5 Ways I Manage PMDD

 It's November 1st, the start of the month that us Americans are starting to prepare for Thanksgiving. It's a time when we're encouraged to be thankful, show gratitude and recognize our blessings. 

Lately, I've been struggling with this. Really struggling. 

I was diagnosed with PMDD several years ago. PMDD stands for Premenstrual Dysphoric Disorder (a great resource from the Mayo Clinic for information can be found here) and is something I only recently have begun to talk about publicly. For years I felt shame around the depression and anxiety I experienced throughout my cycle. I told myself that women around the world deal with hormones and have since the dawn of time, so I could suck it up and wait it out. Since around the age of sixteen, I had experienced monthly episodes of near debilitating depression mixed with a feeling of hopelessness, anxiety and severe panic. In high school, this presented itself as going to bed feeling perfectly fine, and waking up in the morning feeling like some creature had taken over my body and my mind and I had zero control over what I was thinking or feeling. I was spiraling, out of breath, in complete panic and the only thing I knew was that I could not go to school that day. Hell, I couldn't even leave my bed that day out of fear that something (to this day, I've never figured out what that 'something' is) tragic would happen and the mere thought of stepping foot outside was not an option. It wasn't a matter of teenage hormones or having a bad hair day-it was something far more significant that I only recognized when I finally would come to a day, a few days or a week later and wonder what the hell happened to me. I would breathe a sigh of relief every month when my period came and I would return to my normal self again. My parents sent me to see a therapist, who told me it was part of being a teenage girl and encouraged me to go to 'mixers' and try to get out more. 

In my twenties, I would blow through my sick days at work halfway through the year, convinced that my "mental health" days were just me being lazy when in reality, there were days I could barely find my voice to pick up the phone and call in that day. Note: I am ever so grateful for this time in society when mental health days are much more socially acceptable and not seen as an excuse to get out of work and watch television all day (but let's be real, sometimes when we're struggling all we can do is sit and watch television all day). 

It wasn't my mid-thirties and years of therapy when a medical doctor finally diagnosed me with PMDD. To have the diagnosis was an absolute relief-but what now? Was there a magic pill that cured this illness I had suffered from for so long and would send me frolicking through the meadow a changed woman? 

Well, I would be lying if I didn't say that medication did help me to some degree. I'm not a medical doctor or prescriber and because of that, my personal medication history isn't important in the context of this story. I will say in my years working in the field of nutrition, I've found pro's and con's to just about every drug or supplement out there and you have to do what works for you. Bio-individuality is key, so if any of this resonates with you I would encourage you to work with a doctor you trust to determine what's best for your own health. I did find though, that no medication out there miraculously gave me the drive to hop out of bed each day with a smile on my face, ready to greet the day with nothing but sunshine and rainbows radiating from my being. This was a learned skill, and one I'm about to teach you, so listen up. 

Here are the five top ways that I manage my PMDD. Disclaimer: I am not a doctor or a therapist, and the tools I'm sharing are from my personal experience only. 

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1. Do something that brings you joy first thing in the morning. 

Photo by Ozgu Ozden on Unsplash

If you hate going to work because you hate your job and the only thing you do in the morning is get ready for said job that you hate, then you're going to hate getting out of bed in the morning. Seems pretty obvious, right? For years I'd seen my only 'free' time as the precious hours after I finished work and before I went to bed, but what if you changed your perspective and saw your free time as also including the hours between waking up and whatever you viewed as your daily obligation? I once tried getting up hours before work just to go to the gym. It lasted about two weeks, I felt more refreshed at the start of my work day but I worked such long hours, I just couldn't justify the amount of sleep I was losing to see it working long-term for me (I was working full time and in school at night so my rest time was precious). We recently got a kitten and I've started getting up an hour before I have to get ready for work just to sit down with a cozy blanket and play with him. Before we got him, I woke up an hour before work and sat outside on the porch to read or listen to my favorite podcast. Sometimes I do a quick yoga session in the morning, or sometimes I just catch up on the latest episode of my favorite TV show. I feel like I've gotten more time back to myself and the cost is only waking up an hour or so earlier each day.

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2. Track your moods to plan ahead.

