“What Do I Do When The Suicidal Thoughts Hit?”

Content Warning: This post talks about suicidality.

If you are currently experiencing active suicidal thoughts please call the

National Suicide Helpline at: 1-800-273-8255 

“To the ones who never left me
We’ve been down this road before. I’m so sorry.”- Demi Lovato

If you are currently living with PMDD and haven’t joined some Facebook support groups I strongly suggest you do. On your bad days, they act as a sounding board for your thoughts and ideas. On your good days, they’re an opportunity to lift up another person and remind them that they are not alone in this fight.

“What Do I Do When The Suicidal Thoughts Hit?”

I read this question in one of the groups I follow and was moved by her vulnerability. I started ovulating 2 days ago. Suicidality is par for the course. Every. Single. Month. These feelings niggle at the back of your brain. Her question touched me and so I thought I would share some of the lovely responses she got.

“Reprogram your brain. Replace the thought with three other positive thoughts. Write down what you are grateful for. … .. Try guided meditations on Youtube or take a salt bath. Message me if you keep having these thoughts… I’ve been there and I’ll tell you. You’re not done yet. Hold on.”

How often do we need to hear these words? I often tell my accountability friends that when I start saying, “I’m tired,” it means they should probably check in on me. Consider writing that short phrase on a sticky note on your bathroom mirror. “You’re not done yet. Hold on.”

“I tell myself I am allowed to feel despair.  am allowed to feel like existence is too much for me right now, but I am not allowed to pass my pain on to others. This will pass. … For me, giving myself permission to not be okay really helps. When I’m in that frame of mind, beating myself up for it only makes it worse.”

Even medicated, many women still experience intrusive thoughts. The cyclical nature of the disorder perpetuates feelings of hopelessness, an inability to think clearly, or sometimes even an inability to function as a part of the society we belong to. It it human to be exhausted by it. Accepting our reality and working within it is a key part of living a more fulfilling life with PMDD.

“My cycle tracking app is so crucial. I can open it and literally say, ‘Ok, only three more days.. I can make it three days.'”

There are also a few action items you should add to your “when I’m thinking clearly to do list.” I know it is long, but these should be moved to the top. Making time to care for yourself is important. The one I want at the top is a Period Tracking App.  Like someone said, they remind you that this is not forever but they also help you be more self-aware. The world is not actually burning down. You are just having a bad day and when your app confirms that, it helps to separate yourself from the intensity of your feelings and look at things more objectively.  Me VS. PMDD is a great one. Here’s a link. 

These methods should be used in conjunction with any doctor recommended treatments you have been given. Suicidality is not a joke, and if you are feeling that way now, I hope that you will know that you are not alone. Just a little bit longer. You are not done yet, friend.



PMDD and Suicidality – You Are Not Alone

As open as I am about my experiences with PMDD, the one topic I find most difficult to talk about is my tendency to not want to exist anymore. I worry that my transparency will be misconstrued as attention seeking. This is the furthest from the truth.

Judy Collins, a musician, writer and mother of a suicide victim said, “For many centuries, suicides were treated like criminals by the society. That is part of the terrible legacy that has come down into society’s method of handling suicide recovery. Now we have to fight off the demons that have been hanging around suicide for centuries.” It is National Suicide Prevention Month and although this is a year-round issue, I think it is timely to touch on something that kills 15% of women with PMDD.

This percentage does not include the women who make unsuccessful attempts.  I was hospitalized for active suicidal ideations four years ago. After that, the natural hesitancy or self-preservation instinct that comes with a suicidal thought was negated by an anxiety medication that the hospital had put me on. My husband found me in the bathroom. Shortly after, I was diagnosed with PMDD, and taken off of all medications. My daughter could have these symptoms one day and that is what fuels me to keep this balanced. I have not tried to hurt myself again but I still experience low points that psychologists call passive suicidality.

