Daily Archives: November 11, 2012

For the Ladies – Living and Thriving with #PMDD

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This post is for anyone who is a woman or knows and loves one. I am 45 and started experiencing hormonal changes about five years ago. Most of the changes were benign to slightly annoying. They started with foggy thinking, crying at a baby shampoo commercials, then included night sweats and very dry facial skin about a week before my periods and left me very confused for a while until I started to pay attention to it all.

Let me start by saying this: anyone who doubts the power of hormonal surges, falls, bounces or whatever, needs to have their head examined. The very substances and chemicals responsible for creating physical changes and menses in young women; deeper voices, chest and facial hair on young men and the ability to create and grow another human baby are some truly powerful shit. They are responsible for good moods and bad moods, heart and brain health and just about everything under our human suns. If your wife, sister, girlfriend, mother, aunt, boss, secretary, teacher, nun, crossing guard, neighbor says she’s having a bad day or that she’s PMSing, take her seriously and offer her a simple kindness. What I’m writing about, Pre-menstrual Dysphoric Disorder, PMDD, is like… PMS on meth.

Some people in my life suggest that when I get like this with both of you, that I am exposing myself to undue commentary or even sensationalizing my situation to garner sympathy. Nothing could be further from the truth EVER. I don’t need to tell anyone any of this. I am doing this because I hope to share a sliver of my life to allow someone, anyone out there; maybe someone you know if it’s not yourself, some semblance of hope when confronting this extremely desperate time of hormonal fluctuation. I don’t care if people look at me as though I have three heads; at times I probably did…

About a year after the night sweats, I began to experience only what I can describe as unpredictable intense rage within days of getting my period. The kind of rage that makes the harpies in a Dracula movie look like the Andrew Sisters.

Harpies.

The Andrew Sisters.
Well, maybe this isn’t such a good comparison. They don’t look too mellow. But they do look nice…

All my life I’d been very fortunate in the female department: I had crampless periods, no bloating or headaches or backaches. Even after having my boys, I continued to be a non-PMS woman. The only symptom with my periods I ever got after having babies was aches and tightness in my hamstrings and a need to sit down until the ibuprofen kicked in. Because I’d never experience any typical PMS symptoms into this new phase of sweats and chills, I didn’t make the connection for about 18 months. It wasn’t until I lost my mind on our dog, fell apart emotionally in the basement during a workout and other weirdness that I started to watch for patterns.

Hold up: when I talk about night sweats, you guys need to understand something if you don’t already know about this. By night sweats I don’t mean getting a little hot and having to kick off the covers. I mean this: getting so freakin’ sweaty that you are drenched and you have soaked through your pajamas. If you have had kids, I’m talking about night sweats on a scale to mimic post-partum night sweats. The kind that wakes you ONLY because you are now chilled to the bone after the ignition. Your sleep is disrupted for about three to four nights in a row. So not only when you get your period are you cranky from the hormones, you are fucking homicidal because you can’t sleep.

You still with me?

Another interruption: during the first two years of the night sweats, I started to take bio-identical hormonal drops that my doctor gave me. I would add them to my tea in the morning and at night. They worked well, until they didn’t anymore. After about a year, I had to increase the dosage and the number of times I took them and that helped. It wasn’t until I was practically mainlining the stuff that I realized it wasn’t working any more. So at this point, I was aware of the night sweats, but nothing else.

Back to the rages.

Most of these rages I wouldn’t be able to recall; they were like micro psychoses. I didn’t hurt anyone physically and I pray not emotionally, but I know I caused some damage to my children and our dog, likely in the form of their being terrified, unsure of who I was and nervous about trusting me. This is a horrible sensation: to be aware that your children are on their guard around you.

The only episode I sort of recall before I started to actively do some investigating was when my husband intervened one evening when he came home from work. He found me screaming, yelling, flailing and snarling over our beautiful then 10-year-old son who was cowering with his back to a corner, his hands were covering his head and his ears, and he wore expression of absolute terror on his face. His little legs were drawn into his body, like a ball. I remember feeling like I was 10 feet tall; my vision was strangely altered, like how a fish-eye lens works. I probably had flames coming out of my mouth and smoke pluming from my ears.

