, pushing her toward the wall.
I didn't do it, but I wanted to, with every fiber of my being, and it scared the crap out of me.
I immediately told my husband I needed to get out of the house before I did something awful. I threw on my coat, grabbed my car keys, and hightailed it out of the house. I didn't return for hours, until I could feel certain that I'd calmed down and would not hurt anyone.
I'm not a violent person. I never pulled wings off flies when I was a kid. I don't even believe in spanking. I couldn't live like this.
The moment my psychiatrist's office opened that Monday, I was on the phone making an appointment.
Later that week he made the diagnosis. PMDD. The hormonal fluctuations I'd been experiencing before my period for several months were causing wild mood swings, excessive binge eating, and a whole lot more.
Already on depression medication -- it's common from PMDD sufferers to also have a depression or anxiety diagnosis -- my doctor suggested a medication change immediately to help bring my emotions in line during the pre-menstrual portion of my cycle.
Three years in, I'm still on the medicine, and I still struggle in the week or so before my period. The extreme rages and the low lows (I was at times inconsolable before the diagnosis) are gone, but my emotions are still rawer than usual in that time frame. I find myself apologizing to my family for snapping on a regular basis.
I have come to better understand my emotional triggers and developed coping mechanisms. Sometimes it is as simple as removing myself from a stressful situation or talking a walk to cool my head. It's an odd almost out-of-body experience to identify a hormonal surge and know that your mood is shifting but not be able to control it. It's frustrating as all get out, but oddly comforting knowing that if I can't stop it, at least I can try to control the outcome. I can protect the people I love from being hurt by me.
If you are starting to feel out of control around your period, don't push it off! You don't have to suffer alone! The PMDD symptoms vary from woman to woman, but if you have regularly experience at least five of the following during the week before your period, you may want to talk to your doctor:
- No interest in daily activities and relationships
- Fatigue or low energy
- Feeling of sadness or hopelessness, possible suicidal thoughts
- Feelings of tension or anxiety
- Feeling out of control
- Food cravings or binge eating
- Mood swings with periods of crying
- Panic attacks
- Irritability or anger that affects other people
- Physical symptoms, such as bloating, breast tenderness, headaches, and joint or muscle pain
- Problems sleeping
- Trouble concentrating
Anti-depressants can help, but they're not the only piece of the puzzle. Studies have shown upping your intake of vitamin B6 can help with PMDD, and cognitive therapy may be beneficial.
Whatever it is you're feeling, don't let people's attitudes about this cross we bear as women stop you from getting help. You don't have to live in misery just because you're still getting your period.
Do you feel out of control when you're PMSing? What happens?
Image via Garo/phanie/Phanie Sarl/Corbis