{"id":16214,"date":"2020-10-20T10:00:43","date_gmt":"2020-10-20T14:00:43","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=16214"},"modified":"2020-10-14T12:17:51","modified_gmt":"2020-10-14T16:17:51","slug":"pmdd-stories","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/pmdd-stories\/","title":{"rendered":"How I identified\u2014and live with\u2014premenstrual dysphoric disorder (PMDD)"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Tampon isn&#8217;t a dirty word, but a lot of girls grow up being told that it is. In fact, American culture stigmatizes many parts of female health, including premenstrual syndrome (PMS). It\u2019s a real condition that can affect a woman\u2019s health, emotions, and behavior that\u2019s often brushed off as \u201ccrazy\u201d\u2014so much so that I actually thought it stood for &#8220;period mood swings\u201d for a good part of my life. When I developed a variant known as <\/span><a href=\"https:\/\/www.womenshealth.gov\/menstrual-cycle\/premenstrual-syndrome\/premenstrual-dysphoric-disorder-pmdd\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">premenstrual dysphoric disorder (PMDD)<\/span><\/a><span style=\"font-weight: 400;\">, I felt like I was what society expected of me: <\/span><i><span style=\"font-weight: 400;\">hysterical<\/span><\/i><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">I showed signs of PMDD by age 14. Days before each cycle, I felt a strong sense of suicidal depression, a feeling that would dissipate by the time I started menstruating. I also experienced urgent fatigue and epic anxiety\u2014but it was mostly the steadfast depression that returned at the same time every month, never failing to take me by surprise. If it hadn\u2019t been for my mother&#8217;s meticulous note taking and the privilege of access to a physician who listened to me, I may have never been diagnosed.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to the International Association for Premenstrual Disorders (<\/span><a href=\"https:\/\/iapmd.org\/facts-and-figures\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">IAPMD<\/span><\/a><span style=\"font-weight: 400;\">), an estimated 5% to 10% of women are living with PMDD.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">PMDD symptoms<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">&#8220;Typically, PMS refers more to physical symptoms while PMDD refers to psychological symptoms,&#8221; explains Sara Lingow, Pharm.D., an assistant professor in the department of pharmacy practice at St. Louis College of Pharmacy. She adds that PMS and PMDD symptoms can range from mild to severe.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In order to get a PMDD diagnosis, you need at least five of the listed symptoms <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279045\/table\/premenstrual-syndrom.table1diag\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">as determined by the American Psychiatric Association<\/span><\/a><span style=\"font-weight: 400;\">, according to the <\/span><a href=\"https:\/\/www.womenshealth.gov\/menstrual-cycle\/premenstrual-syndrome\/premenstrual-dysphoric-disorder-pmdd\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Office of Women&#8217;s Health<\/span><\/a><span style=\"font-weight: 400;\"> during the final week before the onset of menses:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Anger and irritability<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Depression and suicidal ideation<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Anxiety, tension and panic attacks<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Mood swings and frequent crying<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Lack of interest of typical routines<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Difficulty concentrating<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Fatigue and exhaustion<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Binge eating and food cravings<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Insomnia<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Dr. Lingow clarifies that the symptoms aren\u2019t depression, but a &#8220;<\/span><i><span style=\"font-weight: 400;\">markedly<\/span><\/i><span style=\"font-weight: 400;\"> depressed mood.&#8221; They don&#8217;t just include anxiety, but &#8220;<\/span><i><span style=\"font-weight: 400;\">marked<\/span><\/i><span style=\"font-weight: 400;\"> anxiety.&#8221; These symptoms are severe enough to disrupt an otherwise neurotypical day-to-day or cause the individual significant distress.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When my cycle is good to me, I only have five of these symptoms. Sometimes, it&#8217;s all of them. But with more than a decade of experience maneuvering my hormonal undulations, I&#8217;ve learned to communicate my symptoms to those closest to me, if only to ask for space or support.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/depression-caused-by-physical-illness\/\"><b>The link between physical and mental health<\/b><\/a><\/p>\n<h2><span style=\"font-weight: 400;\">Diagnosing PMDD<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">For PMDD, diagnosis is a tool for legitimacy, a reminder it&#8217;s not all in your head. If you think you have PMDD, the first step is tracking symptoms and mood changes on a calendar or in a menstrual app. With this information, you can ask yourself: When are my symptoms present, and do they line up with the luteal phase (post-ovulation and pre-menstruation) of my menstrual cycle? Do they return around the same time each month? Bringing this information to a primary care provider or gynecologist will help you receive the care you need\u2014through pharmaceuticals, lifestyle changes, and a sense of validation.