This.

I don’t remember anything about the episode, what set me off, what it was about, if I had touched him (which he tells me I hadn’t) or what I said to him (he can’t remember or chooses not to say, he’s very tender). I remember being told by my husband that he dashed into the room, pulled me away from our son and that I shoved him back about five feet and that he caught  himself on a door jamb. Mr. Grass Oil is no wallflower: he is very athletic and weighs about 190 and is 5’10”.  Although I’m in shape, I have never been able to tackle him in play or jest, he’s like a wall. He told me he sent me out of the room and I do remember telling him something elegant and articulate like “Fuck you!” and that I was probably gnashing and snarling. My husband is a peach. Anyone who says that to him deserves a kick in the butt.

I don’t know where I went next, I don’t know what happened other than to say I was completely beside myself with rage, and a  sensation that can only be described as profound and gut-wrenching feelings of being unseen and unheard. Several hours later, I got my period, a couple days early, and the rage was gone. Although I was emotionally and outwardly lighter, internally I was crushed with confusion and woe. That episode had been perhaps the fifth involving our children, but gratefully they were not in succession.

My feelings of being unseen and unheard hails from being an Adult Child of Alcoholics (ACOA) and because of this, they might be more profound than yours. Very often, we ACOAs were denied attention by our parents in favor of their addictions and diseases. Look, I’m 45. I’m not gonna harp (ha! harp) on my parents and their stuff. The fact is that I know there is a correlation between PMDD and ACOA women. Medical experts also suggest that PMDD sufferers are adult child survivors of physical or sexual abuse and that keeping in all that rage directed at others is what can cause the unconscious hormonal rage releases. Whatever the cause, it’s real and people need to give women a break.

Onward.

Fast forward three months to the final time I had a PMDD episode and didn’t know it. I was on a beautiful vacation with my children and husband and other family members whom I love very much. I love them so much I’m not going to tell you who they are. Being in close quarters and attached at the hip for a few days in a row is fine, but it can get to grow on people. On the penultimate day of our togetherness, one of these people and I had exchanged a couple jabs, and I was sorta tired of it because I felt like I had mostly been the recipient, just due to old behavioral habits and family dynamic patterns. A final jab had been given and while most people who witnessed it believed it was uncool, I treated it as though it were possibly the. most. horrible. thing. that. had. ever. been. said. to. me. in all of my years of existence.

I stewed.

I stewed. Omigaaaad, did I stew. I behaved like a baby at the evening’s celebratory dinner for my parents’ 45th wedding anniversary. I was such a pill that I left early. Even though this person and I weren’t really speaking (at least I wasn’t) I still had never been so insulted in my whole life. The next morning, I insisted in a summit on the beach with this person. Apparently I became a shrew. I do remember spewing a torrent of epithets at this person, you know, on an open beach slightly after nine in the morning on the day of their departure.  Totally rational, right?

The conversation — in fact this person, who is smarter than everyone on this planet put together, said that words failed when trying to describe the interaction — was jointless, mostly one way (mine), jagged and abusive. This person conceded to their wrong doings on the beach and apologized for the jabs, but apparently I wasn’t listening.

This is Lucy from Dracula. I was not Lucy, nor was I lucid. But her demeanor feels familiar.

We broke off on the beach with my teeth dripping blood and innards of a gull in my hands. (Joke.) But I was still screaming and swearing.

This person was insanely important to me and I was still blind with rage when I watched their car drive away. I didn’t understand what was going on, but I didn’t want to be left holding the bag for our disagreement. After all, I was provoked. Whatever. I was told by this person and its spouse to leave them alone and not contact them again. My treatment had been deplorable and disproportionate to what I had deemed to be the provocation. I was consumed with sadness. I thought I had lost those people forever. That night, my period came: three days early. Even with my vigilance, there was no way to have predicted the hormonal and mood changes. So not only was my body clock jacked up, my hormones were basically holding me hostage. The following days of my vacation were absolute hell for me. I couldn’t eat, sleep or really function outside of thinking of how horribly I had treated these people.  I felt betrayed by my body.

