What is pre-menstrual dysphoric disorder (PMDD)?

Lovelynn Ndlovu is 22 from London. She is a part of the new wave of mental health activism that intends to bring the topic closer to home and encourages people to reflect inwards. By sharing her own journey with depression, anxiety and PMDD through funny and relatable anecdotes, she hopes to empower people to break down the stigma of mental health, what it’s supposed to look like and who it supposedly effects.

Imagine. It’s a post-lockdown world and everything has gone back to normal.

You look at your calendar and see “Bottomless Brunch w/Gals 🍹🥂”. You are excited! The drinks are going to be flowing, the good times will be rolling and the looks will be served. However, your adulting alarm bells go off and you decide to check your period tracker app. Heartbreak. Looks like you are going to be starting your period that weekend.

We’ve all been there – the disappointment that seeps through your body as you think of all the outfits you probably won’t want to wear anymore, the stash of tampons you’ll have to carry and the painkillers you’ll be chugging between proseccos (n.b. not a doctor and do not condone).

PMDD

Now imagine this scenario, instead of it being the weekend you start your period, it’s actually two weeks prior. Crazy right? Because why would this be an inconvenience? Well for about five per cent of people with periods, because of PMDD, this is our reality.

Premenstrual dysphoric disorder (PMDD) is a range of emotional and physical symptoms, similar to premenstrual symptoms (PMS), but these symptoms tend to be so debilitating, they often interfere with their daily lives, including work, school, social life, and relationships. It’s PMS’s older, more experienced cousin.

My experience with PMDD

For me, I spend five to ten days of the month dealing with various symptoms, in the form of spinning plates, and trying to not let it implode my life.

I will deal with depression, anxiety, brain fog, binging, lightheadedness, disassociation, acne, bloating etc, all the sexy stuff. A lot of these symptoms are similar to PMS, however, the difference between PMDD and PMS, is how the symptoms obstruct daily life. In fact, that was how I came to the realisation that something wasn’t right and encouraged me to further investigate what was going on with my body.   

When I was younger, I went through a few depressive episodes, but for the most part, I had moved away from the situations that were making me depressed and my mental health had levelled out. So imagine my confusion when I realised I still felt this overwhelming sadness every so often and I couldn’t figure out why. I looked back on my messages to my friend and realised I was feeling low on a cycle that averaged out to about once a month. After many, many Google searches and my good friend Web MD, I found some light when I came across the acronym ‘PMDD’.

Solutions

So we have a name, great, now let’s find a solution.

How do you find solutions? By looking at the cause. Oh but here’s the kicker, scientists aren’t sure what causes PMDD – fabulous! It’s thought to be due to increased sensitivity, which leads to alterations in the brain makeup which controls your mood and your general sense of wellbeing. But due to the lack of research surrounding women’s health, it is unclear what causes the sensitivity. What we do know though, is that PMDD is not a hormonal imbalance. It’s more to do with how your body is reacting to the hormonal changes during the menstrual cycle.

Gender bias

Okay, no straightforward cause and effect solution on the web, what about going to the doctor? Well, naive Lovelynn thought she could walk into her local GP and tell them that she has this condition. HA. Fool. As my identity is at the intersection of being black and a woman, I’m less likely to be believed by doctors anyway, let alone for a ‘woman’s issue’.

Years of gender bias in medicine means to diagnose PMDD, I have to prove it. This means filling out a symptoms chart for three months and tracking your symptoms with relation to your bleed. Side note – this was actually a helpful exercise because it meant I was more in tune with my body, it just seems ludicrous that this is the method of diagnosis. Something about it screams patriarchy to me. Nonetheless, after a few months of tracking my symptoms, I went to a gynaecologist and I was ready to start my new PMDD-free life.

Again, naive. There are many treatments for PMDD including therapy, antidepressants, painkillers or anti-inflammatory drugs, combined oral contraceptives, vitamins and supplements, GnRH analogue injections, hormone replacement therapy (HRT) and surgery. It’s all dependent on you and at that time I had already been on antidepressants for a substantial amount of time with no luck, so I was looking for something else. I tried HRT through progesterone pills and oestrogen patches and it was not for me at all. This isn’t to say it wouldn’t work for someone else but for me, the most effective treatment I’ve had to date is therapy.

Therapy

It changed my life in a way I couldn’t imagine, which is such a cliche but also very true. Besides giving me the tools to manage my PMDD, more importantly, it gave me the space to accept my PMDD.

I had spent so much energy trying to fight against the PMDD and was convinced that my life would either go back to normal or reset, once I had ‘beaten’ the PMDD. I thought I was just pausing my life during my PMDD days, not realising my whole life was at a standstill because I was so convinced I couldn’t achieve what I wanted until I was ‘better’. This is a very dangerous way of thinking and if anything, was probably more detrimental to me than the PMDD ever could have been.

Now, I’m not saying I’m perfect or that it’s easy because it definitely is not. There are still some days where I will sleep for six hours to take the stress away, or cry until I feel sick, but these are few and far in between.

Being my own advocate in those early days when I knew something wasn’t right, got me to the place I’m at now.

It can be tough, especially when people are telling you it’s all in your head, you can positively think yourself out of it or exercise your way to happiness but you deserve to feel good about yourself, just as much as the next person. If you think your cycle is affecting you in an abnormal way, tell someone.

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