PMDD Awareness Month 2015

Show your support! 

The National Association for PMDD is continuing the PMDD Awareness month throughout April. 

Use the hashtag #pmddbrave

Where I am with things now...

The following is part of a message I wrote to my new UK support group...  I thought I'd share here too.

When I started the support groups I was very active in all of them.  I was still struggling with my PMDD and needed the valuable words of support and advice that you can find in the group, however, life moves on and my struggles are far more under my control and I am beginning to focus my time on other things.  What this means is although I am the group owner, I may not be in here and posting all the time.  I will always respond to anything I'm tagged in, but I unfortunately don't have the time I used to have to dedicate to the groups.  There was one point in my life when my PMDD groups were the first thing I checked in the morning and the last thing at night!  I have always seen the need to create a UK group, so this, I think, will be the last group I set up!

I have been writing my blog for about 6 years and writing has my saviour so many times.  Go back a few years and you can read my posts from when I was at my worst, right up to now where I tend to focus my writing into creating more positive articles and blogs.  It has proved quite popular and I thank the Goddess for ever comment that keeps me writing.  I get lots of emails and inbox messages for people looking for help.  It would be impossible for me to help and support everyone, but what I can do is create a space where you can do it for each other.

I have lived with this since I was 13, and have tried many medications, birth controls, IUD's etc but the only thing that worked for me was changing the way I saw my period. I began working with the natural ups and downs.  I learned to deal better with stress and I make sure I avoid stressful situations.  Looking after myself, honouring what having a powerful connection to the cycle means has helped turn things around for me. I do not believe in medications.  I do not believe this incurable.  I see PMDD as a severe imbalance within the system, with many factors contributing to the overall list of symptoms.  It's a whole mix up of low serotonin, adrenal fatigue, excess hormones or lack of, sensitivity to the hormonal changes, not enough healthy food and exercise, lack of sleep, traumatic situations, childhood baggage, unhealthy relationships, being over worked, and negative though patterns etc etc... possibly mixed up with some depression and other health conditions you may have, and possibly brought on by some kind of reaction to hormonal medication, pregnancy, or underlying problem in the sex organs.

I now manage my PMDD and life so that I rarely suffer the severe symptoms.  I'm not free of it, but neither would I want to be.  PMDD makes me look at my life and the things I am doing.  It stops me from taking on more than I can handle.  It makes me streamline my friendships so that I only have people around me who I trust and who understand me.  It has led me to become strong and there is nothing better than PMDD to teach you how to 'not sweat the small stuff'.  I have achieved this through stopping all meds and birth control, getting lots of counseling, moving on from bad relationships and stressful friendships, and becoming more aware of my cycle.  I use spiritual views and ideas to get me through, concepts about the menstrual cycle that I connected with in a spiritual way.  It's made me be more honest and open with those around me.  It makes me ask for help when I need it. 

My menstrual cycle has become a source of inspiration for me and I no longer fear it.  I know the cycle.  I know MY cycle.  I rest when I need to, I work hard when I can.  I see my life, much like a circus act.  I'm the plate spinner.  I get one going, then my mood changes, so I set another one spinning... I keep going till there are things to do no matter what mood I'm in, so I focus on those things in turn as my mood changes.  Sometimes I drop all the plates, and after a rant, rest or cry, I start picking them back up and get spinning again.

 

One thing I have realised is that I will never be able to work a normal 9-5.  I cannot fit into the schedules of the outside world, so I will no longer strive to.  It has always been my plan to run my own business or go self employed, so that is now where I see myself heading.  One step at a time, always chipping away.  I used to think I would never get anywhere, locked into the crazy cycles, but now I see a path where before there was none.  

By meeting others and realising I was not alone I broke the first chain.  By learning from others and never giving up, never closing my mind to new possibilities I have got this far and so can you.  No matter what path you follow, whether it's meds, hormones, lifestyle, spirituality, alternative treatments or surgery, you will hopefully find someone else in the same boat who can relate, and who can offer support.  We should always be accepting of other peoples choices and remember that what may have worked for us may not work for someone else.  We can always offer a word of support even if we don't fully relate...

