Pre-Menstrual Dysphoric Disorder (PMDD)

I was diagnosed with Pre-Menstrual Dysphoric Disorder (PMDD) about a year ago. I am a mother of three beautiful children. I had Postpartum Depression (PPD), each time successively worse than the last. Needless to say my husband and I have agreed that we are done having children for the obvious health risks implicated by doing so. It was with my third child that I finally resorted to medication to help with the PPD. I was prescribed Zoloft to help keep it in check. I did my homework and found out that it takes 4-6 weeks for antidepressants to kick in, because they accumulate in your system over time; however it was common for people with depression to feel better once they began the medication, because the simple act of being proactive in finding a solution can lend a great deal to one's outlook.

I was all right on the Zoloft for some time, though my husband did raise the concern that I seemed to maintain TOO even of a keel. He's always known me to be a very fiery and passionate person. On Zoloft I was in more of a Zen state than my normal personality usually allows. It was about the time my youngest child started solid food and my hormones from breast feeding changed that I had a complete breakdown. I spoke to my mom who makes it a regular habit to study medications and their affects, as she works with children who are often troubled or challenged in some manner. It was from her that I learned that anti-depressants are not an exact science… but more of a fine art. Because everybody's body chemistry is slightly different some people might not respond the same to a certain antidepressant that another group might. Having the wrong dose or combinations of antidepressant can in fact worsen the depression, which is why it is so important for professional counseling and monitoring to accompany the use of antidepressants.

It was time for me to reassess my need for medication. Upon visiting my counselor they agreed that it quite probably was a hormonal shift that caused my severe reaction to Zoloft, and they began titrating me off of it. The transition off of it proved difficult. Added to it, my personal life was going topsy- turvy, with a move to another town and developing children.

Life was bumpy for several months. We began our own business, purchased; a building to live in and run it out of… and I began sinking deeper and deeper into depression. It took me some time to find a counselor again. After visiting though she and I began tracking my worst bouts of depression and as it turns out they centered on my menstrual cycles. A week before my cycle hit I was irrationally angry and irritable with everyone, including my children. Unfortunately it was my husband that suffered the worst of my venom. During the week of my cycle though, I slipped into something that seemed beyond despondent depression. Only slightly more alarming was the fact that my cycles were not spaced out to the average 28 days. Instead I was cycling almost every 18 days, giving my husband and children about 1 week in every three that I was not an unreasonable tyrant, or a self pitying, weeping, thing in the corner.

My counselor and I both believed by this point I was suffering from PMDD. I was displaying all of the signs, and digging back through my journals for the months prior seemed to reaffirm. However she asked me to see my OB GYN to have a physical. They ran several tests and based on the record of my behavior and the results of the test, they confirmed the diagnosis and prescribed a low dose of Wellbutrin to me.

I responded completely differently to this medication. Because it contains a stimulant, I became more active, more engaged with the people around me. As time has progressed I do still suffer some PMS but not the magnified effect that the PMDD seemed to ratcheted me up in.

So what are the indications of PMDD?

depressed mood

anger or irritability

difficulty in concentrating

lack of interest in activities once enjoyed

moodiness

increased appetite

insomnia or hypersomnia

feeling overwhelmed or out of control

other physical symptoms

Symptoms that disturb social, occupational, or physical functioning

Symptoms that are not related to, or exaggerated by, another medical condition

Many might say that these symptoms sound like regular PMS, and yes women may encounter this range of problems with normal PMS. The difference however is the severity. When I describe PMDD I often describe it as "PMS on Steroids". A woman with PMDD who while otherwise a rational person may have trouble defocusing and de-escalating when experiencing an intense emotion such as anger. For me I could often feel myself grappling unsuccessfully for control of my anger. With the depression thoughts of self harm and suicide were par for the course. This sort of intensity should not be passed off as "mere PMS" but should be treated seriously.

The range of problems PMDD can cause affects relationships, work, activities, and self worth. It becomes easy for the person going through it to blame themselves, when it is something that is entirely beyond their control. A person going through PMDD needs a great deal of support and empathy. Condemnation does nothing but compound and feed the message that they are already telling themselves about their behavior… that there is something wrong with them, and it's their entire fault. Yes there is something wrong, but it is not their fault. However there are solutions out there and encouraging the person to seek them is a constructive and supportive way to help them through it.