The Honesty Debate – Authenticity While Living With P.M.D.D.

Within the last 3 months I have changed jobs, gone through a breakup and moved to a new city. My last post was me trying to stay above water. This one is to let those who read this know that I made it through to the other side.

A few friends of mine have partners with mental health issues or with disabilities. We often have conversations about their feeling the need to be a less authentic version of themselves in order to hold space for the individual they love. My friends feel the need to go out less or speak and hold themselves differently to properly convey their ideas in a safe way.

I outwardly encourage autonomy but I know what it is to want to perpetuate a relationship with someone who is not carrying their share of the emotional labor. When those of us with mental health complexities are our most authentic selves, do we then require those around us to be less so?

I am 30 years old and have been married (and divorced) twice. I am officially THAT person. Obviously I find myself questioning the losses in my life. Can we have life long relationships when our mental health creates controversy? Asking the people in our lives to hold space for the somewhat volatile nature associated with PMDD feels like a lot. My symptoms often mimic Borderline Personality Disorder or essentially crippling panic that every partner I have will leave. There also seem to be some somewhat abrasive problem solving techniques when I’m feeling vulnerable. I’m working on the last part, but the first (crippling panic) feels well founded most days given the circumstances.

It takes a reasonable amount of emotional labor to maintain a relationship with people like me. We need partners who are capable of establishing and kindly asserting safe boundaries for themselves. Boundaries are useless if you do not communicate them effectively. Self-care is something that our partners must learn but do individuals who have their shit together genuinely want to engage in a relationship that they have to have more aggressive boundaries?

I have come to the conclusion that until I figure out what I need, it is important that my romantic interactions maintain a certain fluidity. Whatever form that takes.

Have a partner with mental health issues? Leave a comment and let me know how you and your partner manage your dynamic.


xo Sarah

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.