What is PMDD?
What exactly is PMDD anyway??
I’m so glad you asked…
For those of you who are new to the world of PMDD or are just trying to get a deeper understanding of it, I hope this adds some light in what can be a very confusing and dim space.
Defining PMDD
The International Association For Premenstrual Disorders defines PMDD as: "a cyclical, hormone-based mood disorder with symptoms arising during the luteal phase of the menstrual cycle and lasting until the onset of menstrual flow. It affects an estimated 2-10% of women of reproductive age. While PMDD is directly connected to a woman’s menstrual cycle, it is not a hormone disorder. It is a suspected genetic disorder with symptoms often worsening over time and following reproductive events including menarche, ovulation, pregnancy, birth, miscarriage, and menopause.”
So… to sum that up, PMDD symptoms show up around the 14th day of your cycle (typically a week and a half to two weeks before your period starts). These symptoms build with the hormone levels in your body and typically start to fade and dissipate after you start your period and hormone levels begin to balance out.
THIS IS NOT PMS
PMS is a term that defines “normal” and typical symptoms that occur when women get their periods. PMDD is a much more significant disturbance of mood and emotion that often has a damaging impact on your life and relationships. It is the “evil twin of PMS,” looking very similar and sharing similar core traits, however PMDD having hidden villainous qualities that can cripple the life of the women suffering from it.
A Little History
PMDD was not recognized as a diagnosable disorder until May of 2013. Prior to that it was acknowledged as provisional due to insufficient research and was often treated as a low level depressive disorder that got worse during menstruation. This led many women to feel guilt and shame around their symptoms and be treated incorrectly for their struggles.
What PMDD Looks Like
The lack of suitable medical research makes it hard to identify the exact symptoms of PMDD, and they can vary from woman to woman. Below are the most common symptoms of PMDD. Keep in mind the intensity level of these symptoms is higher than “common” PMS symptoms.
Depression
Sadness
Hopelessness
Anxiety / Panic Attacks
Tension / Restlessness
Extreme Sensitivity / Mood Swings
Irritability
Rage / Anger
Suicidal Ideations
Racing thoughts / Difficulty Concentration
Relational Tension & Conflict
Low Self-esteem / Negative self-talk
Fatigue / Insomnia
Self-Harming
Self Deprecating Thoughts
And many more…
What PMDD Feels Like…
Women suffering from PMDD have described it as feeling like a completely different person, as though you are living a different life. Here are some quotes from courageous women who chose to share their experience.
“I felt deep misery and severe panic attacks, and when in the thick of it, I felt as though I would always be this miserable and it wouldn’t go away.”
- Marie, 31
“When I am in the worst of it, I feel as if my body could literally explode with the amount of tension I experience. The littlest things will completely overwhelm me to the point of inability to function and do daily tasks.”
- Jennifer, 37
“I tend to be a perfectionist naturally but when it is the week before my period I am wholeheartedly convinced I am failing at everything in life, and that EVERYONE feels the same way. I am a complete irrational mess.”
- Anita, 29
“I cry for a week… I am wrecked by any and all emotions. Songs, commercials, certain sounds, I’m crying. And not just a few tears shed, a deep, raw, ugly cry!”
- Kendra, 40
“My husband was fearful of this time of the month, every month. Before we knew what was happening to me, and before we even knew what PMDD was, we used to fight a lot about how bad I got. It was so hard to explain to him what was happening for me when I didn’t even know myself. I felt GUILT like I’ve never felt about anything else in life.”
- Lisa, 39
See what more women say about their experiences with PMDD here.
If you relate to these women, I hope this helps you know, YOU ARE NOT ALONE. You are not broken, you are not crazy.
Treatment
There are many different treatments for PMDD, some natural remedies as well as medications. Most commonly prescribed are antidepressants that slow the re-uptake of serotonin (SSRI’s: Prozac, Celexa, Effexor, etc.), which have shown to be an effective treatment of PMDD. These drugs decrease symptoms of PMDD more rapidly than typical depression or major depressive disorder, which means that women don't necessarily have to take them every day. Instead, these drugs are commonly prescribed to be taken as “luteal-phase” doses, beginning approximately 14 days before mensuration starts and ending shortly after.
There are a multitude of dietary changes that aid in the treatment of PMDD. Foods and supplements that are known to decrease inflammation are important as that is a key component in symptoms like anxiety, irritability, strong shifts in mood. Decreasing dairy intake, as it is known to cause inflammation, as well as caffeine or other nerve stimulating or enhancing ingredients.
Moving your body during the luteal phase is a way to help move the energy that arises during this time and if stagnant can cause symptom exacerbation. This doesn’t have to be running a marathon by any means. Sometimes the slow movements of yoga or a short walk in the sunshine is enough to jump start the flow that is needed to shift your mood and energy.
Mental and emotional exercise is another strong way to combat symptoms of PMDD. Mindfulness strategies, meditation, journaling and grounding exercises are great mental cardio, just to name a few as there is a vast collection of things to try.
Psychotherapy is another incredibly beneficial way to treat PMDD (I know I may be biased here but just trust me J). Much like coaching, therapy is a place to be accepted just as you are and to feel seen, heard, understood and supported. Sitting with a therapist who understand PMDD and can help guide you through what is often the blinding storm of symptoms can make a world of difference in treating PMDD effectively. The biggest thing that a psychotherapist can provide that is not a part of coaching is deep insight into past traumas and experiences that are influencing not only how your PMDD symptoms and triggers arise but the ways in which you cope with them. Addressing and healing some of the underlying wounds from your past can propel your coping and growth.
If you are in California and feel like you would benefit from psychotherapy services I can help with that: Click this link to find my psychotherapy practice where this work originally started: www.drkimberlytherapy.com
How Coaching Can Help
PMDD can create shifts in our thoughts that can blind us to reality as well as disconnect us with our own inner strengths.
Coaching is a way to keep you on track and accountable with gentle and compassionate reminders of who you are and the strengths you already possess.
Coaching can help you find ways to create more clarity and increase your ability to execute your self-care plan and coping skills.
It can also help to ground you and connect you to who you are underneath the havoc that PMDD is wreaking on your life.
Coaching can help you navigate your triggers and find your unique arsenal of tools and armor necessary to keep you pushing through the peak of struggle.
More than anything, THIS is place to be heard, to be understood, and to NEVER be judged for what you are feeling or experiencing.
If you think coaching services fit with the support you are looking for; start by scheduling a FREE 20-minute phone consultation HERE now so we can chat about how you can be supported, today.
Because PMDD is still a fairly new diagnosis and less widely known by the general public it can be hard to find people to talk to and connect with. If you suffer from PMDD or think that you might, I hope you will reach out for help and know you are not alone.
Much Love,
Kimberly Ciardella, Psy.D. is a PMDD coach and consultant, a doctor of psychology, and a psychotherapist licensed in California. She specializes in working with individuals, and the people who love + support them, who are experiencing the obstacles and challenges of Premenstrual Dysphoric Disorder (PMDD). Dr. Ciardella works with determined individuals to overcome and manage many of the symptoms of PMDD, along with strengthening relationships and support systems in order to thrive and live a fulfilling life WITH PMDD. She works with couples who are facing these monthly battles together and parents who are doing whatever they can to support their daughters who live with PMDD. Click here to schedule a free 20-minute phone consultation to work with Dr. Ciardella. Follow The PMDD Coach on Facebook + Instagram.