Handle It. Five Tips to Managing PMDD and a Career.

I want to preface this blog by saying that people who genuinely cannot function due to their mental health are not bad people. Nor do I think that they are lazy or have poor character. Mental illness is a disease like any other and exists on a spectrum.

I have often considered printing something like this and putting it on my office door. Maybe it some of the three hundred and seventy- two people who walk through my door each day would think twice and give me five minutes respite. As the full-time Wholesale Director and acting upper level management for a start up apparel company I wear a lot of hats. Not literally though. I look terrible in hats.

I love the challenge and complexity of the job but its stressful. Unfortunately, choosing to not go in because of my PMDD is simply not an option. So … what does one do? Quitting will not pay the bills and PMDD has not been declared a disability. I want to be more than just a blip on humanity’s radar. I need the money. I also need the challege keeping my overactive imagination busy with productive problems. I have to manage this disease, the depression, the anxiety and the suicidal ideations. I do not take medications and so I came up with a list in regards to my current PMDD management plan:

  1. Tracking Symptoms. – Get a period tracker. This gives you insight into your cycle. Knowing your body and how you react is going to enable you to control your environment, helping you to fight back a little.  Pay attention to your moods each day during your cycle. Maybe even keep a cycle journal. The Gia Allemand Foundation is working on an app for this right now! So excited.
  2. Self-Care: I’m a mother of two and “me-time” is hard to come by. I deliberately instituted hard 8pm bed-time rules so that Mommy could have a glass of wine (or Sweet Tea during PMDD) on the front porch in silence. I need it. We have a system that we follow every night. Dinner-bath- cuddles- teeth- potty- bed. Sure, things happen but knowing that my scheduled quiet time is coming helps me deal with things that may come up.
  3. Caffeine/Alcohol consumption – My PMDD presents primarily as anger or anxiety in the work place. On those mornings that I wake up feeling dysphoric, I know not to consume coffee. It will only turn up the volume on all of those feelings that I’m fighting to control.  Drinking during that time typically results in my depressive spirals.
  4. Dietary changes- As much as I HATE dieting, it really helps when I take a multi-vitamin and make more vegetable oriented choices during more symptomatic times. Drinking LOTS of water helps a lot too. It gives me more energy to fight back.
  5. Leaving Work At Work- I am a natural over-achiever and so I struggle with this but I have been deliberately not checking my email, responding to work texts or mulling over work problems at home. As a salaried employee the temptation is always there but I have to give my brain some space to process day to day life.  A proper work- life balance will not help you not WANT to give your notice every month but you will have the strength to remind yourself to focus on the positive.

Sometimes having a chronic disorder can feel like you are at war with your body. You only get one. Remind yourself of the reasons that you do this. You are smart. You are worthy of good things and you deserve a life that you own. Live your life on your terms. Do not allow PMDD to give you an excuse to not live the life you deserve.

I Love You Honeybear

“I brought my mother’s depression. You’ve got your father’s scorn and a wayward aunt’s schizophrenia. But everything is fine. Don’t give into despair, cause I love you honeybear.” – Father John Misty

There seem to be a a few basic expectations for relationships depending on who you ask.

  1. Need each other just enough… but don’t need each other too much (this constitutes as codependency and is frowned upon by most folks it seems).
  2. Respect aka be nice.
  3. Like a reasonable amount of the same stuff. Religion falls here too.
  4. – In one form or another. (For asexuals this is negotiable) General physical attraction falls under sex.

I suck at number one. When it’s PMDD time… it is like my brain is a ship and everything that had me tied to my port was cut in one fell swoop. All of the sudden I need to know that you’re here. Not just tolerating me. Not just saying something to make me shut up, but here. On my side.

PMDD or Paranoid. Malicious. Depressed. Dependent. I just made that up.

Often, it’s so intense that most people don’t know what to do with me. I lash out in insecurity because I’m convinced everyone thinks I’m ridiculous. My anxiety is so high that I’m sensitive to immense amounts of noise. The thing my boss said to me last week, the way that woman looked at me in the grocery store and my fears about my effect on my kids begin to swirl in front of my eyes. “It’s all hopeless,” I think. I convince myself that this misery is the rest of my life and I am a burden to my friends and my family.

Where does a partner fall in this? When difficulty maintaining relationships is a symptom of your disorder, how do you even keep one around long enough for them to learn?  In my ideal world, a partner helps me navigate life. I’m not a full time job. I just need some help getting back on course every once in a while. Once a month to be exact.