Passive Suicidality, a symptom commonly associated with Borderline Personality Disorder (people with PMDD are often misdiagnosed), is the relatively persistent wish to no longer exist. Active Suicidality is planning how you are going to make it happen. When I refer to myself as having suicidal ideations in these posts, I am referring to the fact that I often (3-4 times a month) wish to no longer be alive. When I have these thoughts I am not actively planning to make that happen. The opposite in fact.  I have to come up with ways to work through my lackluster enthusiasm for existence on a monthly basis by acknowledging the source(s). My unhealthy thoughts are often triggered by three things:

  1. Excessive alcohol consumption during ovulation in combination with interacting with large groups or just new people. – I have relatively intense post-interaction social anxiety. The entire way home from any social gathering I reel in all of the “complete nonsense” that came out of my mouth and convince myself that everyone hates me. If I consume excessive amounts of alcohol in tandem I will typically wake up the next morning in an emotional hurricane.
  2. The breaking down of a relationship that I care about. – Knowing that this disease causes intense and sometimes crude reactions to stressful circumstances has me beating myself up for weeks after a relationship goes through turmoil. What am I subjecting the people in my life to? What kind of awful person says these things? I tell myself that I am doomed to destroy all relationships in an emotional ball of flames and that I should just stop.
  3. The idea that I am only 29 and that for the rest of my ovulating days, THIS is my fate. – The cyclical nature of this disorder perpetuates an idea of hopelessness. Prayers for menopause circulate the Facebook groups I am a part of. Many people with uteruses dread the physical implications of being in their late 40’s and early 50’s. Individuals with PMDD see it as the light at the end of the 30+ year tunnel.


I have found that if I have chosen to eat poorly (i.e.: Lots of carbs, red meat and sugar) for consecutive days or consume too much caffeine or alcohol that I can count on having an overall poor demeanor the between ovulation and starting my period. This makes the aforementioned triggers more significant and causes the spiral that if not circumvented can end in more “active” thoughts. I make occasional statements about being “tired,” but not tired physically. An emotional exhaustion permeates my every waking moment. This is my clue to make some life changes.

Like what you ask? I know you asked. Let me tell you. Wait for it…… aaaaand a cure has not been found. Consistent treatment is spotty. Not everyone has access to a hysterectomy. I know what you are thinking. “This is not helping, Sarah.” Reality bites my friend… but we have to keep moving forward.  A few things seem to offer relief for most sufferers:

    • Cognitive Behavioral Therapy– This is simply defined as looking at your symptoms objectively and finding triggers. Therapists are a wonderful resource for you, your partner and your kids as you explore PMDD and what it means for your day to day life. When you are choosing a therapist, consider how you communicate, and how you prefer to receive information. Try different people until you find someone who you connect with. I have spoken to so many people who have gone to a therapist once, have a bad experience and never try again.

        • THIS INCLUDES SYSTEM TRACKING- I cannot emphasize how important system tracking is to your ability to be aware of what is happening in your own body. There are so many apps you can use. Click here for GAF’s suggested trackers.
    • Medications– Everyone has a different chemical makeup. It is important that you talk to your doctor about your options. The link takes you to the Gia Allemand Foundation’s Clinical Care Help sheet. This can help someone educate themselves prior to finding a physician and prepare for talking to them about a disease that is not widely known.


    • Self-Care:  The guilt that is triggered by our actions needs to be quieted occasionally. I have a difficult time just doing something for myself when I know I have been a lackluster parent, friend or partner. I am constantly working to compensate for my bad days though exhausting myself on my good ones. If you are like me and have a hard time coming up with things to do for yourself, the link will take you to a page where someone else has put a lot of thought into it for you.

For some, doing all of these things will not work. Do not give up. You are not a burden. People WILL miss you. Your life is not too messed up to have value. The more you talk about it, the less likely you are to act on it. Having a rough time finding someone to talk to? Gia Allemand has peer counselors available for you! Click here and schedule an appointment today!

You can also call the National Suicide Prevention Lifeline 24 hours a Day: 1-800-273-8255.