Premenstrual Dysphoric Disorder: No, it’s not “just really bad PMS.”

For the past week I’ve had…..well, first off, NOT a Lyme disease flare up! :) But I have been experiencing another type of “flare up,” if you will: Premenstrual Dysphoric Disorder, or PMDD.

PMDD can probably best be described as an abnormal reaction to the normal hormonal changes that occur with each menstrual cycle, and it can feel more like a mild form of psychosis than a type of dysphoria. It destroys your perception of what is actually going on around you, and can be strong enough to make you want to die by suicide. It is also associated with “premenstrual exacerbation,” whereby any existing stressors or mental illness will be amplified, sometimes to the point of mental breakdown.

It begins two weeks before menstruation and continues worsening in severity until menstruation begins, when all symptoms abruptly go away due to the body’s hormones stabilizing. No one has come up with a way to cure it, yet, or even knows what causes it. One of my psychology professors in university thought it was just a made-up term for people who wanted more attention. There’s been talk of genetic predisposition, correlation with PTSD and trauma, and a history of other mood disorders. For some, diet and exercise improve things, but diet and exercise improve most things if you’re able to engage them: it’s not enough to make the difference between suicidal and not suicidal, and if you ask me, it’s ridiculous to suggest treating such a dangerous condition with an afternoon walk and eating more lettuce. That’s just an example of the usual, “We don’t understand it or even think it’s real, so just get outside more and you’ll be okay.” (ETA: I’m happy to report this condition has been taken much more seriously since this post made in mid-2011, to the degree of even having a dedicated page on Johns Hopkins Medicine.)

Common symptoms include (of which I’ve had most all): 

  • feelings of deep sadness or despair, possible suicide ideation
  • feelings of tension or anxiety
  • increased sensitivity to rejection or criticism
  • panic attacks
  • mood swings, crying
  • lasting irritability or anger, increased interpersonal conflicts; typically sufferers are unaware of the impact they have on those close to them
  • apathy or disinterest in daily activities and relationships
  • difficulty concentrating
  • fatigue
  • food cravings or binge eating
  • hypersomnia, sleeping more than usual; or (in a smaller group of sufferers), insomnia, being unable to sleep
  • feeling overwhelmed or feelings of being out of control
  • increase or decrease in sex drive
  • increased need for emotional closeness

My main treatment, as it is for a majority of sufferers, is Zoloft. (And, having M.E., a very, very small dose of Zoloft.) Medication is taken for the two weeks prior to one’s menses: It is safe to take at such short intervals without inducing withdrawals. In my case, I only do this every 2-3 months, and I haven’t had a PMDD episode in over two years. It seems to resets my brain chemistry and last for a bit so that things don’t fall off kilter whenever a trigger like hormone fluctuations come along. But after getting all the migraines, having to start Topamax, and being unable to have caffeine, that left only Treximet to treat the migraines that were still popping up, and you cannot take antidepressants with Treximet. So I haven’t been able to take any preventative Zoloft since.. January, while I waited to see how long it would take the Topamax to stabilize things. Because my migraines haven’t been so frequent, I started my Zoloft this morning. Within three or four days, I’ll be much better.

Yesterday I had a bartonella flare up on top of all the PMDD madness, so I was a complete emotional wreck. Other life events weren’t helping. Thankfully, today is here! But last night I decided to take one of those online psychiatric evalutation-type tests that I’ve played with over the years, out of curiosity. My results were very shocking!

Disorder Rating
Paranoid: Very High
Schizoid: High
Schizotypal: Very High
Antisocial: Low
Borderline: Moderate
Histrionic: Moderate
Narcissistic: High
Avoidant: Very High
Dependent: High
Obsessive-Compulsive: High

Personality Disorder Test
Personality Disorder Information

I know what my usual results are: Low on everything except OCD, which I actually have; and Antisocial, no doubt due to my introverted tendencies overlapping with the questions.

So, in case you needed a visual of what PMDD and bartonellosis can do to a person, there you go. They can take someone with good mental health and turn them into that.

a rainbow at night

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