Currently, I am building a new website to launch PMDD Awareness UK.  I am hoping this will become a base for PMDD news and campaigns in the UK.  I am also hoping that women will join in in raising awareness, and the website will eventually provide posters to download, and info sheets to give to GP's.  I am also looking at creating a mood chart, downloadable from the website.  There are no organisations working solely for PMDD in the UK.  NAPS do a great job in working on behalf of women with PMDD, and I liase with them regarding PMDD Awareness issues.  They are still our only official organisation and a great place to get info and help.  They are also all set up for that kind of thing, so me, with my PMDD Awareness UK plans will need to continue to ask women to step forward, join the tribe and help try and change things.  You know that saying.. 'if you want something done...' well WE need something done about the state of PMDD and how it is dealt with, WE need to be prepared to write a letter or put up a poster...  It may only seem like small steps, but that's all we need to get started.  It's better than no steps at all! If you haven't liked the PMDD Awareness UK page, please come and do so www.facebook.com/pmddawarenessuk

Lots of love to you all! I wouldn't have got here if it hadn't been for these groups and the readers comments and messages on my blog! all of which have supported me along my journey, so thank you!

If you would like to join my new UK Facebook support group, and you currently live in the UK, please follow this link!  https://www.facebook.com/groups/ukpmddsupport/

The Menstrual Cycle - A Visual Guide

It never ceases to amaze me how many women don't really know what is going in inside their bodies during the menstrual cycle, or how to chart their cycle.  I don't mean that in an unkind way, it's just an observation.  Knowledge is the best tool you can have, and if you suffer with PMDD you need to do a bit of reading and get some of that valuable knowledge under you belt.  It will help as you try and figure out what happens at what point of your cycle, and having an idea of the physical changes inside you can really help.

Over the years I have come across videos and charts which have helped me to understand the changes my body goes through.  That understanding, in turn, led me to look for ways to support the changes rather than fight against them.  Timing and planning things around the different energies is now second nature.  Knowing my limits at each point of the cycle has really helped me live with PMDD.  I have the odd breakdown, but I am much more in control on a regular basis during all points of my cyclical changes.  That to me is like winning the lottery.

I decided to create a chart just for PMDD/PMS sufferers to refer to.  It shows the fluctuations in hormones, the physical changes, and the energetic/emotional changes.  Hopefully it will give you a good idea as to what is happening in side you when all hell breaks loose!  It also has key words to give you a feel for the natural energy of each phase..

I will go into the seasonal correspondences in another post, but it's quite easy to connect with.  Our energy grows after our period, peaks at ovulation and then slowly wanes until we bleed again. You can see this cycle happen in nature every year.  We have like a mini years worth of seasons in one month!  I have blogged about these theories before, you can find some of them here and here.  I also created a poster about these energies which you can find here -  http://naturalshaman.blogspot.co.uk/p/energy-cycle-poster.html.

We get all stressed out about feeling low, tired or crabby, but if we are pre menstrual or hitting ovulation there is a simple explanation!  Hormonal changes!  If you are still having trouble during the times when the hormones level out and are not finding yourself feeling better, then maybe there are other issues at play.  PMDD will drag you down during pre menstruation and in some cases, at ovulation too.  You should always feel better at each point between to two, but if you are not, you may need to look at whether your unhappiness/frustration is coming from a depression, an unsuitable job, an unhappy relationship, a past trauma or issue that hasn't been resolved.  PMDD plays a huge part in our emotional wellbeing, but it's not the only factor.  Stress and unresolved issues can add to the pressure and make an uncontrollable outburst more likely.

Here is the chart.  It clearly shows the fluctuations and changes the body goes through.  I have added where the PMDD crisis points are, along with the seasons of the year and key words that can give you an idea of the energies present during each phase.  Hopefully it is simple enough to understand, and below, is a written explanation.  Again, I hope I have written it in such a way that it is easy to understand.  I have read many a medical site that uses such technical words that it gets too complicated to understand!

To chart your periods, you start counting on the first day of bleeding.  That is day 1.  You keep counting until you bleed again and the again, the first day of bleeding becomes day 1.  Mark it on a calendar or use an app to keep track of your period.  This helps you to plan around your period by not taking on too much during the times that could be challenging.  I often count forward and also mark day 7, 14, 21 and 28.   That then gives me a quick view of where I will be emotionally and physically throughout the month.  Lots of cycles are longer or shorter, and that is normal.  28 days is just the average.  Ovulation always occurs around 14 days before your period, so if you have a short cycle, say, 21 days, you will ovulate on day 7.. if it is a longer cycle, say 32 days, you will ovulate around day 18.  It IS possible to ovulate twice in a month and to not ovulate at all.