When your grandparent with Alzheimer’s begins reacting to over stimulation, do you dismiss them? Do you just sit there while they spiral into destructive behavior? Do you tell them that they’re crazy? No. Of course you don’t. You help them to calm down while you take them into a quiet room or ask people to leave. You hold their hand and remind them you are on their side. When they scream at you that they don’t know who you are and to leave them alone, you walk away for a while… but you come back.

Is that really a relationship though? Can someone ever really love someone like me? Or will I forever be seen as the energy leech they dated one time? It is my hope that there is someone out there who doesn’t feel like I suck out their soul. Someone who knows that my disease isn’t all that I am. I want to write a blog with a happy ending about how I’ve figured out how to relationship with this disease but I haven’t. Thankfully, someone else has!

The Gia Allemand Foundation has a video about relationships and PMDD that I came across about an hour into writing this blog so I am going to link it here. It was so encouraging to hear from Amanda’s husband who talks about having to learn that PMDD wasn’t just this PMS where she could take a Midol and power through. In this video, they share different books and resources for helping people with PMDD build meaningful relationships. They talk about getting counseling as a couple but also as individuals to learn how to cope with what PMDD does to you.  I encourage you to check it out!

This disease deserves to be treated with respect. I wish you a partner who not only respects you but respects how this effects you. You deserve love. You deserve good things. Don’t forget it.

Once again, you’re not alone and if you’re reading this and you are spiraling, please call the National Suicide Prevention Lifeline: 1-800-273-8255

One More Time… With Feelings.

Is This a Fancy or a Feeling?

Before my PMDD diagnosis, my self-esteem was in tiny pieces all over everyone else’s floor. Who am I? Love me! I couldn’t figure out why I was being so irrational and if that was because of who I was spending my time with, or if I was just as screwed up as people seemed to think. After my diagnosis, I spent a lot of time trying to figure out what was just my opinionated personality and which attributes were caused by the PMDD. When you’re dysphoric, it all seems rational.

PMDD comes in a variety of flavors; as many as exist on the personality spectrum. To better understand what aspects of your sometimes less “enjoyable” actions are part of your personality and what is genuinely PMDD, exploring your personality a bit can help. The New York Times wrote an article on the better personality tests out there. There are books upon books about these personality types. Educate yourself. Facts will build your confidence and lessen the post-ovulation tsunami of guilt we all know and love. Isabel Briggs Myers said, “Whatever the circumstances of your life, the understanding of type can make your perceptions clearer, your judgements sounder, and your life closer to your heart’s desire.” 

Seeing a therapist that can help you define which ideas are less logical and which are more significant is ALWAYS worthwhile. You can ask them to help develop coping mechanisms that are beneficial as opposed to the choices that can harm you or others.

Coping Mechanisms

Having a more technical or analytical approach to PMDD is a coping mechanism for me. I know that I’m erratic at times and so I tell myself, if I can wrap these ideas neatly in a box to share with potential friends, I will sound more sane. The goal, motivating those around me to be more tolerant. It works until I insult them in a panic of dysphoria, accusing them of being a womanizing jerk. Then the potential friend wonders what happened to the rational girl they’ve been friends with for 6 months. I’m working on a balance.

I know it seems helpless but there are ways to manage without a hysterectomy. Self care is mandatory. Making sure your body is running on all cylinders will help to alleviate some of the more manageable symptoms. For example: While you’re ovulating, exercise or cutting back on caffeine can help lessen anxiety and avoiding alcohol can help with managing some of the inevitable depression. You’re already stuck with it. Why make it worse with substances?

What fills your emotional gas tank? Reading a book? Taking a bath? Yoga or taking the dog on a long, quiet walk? Put the kids in front of their favorite movie with a snack and take care of yourself. They’ll live with a little bit of tv time but will you live without it? Justifying self care is especially difficult for parents, but you MUST take that time.

Talking about your symptoms will always alleviate some of your suffering. There are multiple support groups on the internet, including Facebook groups like PMDD Mom’s. Finding other people who know that your intention is not to hurt those around you gives you hope in the really dark moments. These people are also all willing to talk you through your monthly spiral when some of your non-suffering friends start to get a little tired of hearing about it.

If diet and exercise don’t help, try talking to your therapist or primary care physician about your SSRI options. They can refer you to a psychiatrist if you need to explore more complex options like more controlled anti-anxiety medications, and Adderall or Vyvance to help with some of the short term inability to concentrate.

Your health and happiness is valuable. Nothing you have said or done during your dysphoria deprives you of that right. Your life is valuable. If you’re reading this, you’re probably fixating and overwhelmed. Breathe in through your nose.. now out through your mouth.

Say this out loud, “It is all going to be ok. It isn’t hopeless. I just have to keep going.” If you can’t do this, and are genuinely considering suicide,  please call the National Suicide Hotline at 1-800-273-8255.