Photo by Estée Janssens on Unsplash

I always knew that during various points of month I felt all sorts of feelings, but it wasn't until I started tracking my emotions and moods that I began to notice patterns around the times of month and time frames. I use the Flo app but there are a lot of others that allow you to track your menstrual cycle and physical symptoms or emotional state each day. The app shows you insights into how your cycle tracks and trends, and many of these types of apps include a journal feature so you can write more detailed notes if you'd like. By tracking I'm now able to anticipate roughly when these feelings will arise, and make a plan for myself in advance so I'm not caught off guard. Usually my plan looks something like this: 

1. Block out the time frame from any major social obligations that could cause more stress if I need to cancel or postpone. For example, if I want to make plans for a special dinner with a friend I haven't seen in ages, I usually plan it for a different time in the event I'm not up for going and breaking the plans makes my mental state even worse. 

2. On the contrary, I try to make easy, non-committal plans with someone close to me who I trust that understands my disorder. This usually looks like a quick walk in the park or half hour face time-something short where I can come as I am and know the person I'm with will take me for whatever state I'm in that day. Having the distraction of someone comforting can allow you to get out of your head and I usually find that I return in a better frame of mind. 

3. If you're able, confide in someone close that this time of month is approaching. I usually find just having someone be able to hold that space and uneasy feeling along with me makes me feel not so alone, even if I don't need to or want to spend hours actually talking about it. 

4. If you're fortunate enough to have PTO to use up, this can be a great use of your time and something you can even plan ahead for. In the past, I have strategically planned long weekends around when I thought I may need the mental break due to shifts in my cycle and it's always a win win-I have the space if I need it, and if not I get a fun day off to do whatever I want. 

 3. Avoid things that make you more anxious (which is probably going to be hard).

Photo by Hello I'm Nik on Unsplash

on tList out the top three things that make you feel a hundred times worse when you're anxious or depressed. What would it look like if you avoided those things for this period of time? A top trigger for me is social media. Our brains aren't meant to process or carry the weight of that many people's opinions and feelings in such a quick period of time. Combined with triggering feelings of FOMO (Fear Of Missing Out) and feeling less than every time you see the random girl from high school's perfectly decorated home, you really truly will survive a social media break for a few days and your brain can use that free space to think about things that actually make you happy. 

Along these lines, I should address other influences like caffeine or alcohol. Again, I'm not a medical doctor but from personal experience, I've never woken up after a depressive episode thinking "Well thank God I drank wine last night." Usually, it just puts a very loose band-aid on whatever I'm feeling and I wake up with a slight headache and my mental state is even worse than it was before. Am I saying I'll never touch a glass of wine or a cup of coffee when I'm feeling down? No, but I can say from personal experience that I have never regretted saying no. Plus, a wine headache and caffeine withdrawal on top of existing depression are THE worst. 

4. Force yourself to do the things, even if you hate it.  

Photo by Emma Simpson on Unsplash

I saw meme once about someone trying to force themselves to do things despite feeling crappy, saying something like "Here I am going for my stupid little walk" and I remind myself of it every time that I am utterly convinced I cannot leave the couch for at least two more days. When my PMDD symptoms are at their worst, even walking to the kitchen can feel like running a marathon. I've heard it compared to walking through mud-even the smallest, slightest thing seems to just take so much energy. The last time I experienced this, I looked at the clock and gave myself an hour of forced recreational "fun" time. I told myself if after the hour I wanted to go home and sit on the couch for the rest of the night, I could. I begrudgingly threw a scrunchie in my dirty hair, found a hoodie from the dirty laundry pile and headed to the park. I didn't even bring my headphones because when I'm that deep in it, there isn't a single thing in the world that I could possibly listen to that would bring me joy. I did one loop around. I began to notice the breeze. My breathing started to relax. I did three more loops and found the energy to hop in my car and grab a decaf coffee (with pumpkin cold foam because #ideserveit ) and suddenly the world seemed a little brighter. I stayed out for three hours. Win. 

5. Remind yourself that it's okay to not be okay. Really. 

At the end of the day, if you've tried doing all the things to snap out of your depression and nothing's cutting it, remember that it's okay to not be okay. The feeling of failure for not being able to lift myself out of the darkness made things even worse for me until I realized that we're human, and we're not going to feel like the best version of ourselves every minute of every day. Sometimes, just accepting it for what it is and allowing myself the space to feel whatever I need to feel in these moments is exactly what I need, and it doesn't mean I'm broken. I always try to go to bed with some shred of hope that the next day will be better, and if not-I go back through each of my practices, continue to work with my amazing medical team and know that I'm not alone in this (and you aren't, either). 


In love and health,
Kacie Leigh