My PMDD is Under Control

For the uninitiated and new readers amongst you, PMDD is an extreme version of PMS/PMT. It can cause cyclical feelings of anxiety, depression, anger and even suicidal thoughts, as well as the physical symptoms typically associated with the menstrual cycle.

It’s been over a year since I last talked about my PMDD. When I lost wrote, I confessed that I felt like I’d become consumed by this disorder – the one thing I’d hoped to avoid above all else. However, after a rocky year or so of trials and tribulations, I finally feel like I have my PMDD under control (for the most part). Since that blog post, I have tried:

Tracking and Not Tracking Cycles

I became worried that my compulsive tracking — counting ahead based on a typical cycle and shading in the calendar when I expected to be sad or angry — was putting me on edge. I worried that I was expecting to be angry, or sad, or paranoid on X day and thus causing a self-fulfilling prophecy. I stopped tracking altogether but then ended up waking up with anxiety, or full of rage, and being unable to figure out why which just made me feel crazy (until I remembered).

I seem to have found a happy medium whereby I track my cycle start time each month and extreme symptoms in an app, but don’t cross-reference or look ahead to see where I expect to be in my cycle. This gives me a point of reference but no doom-mongering.

Consistent, Varied Exercise

I’m usually active in one way or another but I have found that I have my best months when I am both consistent in my workouts and do more than one activity, e.g. lifting and running in the same month. Months where I’ve run the furthest I find my cycle the most bearable, but then I have always found my mental health directly correlates to the amount of cardio based exercise I do.

During February and early April when I was not able to do as much as I would like (half term and Easter holidays respectively) it didn’t take long for the activity gap to hit me.

Vitamin Supplementation

I read a guest post by Beckie Takacs via the Gia Allemand Foundation (PMDD charity) in October 2017 about the supposed benefits of potassium supplementation in the treatment of PMDD. The piece struck a cord, and given my history of hyperemesis during pregnancies and probably execessive alcohol use, it wasn’t that unlikely that I had a low-level potassium deficiency. However, I got in touch with the author of the post and although mostly common sense stuff, the detailed protocol she sent me made reference to the “potential health hazards of wireless devices and smart meters” which immediately put me off; I’ve no interest in tinfoil hat science.

Nevertheless, my sister started a lower dose potassium supplement schedule and mentioned some relief of some of her pre-menstrual symptoms, so I started taking 300mg (half Takacs’ recommended dose) on an every-other-day basis, as well as magnesium, which also reportedly improves PMS. (Magnesium is also recommended for runners and those taking part in regular exercise.) My temper and anxiety/paranoia symptoms have improved since starting supplementation.

Sobriety

Last, but definitely not least: I gave up alcohol again.

After my brother’s suicide last year put me in a downwards spiral with my drinking, despite my best efforts to “be chill about it“, it wasn’t long before the casual on-off drinking became multiple triple vodka shots on a Friday night “just because”. I hit rock bottom again in mid-December and crushed by the weight of my own mental health I knew I had two choices: give in to the paranoia and anxiety and voices that told me I was shit and stupid and useless and fat and unloveable and just throw myself off a building, OR stop being a whiny dick and make the sensible decision to stop drinking.

Obviously choice A was no choice at all, so giving up it was. Just like the first time I stopped, this had an almost immediate affect on my anxiety-related symptoms.

And so here I am. I am not miraculously cured of all ills, & I can’t be sure that this isn’t all some massive coincidence, but each subsequent step against this debilitating disorder has given me back a piece of myself and some semblance of control. That’s better than nothing.

