Disclaimer: This article may link to external articles and include language that is gendered. It is important to recognize that trans and gender non-conforming people can also have a menstrual cycle. Menstrual cycles are not an experience that is limited or reserved to cis women.
You know that scene in movies where the girl is sitting in her living room in sweatpants surrounded by ice cream and chocolate? She’s most likely crying, with a blanket over her shoulders watching some kind of romantic comedy. Cue roommate/friend/boyfriend coming into the scene to ask what is wrong and she screams something along the lines of “I’m PMSing leave me alone” and makes the whole interaction awkward and uncomfortable.
That was my understanding of PMS for most of my adolescent/adult life. It was sort of an annoying, difficult, uncomfortable time where you wanted to eat a lot of sweets and it was ok to yell at your loved ones. It was normal, funny even, and not something to be overly concerned with or aware of.
While mild PMS symptoms are natural and “normal”, symptoms that leave you unable to live your life as you naturally would and deeply impact your physical, mental, and emotional well-being are a sign of a deeper issue. PMS should be a slight inconvenience at worst and not a significantly negative monthly experience.
I believe this media depiction played a fundamental role in why I spent so many years unknowingly suffering in silence with PMDD. I was uneducated, and unaware of my reproductive health as it relates to my mental well-being.
My Diagnosis Journey
I remember exactly where I was sitting and what I was doing when I learned about PMDD. I was with my friends scrolling on Instagram when I came across a post by Dr. Monique Gonzalez discussing the potential symptoms of something called Premenstrual Dysphoric Disorder.
The post listed the symptoms of PMDD as being hypersomnia or insomnia, depression, anxiety, self-deprecating thoughts, irritability, anger, brain fog, decreased interest in usual activities, etc. It went on to explain that PMDD is a cyclical hormone-based mood disorder in which symptoms occur during your luteal phase right before your menstrual phase. It was essentially a severe PMS.
The post described me exactly and it linked to a self-screen quiz by the International Association for Premenstrual Disorders. I knew immediately this is what I had been experiencing and after taking the quiz it was confirmed that I was 1 in 20. I had PMDD.
I had spent the last few years of my life in and out of psychiatric wards and psychologist offices and been diagnosed with a myriad of mental health disorders but this made perfect sense. I did struggle with severe anxiety, depression, irritability, self-deprecating thoughts and even self-harm for certain stints but it was reserved for a few days during the month. The SAME few days every month. I had never really realized before how when my period actually came I started to feel much better mentally.
I spent the next two months tracking my mental health and sure enough, while I did experience mild anxiety and depression during various times of the month - it was nothing compared to the days leading up to my period. The darkness, confusion, hopelessness, fear, and struggle I experienced during those days were unparalleled. I ended up going to a psychiatrist armed with what I had researched and tracked - my own behavior and symptoms - and I was officially diagnosed with PMDD when I was 23.
At first, I felt frustrated that it took me so long to learn about PMDD and be diagnosed with this condition. I was already at high risk for an illness like this because I lived with endometriosis - a chronic pain disorder connected to hormone imbalances. Why had no doctor taken the time to look at me holistically and connect my physical disorders to potential mental disorders?
And then I thought back to those girls in those movies and the overall stigma and shame surrounding reproductive health. Menstrual cycle-related disorders, illnesses, and conditions are severely under-researched, underfunded, misunderstood and disregarded at a huge cost to people with periods who deserved to be treated and cared for their conditions.
At the time the only treatment options that were presented to me were birth control, antidepressants, anti-anxiety medication, mood stabilizers, or SSRIs. I spent a period of time testing each of the treatments before deciding to learn to manage my symptoms naturally without the support of medication.
My Life Today
Learning to live with PMDD has been one of the most difficult but also one of the most empowering experiences of my life. I have found by taking a multi-pronged approach to manage my symptoms I have been able to live a happier, healthier life. Here are three changes I made:
- Accept All Parts of Myself
People with PMDD, myself included, often describe their experience as one of a half-life. The person they are during their luteal phase is deeply and fundamentally different from the person they are the rest of the time.
I have found the most healing when I have learned to get to know the person I am during my luteal phase and accept her as she is. Not labelling her as crazy or needy or lesser-than has really helped me be at peace with her. Here are some questions I asked and continue to ask myself during that phase:
- What are her strengths?
- What are her weaknesses?
- What are her fears?
- What does she need?
- How can I hold space for whatever is coming up for her right now?
- How can I best care for her the way she deserves?
- Prioritizing Rest
Learning HOW to rest has been monumental in being able to manage my PMDD symptoms. Before I was diagnosed I used to get so frustrated when I was unable to perform at the level I wanted to. I would push myself through work, workouts, events, and meal plans and not respect or honor my body’s wants or needs which only made my symptoms worse.
Today, I prioritize listening and responding to my body and making time to best care for it. Sometimes that means sleeping 10 hours, other times that means skipping hard workouts in exchange for soft yoga classes and walks. The key is to let myself be “lazy” and not push myself outside of my comfort zone.
The more time and space I make to go internal during my luteal phase - to rest and rejuvenate - the more energy I can output during my ovulatory phase and ultimately be more efficient and productive.
- Making Time for Play and Joy
The number one symptom associated with PMDD is depression. It is, in fact, estimated that 34% of people with PMDD have attempted suicide. That was an urge I experienced many times during my luteal phase.
The way I was able to combat that was by finding things I enjoy and making sure I have those things available to me during my luteal phase. For me, that looks like spending time with friends and family, spending time on self-care, like skincare, taking baths, and making time to be creative.
PMDD is a tough condition to live with but you don’t have to go through it alone. If you or someone you know is experiencing symptoms similar to the ones outlined in this article, here are two of my favorite resources: Dr. Monique Gonzalez and IAPMD.
Domunique Lashay (she/her) is a menstrual health advocate, content creator and writer. Follow her on TikTok: @domuniquelashay