How much should I believe my PMS/PMDD?
October 15, 2015 12:09 PM   Subscribe

I want to leave my life half of the month—is this the truth? Or is the truth the first half of the month, when things are basically fine?

Half the month things are quite lovely with my boyfriend of 6 years, my home, my friends. The other half of the month, I want to break up, run away, I think I have made horrible mistakes. I am starting Prozac to deal with this second half of the month, but I am also aware that sometimes drugs can mask real problems.

So this is a question mainly for those who have suffered from PMDD or have been close to women who have: How much do you think you/they should listen to the darkest impressions of their partner/life choices? I worry that I really shouldn't be with my partner (I tend to focus much of my anxiety and frustration on him -- we have lived together all this time; I know this is common for women with PMS... before him, the person I was closest to was my best female friend, and she said she felt the brunt of it.). This is a vague question, it's just really me trying to assess how realistic the dark thoughts are; how I can evaluate my life when half the month it's rosy, half the month it's dark. I feel stuck in this loop; from which position should I be judging things?

I'm a 38-year-old women, no children (I never really wanted any). I'm a working artist. The whole PMS thing has gotten worse into my late thirties.
posted by Clotilde to Human Relations (22 answers total) 22 users marked this as a favorite
Best answer: No one can tell you for sure, but I can tell you that my period used to bring on some awful, awful days and thoughts for me, and now that my underlying mental illness is well taken care of, I don't feel like that at all. This is from crying, heartbroken, for days about the relationship; when the black cloud lifted, I could see I had nothing to worry or cry about after all. Don't make any big decisions till you can get some stability. I hope that the Prozac goes well for you. Don't worry about it "masking real problems": it's a change, but it doesn't make you any less you; instead, it can help you BE you again. Love and best wishes.
posted by fiercecupcake at 12:12 PM on October 15, 2015 [9 favorites]

I've had PMDD for 15 years and only started being properly treated for it last year. The right BC pill and a prescription for Xanax have changed my life dramatically. Everything PMDD makes us think is a lie. Talk to your gyno or GP. You don't have to live like this, I promise.
posted by Hermione Granger at 12:17 PM on October 15, 2015 [7 favorites]

I have depression that coincides with my cycle. If I'm unmedicated, I'm a depressed, paranoid, anxious mess during the last two weeks of my cycle and I spend the first two weeks of the next cycle apologizing to everyone around me. After two months taking an SSRI, the regular intervals of depression mostly resolved and I now feel steady throughout the month.

The Prozac will help; just hang in there for a month or two while it works its magic. If you're not feeling measurably better by month three, head back to your GP to try something else. You can do it!
posted by theraflu at 12:20 PM on October 15, 2015 [2 favorites]

You feel terrible and look for reasons why, you find the things closest to you to blame. It really is your perception/interpretation changing and not the people/situations.
Maybe try writing down how the anxious/angry thoughts and then read them over when you're in the good part of your cycle, and ask yourself "is this true"?
posted by lafemma at 12:28 PM on October 15, 2015 [3 favorites]

Response by poster: Those of you who have taken SSRIs—are you taking them every day of the month, or only during the luteal phase? This is what I am trying, as studies say it's only necessary post-ovulation. Thank you for your comments! What a relief. I feel like crying (of course! ha!).
posted by Clotilde at 12:29 PM on October 15, 2015 [1 favorite]

I've grappled with the exact same questions. Kudos to you for recognizing how tied your feelings are to your cycle -- it's a good first start!

For me, sometimes the relief of being back into the rosy half of the cycle can make me push problems under the rug. The challenge has been to figure out what problems are real and treat them in a steady way even as my emotional response to them fluctuates so drastically, from "utter catastrophe!" to "zero problem whatsoever!", and then back again. And... I haven't really found a good solution, to be honest; treating the PMDD worked much better. (Zoloft at first, but then the right birth control pills 100% eliminated it for me.)

