Illustration by Sophi Gullbrandts
Written by Emily Jane-Yates
Anyone who’s ever experienced PMSing knows that it is the worst. We bloat, we overeat, we cry all the time, the mood swings are horrendous, and we generally just want to kill ourselves.
Wait, no. That last one doesn’t seem right does it?
That’s because if your PMS makes you feel suicidal, depressed, and very anxious, it’s more likely to be PMDD. PMDD stands for Premenstrual Dysphoric Disorder, commonly described as “PMS on steroids.” Though it causes symptoms similar to depression and anxiety, the most current research suggests it is actually a genetic disorder. PMDD causes sufferers to be more sensitive than others to fluctuations in our natural hormonal changes. It’s almost like an allergic reaction to our own reproductive chemicals, but instead of hives, we get psychological and physiological symptoms that can include bloating, clumsiness, sore breasts, fatigue, changes in sexual drive, cravings, joint pain, and many more. As well as the depression and anxiety mentioned above, the psychological symptoms include extreme mood swings, rage, explosive anger and outbursts, disassociation, low self-esteem, hopelessness, extreme tension, suicide ideology, self-harm, and many more.
Since we first got our periods, we’ve been told we just have to get up and get on with it. But it isn’t normal for your menstrual cycle to negatively impact your life in such huge ways, and PMDD affects an estimated 1 in 20 people of menstruating capability (including Trans men and genderqueer people). 1 in 20 is a lot of people to suffer from an illness that very few have heard about – even within medical circles. So what’s with the lack of coverage?
1 in 20 is a lot of people to suffer from an illness that very few have heard about – even within medical circles.
Because these symptoms sound like any number of other mental illnesses, many think PMDD is just relabelling an already existing illness. The answer? Yes and no.
Historically, women have been locked up and treated for illnesses like “hysteria,” which was described as an infliction of the womb that affected women’s behavior, and was probably exactly what PMDD is today. But PMDD differs from other mental illnesses in its presentation. The key aspect of the illness is that the symptoms only appear premenstrually (about 10-14 days before your period) and disappear as the period arrives. In the time over the menstrual phase and the follicular phase of a person’s cycle, their behavior and state of mind is within the boundaries of what they consider happy and healthy. Whereas any time around and after ovulation and throughout the luteal phase, symptoms that make them feel unhealthy and affect their day-to-day lives in overwhelmingly negative ways.
Because symptoms, cycles, and the timing of PMDD varies from person to person, it’s crucial for you to know your body and its nuances. Especially if you suspect there could be an issue. Tracking your menstrual cycle is not only fantastic for your reproductive health – it also helps you monitor when you bleed, spot, have discharge, get acne, bloat, and so on. Ultimately, tracking will help you notice when there is something out of the ordinary going on.
To diagnose PMDD, it’s important to keep a log of what symptoms appear and when for at least two months in order to determine a correlation, which you can then show to your medical professional. Whether you have PMDD or not, being attuned to your body is a powerful way to take care of yourself and feel in control. In a world of menstrual shame that teaches us our periods are dirty, it also breaks all sorts of stigmas to be in close relationship with your menstrual cycle. There’s dozens of tracking apps you can download to your phone for free; you’re bound to find one that suits you. If you have PMDD, or suspect you do, an app was released recently called meVpmdd which has specific functions for tracking mood changes (and was recently mentioned in Autostraddle for their efforts to be inclusive of all gender identities in app design).
Is tracking really the only way to diagnose? Pretty much, yes. There is no test or measure that can show whether you suffer or not, because hormonally your body is functioning as normal, even if you are reacting badly to those functions. If you think you might have PMDD, take your tracker to your doctor and open the discussion with them — but be prepared to face some wariness. A variety of studies and articles highlight how women’s pain and distress is often ignored, downplayed, or blamed on lifestyle and stress. Additionally, there simply is not enough research going on PMDD.
Your doctor is by no means your only route to help and care; you can also consider your therapist or gynecologist. When you do find a medical professional who’s on board, there are numerous options for treatment. The first line of treatment often includes supplements, lifestyle changes, anti-depressants and possibly birth control, with further options such as hormonal replacement therapy if the former don’t help at all. Getting the right help can feel a little like trial and error before you settle on an effective treatment. This is largely because PMDD affects everyone differently, so you will need to experiment to find what’s best for you.
Looking further for support and guidance, you can find many resources on social media. On Instagram, hashtags like #pmddpeeps are bringing people involved in PMDD awareness together, and there are many accounts raising awareness and talking about their experiences. On Facebook, you can find many peer support groups, many of which have a focus, such as health and fitness, faith and spirituality, or medication free – whatever you need you’ll likely find it on Facebook. The Vicious Cycle Project and the Gia Allemand Foundation are both on Facebook and Twitter, and are a mine of information and are endlessly supportive.
It’s important we talk about PMDD, it’s important that women, trans men, and genderqueer people have the platform to stand up and say “we’re here, and we’re suffering.” You deserve correct and effective treatments for your PMDD or other menstrual illnesses. The more vocal we are, the more seriously the medical world has to take us. We can make them realize that this is not something we have to accept as part of our cycle.