I called my therapist and she suggested that it might be hormonal and I agreed, but didn’t really buy it. It wasn’t until I talked to my husband and other family members that I was able to put together patterns.

When my family and I returned from the vacation, I got online and went to the library and called people and finally found a resource to help me. My husband in the meantime was having conversations that I wasn’t aware of to mitigate the damage and to keep my valued people abreast of what I was doing to address the problem. I felt as small as a flea on an elephant. Finally, my research hit pay-dirt. I took a quiz online and self-diagnosed with PMDD. What is PMDD?

Pre-Menstrual Dysphoric Disorder.

Premenstrual dysphoric disorder (PMDD) is a condition in which a woman has severe depression symptoms, irritability, and tension before menstruation. The symptoms of PMDD are more severe than those seen with premenstrual syndrome (PMS).

PMS refers to a wide range of physical or emotional symptoms that typically occur about 5 to 11 days before a woman starts her monthly menstrual cycle. The symptoms usually stop when or shortly after her period begins. (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004461/)

another resource http://www.pmdd-community.com

and a link to a Facebook chat hosted by Dr. Northrup: https://www.facebook.com/DrChristianeNorthrup/posts/10151180624930029  – a Facebook account is required.

After that self-diagnosis, I called my gynecologist for a phone consult. She asked me to come in and we talked about it. She confirmed my suspicions and said that I should watch what I eat, get rest and plenty of exercise before my period. I said, “My periods are all over the map, I have severely affected a personal relationship that I value very much and if running three miles every day and doing yoga twice a week in classes doesn’t count as exercise, I’m not sure what else you can suggest. I have a very balanced diet and I love sleep. What else do you have for me?”

Apparently nothing.

I went back online and I started to dig and I remembered hearing Christiane Northrup, MD, on a talk show about female changes a few months before. Northrup is a fantastic pro-women and amazing obstetrician and physician who has written many books about women’s health, menopause, perimenopause, female health. She has said of PMS and PMDD, that “they are the bill for the previous month’s experiences,” meaning that if you were good to yourself health and spirit -wise, you would have a relatively uneventful period; but if you denied yourself, put yourself last, didn’t take care of yourself and other similar behaviors, your period would be painful or challenging.

After digging a little more, I discovered Women to Women, which turned out to be a company that Dr. Northrup co-founded. I searched their site for PMDD and took their quiz even though I knew the answer. I called their nurses and signed up for their program which included fish oil and a daily vitamin and calcium supplements — things I was already taking and I was taking even more of the fish oil than they sent. Along with those supplements, they also sent me me bio-identical herbal supplements on a monthly basis called “Herbal Equilibrium” and I take them every day without fail. Five days before my period, I double up through my cycle’s third day. The supplements have SAVED ME. Within one cycle, the PMDD rage symptoms were gone, my periods were more regular and the night sweats were reduced. If you don’t buy from them, call their support line anyway, their nurses can help you with questions.

Northrup has a cohort, Dr. Mona Lisa Schulz who is a medical intuitive: she has a medical degree in treating and diagnosing brain trauma and brain injury and she’s also a gifted psychic. Drs. Northrup and Schulz have a set of CDs called “Intuitive Listening” based on their discussions about female health and how the spiritual or emotional directly affects the physical. A quick example: a woman has had terrible back pain for years. Her husband lost his job about four years prior, just as she was launching her own business as an entrepreneur. Her husband suffered from major depression as a result of his job loss and she ends up going back to work in a job she hated. Along with the back pain, she is beginning to suffer from adrenal failure, experience massive fatigue and has weakness in her legs. Dr. Schulz diagnosed her with some ailments and then said something along these lines: “Your back is literally breaking and your legs are giving out because you are spiritually carrying your husband around and you have been, against your will, for the last few years. If you don’t get out from under him spiritually, you will suffer from these progressive diseases…” and she went on to list them.