The menstrual cycle is split into 3 phases, follicular, ovulation and luteal. The first phase is the follicular phase and corresponds to when the FSH (follicle stimulating hormone, produced in the brain) sends signals to the ovary to ripen and produce and egg.. This then produces more estrogen from the ovaries to enable the egg to ripen.. At ovulation, increasing estrogen levels from the maturing follicles cause the LH, luteinizing hormone, to surge, which releases the egg. The corpus luteum (a solid body of cells) is left behind at ovulation. The corpus luteum excretes progesterone and small amounts of estrogen and causes the womb lining to thicken in preparation for the egg. This is called the luteal phase. It prepares the body for pregnancy. During the luteal phase, estrogen drops quite rapidly and will fluctuate until your period. At the same time, progesterone is rising. It spikes around day 21, and then drops off rapidly. When the egg is not fertilised, the corpus luteum dies and stops producing progesterone and estrogen, this allows the womb to shed it's lining and cleanse the uterus.

The other hormones involved are those that are produced in the brain that send signals to the ovaries.  Gonadotropic hormones come from the pituitary glad in the brain.  They are controlled by GnRH frequencies that send out pulses to regulate the production of gonadotropic hormones.  In men, this pulse is contstant and steady.  In women, the frequencies change throughout the cycle which is what gives us a cycle that changes and fluctuates.  The change in frequency is what sends out the right amount of gonadotropic hormones to our ovaries to trigger the stages of the menstrual cycle.

The basal body temperature can help clearly indicate ovulation and is important for those trying to conceive or who use the fertility awareness method of contraception.  By orally taking your temperature every morning as soon as you wake (before even getting out of bed) and keeping a record, you will see a drop in temperature at ovulation and then it will rise from around 36.4°F to 36.7°F.  Other signs of ovulation is the consistency of cervical mucus.  At ovulation, this mucus will be fluid and watery.  Some women can tell they are ovulating just by how wet or moist they get.  This fluid helps sperm to swim more easily into the womb.  After ovulation, the cervical mucus will get thicker and more sticky.  This is much harder for the sperm to swim through, which helps with contraception.  For more info on the fertility awareness method and charting temperature, take a look at TCOYF.  Some women do also experience pain at ovulation.  Stabbing sharp pains on either the left or right side can signify which ovary you are ovulating from!  They are known as mittelschmerz.

By having even a basic understanding of the physiology of the menstrual cycle, you can get to grips with why we experience these changes in mind and body.  This is the physical process, but we all know that these changes DO have a significant effect on our mental health, moods and wellbeing. 

When you really learn and come to terms with the fact that our bodily processes are pretty much out of our hands.. meaning, we cannot stop them, (unless we control them with birth control/hormone therapy or hysterectomy) but we can start to look at ways of how to live and work WITH them.  Of course, we can influence our bodily functions.  By eating and sleeping right, exercising and staying away from stress we can encourage a healthier system... 

Never underestimate stress.  Stress can knock out these physical rhythms, causing the cycle to become off balance.  This can lead to irregular periods, changes in cycle length, missing or late periods and all manner of emotional symptoms.

I have produced an alternate version of this chart to share on Facebook, and may look at getting some printed for those who would like a hard copy to stick up at home...  If you are interested in buying a copy, please message me via my Facebook page or use my Kontactr box. 

Chart is for illustrative purposes only and includes the main factors responsible for the menstrual cycle.  There are obviously other smaller players on the menstrual stage, but for the purposes of PMDD education, I have focused on the star performers!

If you choose to download and share, please link back to me and do not remove my copyright from the image.  Please contact me if you wish to re blog, so I can give you a shout out in return!  Thank you. xx

© Cat Hawkins 2012 - Art and design by chaoticat.com.

