PMDD and Me

Content warnings: suicide, depression, anxiety, self-harm

Imagine being trapped in a dark well. The deep water threatens to drown you, so you kick your legs with all your might. You see a tiny pinprick of light far, far above you, but no matter how hard you try, you'll never reach it. The slippery walls are closing in.

You call out again with your hoarse voice. Maybe this time, someone will hear you?

Help never comes.

Now imagine being trapped in that well for 2 weeks. Every. Single. Month.

Vicious Cycles

Since puberty, I'd had these periods of hopelessness, but I'd never thought to track when they happened. At the time, no one around me (nor myself, for that matter) knew about PMDD (pre-menstrual dysphoric disorder). Everyone figured I was just a moody teenager.

Normal mood swings don’t make you take a razor blade to your arm after a spat with your boyfriend, though.

Here's the Cleveland Clinic's definition of PMDD:

People with premenstrual dysphoric disorder (PMDD) have PMS symptoms (bloating, headaches and breast tenderness) in the weeks before their period. But PMDD also causes severe anxiety, depression and mood changes. Some people with PMDD become suicidal.

During the first half of my cycle, I'm a pretty even-keeled person. I've been described as optimistic, friendly and considerate. I lean towards the glass-half-full side of things.

The 2 weeks before my period, though, I become a completely different person. It's like my partner says: "You look the same, but I can't connect with you. It's like you've all the light and positivity sucked out of you."

Sometimes, I'd get mean. I'd answer passive-aggressively or use emotional blackmail to make myself feel better (it never worked). "Oh, I'm fine, you'd know if you actually cared." "You're welcome, by the way. How come you never thank me for cooking??" This usually resulted in lots of tears (me) and stony silences (him).

I once had a massive breakdown because he'd jokingly replied "Sure, boss." when I asked for a coffee in the morning. After he went to work, I started sobbing uncontrollably. I curled up on the bathroom floor and contemplated whether sticking a kitchen knife in my chest would be worth the pain. Even the thought of my children ending up motherless couldn't pull me out of that dark well.

I nearly scared myself to death.

Am I Crazy?

I thought I was a bad person who didn't have their emotions under control. Every time my partner and I fought, I'd vow to do better the next time. "Just be rational. Don't let your emotions overwhelm you. Don't cry.", I'd think to myself. It never worked. We'd fight, I'd feel like crap, I'd get my period, we'd make up, we'd fight again. Rinse and repeat.

After 1.5 years of monthly fights, my partner'd had enough. "I don't think I can do this anymore. If we don't tackle this, I can't be with you."

Shit.

Not long after his ultimatum, COVID hit. No social interactions, working from home, the same routine, day in, day out. Ironically, the mundanity of life during the pandemic calmed my PMDD. There were no triggers. I think this was the saving grace for our relationship.

Looking back, it feels strange that none of us thought to seek medical help all these years.

During the COVID pandemic, we started trying to have a child. I noticed something strange: during my pregnancy, I didn’t have these extreme lows. No mood swings, no irrational despair.

For the first time in years, I felt steady.

The exact same thing happened during my second pregnancy in 2023: no crazy outbursts, no suicidal ideations.

Those were solid clues that I wasn't crazy: I had a premenstrual disorder.

For an official PMDD diagnosis, you need to exhibit at least five symptoms from a pre-defined list.

Symptom #1: markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts - check!

404 - Diagnosis not found

By February 2025, I was done with it. My new year’s resolution wasn’t about fitness or reading more books; I needed to figure out how to fix this.

My negativity had started seeped into everything again. My partner felt it. Our kids felt it: even my one-year-old picked up on the tension, clinging to me like he was scared I was going to disappear forever.

Symptom #2: persistent and marked anger or irritability or increased interpersonal conflicts - yes!

I needed help.

So I went to my GP.

My doctor nodded, listened, then suggested an experiment. Since PMDD is triggered by hormonal fluctuations, she wanted to see what would happen if we stabilised my hormones. She put me on the pill alongside my IUD.

The result? Instead of 2 weeks of being an emotional mess, I only had one or two days.

But those days? They were brutal. I cried nonstop over the smallest things. I wanted to break things, I wanted to scream, I wanted to hurt myself.

I was scared. Not just scared of the feelings, but of what I might do. The thought of not existing anymore felt... reasonable. Logical, even. I couldn't find joy. I couldn’t see a way out. I wondered why I was even here.

I stopped the birth control. Got my IUD removed. My GP wasn’t convinced it was PMDD.

We tried one last thing: no artificial hormones, so no pills, no IUD, just to see what would happen (a PMDD bingo of sorts).

Mummy loves you.

My son woke up screaming at 4 am. In a daze, I stumbled to his room. I started comforting him by rubbing his back. He responded by yelling "papa, papa, PAPAAAAA" and swatting my hand away. Rejected.

I went to wake my partner up, but (understandably), he wasn't too enthused about going to our son. After all, it was my shift (we take turns sleeping next to him). Rejected again.

Symptom #3: marked affective lability (e.g., mood swings; feeling suddenly sad or tearful or increased sensitivity to rejection) - got that one for sure

I ended up crying for an hour, rubbing snot all over my duvet because my son was holding on to index finger, his little hand barely able to close around it. I must've seemed like a lunatic, sobbing and sniffing while whispering over and over:

"Mummy loves you..."

Am I a bad mother? When I don't have PMDD symptoms, I'm the best mum: I play with them, I cuddle them, I laugh with them. I never lose my patience with them. They're my everything.

When I do, though, I'm still patient and considerate. But there's an underlying tension, a feeling that something might snap at any moment and I might start screaming, and never stop.

Symptom #4: marked anxiety, tension, feelings of being “keyed up” or “on edge” - definitely...

Me, PMDD

Am I a bubbly, carefree, self-confident woman or an emotionally unstable maniac? Are both versions me? If I hate the PMDD version of myself, do I hate myself?

In the last 20 years, how many relationships (romantic and platonic) have been wrecked by this monster that lives inside me? I don't think I'll ever find the answer.

Symptom #5: a subjective sense of being overwhelmed or out of control - jackpot.

For now, I've decided to try medication. A type of antidepressant called SSRI has been proven effective in treating PMDD, reducing psychological symptoms and making them easier to manage.

It's not going to cure my illness, but it'll give me a fighting chance to be a version of myself that I like.

If you (suspect you might) have PMDD, seek help. Don't stop until you receive it.

Don't give up. You're not alone.