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.

Reproducing With A Genetic Disorder- A Letter To My Daughter

Originally Posted on the Gia Allemand Foundation Blog

Hey Bug,

You are 8 years old and without a doubt the most gorgeous little girl I have ever seen. Your sensitivity, vibrancy, and compassion are enviable and they are going to make you a more compassionate person when you get older. I am terrified that something I do or that I have already done is going to tarnish that.

You do not live with me full-time anymore. You live with your father. The cyclical nature of my moods is not easy to live with and it seems to affect you more than your brother. The guilt from not being able to be the mother that you deserve eats me alive every time I think about you. What will you remember about me?

I often wonder what you will be like when you are 25. There are three distinct possibilities. I will get lucky, be successful, stabilize my life and maybe you will think that I am awesome and want to be like me. More than likely though, you will come to terms with this disease and have a tenuous yet strained relationship with me that exists on “your terms.” It is also quite possible that I will be the reason that you see a therapist monthly.

When I chose to have children, I was unaware of the implications of that decision. I had not been diagnosed with PMDD. I did not know that the choices I was making could take a young, innocent life and change it forever. PMDD is genetic. This means that the monster that crawls into my brain every single month could come after you as well. What kind of mother am I, who allows such a thing? I am supposed to be your protector.

You are here now, and this is your reality too. I want to be a good example for you and so I want to make a few things clear. I may not be able to undo this disease or the poor choices that I sometimes make, but I can make you a few promises:

  • I promise to be here. I promise not to take the easy way out or to cower under the weight of my symptoms. I promise to get up every morning and actively work to create a better world for you to exist in.
  •  I promise to get you tested when the time is right and if you test positive, I promise to help you find a good doctor who trusts your experiences. Nothing you say will sound foreign or intimidating to me. We will get up together. We will conquer this together.
  •  I promise to pursue my dreams so that you have confidence that this disease hasn’t put a cap on your possibilities. In turn, I will do everything in my power to help support the vision you have for your future and encourage you to keep moving forward even when the clouds look dark ahead. You will hear, “The only way out is through,” more times than you can count.
  • Finally, I promise to do my best to spread awareness of this disease, so by the time you are ready to consider having your own kids, doctors will have an effective treatment.

I love you baby and I cannot promise you that any of this is going to be easy. Thankfully more than just PMDD runs in our blood. We are from a line of strong people who have worked hard for what they want and what they have. I am confident that you will not let this conquer you. You are going to change the world.


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