PMDD - Advice for Men by Liana

The lovely Liana over at http://livingonaprayerwithpmdd.blogspot.co.uk/ has agreed for me to re blog a couple of her awesome posts on Men and PMDD.  I have never managed to write about this particular topic, mainly because my focus has always been to help women understand what is happening to them, so there is a bit of a gap in my blog about PMDD, men and relationships.  I want to rectify this, so to begin with, Liana's articles will help start off some more posts about Men and PMDD.  Obviously, if in a same sex relationship, this advice will still help partners of women with PMDD.

Dealing with PMDD - Advice for Men by Liana

I’ve spent quite a bit of time searching the internet for Resources and Advice for men dealing with a woman who suffers from PMDD. Unfortunately, most articles lump PMS and PMDD together, which does a great disservice to women with PMDD. In the comment sections of these articles both men and women express anger and resentment toward the women who experience true PMDD: the men claiming the articles give women a license to behave badly two weeks out of the month, and the women claiming the women with extreme mood swings give all women a bad name.

So, to clear a few things up…

20% of women suffer no pre-menstrual symptoms at all
80% of women suffer from some combination of pre-menstrual symptoms
20-40% experience moderate discomfort pre-menstrually
Up to 10% of women suffer from PMDD

This post is written for the men who have partners in the last category.

But before we get started, a quick primer on the differences between PMS and PMDD.

PMS deals primarily with physical symptoms. Bloating, aching, cramping, tenderness, fatigue, headaches, food cravings, and mild mood swings are the most well-known of the more than 150 symptoms possible. A little irritability, tension, sadness, weepiness, or any combination thereof is par for the course.

The major component of PMDD is mood swings in the extreme. PMDD actually affects your brain’s capability to regulate itself, and therefore affects just about every other hormone in your body. That’s not to say a woman can’t have the bloating, aching, cramping, fatigue, cravings, and other physical symptoms. If she does, it may well be that she suffers from both PMDD and PMS, and once she gets her PMDD under control, all she’ll be left with is some PMS.

Frankly, I think most women with PMDD would be happy to simply suffer some form of PMS. Because PMS is to PMDD what a headache is to a migraine. There is a distinct difference, and that difference is biological—not mental. The biology of PMS and PMDD share many similarities, but at some point they split into completely different paths. An explanation of that is beyond the scope of this post, but I’ll be happy to write about it some other time.

For now, it’s enough to know that PMS and PMDD are two completely different things.

That’s not to say your relationship won’t benefit from the advice in this post if your partner simply has PMS. But we’re not talking about PMS here today, we’re talking full-blown PMDD.

1. Both you and your partner should mark the time on a calendar when you expect her to be pre-menstrual. This can be hard if her cycle is not regular, but do the best you can to identify patterns. An explanation of my pattern is here, and can give you an idea of what symptoms to look for.

If your partner is in denial, and claims there’s nothing wrong with her—mark your own calendar separately. In many cases, the man can tell before the woman that she’s entering into her pre-menstrual phase, because he’s watching from the outside, while she’s busy trying to cope—either consciously or sub-consciously--with the unwanted changes going on in her brain and body.

Please note: There are women who are in complete denial that anything different is happening to them, and then there are women who know what’s happening, but “really don’t want to deal with this right now” because they are too busy to, and so they pretend nothing is happening, and they really aren’t feeling any differently, until it’s too late to do anything about it, and the episode erupts full force.

Determine which type of woman you are living with, and keep track accordingly. Apparently there are several applications available on the iPhone and Android phones to help you track her cycle, but an old-fashioned calendar will do just as well.

2. If she’s indicated that this is what she would prefer, try to stay clear of her until the episode passes. This has nothing to do with you, or her love for you. It’s simply due to her heightened sensitivity to any combination of the five senses. She literally can’t handle any more sensory input—be it bright lights, loud noises, touch of any kind, strong smells, or even certain foods. If a PMDD woman has allergies of any kind, they can be exacerbated pre-menstrually. If she has any another condition, such as arthritis, diabetes, or fibromyalgia, they can be exacerbated as well.

Even if she’s otherwise healthy, during an episode of PMDD a woman is literally is a walking bundle of nerves. Unfortunately for both of you, this heightened sensitivity and discomfort can be so distracting that it causes her an inability to focus on things like questions, requests, conversations, or simple instructions. (Now you know why she forgot to pick up your suit at the cleaners.)