Some things I've thought about include writing down my concerns when I'm down, and then trying to remember to read the list later; scheduling regular times to talk about things with my partner (and then making though to follow through even when I'm feeling great); doing meditation and other acceptance-based strategies during the down times to work against the catastrophizing and keep my moods enough in check that I don't take them out on those around me.
posted by wyzewoman at 12:33 PM on October 15, 2015 [2 favorites]

I did the SSRIs throughout the cycle -- although that was mainly because I wasn't bleeding so it was hard to track my cycle (thank you Mirena!) They helped a bunch, but I still lost a few days of productive happiness each month to feeling pretty blah.
posted by wyzewoman at 12:34 PM on October 15, 2015 [1 favorite]

I take my BC pill every day and skip the placebo week so I never have a period. Sometimes this isn't possible if my pharmacy has messed up and I can't take the pill for a few days, and when that happens I take Xanax immediately to stave off the PMDD hormone induced mental breakdowns. I also take thyroid medication which occasionally messes with my hormones, too, so I take small doses of Xanax to help with that as needed. This is the only thing that works for me, but all uterus bearing bodies are different, so YMMV.
posted by Hermione Granger at 12:35 PM on October 15, 2015 [2 favorites]

Right there with you! Since the tail end of my 20s, PMDD has made me question reality in a way that's unlike anything else I've ever experienced. I feel like a pent-up animal, totally unpredictable, suffocated by sadness but still deeply hostile and wary of my surroundings, like I can't do anything but frantically gnaw at the bars on my cage. It's just wild. Only meticulously tracking my cycle made it clear that my deepest bouts of "what is everything, who am I, and how can I abandon or destroy all of this immediately?" despair coincided directly with the week before my period. It was such a relief to discover.

After a couple of months on a low (10mg) dose of Prozac, my mood evened out like a dream. I took it every day because I also have regular old depression, but my MD said that it's perfectly normal to only take it half the month specifically for PMDD. Good luck, I hope fluoxetine works for you, too!
posted by divined by radio at 12:48 PM on October 15, 2015 [6 favorites]

I also take my SSRI and my BC pill every day, and skip the placebo week of BC pills. We've decided for a number of reasons that it's best to keep things as even as possible.
posted by fiercecupcake at 12:48 PM on October 15, 2015 [1 favorite]

I am on the pill and prozac and it makes a world of difference!!! just hang in there and give the prozac a few weeks.
posted by supermedusa at 1:08 PM on October 15, 2015 [1 favorite]

My pmdd got way worse in my late thirties but as my regular depression did as well I am on SSRIs daily. Notably though my moods were easier during pregnancy (even though physically I felt like hell). I do plan to try doing half dose for two weeks and then full dose for luteal phase.
posted by biggreenplant at 1:43 PM on October 15, 2015 [1 favorite]

Best answer: Prozac shouldn't like, make you super happy when everything around you is objectively shitty and needs to change. That's not how it works, and I would give it a few months before reassessing your life in general. Hope it is helpful for you--I know someone who takes an SSRI for PMDD just for two weeks per month and it is working really well for her.
posted by hejrat at 1:46 PM on October 15, 2015 [6 favorites]

I'm right there with you too. For me, birth control was a bad choice - I am not good at daily pills and depo provera pretty much ruined my mental state during my 20s. I was treated for depression and anxiety for many years before a non-medical-professional friend suggested going off depo (which is linked to depression and anxiety). Once my cycle stabilized, I found that it was just during days ~18-24ish of my cycle (most, but not all, of the luteal phase) that I had these issues. Depo, by mimicking the hormonal levels of that week, made all days bad days. SSRIs came with other side effects for me that I didn't like. But Xanax, Klonopin, and cannabis have worked well (not usually all at once, but I'm not ruling that out).

Tracking my cycle has been key for me. If I start feeling those dark thoughts and really just not being nice to my husband/friends, I check the calendar, and inevitably, it's my bad week. So I try to engage in intensive self care, not initiate any relationship-issue discussions, and also warn my husband ("babe, it's day 21, I'm just having a hard time"). I avoid certain triggering media/sites/topics and try my hardest to surround myself with things that are less likely to make me enter a depression spiral (sorry horrible disaster, can't read about you this week; sorry sexist-trope movie, it's not gonna happen). If there was a safe pill that would make all days feel like day 12/13 I'd take it in a heartbeat.

I've also wondered - Is it all hormonal? Is this the real me and the follicular phase me is a lie? Or is that the real me and is the luteal phase a liar? The answer is neither and both. To quote Fiona Apple: "He said 'it's all in your head,' and I said 'so's everything,' but he didn't get."

