6 Tips for surviving a PMDD crisis

If you have ever experienced a PMDD crisis, you know how frustrating and debilitating it is to deal with your cycle every month and how devastating the hurricane is. Irrational outbursts of anger, depression, anxiety, migraines, and massive brain fog, just to name a few… This hurricane impacts our lives with an uncontrollable force and speed and negatively affects our personal, family and work lives. Sometimes it causes cracks that we manage to cover somehow; other times, it can cause actual holes that are challenging to fix.
What’s ridiculous to me is that when the storm ends and the rainbow shines again (and I regain my positive energies), I feel a bit stronger than before. That leads me to believe that it cannot happen again and that I will be able to manage it better the next time. How naive…

And although it is not possible to escape from it, there are some tips and tricks that can help you relieve your worst symptoms, control anger and mood swings, and give you hope and motivation to go through the storm. And the good news is that all of them are free and accessible to anyone!

But what’s exactly a PMDD crisis, and why does it happen? When does it occur? Let’s answer some basic questions first, and then I’ll give you the best tips ever (that I’ve experienced myself in the past) that will help you survive a PMDD crisis and deal with the beast when it comes.

What’s a PMDD crisis?

A PMDD crisis occurs during the premenstrual phase (or luteal phase) with the onset of psycho-behavioural and somatic symptoms related to the dysphoric disorder. In general, disappears with the arrival of menstruation. It usually lasts between one and two weeks, and its manifestation varies from person to person. For some women, some symptoms are more debilitating than others. It’s basically when the monster shows up at the door and enters the house uninvited!

N.B. It is useless to try to hunt or ignore it (I tried many times); it will not go away until it has drained you mentally and physically and, anyway, NEVER before the arrival of the cycle.

Read The Beginners Guide to PMDD for all detailed information on symptoms and PMDD in general.

When are PMDD symptoms the worst?

As I mentioned earlier, symptoms and intensity vary from person to person, and some can be more debilitating than others for some women.
For example, after tracking my cycle for months, I realised that my PMDD crisis begins during ovulation with some physical symptoms (bloating, low abdominal pain, aching, etc.). Then it takes off with episodes of severe brain fog, mood swings, states of depression, and loss of interest in activities that generally give me joy. Finally, the week before, I experience my most debilitating symptom: anger! It’s debilitating because it’s not really part of me, and I haven’t learned to control it yet. I experience senseless, uncontrolled outbursts of rage, destructive for me and my relationships; they leave me with an unbridgeable sense of emptiness and guilt and make room for despair.

What triggers PMDD?

The premenstrual dysphoric disorder is NOT a hormonal imbalance! The PMDD crisis is caused by adverse brain reactions to normal hormonal fluctuations during the premenstrual phase. So don’t be surprised if your estrogen and progesterone levels are entirely normal. However, doing blood tests is helpful to rule out other possible diseases (e.g., chronic fatigue syndrome, endometriosis, fibromyalgia, hormonal imbalances, depression, bipolar disorder, etc.).

Unfortunately, the factors that cause PMDD are not currently known. It is known that individuals with PMDD have a greater sensitivity to the normal hormone fluctuations that occur during the luteal phase of the menstrual cycle. There may also be a genetic component: some researchers at the National Institutes of Health (NIH) have found that women with PMDD have an altered gene complex that processes the body’s response to hormones and stressors. 

Other factors can also trigger and/or amplify PMDD symptoms (read The Beginners Guide to PMDD):

• unhealthy lifestyle (poor diet, lack of exercise, lack of sleep, stress, alcohol and caffeine abuse)
• stressful or traumatic events.

The 6 Best Tips to survive a PMDD crisis (and relief PMDD naturally)

Chasing away the monster before the time, I am afraid, is not possible! However, some strategies can ease and help us manage the more debilitating symptoms. At first, it will seem impossible, but you will see that, in time, these suggestions will help you regain control of your life.

And there will always be days when it will be indomitable and little, or nothing, will help bring you back to the Earth, but I assure you that the bad days will be fewer and more manageable. 😉

Here are the six best suggestions to use when you can’t take it anymore.

1. Talk to someone / Share your story

It’s not easy to open up and talk openly about this disorder, but it might help. And this statement is even more valid coming from a private, introverted person like me. Keeping it all inside has never been, and never will be, a good remedy for any kind of pain, discomfort, or emotion. Over time it can only worsen and heighten the feelings until they burst, and usually, the burst is always accompanied by tears and debris.

The stigma that still hangs around female reproductive health very often prevents helpful discussions from happening. We grew up believing that menstruation is just an inconvenience, something we don’t talk about, especially in public and in front of a male audience. And the less we talk about it, the less we dissolve this stigma. It’s time to change that belief!