Take the first one, for example: You have a question that requires more than minimal thought and consideration.
Examples would be:
Major purchases—car, appliances, maybe that boat/motorcycle/sportscar you’ve always wanted (not a good time to bring it up)
Health decisions
Financial decisions
Employment decisions
Decisions involving having or raising children
Vacation plans
Any change of routine or structure in your life

Why? Because during a PMDD episode a woman’s brain is not functioning properly. This has nothing to do with how smart or intelligent she is. This is her brain chemistry being disrupted due to the hormonal shifts taking place in her body. During a PMDD episode it can take all of her concentration simply to focus on the basics of getting through each day. If you come at her with anything resembling a major decision, it could overload her brain and cause a meltdown.

So if she asks for space during that time, please give it to her.

3. Be patient. Dealing with anybody on a short fuse can be challenging. If she snaps at you, or does something that irritates you, don't lose your temper and fight back. It won't do any good, and in most cases will only make things worse. Just (discreetly) take a deep breath, maybe say a prayer, and ignore whatever she just did that bothered you. Remember that she's not normally like this and she’ll be herself again soon.

4. Do not enable immature behavior. I’ve said all along, PMDD is an explanation, not an excuse. Being emotional does not excuse inappropriate behavior, any more than being drunk excuses offensive behavior. If she’s being immature, yelling, shouting, stomping, snapping, cursing, slamming or throwing things, don’t respond with your own immature behavior. She at least has an explanation for it—a biological explanation. What’s your excuse?

Stay calm and leave the room if you have to, until she settles down. Let her know you love her and you’ll be nearby, but you can’t have a conversation with her when she’s being irrational. Believe me, she knows she’s being irrational. But without conscious effort at awareness, she can’t stop herself any more than she could stop an allergic reaction. If you calmly point out that she’s being immature or irrational and say you’ll be happy to continue this conversation another time, things will settle down a lot more quickly than if you respond with your own emotional outburst.

5. Listen to her, even if she’s not making any sense. Try to figure out what the REAL problem is. If she’s complaining about something that’s never bothered her before, or doesn’t usually bother her, most likely what she’s saying is “I feel miserable, and there’s nothing I can do about it, so I’m looking for something else to change and hoping that will make me feel better.” This is a time of true desperation for her. She’s looking for anything, rational or irrational, that will make her feel better. This is a good time to suggest she take some time out for herself, maybe a hot bath, or a cup of tea and a good book, or whatever soothes her soul. Let her know you support her need to have a little time to pamper herself in whatever way makes her the happiest.

But beware of sending her out on a shopping spree. Retail therapy will only make things worse when the mood has passed and the bills come in.

6. Don't take it personally. During an episode of PMDD, you can count on her emotions getting the best of her, and she'll probably question your relationship. She might question you. Might question her whole life and everything she believes or stands for. This is normal and natural for a woman during an episode of PMDD. As mentioned in Number 5 above, she's feeling helpless, and sometimes when people feel helpless they look for other things they can control, and that might mean bringing up topics or suggesting changes that trigger your emotions. Your best defense against this is to stay level-headed and calmly say, "Ok, I understand." What you really understand is that you're still the same person she loved before her PMDD episode kicked in, and her change in perception of you and her life overall is the PMDD talking, not her. For more information on this, see my post It’s Not Personal – It’s Just My PMDD.

7. Be compassionate. Think about a time when stress or physical changes made you hard to get along with. Have you ever been sleep-deprived? Maybe you had an accident or were the hospital, and the chronic pain made you want to lash out at everybody. Put yourself in her shoes. Not only is she experiencing uncomfortable physical symptoms, but her hormones also ebbing and flowing, making it almost impossible for her to know how she feels or what she wants. Think of the effect testosterone has had on you, like when you get sexually aroused, or on any occasion when you felt aggression or rage. You remember how you felt caught up in the emotion, how it made you want to say and do things you ordinarily wouldn’t say or do. That’s what’s happening to her.

