While premenstrual dysphoric disorder (PMDD) is a medical condition—more specifically an endocrine disorder, meaning that it is a hormone-related disorder—PMDD is also a mental health condition that affects women and those who identify as female mentally, emotionally, relationally and even spiritually. People living with PMDD, which is a severe form of PMS, can experience a wide range of mental/emotional symptoms, including depression, severe depression that can include suicidal ideation, anxiety and more.
Given the mental/emotional impacts of PMDD, premenstrual dysphoric disorder was added to the DSM-5, recognizing it an official mental health diagnosis, as well as a still significantly misunderstood medical condition.
As a medical condition, PMDD can be difficult to diagnose, with some women under-diagnosed (the “it’s hormonal and just get over it” dismissive mentality) or misdiagnosed (it’s not uncommon for women with PMDD to be misdiagnosed with bipolar disorder). It is a challenge to get an official diagnosis, as I personally experienced during my 14-year experience with PMDD. The journey to finally hearing the words “premenstrual dysphoric disorder” can be overwhelming, however, for some women who have been struggling with extremely debilitating symptoms for years, there can be a short-lived sense of relief.
Given how difficult it is to treat the physical symptoms of PMDD, most women, hoping for some kind of quick fix or medical treatment, feel even more frustrated, confused and in further search for some semblance of relief as they learn that PMDD is a chronic condition that is not easily treated medically. While there are medical treatments that can help some women with some symptoms, that is not the case for everyone. Talking to a doctor may not provide an answer when we really need one.
Our menstrual cycle can, and often does—whether it’s through PMDD, another hormonal condition, or our normal cycle—significantly impact our mental health. And, as a therapist and woman who struggled with PMDD for almost a decade and half, I believe it is due time that the mental, emotional, relational and even spiritual impacts of PMDD and other hormone-related conditions become a larger part of the conversation.The search for relief is so important, yet can it be long, overwhelming and exhausting. And when you are already feeling poorly, it can become increasingly difficult to continue looking and hoping for relief.
You Are Not Alone
Many—if not most—women who experience PMDD suffer greatly. It’s not uncommon for women to experience highly distressing symptoms for up to two weeks each month, sometimes with symptoms so severe that it makes normal functioning almost unmanageable. PMDD often leads to depression, thoughts of suicide, severe anxiety and major disruption in all aspects of a woman’s life.
Those of us who have experienced living with PMDD know that there is much more to the story than a medical diagnosis. It impacts our routines. It impacts our ability to work. It impacts our energy levels and ability to emotionally regulate. And, it really impacts our relationships. It affects our relationships with loved ones and colleagues, especially when we find it difficult to explain what is happening, and especially when we don’t really understand what is going on ourselves. And, it definitely impacts the relationship that we have with ourselves. It affects our self-worth, confidence and energy levels, and often leads us to feeling guilt, shame, fear, anger, exhaustion and even wondering if there may be something significantly and seriously wrong with us.
This is where therapy for PMDD can help.
PMDD Therapy Can Help You Live With Increased Peace And Ease
As a woman who personally struggled with PMDD for 14 years and as a therapist who has been helping other women navigate the mental, emotional, physical and relational challenges of premenstrual dysphoric disorder since 2011, I understand the struggles that come with PMDD from the inside out. I know through my own personal journey and helping others along theirs that there are no easy, cut and dry answers. Unfortunately, there are no “quick fixes” or sure-footed treatments.
However, there is good news. There are many approaches that can help mitigate PMDD symptoms and things you can try and do that can help you better understand your personal experience with PMDD. Some of these include: tracking your cycle and symptoms; engaging in various movement, meditation and exercise routines; making dietary alterations; learning and implementing stress management techniques and self-care practices; and taking vitamin supplements. SSRIs and birth control pills help some women, too. Therapy can help determine what direction is a good fit for you.
Therapy can also help you with much more than navigating the physical symptoms. While making some physical changes and medical interventions can help, in my personal experience, talking with other women with PMDD and other hormone-related conditions and in treating clients, I’ve learned that it is often a variety/combination of things and treating PMDD holistically (mind-body-spirit) that makes a difference.
In my personal experience, acknowledging that/when I needed rest and actually allowing myself to rest was a big help. It is not always possible to rest, but learning that it is okay to cancel plans to stay home and take care of oneself is important. I also found communicating with others very helpful. Therapists, friends, family and even strangers that had similar symptoms were a lifeline. Sometimes the suggestions they gave were helpful, and sometimes they were not. However, knowing that I, that you, that we are not alone can make a big difference.
Also, unknown to many, a significant risk factor for developing PMDD is trauma experienced through mental, emotional, physical or sexual abuse. Research has also highlighted a relationship between childhood trauma and the development of PMDD. If you know or we determine that you are suffering from trauma, we can incorporate trauma therapy into our sessions. I am certified in EMDR, which is scientifically proven and known to be highly effective in treating trauma and trauma-related disorders.
Trauma affects emotional regulation skills, and women who suffer trauma, especially at a young age, may not have the skills to deal with the many mental, emotional and physical symptoms that come with PMDD, especially during the Luteal Phase before menstruation. Both trauma and PMDD can also increase sensitivity to any negativity in the environment, and many women experience feelings of sadness, hopelessness, reduced self-efficacy, frustration with self, and increasingly worsening symptoms of depression and anxiety.
A Compassionate, Practical And Holistic Approach To Health And Healing
Living with PMDD is a challenge, but please know you are not alone on this journey. PMDD therapy and trauma therapy both provide guidance and resources to help you navigate and mitigate PMDD symptoms and the relational challenges that are part of each month. Together, we discuss how to plan for each month and how to manage when the plan falls apart. We talk about how to deal with self-hate and the negative self-talk that arise when in the throes of PMDD. And, I help you work toward increasing emotional regulation and communication skills so you can explain what is occurring to loved ones and ask for help when you need it.
For most diagnosed women, PMDD is a chronic condition, but there are ways to live with more peace and ease. To learn more about PMDD and my compassionate and practical approach to helping women visit my PMDD Therapy page and/or contact me at 303-963-9249 or at joanna@joannafordcounseling with questions and/or to schedule an initial session. I’ll meet you where you are with an open heart, tenderness, empathy and compassion.