Lead photo by Hoàng Duy Lê

An Insight into PMDD aka Today I’m Crazy Because…

Today is day 12 of my cycle, so over the next few days I will be at peak hormone anxiety-ridden mess. To put this into perspective, this is how it’s affected my day so far:

  • I turned down the opportunity to work for a local agency today because I couldn’t face people. My usual day rate is £400, so this isn’t just like turning down the last slice of pizza.
  • I took a phone call from a client, arranged a meeting for tomorrow AM, spent a couple of hours after that panicking that they wouldn’t be happy with the quality of my work (despite being my longest standing client of some 11+ years) and proceeded to hide from a follow up phone call.
  • Noticed another client on twitter chatting to a tangentially related business and convinced myself that they were going to ‘leave me’ for a better alternative. Had a panic attack. Cried.
  • I ate an entire tub of pringles because I had an overwhelming carby salty craving and then convinced myself I was going to be fat forever thanks to my poor diet choices and the meds I recently gave up.
  • Masturbated. 6 times. Thanks, ovulatory libido increase.
  • Got angry at Gaz because he didn’t reply to a text message this afternoon (despite the fact that he is, you know, working) and convinced myself it’s because he doesn’t love me, and goes to work to get away from me. Cried.
  • Had a small glass of prosecco because it was the only thing I could think of that would calm down the anxiety enough for me to function this afternoon. Convinced myself I am an alcoholic that’s going to die of massive liver failure. Cried.
  • Realised I hadn’t thought of suicide ‘properly’ since coming off the meds. Thought about suicide. Cried.
  • Pondered what I did to deserve life throwing so much shit at me (completely ignoring all the pretty cool experiences and stuff I get to do). Cried.

I am unproductive and unpredictable, up and down and anxious. I see no worth in myself or my creations and can’t understand why people like me, let alone love me.

& I’m already having doubts about my choice to drop the meds, instead of increasing the dosage.

I guess I should hurry up and investigate that rabbit hole.

Progesterone, PMDD and a rabbit hole

(Please note this post is more so that I can refer back to important links and notes later on, rather than for you guys. I won’t be offended if you’re not interested or find the whole thing a little TMI…)

I’m currently pre-menstrual and, as with all periods (pun) of pre-menses symptoms, I have sore boobs, massive mood issues and something I’ve never given much thought to before: I have small fluid-filled lumps on my hands. After consulting Dr Google, I have learned that cyclical skin issues such as mine are often related to progesterone intolerance/allergies. Given my previous issues with progesterone (after taking the mini pill, 2014 and Depo Provera side effects, 2008) this wasn’t a surprise.

What was a surprise, however, is that progesterone intolerance and PMDD can be closely linked. Leading me down a rabbit hole of hormone related articles and gynaecological fun facts, I’ve discovered a couple of learned leading gynaecologists (Professor John Studd, Mr Nick Panay) who specialise in PMDD who have experience treating it with hormone therapy: battling the side effects with more of what the body tolerates and less of what it doesn’t.

I’ve also discovered and ended up knee-deep in blog posts by a lady who had a hysterectomy to relieve her PMDD after hormone therapy following a private consult with one of the aforementioned specialists.

My curiousity is piqued. I know that the combined pill does offer small improvement to my symptoms (which lends support to the idea of hormone therapy being of use) as does weight lifting (which is known for its testosterone boost) but I had no idea that all of my issues were specifically linked in with progesterone problems. I don’t particularly want to take pills every day for the rest of my life, hence being sterilised, but neither do I want to put up with mood swings, anxiety, depression, pain and suicidal thoughts that leave me unable to function for three quarters of a month.

I have a lot of reading to do, I think…

Giving in

I went to the doctors a couple of weeks ago and got my referral for sterilisation as mentioned back in January. The doctor tried to give me non-permanent long term contraceptive options but was obviously content that I had done my research and knew what I wanted as he consented to the referral. I can only hope that it continues to be as simple a process when I see the gynae specialist (must make that appointment).

While I was at the doctors we talked again about the debilitating effect the suspected PMDD has on my life: that I am basically inable to function for 2 out of every 4 weeks. I “gave in” and accepted his recommendation of trying fluoxetine (prozac) which has been shown to be effective in several studies, e.g.:

The marked increase in the number of well-designed placebo-controlled studies in the past decade has established several selective serotonin reuptake– inhibiting antidepressants as effective first-line treatments for this disorder. Both continuous dosing and intermittent luteal dosing strategies lead to rapid improvement in symptoms and functioning.

ncbi.nlm.nih.gov/pmc/articles/PMC353031

I say “gave in”, because that’s what it feels like I am doing. Feels like I’m letting it win. Having spent a lifetime stubbornly battling my problems by myself, this feels like a step backwards. Of course it’s not giving in: it’s fighting back. It’s accepting that there are ways to combat the issues I have without driving myself crazy shouldering it alone, or making excuses for myself and my inability to cope.