What I’m trying to say, is that what we do in our outside world affects our inside world and over time, it can become bigger than we are.

One more thing about the PMDD: Before I knew what was going on, and after that episode with my son, I decided to pay more attention to things and to chart my periods. I got an app on my Droid phone called “My Days” which is mostly used for people trying to have a baby, unless you’re like me: trying to stay out of the mental hospital.

One size fits all.

Speaking of the mental hospital, I also take several over-the-counter supplements to help me keep a even keel emotionally. I’ve been taking them for about six years, ever since my internist suggested I take a low-dose SSRI (seratonin serum reuptake inhibitor: prozac, lexapro, wellbutrin, zoloft, etc.) for mild anxiety and I was fearful that an SSRI was a slippery slope due to the side effects. They are: 200mg SAM-e, 100mg 5HTP (at night, read about it), B-complex, “sustenex” a probiotic for gut / brain health, 3000mg fish oil 2x a day among calcium, etc. and I don’t see any side effects. This works for me — I workout like a maniac and practice meditation, give myself time-outs when I’m nonplussed and angry and I try to keep my voice calm. All of this requires tremendous self-awareness, and I’m OK with that.

Back to the app: it was very helpful until that trip to the beach. Why wasn’t it helpful? It wasn’t hooked up to my hormones and it didn’t know to put me on alert for my own built-in personal hell three days early. But after being on this program for 28 months now, I can only tell you that I’m in a far better place. Now I just get a small backache before my period and even if it’s early or late, I have no mood symptoms other than being just slightly tired because of the disrupted sleep. That’s the only tip off. Now I have this great website saved on my phone to help me keep track of what’s going on with my emotions and my hormones. I hope to have it memorized soon.
http://www.menstruation.com.au/periodpages/knowyourbody.html

So here’s the deal: we have to pay attention to ourselves and sit still long enough to notice that stuff is changing in our bodies. It’s one thing to be on the cusp or in the throes of being of a certain age and not sensing symptoms, it’s quite another to see them occur and totally ignore them, or just pass them off as a fluke. PMDD is no fluke. It is hell. If you suspect you have it, or know someone who might or see these changes in a loved one, please get her some help or have her read this post.

If nothing else, she will know she’s not alone.

This was a very long post. My use of humor in conveying the severity of this disorder is not meant to dilute or diminish anyone’s experiences with it; in fact it’s essential to me. In person, I’m a very quick-witted and funny person which means that I am also a very cutting and at-times angry person. I have found that I prefer the laughing over the tears.

I appreciate you sticking it out with me. I also invite you to read the comments below. There is helpful info there. By the way, my relationship with that special person is ok.

Thank you.

ps – This is my personal story. I’m not offering medical advice or a diagnosis and this post should by no means be substituted for a proper diagnosis performed by a practicing medical healthcare professional. I’m also not affiliated with Women to Women; I just take their stuff. What you do is up to you.

I seldom ask this: please SHARE this post if you think one person can be helped. Read the comments. We are together in this.

UPDATE: 1/15/14: I have been asked by a couple readers if there is anything new to share in my experience. I would like to say no, that I’m cured and that I have nothing else to say. The fact is that PMDD is something I will live with until I finish menopause. It’s something that will follow me, lurking in the shadows and that no amount of awareness will ever defeat. What the awareness does, however, is remind me that I have a role to play in this: no longer the victim; just the survivor and winner. I feel myself get edgy before my cycle kicks in. I feel bloating and headaches and something in me says, “Don’t take that shit! You can beat it!” but the fact remains that the larger my ego, the greater my fall, so I do have do fall out, I do need to take a few hours away on my own. It’s OK to say you need a break. It’s OK to say, you’re tired and you just want to be alone. Anyone who doesn’t get that, needs to get with someone else or educate him or her -self. PMDD is real, it’s here to stay. Just like the Taliban is here to stay, but we don’t have to take that and be afraid. We just keep going on. With awareness and new rules.

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