Talk to your doctor about a short-term anxiety med like xanax or klonopin (or SSRIs). Consider marijuana, if that is something that you are comfortable with. Track your cycle and be sure not to make any big decisions during your problem days. Maybe follicular you is not the "most real and true version of you ever" - authenticity is overrated IMO.
posted by melissasaurus at 2:25 PM on October 15, 2015 [11 favorites]

For what it's worth, I treated my anxiety, which was affected by my cycle, with Zoloft. In comparison to feeling as though the medication is masking a deeper unhappiness, it was only when I stabilized my mood that I realized that there actually was a whole lot of shit objectively wrong. I think it's less likely that you'll drug yourself into a passive acceptance of your state than it is that you may find yourself capable of making changes in your life that your old, depressive, tumult-tossed self was too scared and exhausted to contemplate.
posted by pretentious illiterate at 2:42 PM on October 15, 2015 [10 favorites]

Prozac did nothing for me but Cerazette (Desogestrel) pretty much completely cured my PMDD - like from seriously suicidal and self harming to happy, stable, regular person. Sometimes I feel like I can feel the hormones trying to do their thing but that's not even regular PMS bad, let alone the I hate everything and I want to die that I have for 10-14 days every month without the pills. Sometimes I need a duvet day - but doesn't everyone?
posted by missmagenta at 3:06 PM on October 15, 2015 [2 favorites]

When things are going badly in my life and I'm not strong enough to face them, my PMS is horrible. When things are fine, it isn't. So, based on my experience, it is possible that you really don't want to be with your boyfriend but you are suppressing your real feelings (this happens when you are brought up to be a nice, sweet girl) and they are only able to come out when your hormones are going crazy. Journaling can really help to figure this out.
posted by myselfasme at 4:35 PM on October 15, 2015 [6 favorites]

PMS/PMDD makes me feel despair - about my job, my marriage, my existence on this planet. Sometimes, I even hated my dogs. That's when I knew those feelings weren't me. I started taking Prozac for the second half of the month. The despair went away. I asked my doctor for a microdose, but she gave me a normal prescription (20mg). It works so well, I'm not going to mess with it.
posted by Barnifer at 5:36 PM on October 15, 2015 [1 favorite]

Zoloft helps me with this (and I take it all month long), and I find it very helpful to take vitamin D, too. When unmedicated, I know that feeling of suddenly not feeling like crap, and enjoying it so much that I then look at everything through rose colored glasses as they say. The thing is, though, that once medicated, you have a sufficient stretch of time of not feeling like crap that you sort of level out and can see things as they are and take constructive actions to change what needs to be changed.
posted by toodles at 7:17 PM on October 15, 2015 [1 favorite]

Best answer: Probably some things are less good than you would want them to be. That's the human condition. But when you're going full-tilt down an anxiety spiral, it makes it much harder to reliably identify and improve them.

Not just because you're wearing rose-colored glasses half the time and the opposite ones the other half, and so you can't see it objectively. But also because when you've been catastrophizing and when you (through brain chemicals, thought patterns, behavior patterns, whatever) are getting sent into a Cat 5 rage hurricane by every reminder of a problem, it's basically impossible to ask for help and to solve problems in a way that's likely to give a good outcome. Nobody responds well to being berated or yelled at, or to having a bunch of seemingly sudden demands piled on them.

Everyone is nicer to people who are nice to them. If you're having PMS/PMDD so badly that your BFF is saying "yeah, that was pretty hard", it's hard on your boyfriend too. And that's going to create problems in your relationship, and it's going to make the difficulties that you two encounter be much harder to deal with, because it weakens you as a team.
posted by Lady Li at 10:11 PM on October 15, 2015 [3 favorites]

You are not alone. I have been treating PMDD with Zoloft on an ad hoc, mostly bi-weekly stop/start basis. It also helped for me to balance out my sex hormones with "seed cycling". I had the same experience as the posters above, where the addition of the SSRI allow me to view my life more objectively. At the very least, I noticed that, with medication during those PMDD weeks, my perceptions of circumstance seemed to line up more with those during my non-PMDD weeks.
posted by phreckles at 11:37 AM on October 16, 2015 [1 favorite]

I also skip the pill's sugar pills (I take it "continuously" is the word), and it helped a great deal. Finding the right one for me took a couple tries - I seem to need very low dose or I get nauseous. Just like Depression Lies, PMS Lies also. Good luck!!!
posted by evening at 6:08 AM on October 17, 2015 [2 favorites]

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