I’m currently trialling intermittent luteal dosing (second half of my cycle) to see if that helps. The side effects (nausea, loss of appetite, trouble sleeping) are hard going but I feel like they’re starting to pass. I do feel quite zombie-like at the moment, literally spending hours feeling absolutely nothing, but I also have seen a marked improvement in rage responses over the past couple of days. I hope this is *it*, and not a fluke…

Be a little patient

We’re on day 3 of the new year and I’m yet to write any of my typical end of year posts for 2015: what I did for christmas, my review of the previous year, my goals for the next.

It’s not that there’s nothing to say. I mean, 2015 saw me complete the remortgage on the house, return to self-employment and move the man I love in with me. If that wasn’t awesome enough, for some bizarre reason that man asked me to marry him and I said yes. And — on a slightly less life-changing level — I lost weight, had my first foreign holiday (and went topless on the beach), got lost in Oxford, got myself a giant bunny and saw my dad for the first time in a couple of years. Amongst other things.

A busy year all in, and plenty to write about, but instead I’m sat here feeling restless and agitated. Instead of focusing on all the massive AWESOME cool stuff that I did / achieved / went through in 2015 I remember the times I skipped a mornings work to lay in bed because my head was telling my silly things or spent 3 hours on twitter because it’s the closest I’d get to adult company and the isolation was setting in. I think of the income I didn’t get because I was too busy doing favours – saying yes when I should have said no. Or just generally procrastinating.

I think about the times I shouted at my kids because they were doing ordinary kid stuff because outside pressure and the PMS and life was making it difficult to relax. I think about the wine and takeaway curries I consumed when I should have been working out and eating homemade food. I think of the failed budgets, the overspending, the constantly fluctuating savings. Most of all I spend a lot of time wondering when I’ll feel normal again.

But what is normal? When you’ve spent the vast majority of your life in situations where you’ve had to build walls and exercise control over the minutiae because it’s the only thing you’re allowed control over; when your relationships are based on defending your emotional health rather than cultivating it; when you’ve spent so long living with oppression that freedom scares the fuck out of you… none of what you “know” is normal. There’s no going back to normal, because there was no normal to begin with.

So… I guess what I’m trying to say is that 2016 is going to be about defining a new normal. Allowing myself to continue building on what I’ve done, finding out who I am and being gentle on myself when I fail. Mark Manson said, in his piece Shut Up and Be Patient (which basically feels like it was written for me at exactly the time I needed it):

There are a thousand tons of emotional and psychological cargo being hauled across the vast oceans of your unconscious. Be a little patient, fucker.

& I think I can do that. :)

Living with PMDD (or why I’m regularly crazy)

I’ve only mentioned once (briefly) before that my doctor thinks I have PMDD. It’s mostly because I’m in denial: I’m a “fixer” and if I have an Actual Thing (with capital letters) then I can’t just fix it. I can take things to help — e.g. the doc wants me on low dose prozac — but I’m probably stuck with it until I go through the menopause. Maybe? I have no idea.

I started experiencing feelings of extreme anger after I had Oliver. I think I may have had post natal depression, or his birth triggered some sort of hormone thing, or something… I don’t know what exactly, but that’s when it all began. (I’m so glad I blog so that I can pinpoint this stuff, you know?)

Counselling helped me to deal with some issues in my life which did seem to help placate some of ANGRY ME’s worst tantrums, so I thought my problems were all ‘mental’. I thought more counselling would fix it, but it didn’t.