You’re not alone my friend. Remember that.

Love and Light,

Sarah

The Diagnosis

For years I’ve been labeled as “the one who says what she thinks,” or “highly sensitive” as my mother likes to say. I am an INFJ (Myers Briggs) so I am naturally a problem-solving-brooder with excessive feelings pretty much about anything. But the two weeks surrounding my period, my body turns the volume all the way up. I have Pre-Menstrual Dysphoric Disorder (PMDD).

Scientists know little about PMDD other than the fact that it is genetic and that those who have been diagnosed have cells that react differently to sex hormones such as estrogen, testosterone and progesterone. The rather long list of symptoms include: severe mood swings, suicidal ideations, and a variety of others that exist in tandem with their body’s natural hormonal fluctuations. One of the few true solutions is to remove the uterus and ovaries in an attempt to significantly reduce the monthly symptoms. Unfortunately, a hysterectomy is a dangerous surgery with many possible complications.

The women I have spoken to find this daunting. One even said:

“I’ve come to the conclusion that I’m never going to get better. I’m never going to be ‘normal.’”

Most of these people born with uteruses live, marry, and have kids before ever hearing of the disease. Their relationships crumbling under the weight of their erratic behavior, most go to doctors in a panic. An incredible 15% of people with PMDD succeed at committing suicide. Many, many others make attempts and end up hospitalized.

I was diagnosed with PMDD after my hospitalization for what was essentially a nervous breakdown. I was living with my in-laws. I was going to school online full time. My partner and I had two young children in our home and we had just moved from Virginia to North Carolina. My one year old wasn’t sleeping. My partner and I were having problems and my sweet 4 year old just wanted to be loved.

I was seeing a therapist weekly for treatment in regards to a sexual assault I had experienced two years before and a history of depression, anxiety and self-destructive behavior. On multiple medications, it would seem like I was getting better for a while and then two weeks later I would spiral. I was getting A’s in all of my classes and keeping my mother in law’s house as clean as possible with two kids but the pressure was mounting.

At an appointment for birth control I was told that I was pregnant but my hormone levels were off and after further testing, it was determined that I had an ectopic pregnancy. This is when a fertilized embryo gets lodged in your fallopian tube and begins to grow there. I was given a shot to dissolve the pregnancy and sent home. A few days later I collapsed at home with my in-laws and the kids. After being taken to the hospital, I was told that I was bleeding internally because the pregnancy had ruptured my fallopian tube. My fallopian tube was surgically removed. This created a major hormonal shift and I began having symptoms similar to the severe postpartum depression I had experienced with both of my other children. Everything the kids did was too much. My partner could look at me adoringly and I would assume he thought I was disgusting. To be fair, he’s not a very expressive guy but he doesn’t think I’m disgusting.

One day, I just couldn’t take it anymore. The kids were being what seemed to be excessively difficult and I just snapped. I locked myself in my bedroom and called my therapist sobbing. I didn’t know what to do. I didn’t want to live anymore. She suggested that I go to the hospital and let them know that I needed to check into their psych unit for a few days for suicidal ideations. She thought that it would give me a much needed break from my life and also allow me to work more intensely on my medications and coping mechanisms.

After staying 4 days, I was put on heavy medications. The strong anti-anxiety meds like Klonopin made me not care if I lived or died. My partner caught me trying to swallow the rest of the bottle that I had on hand and shoved his finger down my throat. It took a while, but one day the patient advocate at my doctors office called to discuss my decline. She expressed her kind frustration that I had been doing so well and couldn’t figure out what had happened. Agreeing and frustrated I said, “You know, I never needed this medication when I was pregnant. Too bad I really don’t want anymore kids.”

That triggered an immediate response. She asked if I had ever heard of a disease called PMDD. Most people’s hormones stabilize when they’re pregnant which could be why my symptoms lessened so much when I was.  She scheduled an appointment for me to see my regular doctor to discuss this possibility and a few days later, I was officially diagnosed with the disorder. They decided to take me off of all of my medications and start me on an IUD (Nexplanon) to regulate my hormones. It has greatly lessened my symptoms and, through diet and self-care are I’ve been able to maintain without being on medications. This may change.

As this blog is still in it’s moulding stages, I welcome your own stories and experiences. It is important to me that people suffering with this chronic disease know that they are not alone and that there is hope.

I’ve started this blog is to share my story and the stories of others who live with PMDD. It is my goal to share my diet, self-care techniques and to talk about the things that people with PMDD or their loved ones care about. I look forward to hearing your feedback and I love topic suggestions. I will do my best to use gender inclusive terms but I do apologize if I slip.

 

Love and Light,

Sarah