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">PMDD can also co-exist with other mental health issues such as clinical depression and generalized anxiety disorder, making treatment and diagnosis\u2014or simply understanding one&#8217;s own mental health issues\u2014that much tricker. According to Dr. Lingow, &#8220;The timing of psychological symptoms would be key in differentiating PMDD and depression.&#8221;\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As someone with multiple mental health diagnoses, keeping a mental health calendar has helped me discern my experiences, especially considering the cyclical nature of PMDD.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What causes PMDD?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">PMDD occurs during the luteal phase, says Kate Placzek, Ph.D., a senior research scientist with ZRT Laboratory, <\/span><span style=\"font-weight: 400;\">performing laboratory research on hormones<\/span><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Her research shows that people living with PMDD are very sensitive to the rise in the progesterone hormone that occurs during the luteal phase. Even though progesterone is widely known as a calming hormone, those with PMDD tend to have an adverse reaction\u2014one that invites depression, anxiety, and other stressful symptoms.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">How do medical experts treat PMDD?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The first line of defense is lifestyle changes like increased fiber and exercise; however, Dr. Lingow says hormonal contraceptives and <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/side-effects-of-antidepressants\/\"><span style=\"font-weight: 400;\">SSRI antidepressants<\/span><\/a><span style=\"font-weight: 400;\"> are two common pharmaceutical PMDD treatments.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to Alison McAllister, ND, a clinician at ZRT Laboratory, not all contraceptives are created equal.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;Women with PMDD may benefit from contraceptives that are monophasic, or the same all month long,&#8221; says McAllister, specifying <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/yaz\"><span style=\"font-weight: 400;\">Yaz<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/yasmin-28\"><span style=\"font-weight: 400;\">Yasmin<\/span><\/a><span style=\"font-weight: 400;\">, and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/mirena-52-mg\"><span style=\"font-weight: 400;\">Mirena<\/span><\/a><span style=\"font-weight: 400;\"> in particular. She also notes that women can use certain oral contraceptives continuously and skip the placebo pill to decrease the number of times their hormones shift per year. Recently, combined hormonal contraceptive pills with drospirenone and ethinyl estradiol received specific FDA approval to treat PMDD.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">I&#8217;ve been on a low-hormone birth control regimen on and off since I was diagnosed with PMDD. It doesn&#8217;t eliminate my symptoms entirely, but it does quell them to keep me from suicidal ideation (IAMPD says that 30% of people with PMDD will attempt suicide in their lifetime).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">What&#8217;s worth noting, though, is that all people react differently to medication, so what works for one person may not work for another. It is important to work closely with your provider to find the most effective treatment regimen.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/birth-control-options\/\"><b>Birth control options<\/b><\/a><\/p>\n<h2><span style=\"font-weight: 400;\">PMDD is not just<\/span> <span style=\"font-weight: 400;\">in your head<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Regardless of the treatment route you choose, don\u2019t doubt your symptoms. Even though PMDD wasn&#8217;t added to the Diagnostic and Statistical Manual of Mental Disorders V until 2013, research is beginning to come around the bend.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;So many times throughout history, women were told they were hysterical,&#8221; says Dr. Placzek. &#8220;But there is a biochemical reason for why they&#8217;re feeling the way they&#8217;re feeling.&#8221;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">I&#8217;m sure my 14-year-old self would have appreciated that validation as well as other women\u2019s PMDD stories, but I&#8217;m just as comforted to hear it more than a decade later.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tampon isn&#8217;t a dirty word, but a lot of girls grow up being told that it is. In fact, American culture stigmatizes many parts of female health, including premenstrual syndrome (PMS). It\u2019s a real condition that can affect a woman\u2019s health, emotions, and behavior that\u2019s often brushed off as \u201ccrazy\u201d\u2014so much so that I actually [&hellip;]<\/p>\n","protected":false},"author":94,"featured_media":16287,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8318],"tags":[8670],"coauthors":[19908],"class_list":["post-16214","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-community","tag-womens-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Living with PMDD: It\u2019s not just in your head<\/title>\n<meta name=\"description\" content=\"5%\u201310% of women have premenstrual dysphoric disorder. 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