8. Be forgiving and reassuring. Her insecurities will definitely come up during an episode of PMDD, and with her heightened sensitivity, every negative thought she has will be magnified ten times over. If she doesn’t consciously stop the negative thoughts, they will flow through her mind in an endless loop. If you can get her to talk about them, fine. Some women won’t want to, because they know the thoughts are irrational, even while they are having them, they just don’t know how to stop them. Nobody wants to share irrational thoughts, and then remember they did so when the episode is over—even if the only one remembering them is her.

If she feels unloved and insecure, she’ll probably act out, which will make you not want to be around her, which will "confirm" her negative thoughts. Most women feel insecure about their bodies to start with, maybe even their lovemaking, child-rearing, housekeeping, or professional skills, and if they’re in any way insecure about your feelings for them, this is when that insecurity will come out. So try to give her a few extra compliments (and don’t be offended if she doesn’t believe you, or snaps at you for it), and—if she’ll let you (remember those heightened sensory sensitivities)--be more affectionate. If she won’t let you near her, don’t make her feel badly by taking it personally. Guilt is the last thing she needs when she’s feeling unlovable. Tell her you understand and you’ll be around if she changes her mind. That could well be all it takes to melt her defenses.

Take care, and good luck!

By Liana

Check out other PMDD posts by Liana at http://livingonaprayerwithpmdd.blogspot.co.uk/ 

If you would like tp join a Facebook support group for Family and Friends of PMDD, please visit: https://www.facebook.com/groups/406176079407609/  and request membership.

 

PMDD and Me

Today, the Mind blog published a blog I wrote for them titled, PMDD and Me.

This is a really good step, as Mind currently do not cover PMDD in their list of disorders, nor have any leaflets about it.  Ladies with PMDD need to speak up.  They need to make 'the powers that be' aware of their existence, their struggles, their needs.

I hope this goes a little way towards making people listen to women with PMDD, and that women eventually get better support and help to living a better life.

You can find the blog here http://www.mind.org.uk/blog/6201_pmdd_and_me.  Please share the link on Facebook or email...

Never stop passing on information and raising awareness, in whatever small way you can.

Cat x 

What is PMDD?

Premenstrual Dysphoric Disorder affects only 3-8% of women. It is a severe form of Premenstrual Syndrome or PMS. Almost all women suffer some kind of symptoms when their menstrual period is due. They may become snappy and grumpy, they may deal with cramps, backache or tender breasts, however, PMS sufferers can manage these symptoms effectively and their lives are not disrupted by their menstrual period.

PMDD sufferers experience many if not all possible physical symptoms, but the distinguishing factor of PMDD is the extreme swings in mood and how they feel about themselves and others.

PMDD is a cyclical disorder. It will affect a woman every single month. Most ladies with PMDD will experience physical discomfort and emotional changes that begin around a week before their period, lasting till bleeding commences. However, due to being sensitive to hormone changes, some women experience symptoms during the ovulatory phase of their cycle too.

It is thought that a women with PMDD is more sensitive to the body's naturally changing hormones. It is also thought that these changes can bring about a drop in serotonin in the brain, which can cause a number of unpleasant symptoms. Serotonin is the body's natural feel good hormones, and many PMDD sufferers experience symptoms of low serotonin.

Physical changes and symptoms can include the following:

Abdominal cramps, period pain, backache, hip pain, tender breasts, nausea and sickness, lethargy, fatigue, insomnia, changes in appetite, sensitivity to sound and smell, headaches, memory loss, bloating, loss or boost to libido and weight gain.

Emotional changes and symptoms can include:

Markedly depressed mood, feelings of hopelessness, heightened anxiety, increased tension, sudden shifts in mood, tearfulness, overly sensitive, persistent angry or irritable outbursts, increased personal conflicts, frustration, panic attacks, persecutory delusions, racing thoughts, feeling overwhelmed or out of control, indecisiveness, and confusion.

Lifestyle changes:

Loss of interest in usual activities, unable to think clearly to make simple decisions, cancelling outings or events, hiding indoors and avoiding contact with others, damaging relationships via texts, online or verbally, losing friends, being unable to cope with usual tasks or requests, difficulty in keeping employment, difficulty focusing on studies or work.

An important note on Dysphoria.

PMDD is distinguished from PMS by the use of the word dysphoric. PMDD sufferers often describe their symptoms as a feeling of 'going mad' or 'going insane'. They feel out of control of their emotions and find their minds full of racing negative thoughts. Some say it feels like being possessed and many women will describe themselves as Jekyll and Hyde.