I thought I could fix it by changing my diet, changing my pill, changing my exercise levels, changing how much I drink, changing how many people I see, changing my boyfriend, changing my job — changing anything and everything I could to be “normal” again. Blaming anything and everything I can because doing so prevents me from having to accept the reality.

But no matter how much I change, no matter how much I blame, it’s still there. Anxious and emotional during “ovulation” and then easily annoyed, touchy and irrational before menstruation. These happen like clockwork, despite taking the pill. It also happens irrelevant of how many packs I take; I will get angry pre-menstrually in my cycle, even when taking 2 or 3 packs back-to-back so not actually bleeding. (It also happens if I don’t take the pill, so it’s not to blame.)

Some months, I get more ‘normal’ PMS: I get a bit emo for few days, then later on a bit grumpy. Some physical symptoms, nothing major.

Some months, like through August and September, I descend into blackness. Getting out of bed is a massive chore. Dealing with life is overwhelming, frustrating, too much to cope with. I become intolerant of my children, I get paranoid that Gaz is going to leave me, I doubt the friendship of people close. I become reliant on ego-stroking, intimacy and affection just to give me the reassurance I need to get through a day, but the little bubble of love is fragile and doesn’t last: for example, despite thriving on intimacy I have (more than once) broken down during sex because of something ridiculous that I’ve suddenly felt or noticed, or assumed about Gaz’s mood.

And while we’re on the subject of sex: my libido (during both ovulation and pre-menstruation) shoots through the roof. Ho ho ho, Jem wants to get it on. Sounds like an amazing side effect. Except not so much, because I can become literally insatiable: like having an itch that that you can’t quite reach. On one occasion I spent four hours in bed masturbating to try and give me the relief I needed, only to end up more frustrated and more angry because it wasn’t working. I couldn’t satisfy the craving.

As well as the mental symptoms, I get the headaches, tender breasts and cramping (varying from minor to extreme).

I have on, more than one occasion, thought about suicide. Not from a planning to do it or a working out the fastest way point of view, purely on a logical basis: if I did X, then I would no longer feel Y. I would never use it as an answer to my problems; having lost my brother to suicide, I couldn’t put my family and specifically my children through that pain, but that is exactly how low and worthless I’ve felt… that my continuing existence is purely for the benefit of not causing others pain.

On/off crying, low self esteem, indecisiveness, feelings of little or no worth, a deep sadness despite everything being ‘good’ in my world, complete brain fog rendering me unable to concentrate or do anything constructive, uncontrollable anger manifesting in shouting or physical aggression (towards objects not people), passive aggressive behaviours and a lot of feeling useless because I know why these moods are happening and can’t just “snap out” of it. And then like a switch is flicked, I am back to ‘normal’ me for a couple of weeks before the next dip.

One of the hardest parts about accepting that I probably have PMDD, apart from all that fun stuff I’ve already mentioned, is coming to terms with the idea that my hormones are to blame. I am sure most women have had to deal with the PMS stereotype in their lives: that they’re pissed off about something because it’s “that time of the month”. To basically embody that stereotype in a very real way makes me feel vulnerable. It makes me feel like anyone can dismiss me because of “that time of the month”. I feel worthless enough when I’m down, the last thing I need is to have my intelligence, my right to have an opinion, my right to exist questioned because it’s “that time of the month”.

After a prolonged down, yesterday was an OK day. Today I’m ‘normal’ again. I might have a few days, maybe a week before the next dip: it could be a nasty one, or I might not even notice it. One thing’s for sure… it’s definitely not my hormones. I can’t have PMDD. Because that would mean I can’t fix it, and I can fix everything.

The things I’m not saying out loud

I am currently sat in bed crying into my second glass of wine. Wine that I shouldn’t be drinking because I’m the sole carer for my children tonight, as with most nights, and if they wake up in the middle of the night with some sort of medical emergency I want to be competent enough to deal with that, especially given Oliver’s recent leg trouble, and yet here I am sobbing into this glass of wine anyway.