Talking to someone doesn’t necessarily mean having a press conference or opening up publicly. It can mean talking to a trusted friend, your mother, sister, or aunt. It can mean writing your own story and emotions and publishing them anonymously to comfort someone else and at the same time feel less alone.

Each of us has our own way of expressing emotions, and what’s suitable for one person isn’t necessarily good for another. And similarly, what makes us feel good now, will not necessarily make us feel good tomorrow. We change, evolve and spiritually grow.

It was hard for me to talk about it at first. For a long time, the only person who knew it was my husband. It took me months (almost years) to confide in someone else, describe what was happening to me and how I was feeling, understand what PMDD really was, accept it, and not feel ashamed. And only when, after so many falls and relapses, I managed to recover a little and have a bit of mental clarity and physical strength could I write on this blog.

2. Contact a specialist organisation

PMDD is still a not well-known disorder. And sometimes, the people we expect empathy from cannot give us what we need. Not because they don’t love us or don’t want to help us, but simply because it’s such a complicated condition that makes it really hard to understand. This also applies to many doctors who, unfortunately, do not know PMDD yet, and too often, we find out that we are the experts of our condition and our emotions (no one knows you better than you do!)

That’s why contacting specialist associations is crucial for a better and faster recovery. They have experience, are knowledgeable and can guide us towards the right path to follow.

There are several international associations of which I leave you the contacts below. They are fantastic groups of people, easy to reach out to, with an outstanding level of empathy, and, above all, they are a safe place for you to talk and express your feelings, whichever they are. No judgement, no shame.

• IAPMD: a worldwide non-profit association that offers support, information and resources to all those suffering from disorders related to their cycle.
• NAPS (UK): a British charity established in 1984 that provides advice and information to support people with premenstrual disorders and their families.
• Vicious Cycle (UK): patient led-awareness campaign conducted by patients with a team of passionate people worldwide.
• See Her Thrive (UK): an association formed by a team of occupational psychologists and women’s health experts who provide the right resources and information to employers to support their employees affected by disorders related to their cycle.
• ITA-PMS: the leading Italian association dealing with premenstrual disorders. They work to develop national guidelines for treating PMS/PMDD in Italy with a team of experienced gynaecologists.

Personally, the support I got from these associations was crucial in my recovery journey. It allowed me to be correctly informed; have the resources to face the world outside; get in touch with people who could understand and inspire me; have the confidence to support my rights and confront qualified people like doctors and professionals.

3. Peer Support

What’s Peer Support?

Peer Support comes from people (adequately trained) who share your own experience and offer their knowledge and help both emotionally and sometimes also practically.

Who better than someone who has walked (or is walking) your own path can understand how you feel when you are in a crisis? Peer Supporters offer their time and experience to help those in need, those who have just taken the rough road, those who are in the middle of the tunnel and find it hard to see the light at the end of it, and those who are hopeless. Sometimes it’s easier to open up to a stranger and show our most intimate emotions and feelings. Just because these people are in the same boat, they don’t need to ask questions to understand and show superior empathy. Which, in the end, is what we need. Talking to someone will not erase the wounds and make the pain go away, but it will make us feel less alone, part of a community of strong and inspirational women.

IAPMD has recently introduced a new peer support system. They teamed up with Hey Peers, a video chat app that allows you to support discussions with other people on a similar journey. The sessions are led by Peer Support Facilitators who are part of the IAPMD team. They have experienced PMDD in person and want to help make the journey easier for others. You can find more information on their page dedicated to Video Support Groups.

4. Get to know your cycle

Maybe this should be the first helpful suggestion, but they’re not thought in a specific order, really.

Knowing your own cycle, your body and how it changes over the month is essential to meet the different needs that your body and mind need in those different stages. This allows you to anticipate when you will be at your best and when you will be at your worst and, consequently, schedule and/or postpone certain activities.

Below are some practices you should consider adding to your routine: they will help you become more aware of yourself and your cycle.

