PMDD & Me

Preface: trigger warning for suicidal ideation. Also a lot of in-depth discussion about PMS, periods, physical symptoms, and emotionality. In short: if you don't like reading about the wiles of being a woman (to a true extreme), you may want to abandon now.

I've had issues around my menstrual cycle for as long as I've had a menstrual cycle, I would say. Much less around my actual period than before it, where my premenstrual symptoms have ranged from such extreme breast tenderness that to simply move would cause intense pain, to raging mood swings that have, particularly lately, caused me to wonder if I have a serious mental illness. Today I was finally confirmed as suffering with Premenstrual Dysphoric Disorder, the most extreme form of PMS.

This isn't a little bloating and feeling a bit tearful a few days before my period, it's a debilitating, all-consuming emotional problem that's taking over my life. Has taken over it, I think it would be fair to say. For much of the past ten years, and certainly more strongly in the most recent five, I've been at the mercy of my hormones, experiencing around 7-10 days at most per month where I feel I am myself. The rest, I am a monster. I am carrying concrete in my throat and chest. I am unable to function. I become somebody I don't recognise, but becoming that person so often caused me to believe that maybe, actually, this was who I actually was. I'm so grateful to be able to say that I'm not that… thing masquerading as a person. I survive underneath it. It just squashes all of the real parts of who I am.

One of the defining features of PMDD is suicidal ideation. This is the one thing above all else that has been most crippling, and most frightening, in recent months. I have sat in queues at petrol stations, waiting to fill my car, wishing I had a lighter to end everything with. I have driven recklessly, crying at drivers who have cut me up. I have prayed for the courage to confront rough-looking characters hovering on roadsides at night, in the hopes that they might fight their way into my car and murder me. I have driven along motorways and eyed the central reservation and bridges, wishing for the guts to end my life. I've fantasised about jumping off bridges as I cross them, or in front of trains as they pass. These are not fleeting thoughts, they are heavy, persistent, and they tease me with an escape from how I feel so often. I've been conditioned into risk assessing and I have two protective factors: 1) I couldn't hurt my family by ending my life, and 2) I'm too scared that anything I tried wouldn't work.

PMDD has destroyed many of the relationships in my life. When it creeps in, I become critical of everything and everyone around me. I become harshly critical of myself, and the perfectionism that tarnished my adolescence makes a comeback. Things that wouldn't usually bother me — I very much subscribe to the ethos of live and let live — become distracting and frustrating, I judge everyone around me and push everyone away. Some elements of my perfectionism are just the way I am, I have high standards for myself and they can cross over into expectations of other people, but when I am verbalising them, when I'm making snide remarks, rolling my eyes, when anger bubbles up — PMDD has taken charge. I truly do not believe this is the person I am, and the fact that I become this person so often terrifies me. I have damaged friendships beyond repair, I have ended relationships to avoid inflicting my moods on other people, I have a strained relationship with my family because two weeks of the month, when they speak to me, I almost literally hiss and spit at them in response. It's like being possessed. PMDD is a visitor in my body, albeit a regular one, and one that barges through any barrier I try to impose.

It hasn't always been this bad. I recall having horrendous mood swings, acne, and breast pain as a teenager, and most of these were remedied with various contraceptive pills or herbal remedies. I dislike the notion of synthetic hormones and found them to be more bad than good oftentimes, so when I discovered Agnus Castus a few years ago, I felt like my prayers had been answered. All of the pain I'd been in, all of my mood swings: they vanished. Early last year, Holland & Barratt changed their stock of Agnus Castus to a much lower dose, and my symptoms returned. I tried several other formulations to no avail. Though it was expensive, I switched to Agnus Castus Support around 5 months ago, a herbal blend containing milk thistle, skull cap and black cohosh. For £20 a month I was expecting a miracle, and I was willing to pay it if it gave me my life back. Needless to say, it did not. I gave up with persevering a few days ago, when the large capsules started to make me heave and retch — all that, for no benefit? No thank you.

So I went back to my GP. Or, rather, any GP available, and when I tried to explain during my telephone consultation what was wrong, I could do little more than cry. To try to put into words how I feel is so hard, and to try to adequately express just how distressing it all is even harder. I made a list of symptoms to show to my doctor, and panicked that she'd think I'd just copied them from the internet, because my symptoms are so classic of PMDD that I somehow feel like a fraud. (I don't get particularly lethargic or suffer with insomnia, does this make what I'm going through more legitimate, or less?). I've been prescribed Fluoxetine and Naproxen to help me manage, but the principal treatment, the treatment I was hoping to get, is likely not going to be an option for me. You see, because my mum has had deep vein thromboses and pulmonary embolisms, the risks of oral contraceptives are considered to outweigh the potential benefits. This guidance was brought in in 2009, and the last time I was prescribed a COC was 2008. If I just wanted to avoid getting pregnant (hahahaha… hahahahah) I'd have a wealth of options available to me. But because I need a pill to balance out my hormones, to stop this loss of control and destruction of my life, I may be out of luck. Out of hope, out of everything.

Fingers crossed I can come back in a few days, edit this with the good news that my usual GP, a practice lead in contraception, has been able to okay the medication. I can't contemplate what will happen if she doesn't, or can't.