The dysphoria element is often overlooked yet is one of the hardest things for a woman to deal with. For a certain amount of days or weeks out of the month right before their period and/or around ovulation, a PMDD sufferer will experience a complete shift and change in being.

Dysphoric states bring about a complete change in perception for the sufferer. They may believe they are being persecuted in some way. That friends and family are fed up with them and dislike them. They may feel panic over not being believed or understood. They feel a great amount of frustration that despite whatever attempts they made during the rest of the month to 'help themselves get better' the feelings and depression are back, with full force and they are yet again caught up in the whirlwind of dysphoria.

A women with PMDD is faced with an eternal cycle of symptoms. The PMDD 'episodes' or 'states of dysphoria' will turn up without fail every month. The only thing that seems to change is the severity. Some months will pass without too much damage to relationships, work or the self, but other months will be explosive and destructive, to the sufferer and those around them.

How do you know if it's PMDD and not something else like depression?

PMDD is characterised by is cyclical nature and the fact that for at least 7-10 days of the month between periods, the woman has no symptoms. They are, for want of a better word, 'normal'. Many women call this their 'good' days or 'up' time. They can maintain relationships, cope with life, home, kids, and work. They are confident, happy and organised. They feel normal, stable and able to cope. They can go out and socialise, answer the phone and participate online. They have a clarity of mind to know what they want and can make decisions again. It really is like a black cloud has lifted and they are able to function normally again.

Depression will not lift in this way. If you suffer from depression, every day is a 'down' day or 'downtime'. PMDD sufferers may experience depression during their 'down' days, but it is a feeling that always lifts, and relief is found.

PMDD is often misdiagnosed as bi-polar disorder due to the extreme changes in mood. Bi-polar sufferers may suffer a couple of episodes a year of extreme up's or downs. These episodes can last months, but when the Bi-polar sufferer becomes stable again they are able to maintain a 'normal' life, sometimes for months, between episodes. The closest form of Bi-polar to PMDD is rapid-cycling Bi-polar, where the diagnosis is for 4 or more episodes in a year. PMDD sufferers don't get a few months between down times, they suffer every month, 12 times a year, double that if they are affected at ovulation as well.

If there is underlying depression or mental health problems, you may then experience PME, Premenstrual Exacerbation. This is a worsening of your current condition due to and during the changes in the menstrual cycle.

Basically, if you feel fine for at least 7-10 days of the month and you have no symptoms, no mood swings, no negative effects to your life, yet a week before menstruation you sink into a depression, find your self anxious and unable to leave the house, or angry with volatile outbursts, then you are probably suffering PMDD. PMDD will lift once your period starts. Some ladies will get relief right from day 1, where as some will find the black cloud lifts on day 5 or 6. One thing is for sure, all the crazy feelings and emotions will pass, and most women just hang on for dear life until their period has ended and they are back into a couple of weeks of feeling stable and happy.

I think I have PMDD, how do I get my doctor to give me a diagnosis?

For PMDD to be diagnosed, you will need to be experiencing at least 5 of the above symptoms every month. They may not always be the same symptoms every month, but currently, the diagnosis is for a combination of at least 5 symptoms. These symptoms have to be extreme enough to interfere significantly with daily life, work, relationships, studies or social activities.

You will need to chart your symptoms for at least 2 months. Charting means keeping a track of all your symptoms throughout the month to build up a picture of your up and down times. If you have PMDD you will be able to see an obvious rise in symptoms during the last part of your cycle, and maybe at ovulation.

You can find mood charts online that you can download and print off. Some websites allow you to track symptoms online, and there are many iPhone and Android apps for keeping track of your cycle. How ever you do it, make sure you can take an actually paper copy in with you to your GP. For me, printing off a chart and filling it in worked better. Simple and not usually anything more that colouring in or ticking boxes.

Visit your GP, and take along some print outs about PMDD. There are many GP's who have still never heard of PMDD. That doesn't mean that they wont want to help, so it's always worth helping your doctor get you the right diagnosis. Start a chart as soon as you can, as you will need 2-3 months worth for your doctor to diagnose you correctly.

Have a look through the links on this blog.. there is lots of information here to get you started.