I didn’t want to write another whiny post. I want to tell you all about my awesome birthday yesterday and the fun I’m having lifting weights or the fact that I managed to run yesterday without my foot hurting for the first time in months… but instead all I can think about is trying to relieve this load weighing me down, constantly dragging my weary body into the dirt because writing helps and I can’t afford therapy right now anyway.

And so I sit here in bed, tired but lacking the will to try and sleep (because what’s the point trying when I know I’ll lie here tossing and turning all night anyway?) I’m googling for ideas to fix me, to stop me feeling like my life is spinning out of control and I hit upon article upon article about depression and I keep repeating to myself that I’m not depressed. It’s just hormones. It’s just stress. I’ve got a lot going on at the minute. I am busy. I just need some sleep.

But the truth is I’m not sure sleep is going to stop me from getting to work and staring at my screen for 3 hours achieving nothing because I can’t even formulate a coherant sentence to reply to a client. Sleep isn’t going to stop me being irritated by the very presence of my children because they’ve looked at me wrong, and the rage I have to surpress when they open their mouths and all I hear is whine whine whine. Are hormones really to blame for the utter loneliness and desperation I feel when I climb into bed, alone and insecure? Is it really just stress & busy-ness that makes me want to give up my job, give up my children, lock myself away and hope I fade into the background so that nobody notices I’m only just managing to keep my head above water?

I guess the truth is that I don’t want to admit that I might be depressed. I don’t want to admit that even though in my lifetime I’ve been through experiences that would make the strongest amongst you wince and I’ve carried on without a second thought, that somehow I’m being brought to my knees by imaginary thoughts and fears and I don’t even know what. I don’t want to have to admit that as each day passes it gets harder and harder to pretend that everything is OK and I don’t have a fucking clue where to go from here.

But it might be the sleep. The hormones. That I’m not exercising enough. That I’m not eating the right foods. So I’ll pour this wine back into the bottle, salty tears and all, and I’ll put down my laptop and attempt to sleep. And tomorrow I’ll take another birth control pill to manage the hormones, and vow to run a little bit more, I’ll skip the sugary chocolate and eat regularly to avoid blood sugar dips. I will keep smiling so that I don’t drive away those I need the most with my constant complaining about how shitty life is.

I’ll do everything I need to do to mask the symptoms and hide the pain. Because I just need a good night’s sleep, right?

In which I nearly have a breakdown

Things have been a little weird recently here at Chez Jem. When I posted Enter title here I was struggling more than I let on.

I was struggling to see the point of anything. I didn’t want to get out of bed in the morning, I didn’t see the point in going to work because I was too stupid & useless to do my job properly (and my ever-increasing todo list was proof of this), I thought Gaz was going to get fed up and leave me, I questioned my role as mum to my children, I was eating virtually nothing because I felt fat and ugly, etc etc.

I have never felt as angry, paranoid, insecure and well.. just generally shitty as I did in November. Early last week, my mood sunk to an all time low. I was angrily snapping at the people I love and then using their retorts as mental justification that everything wrong in my life was all my fault.

I am usually ridiculously laid back, so it was like being a completely different person. The scary part was not so much that though, but rather I couldn’t remember who I really was. It was almost like the ‘me’ before this black cloud surrounded me had never existed at all. I am not sure if I’ve ever truly experienced depression but I’m fairly sure that *that* was as close as I’ve ever been, and it was fucking terrifying. I felt like I had lost my identity and my “self”.

I put the black mood down to not running (it’s been really pissing me off) so I thought fuck it, and blew nearly £200 on an exercise bike I couldn’t afford (yay overdraft!) Of course, sod’s law, having received and assembled said exercise bike (I’m NEVER complaining about putting together IKEA furniture ever again) I’m now pretty certain that it wasn’t actually not running that’s caused my moods at all.

Around Thursday evening last week I suddenly began to feel… normal. This followed into Friday, and Saturday, and Sunday and here I am today still feeling normal. Normal. Like me again! I never thought I’d be so grateful for being me.

