PMDD: A relationship with my menstruating Body

I have struggled with PMDD (Premenstrual Dysphoric Disorder) since I was around the age of fourteen. My most severe symptoms didn’t show up until around the age of twenty, likely combined with hormonal fluctuations of adulthood and coming out of a cult-like environment. It was a double whammy that my parents did not know what to do with. I mean, I had no idea either. But we did it. We made it out alive!

For starters let’s talk about what PMDD is:

Premenstrual Dysphoric Disorder (PMDD) is a Neurological and Hormonal condition where one’s brain and body are shifting in response to hormone fluctuations. It is a more severe case of PMS, where people who menstruate indicate feeling an extreme sense of depression, anxiety, hopelessness, suicidal ideation, difficulty focusing, fatigue, irritability and anger, decreased desire in activities and lack of motivation, recklessness and impulsivity, difficulty regulating, overwhelm and stress. Not to mention the physical symptoms that go along with it: tender breasts, cramping, cravings, insomnia or sleep disturbances, headaches and bloating. These symptoms come on a week or two before menses, and usually ease up significantly once bleeding occurs. Around 3-8% of people who menstruate experience PMDD.

It wasn’t until my Physiological Psychology class in undergrad that I learnt about PMDD, and my first serious boyfriend at the time never fully understood it when I would explain it, or re-emerge after a few days of isolation. I mean, it’s hard for anyone who doesn’t suffer from it to fully get it – something I have accepted. No fault of their own. His step-mom at the time would tell him, and me, casually in the kitchen, that PMS just “wasn’t a thing”. It was simply “something women used as an excuse for their emotions.” How disappointing. A woman my senior whom I thought “surely SHE will get it?” Nope. She drank the patriarchal, evangelical Kool-aid where feminism goes to die. I can’t judge her for it – I had been there too.

I had a bit of a corrective experience when my sister and I travelled to Northern Ireland in 2017. We stayed with this lovely artist woman in her flat. She poured wine and we shared stories. I was in one of those weeks leading up to bleeding, and I shared with her my experience. She was probably in her mid fifties, and through her warm but determined voice said, “You should not have to suffer this much! This doesn’t seem normal.” And well who knows what normal actually means, her sisterhood in that moment, older woman to younger woman, advocating for me, began a deeper journey.

The thing I love about the body is that she never lies. Even when dogma, or belief systems, even medical professionals tell you otherwise – our bodies always tell the truth. I love what Jamie Lee Finch says about bodies: “A loud body is a kind body.” And boy does my body get loud sometimes. She goes on to say, “Our bodies always tell the truth, but they aren’t always accurate”. There is discerning involved here, especially when there is trauma stored in the body. Regardless, our bodies communicate loyally. They are always telling us information. And this is true for the PMDD sufferer.

“What is my body needing? What is she yearning for? What boundaries have been pushed to make my rage so big? What grief has been pushed down that it is bursting open now? Where have I abandoned myself that this depression is calling me back home? Where is the meaning in my life, that this existential angst is asking for my spiritual practice to resurrect?“

There was a time a few years ago where I was seriously considering a Hysterectomy. This is generally considered a last resort treatment for PMDD. But I was reaching my last resort. Who needed a Uterus anyway? Of course as I got more serious in looking into it, the grief set in. Even though I was quite sure then that I wouldn’t have any biological children of my own – this connection to my uterus, to this part of my womanhood, I was not ready to lose. These parts of a woman’s body are invaluable regardless of whether she has children or not. They are hers.

As a Psychotherapist, I know that treatment and healing are not fixed destinations. Firstly, we are not broken. Even us PMDD folks. Something my partner has to remind me of monthly when I feel like Jekyll and Hyde! Healing is the relationship we have to our symptomology and to our bodies. It is how we learn to be with the pain. Not to just get rid of the pain. But to listen to it.

My relationship to this part of my life has had many iterations and ebbs and flows. Some more intense and serious, and some much more easy and relieving. I imagine, as I continue to age and my hormones continue to do what they do, I will need to be flexible and adapt. This is the gift though, the gift of the sensitivity to our body: life is never not changing. Life is always in transition and it is always seasonal. Where and when did we learn that we were owed permanence and predictability? So much of my work in myself, and with my clients, is reminding ourselves that health and vitality come from growing our capacity for change, and being able to move through the different states of our nervous system at the appropriate times. We aren’t meant to be regulated and calm ALL of the time. We are meant to feel and experience different states of feeling and sensation, and allow ourselves to ride those waves.

Calm – Steepening – Peak – Crest – Breaking – Collapse – Calm.

Just like a wave.

So, in the end I didn’t go under the knife, but I did seek out further treatments over the years. Every single person is different, and some treatments may really work for you, and some may not. Some may work this year, and some may work next year. That is completely okay. This is about what works for you in this moment, what supports you, and allows you to be a more compassionate witness and friend to your PMDD and menstruating body. Here is a list of the one’s I have tried and some I still use today:

• SSRI’s
• IUD (body rejected that one)
• Naturopath
• Natural Allergist
• Supplements and Vitamins
• Dutch Test blood work
• Exercise for each phase of my cycle (cycle synching)
• Specific foods during each phase of cycle
• Followed PMDD educators on social media
• Read books and research – knowledge is empowering, for me and with the clients I work with
• Write about it and share with others who experience it
• Radical Self-Consideration
• A few close people who check in and show up
• Hermitting/introverting and being cozy
• Candles and creature comforts
• Laying on the ground
• Poetry

I think the one thing that has forever been the most helpful in my experience with PMDD is Self-Compassion & Compassion from others. It is truly an excruciating experience sometimes. I know. It is one where all you want to do, and can do sometimes, is hide under the blankets of your life and wait until it passes. And then there are times when we can’t do that. Where you have to continue on. Go to your job. Take care of your kids. Bathe yourself. In those times, tempering your expectations of yourself is huge. Take anything and everything that is not essential off your plate. Receive the help and care from your loved ones. Order take-out. Only do the movement your body tells you it needs and wants. Watch comedy specials. Cry. Scream in the car. Apologize when you need to, and believe them when they say, “it’s okay”. Sleep as much as you need to. Hug your pets.

Remember that it always passes, and this too is an invitation to return to yourself. Go towards what hurts when you can. Be with it. This presence is what your body longs for – even her screams are a kindness towards you.