PMDD- PMS on Steroid

Premenstrual dysphoric disorder (PMDD) – Premenstrual Syndrome (PMS) on steroid

Feminine Vitae (FV) interviewed Sarah Rawsthorn who relied on her lived experience with Premenstrual dysphoric disorder (PMDD) to develop mental health education programmes. PMDD affects around 1 in 20 women.

Hormone-related Mood Disorder

Premenstrual Dysphoric Disorder (PMDD) is a mood disorder which is similar to but more severe than the better known Premenstrual Syndrome (PMS). PMDD affects 1 in 20 women of reproductive age. Women with PMDD experience a range of severe symptoms which are disruptive to daily tasks and can cause them to struggle to function effectively in their work and personal lives. Symptoms include irritability, anxiety, depression lack of energy, hopelessness, difficulty concentrating and suicidal thoughts. These symptoms arise in the weeks preceding their period and remit when they get their period. As the condition is not as well known as PMS, women with PMDD may be self-managing symptoms of PMDD thinking that they are experiencing PMS.

One such woman is Sarah Rawsthorn, director of Mind Mechanics. Sarah recounts experiencing severe PMDD symptoms for around ten years without realising that what she was experiencing went beyond the boundaries of PMS. In addition to the PMS symptoms of pain, bloating and headaches, she would also have symptoms characteristic of PMDD.

Watch our interview with Sarah

PMDD symptoms

In the days leading up to her period, she would experience anxiety, depression, difficulty managing stressful situations, poor decision making, unhappiness and self-deprecating thoughts. Due to PMDD, she couldn’t cope emotionally and mentally.

She describes it as being in a very dark place and seeing everything through “a PMDD lens”.

She tried to manage her symptoms with techniques that work with PMS but found them to be ineffective. Her symptoms meant that she responded inappropriately to difficult situations and found it difficult to regulate her responses to stressful situations both in her personal life and at work. Once her period started these symptoms would entirely dissipate.After around 10 years of experiencing what she describes as “PMS on steroids,” she heard about PMDD from a friend. Upon doing further research, she realised that she was experiencing all of the symptoms and self-diagnosed herself with PMDD. Her GP agreed that she in fact had PMDD.

More info on PMDD

For more info on Premenstrual Dysphoric Disorder (PMDD), refer to Vicious Cycle PMDD, International Association For Premenstrual Disorders, Mind factsheet

The Diagnosis

Upon being formally diagnosed with PMDD, Sarah used a combination of antidepressants and non-medical lifestyle techniques to manage her condition. Her arsenal of techniques include regularly going to the gym, doing yoga, engaging in mindfulness, resilience building activities, and cognitive behavioural therapy. She has also drawn on support from her friends, one of whom also has PMDD, and online support groups.

Moving forward

When asked what she would recommend to other women with PMDD, she suggested exploring medical options with a GP as well as self-care tools. Treatment of PMDD can involve a combination of medical and lifestyle interventions. Treatment options for PMDD include dietary changes, stress management, antidepressants, anti-inflammatory medication, birth control and vitamin supplements. She also suggests informing your manager if you have PMDD and explaining how it affects you and your work. She also encourages workplaces to institute health and wellbeing strategy training.

Interview by Rebecca Bairstow | Author: Rachel Trotman

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