A Day in the Life of Someone Suffering from Premenstrual Dysphoric Disorder

Rage - like nothing I had ever experienced before. I feel like my insides are going to explode if I can't hit something. Crying - why am I crying over a stupid television commercial? Tired - so tired - I can't get off the couch to fix dinner or read my child a book. What day is it? Who cares anyway and I can't remember if I took a shower this morning. Hot - so hot - off comes more clothes. Damn - now I'm cold. Where's my blanket? Now I have this uncontrollable urge for chocolate, caffeine - I think I drank five cans of Diet Pepsi today.

What is this out of body feeling I am experiencing? God, who am I? I don't know myself this week. My husband is staying away and my son has that confused look on his face again. He's afraid to ask me for a drink because I'll snap at him uncontrollably. What's wrong with me? I keep telling myself all women go through PMS and menstrual cycles every month. So why can't I handle it? Why is is that I can't function for days before my menstrual cycle starts? Why is is that a normal part of life has become so dramatic for me?

I'm already on anti-depressants, so why aren't they working now? I'm too young to be going through menopause, yet I keep thinking this must be what it's like. I've been dealing with this for months so something must have hormonally changed. I was never a happy camper prior to my period but this is out of hand. I feel out of control and I can't make these feelings stop. Why won't my menstrual cycle just start? These feelings will all go away it would just start!

Next week is my yearly exam with my physician. My husband tells me I desperately need to talk to her. He says that he can handle this. But what about our son? He's too little to understand and it's unfair to him to have this unknown being who takes over his mommy every month. My husband knows it's more than just the normal PMS. I become just a shell of the usually upbeat, bubbly woman he married. I need help and I need it now.

When I go to see my doctor I give her the rundown on my problems that have developed since my last yearly exam. I breakdown while describing my monthly ordeal and she kindly asks me a list of questions. She smiles and tells me it's okay, I'm not crazy. I have what is called Premenstrual Dysphoric Disorder. My physician went on to tell me that 3% - 10% of women who are childbearing age suffer from this disorder. My first thoughts are, "Great - just what I need. Another disorder to add to my growing medical history - Chronic Fatigue Syndrome, Fibromyalgia, Interstitial Cystitis, Benign Essential Tremor and now this!" My second thought is relief. At least now I know I'm not crazy.

My physician told me that she was asking me the questions to see if I fit the criteria for Premenstrual Dysphoric Disorder (PMDD).

A woman must present with at least five of 11 specific symptoms in order to be diagnosed with PMDD. These symptoms must be present one to two weeks before the onset of a woman's menstrual cycle.

Research Criteria for PMDD:

1. Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts.
2. Marked anxiety, tension, feelings of being "keyed up" or "on edge".
3. Marked affective lability (feeling suddenly sad or tearful or increased sensitivity to rejection).
4. Persistent and marked anger or irritability or increased interpersonal conflicts.
5. Decreased interest in usual activities (work, school, friends, hobbies).
6. Subjective sense of difficulty in concentrating.
7. Lethargy, easy fatigability, or marked lack of energy.
8. Marked change in appetite, overeating, or specific food cravings.
9. Hypersomnia or insomnia.
10. A subjective sense of being overwhelmed or out of control.
11. Other physical symptoms such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of "bloating" or weight gain.

The disturbance markedly interferes with work, school, and/or social activities and relationships leading to avoidance of social activities, decreased job or school productivity and efficiency.

The disturbance is not an exacerbation of symptoms from other disorders such as panic disorder, major depressive disorder or a personality disorder.

My physician decided to start me out on Sarafem, which is a form of Prozac for two weeks out of each month. She said that due to the severity of my symptoms, women with PMDD usually require prescription medication help. For women with mild to moderate PMDD, she recommends dietary and lifestyle adjustments.

When I asked my doctor what causes some women to suffer from PMDD, she didn't know. She said it could be the hormone changes, a genetic predisposition or stress. The exact cause has not yet been found.

My physician also recommended I keep a journal where I can record my symptoms and the frequency each day of the month so that she can note my progress to see if the prescription medication, Sarafem (which is a selective serotonin reuptake inhibitor), needs adjusted.

Knowing that there is help and that I reached out for it is a step in the right direction. Hopefully next month the monster will stay in the closet and all my husband and son will see is the real me.