Weathering PMDD

Premenstrual Dysphoric Disorder (PMDD) is a monthly storm that affects an estimated 3–10% of all menstruating women. It's an intense inner upheaval that can leave a path of functional, relational, and emotional damage in its wake. In fact, many women with PMDD feel like the 10-14 days of symptoms every month requires the remaining days just to catch up or make up. It can feel like life's ship never quite leaves port before it all starts over again. The pain and discomfort are real, but there's no need to suffer more than necessary. If you are one of the unfortunates who experiences this unique monthly curse, here are some important things to remember to help you weather the storm:

1. You're not crazy.

It can feel like you've completely lost your real personality, let alone the rest of your sanity when you are going through the symptoms. You're not crazy; you're subject to a hormonal storm that no one could handle any better. You simply might not be able to control your responses right now. And you may do or say things that are totally shitty or stupid, but that's not because you're "making it all up," "being dramatic," or "a terrible, horrible person." It's because of chemicals and your sensitivity to them.

2. Not many will understand.

Sad to say, but there won't be many people who can understand what you are going through. Friends might be able to offer some sympathy or compassion and medical professionals or family might be able to offer support, but the only ones who will ever know what you are really going through are other women with PMDD. That lack of understanding from others can sometimes be a crushing and painful expectation, so the best thing to do is realize early on that it is impossible for anyone to know what it is like unless he or she is living it.

That said, the compassion and empathy of other women who also have PMDD are invaluable when the tough gets tougher. When you're at what feels like the end of your "ability to cope" rope, reach out in forums and groups.

3. You can say no.

This is always true, but especially true when you are in the throes of PMDD. If you don't want to go out with friends, if you don't want to take that planned daytrip with your sweetie, if you don't want to talk or shower or get out of bed, you can say no. You can even say no to yourself when you start thinking, "but I should..."

But there's another aspect here too. You are allowed to say no when someone is trying to shove useless advice down your throat. You can say no when someone tries to tell you what you should be doing or taking for your condition. You can say no to all the projections, judgments, and expectations of others.

4. You can be a little selfish.

Similarly to No. 2, this is the time to be even more loving toward yourself... when it is harder. Sleep in. Cook for yourself and let the family fend for itself. Don't let others guilt-trip you into doing what they want. That's them being selfish, not you! We all know we have to put the oxygen masks on ourselves first. And if you need time alone, yes, permission is granted to take it. Just take that sucker! Whoever you have to put off will survive. It bears repeating that you are not obligated to the expectations of others, and not even necessarily to your own.

5. You don't have to do more than you can.

Sure we all have responsibilities, and certain things have to be done no matter how we are feeling. But many if not most of what we do every day doesn't have to be done then and there. You can put off tasks you simply don't have the energy for. Shower in the morning instead of after work. Let the laundry sit for a few days. Go grocery shopping when symptoms start to lift. Better yet, if you have help available, ask for it. Of course, under normal circumstances, there are things that are better taken care of as they arise. But when symptoms of PMDD hit hard, it's okay to exercise a little selective procrastination.

6. Forgive yourself.

Okay, so you messed up. You did or said something you regret. You ate too much. You self-harmed or hurt someone else. Honey, forgive yourself. You're always doing the best you can do in every moment, no matter what anyone else says. So if you can't control yourself and something goes wrong, breathe through it and be compassionate towards yourself. You might do better next time. But if you don't, again, forgive yourself. Don't wait for anyone else to forgive you. It's gotta come from inside. You can do it! Go to a mirror, look into your eyes, and say, "I forgive you." Say it over and over until it feels true. Cry if you want to. It's okay. Let it all out.

7. Love yourself.

It follows that each of these reminders really points to this single reminder: to love yourself, just as you are. You have a really shitty condition that can make life a misery. Hate the condition, not yourself. Remember that the things you think and believe when you have PMDD don't necessarily (and in fact, likely) have nothing to do with reality. Wait it out. Check in when things are calmer. In truth, you are a beautiful, strong, capable, inspiring, and lovable human!