• Keep a daily track of your symptoms (and their intensity). At first, this can give you the feeling of wasting your time, but I assure you that the effort and commitment will be repaid over time. You must note every specific symptom, behaviour, sensation, and mood and when they appear (which day of the month). Recognize when you activate the Fight/Flight/Freeze response (our body’s response to stress events) and if certain situations trigger or worsen it. When you have a history of at least 3 or 4 months, you will start to notice the cyclical trends of some behaviours and moods that you can predict the next time! (If you prefer technology, you can rely on one of The best period tracking Apps of all time!)
• Reschedule/reorganize stressful events. Don’t be afraid/ashamed to say ‘NO’ or call someone to postpone an event. I guarantee that staying home with the monster, most of the time, it’s better than carrying it with you… it’s not a good buddy.
• Plan activities that will relax you. When you feel down, depressed, or anxious, rather than stubbornly continuing what you had planned to do, change your plan. Try something else, something different, something to help you empty your head, to relax, to give you inner peace. Don’t be afraid to experiment: have you always thought you’d like to try gardening? Do it! You would like to try a new recipe, but you are not sure if it will be good? What does it matter!? The important thing is that, while you prepare it, it makes you feel good. It’s not the result that matters but the path you take to reach it. It was during a crisis that, totally by chance, I discovered how cooking a new recipe is one of my relaxing activities.
• Implement a support plan. Ask yourself this question: “How would I like to be supported? What kind of help do I need when I’m in the middle of the storm?” Write all your answers on a sheet of paper or in your journal, do not keep them in mind. Writing is much more effective; it remains and does not evaporate with the brain fog and the loss of memories of the dark days. Involve the people who can help you and are part of your support plan. This step is essential because, with the appropriate support, you have a better chance of making it.
• Create a Self-care box. Take a box that you like, buy one, or make it yourself as you most like if you are a creative person. Put in it any objects that have the power to make you feel better and which you can rely on when you’re not at the top: body and skincare products, photos, letters, journals, essential oils, books, a gift from a loved one, anything you care about. For example, my Self-care box contains: my lavender eye cushion (which since I discovered I carry with me like a Linus blanket!), essential oils (Lavender, Grapefruit, and Frankincense among my favourites), hand lotion, earbuds, my journal (another Linus blanket!)
• Communicate with your partner/family. How often have you felt alone and abandoned, thinking that no one around you cares? When you’re in the whirlwind spiral, it’s hard to see things for what they are, and you confuse your negative thoughts with reality. Helping someone is complicated, especially if they don’t accept help. Many times people around us have no idea what’s going on in our minds, and even if they would like to help, they don’t know how to do it. Asking for help is not a sign of weakness; far from it! It’s a sign that you’ve become more aware of yourself, of what you need to feel good. It’s a sign that you’re getting stronger. Involving those who love you is fundamental to overcoming the crisis and strengthening relations with them.

5. Look after your Physical Wellbeing

• Sleep! Before talking about nutrition and exercise, our body and mind need to rest before eating and moving. From my experience and from many readings, I believe that the importance of a good night’s sleep is one of the most underestimated things ever. Did you know that, while you sleep, your body regenerates, your memory and your emotions consolidate? Conversely, the lack of adequate sleep compromises your immune, digestive and cardiovascular systems and stress response.
• Eat healthily. Incorporate healthy, fresh foods into your diet. If you can, buy organic, seasonal fruits and vegetables, local products, legumes, protein (which for women are fundamental to the hormonal balance), and fish such as salmon, sardines and mackerel rich in omega-3. Avoid refined sugars, alcohol, processed foods, cured meats and hard cheeses, sweets and treats. Eat a wide variety of food.
• Exercise. Whatever your preference is, just move! Whether it’s running, swimming, doing competitive sports, playing volleyball, cardio, HIIT, aerobics, yoga or just walking. Did you know that an open-air walk reduces the risk of heart disease, helps you lose weight, prevents diabetes and obesity, and stimulates creativity and productivity? When I can’t think clearly or have no motivation, I take a nice walk, possibly while listening to a book or music, and I come back regenerated!

6. Look after your Emotional Wellbeing

Much like we provide food and water for the body to remain healthy and strong, our souls also need to be fed.  This nourishment comes from us in the form of meditation, prayer, and gratitude.

Source: https://www.purposefairy.com

As important as physical well-being, it’s an emotional one. The two go hand in hand. Our body and soul both need to be fed at the same time. Here are some of my favourite techniques:

• Relaxation/breathing techniques
• Nature
• Essential Oils
• Meditation
• Mindfulness

Mindfulness is the awareness that arises through paying attention, on purpose, in the present moment, non-judgementally,” … “And then I sometimes add, in the service of self-understanding and wisdom.”

Jon Kabat-Zinn

The bottom line

No matter what you do, no matter what activity you choose to pursue, the simple fact of doing something will boost your well-being and contribute to the release of your loved friends: serotonin, endorphin, dopamine, etc.

What are the activities that have the power to get you out of the tunnel? Leave me a comment or write to me at francesca.thepetiteblogger.com.

I hope this article has been helpful to you. If you think it can benefit others, share it as much as you can.

Sources

[1] Burnout (Chapter 7), by Nagoski, Emily and Nagoski, Amelia.

[2] www.purposefairy.com – https://www.purposefairy.com/89962/soul-guidance-how-to-let-your-soul-lead-your-way-into-life/https://www.purposefairy.com/89962/soul-guidance-how-to-let-your-soul-lead-your-way-into-life/

[3] https://www.mindful.org/jon-kabat-zinn-defining-mindfulness/

[4] https://www.apc.it/wp-content/uploads/2013/03/3-RainonePE.pdf