Premenstrual Dysphoric Disorder and Me: How My Menstrual Cycle Impacts My Mental Health

By Laila Hodd

I recently had a conversation with my best friend, a conversation that we had never had before. The topic? My experiences and struggles with mental health in relation to my menstrual cycle. 

Considering that we have been accomplices to each other’s stupid decisions and embarrassing moments since the age of eleven, no topics are off-limits between us. Yet, some conversations are more difficult to have than others. 

These days we are more aware of the benefits of discussing mental health, but while it is easier to talk in theory, it is much harder to open up in practice. From personal experience, it is far easier to put these thoughts on paper than to voice them out loud. Both actions make thoughts and feelings tangible and real, but there is something about writing them down that makes it more private and therefore less intimidating. 

While I have suffered with anxiety for as long as I can remember, it was only when I moved away to university in Cardiff that it began to impact my day-to-day life significantly. Depression also started to have a real impact on my life during my time at uni. During this time, my eating, which had always been disordered, came to have a real and damaging impact on my relationship with myself and others. 

What I began to recognise was that my mood and levels of anxiety, as well as my relationship with food, would fluctuate throughout the month. While we all have our good and bad days, the cyclical nature of my symptoms was unmistakable. 

After doing a little research, I came across PMDD (Premenstrual dysphoric disorder). The easiest way to explain PMDD is as an exaggerated and extreme version of PMS (premenstrual syndrome). The reality, though, is hard to describe. PMDD symptoms present themselves during the luteal phase, the time between ovulation and the start of the period. The cyclical nature of these symptoms means that those who suffer universally spend two weeks every month recovering from our last period and preparing for the next one. 

For about ten days each month, I become a different person. My symptoms of anxiety and depression are exaggerated. In the last few days before my period, they become so heavy that it makes it feel impossible to perform everyday tasks. I withdraw from family and friends and isolate myself within a mind that feels out to get me. Uncontrollable crying, more regular panic attacks, emotional and physical exhaustion – all of these come around like clockwork. For some sufferers of PMDD, these emotional symptoms sadly can be too much to cope with. The International Association for Premenstrual Disorders (IAPMD) reports that 15% of people with PMDD will attempt suicide.  

Along with the devastating emotional symptoms, PMDD comes with a cocktail of physical ones. For me, these include increased appetite and severe bloating (which triggers unhealthy thoughts about body image and food), joint pain, fatigue, dizziness, impaired coordination, and sight issues. I also get muscle spasms, which present themselves in the form of a tic. Those who struggle with PMDD may also have physical symptoms including trouble sleeping, acne, constipation, nausea, vomiting, as well as easy bruising, heart palpitations, and limb numbness. 

The fact that I had not heard about PMDD and had only come across it in my own research (despite having multiple appointments with my doctor where I discussed the cyclical nature of my symptoms) highlights a deeper issue. Mental and menstrual health both need to be discussed more openly and the issues faced by those of us who menstruate taken more seriously. 

Due to the patriarchal nature of society, PMS and the struggles that people who menstruate face are often minimalised and trivialised. It is unsurprising then that those whose mental health is affected by their cycle find it hard to discuss. Whether this is because of the fear of being dismissed as hysterical or overdramatic, to protect those around them from the darkness of their thoughts and feelings, or for countless other reasons, the stigmas that surround both mental and menstrual health leave those of us who suffer feeling isolated.

Only when these topics become less ‘taboo’ will we feel more comfortable discussing our struggles and reaching out for help. Awareness and diagnoses are what we need more of. While a diagnosis will not take the symptoms and struggles away, it does provide an explanation for what is going on in your mind and your body, which can bring some small comfort.  

Recognising PMDD can make treatment easier since it provides a base from which you can start figuring out what works best for you. Whether it be the birth control pill or anti-depressants (specifically SSRIs) and/or lifestyle changes such as adjustments to your diet and increased exercise, raising awareness of PMDD is key to helping those suffering.