A Vicious Cycle: Living With Premenstrual Dysphoric Disorder (PMDD)

As part of PMDD Awareness Month, we interviewed four different women with the condition to better understand their lived experience. We wanted to share these conversations and really open up this space for anyone who is struggling with PMDD, or for those wanting to learn more about supporting someone in their lives who is.  

Photograph by Niamh Quigley.

Can you describe what it’s like to live with Premenstrual Dysphoric Disorder (PMDD)?

"It feels unstable and at times very dark. I have to really utilise the 2 weeks after my period finishes because the ~10 days before can sometimes be a complete write-off. The unpredictably of how it’ll be that month is really tumultuous; it can range from feeling very flat, to not being able to leave the house, to intense suicidal ideation. Often remembering that feeling is caused by PMDD doesn’t happen until my period starts, so the emotions are difficult to navigate.

I am very sensitive during that time and, more often than not, extremely anxious.

My mental resilience also takes a hit and I find motivating myself to do even small tasks a real struggle. I’m usually very motivated and pro active so it ends up making me feel shit about myself which makes me less motivated and it becomes a vicious cycle.

It’s a lot to go through and having to do it every single month is mentally exhausting."

Have you received a diagnosis? If yes, how was this process? If not, is there something holding you back or making this difficult?

"I knew what I was experiencing was really intense but assumed it must’ve been the norm because I didn’t know any different. I hadn’t had any conversations about PMS with anyone or seen anyone talk about PMDD. It was following a conversation I had with my mum that she said what I was experiencing was beyond the scope of regular PMS and suggested I speak to a doctor because its a huge percentage of your life to spend feeling that way. I then began looking into what was a very small pool of research about PMDD.

I tracked my symptoms and then spoke to my GP who confirmed that what I was experiencing was indicative of PMDD. I specifically requested a female GP and was met with a lot of empathy and compassion from her which was very comforting. I also told her that I felt that my ADHD meds were ineffective just before my period and was advised to speak to my psychiatrist to get an increased dose for the week before my period.

My psychiatrist told me that PMDD is very common for people who menstruate with ADHD and I was prescribed a higher dosage for that week. This did help slightly but I now just take a higher dose for the full month because the process of getting the dual prescription was an absolute nightmare due to lack of communication between the GP Surgery and psychiatrists office so I just had my prescription increased permanently."

Photograph by Niamh Quigley.

What have you found helpful in dealing with PMDD? This could be tools, techniques, therapies or other.

"How well I manage it depends how it intense it is that month. I have learnt how to be a lot kinder and forgiving to myself - actually allowing myself to slow down and accept the change of pace when I’m having symptoms.

If it’s an easier month, I can try and override my mind and get myself up and out.

If it’s a more difficult month, I sometimes end up just sort of siting and stewing in it (definitely not a good idea as it makes it worse lol). I can be really unkind about myself so sometimes I journal about how I’m feeling and then go back and read it when I’m on the other side of it and in a more stable headspace and try to give myself the compassion that I needed then.

It’s a very lonely thing to experience and there can be a lot of shame attached to it, so speaking about it does help to normalise it.

For physical symptoms; hot baths, herbal teas and a hot water bottle for bloating and swelling. I’ve found yoga (Yin specifically) is good for when my body feels sore and I put my legs up the wall to drain them. I get extremely fatigued during symptom week so, so I let myself sleep whenever I need to and for as long as I need to."

Photograph by Patrick Owen.

How can people around you support you?

"Honestly just giving me space to feel however I need to feel in that moment, I can really really withdraw, become much less talkative and engaged and would rather be left alone. I try and avoid social situations that feel too much to handle because I get anxious about how my energy may have come across to someone and that then feeds into the anxious, self-deprecating PMDD thoughts. I do explain to people that I have PMDD and how it can make me act differently to how I usually would and that I need to be given some grace during that time."

How does PMDD affect your relationships and/or work?

"A particularly difficult symptoms for me is bloating/water retention and extremely sore boobs and joints - I’m a professional dancer and it’s has a real impact on my job.  I’ve had to take days off work because the overall pain of my whole body is too intense. My movement can become restricted and uncomfortable and my body generally just feels extremely heavy. The fatigue I experience with PMDD makes doing a show substantially more difficult and the recovery harder. If I’m on a contract doing 8 shows a week, there is always about 8-10 days of shows per month that are incomparably harder.

It has affected romantic relationships for me. I can become very distant during PMDD and that is, understandably, confusing for partners. Especially if they haven’t been in my life long enough to really understand what’s going on. I’ll hold my hands up and say I’ve been straight up mean because of how I’m feeling and it pushes people away. Sometimes it’s easier to communicate what’s going on but sometimes it isn’t and it’s painful to see people leave because of it.

I do find that my female friendships are largely unaffected by it - maybe because there is a level of knowing and understanding there?"

Photograph by Patrick Owen.

What is the most difficult part of dealing with PMDD?

"If I use the seasons as an example - taking the stereotypical emotions associated with each one and dial it up to the extreme version - that’s the cycle I seem to go through every month. It’s really draining and the world only really caters for consistency, of which living with PMDD is almost impossible to achieve."

How does PMDD shape your relationship with your menstrual cycle?

"My actual bleeding is so absolutely fine, It’s light and no hassle at all. When it does begin, I breathe a sign of relief because I know that means my brain and body will settle. It’s almost instantaneous.

It’s like the PMDD and my period are two separate entities, when I’m experiencing intense PMDD I find myself wishing for my period to come so I can start to feel more like myself again."