What changed? The only think I can think of is that it’s because I have finally had an actual period for the first time in ages. After months of stupidly short cycles, followed by an extra long one, I think I’ve been suffering from raging PMS symptoms. That and the withdrawal from the mini pill / starting a new one (combined pill) must have caused some sort of mad hormone-cocktail mess. I should have known what the progesterone withdrawal would have done to me: I’ve been there before.

Of course I could be wrong. It could be a complete coincidence that my symptoms are identical to when I came off the depo jabs years ago, but really I don’t care. As long as I don’t end up feeling like that again it’s all good.

Probably stressed

Bit of a blogging hiatus here recently, although not intentionally. I’ve been struggling with my mood a lot recently, which I had mostly attributed to PMS but had also considered the possibility of a reaction to the reintroduction of alcohol after going dry for July. It all came to a head on Saturday night when I broke down sobbing on Gaz for the second time in a week and I realised something was amiss.

Having got to the point where I am struggling to motivate myself to drag my lazy arse out of bed in the morning, I saw my counsellor again yesterday. Turns out that my negative mood is probably neither PMS nor alcohol, but a little more complicated than that. As usual, talking things through and having them repeated back at me for an amazing amount of money that I can’t really afford gave me my moment of clarity and I know for definite what I need to do now. More on that at a later date, though.

In other (more cheerful) news, I have ticked off another item from my 30 things before I’m thirty list, having completed my first parkrun on Saturday 9th August with a time of exactly 29 minutes. I am really, really pleased that I managed a sub-30 minute 5k, although credit goes to Rachael who basically abused me around the course to keep me going ;) Now just to compete in a race to cross the other running goal off my list…

The PMS Monster

For the first time in years (well, since 2008 if my archives are right!) I have spent the past week, give or take, absolutely crippled with horrific PMS symptoms. Uber cramps, lethargy, insomnia, bloating, stress, carb cravings, you name it: I’m suffering with it.

But… worst of all, I seemed to have developed the emotional stability of a toddler. Crying just because. Raging at things completely out of anyone’s control. Sudden need to be attached to the nearest human that will tolerate it. General overwhelming neediness.

I suddenly empathise with my 2 year old.

Snap, Crackle and PMS!

This post is probably a bit girly for most of you, feel free to bugger off now…

About 4 years ago I went on the Depo Provera jabs. As well as wanting the extra contraceptive power, I figured it’d be a good way to ditch the Monthly Terrors and the accompanying symptoms (agonising cramps, ridiculous food cravings, piss right off or I’ll rip your head off attitude, etc.) It worked like a charm and within about 2 months of starting, it was like being 12 years old all over again.. except with bigger boobies.

Anyway, I decided to come off the jabs last year for a variety of reasons. Not least because the long term side effects of the contraceptive are enough to make a girl want to say “screw the jabs, no sex EVER”. There’s loss of bone density leading to an increased risk of osteoporosis, lack of sex drive, possible weight gain due to increased appetite and so on. I managed to avoid the weight gain, and I’m pretty sure my bones are doing fine, however, it was worth taking a break.

So, I’m off the depo. My last jab was due October 19th 07, and that was the one I didn’t have. I had a very light period with on/off days in December and because I’ve always been regular as clockwork I assumed that was it, back to normal after that. No such “luck” (if you can call bleeding through your va-jay-jay luck – whatever!) Since then I’ve been in a permanent state of PMS of one degree or another, up and down like a bloody yoyo.

I’m physically aware of the mood swings — unlike when I was a teenager — so I can stop it interfering with day to day stuff. However, some days I get so bloody frustrated at the most stupid things I feel like I’m going to stand up and punch the wall. It’s not even people that are pissing me off (now that does makes a change) but stupid shit like my e-mail not downloading fast enough, or my chair not being comfy enough and worst of all: my FTP timing out at work.

So here I am, having eaten 2 chocolate bars, a chocolate biscuit and a chicken thigh this evening (oops, those food cravings are back) fully aware that I’m PMSing at idiotic, inanimate things.. impatient at some impending news that may or may not affect my schedule for the next 2-3 months and all I can think about is by golly, being a woman is a pain in the bloody arse sometimes.