Warning: mention of suicide
Last Monday I walked into work quietly weeping. “Ignore my tears,” I told my startled co-worker, “nothing’s wrong, it’s just my hormones. I can’t stop crying, but once I start working I’ll be fine”. For the rest of the day I managed to pull myself together (sort of), the only signs that something was amiss a smudge of mascara under my eye I didn’t know of for about 6 hours until I went to the bathroom, and not giving my usual cheery answer of “I’m fine!” to the obligatory “how are you?”, instead opting for “I’m okay”. I was crying again on the way home, more from sheer relief that I’d made it through the work day than anything else.
The weekend had been unseasonably warm and sunny, with a picture-perfect deep blue sky, warm temperatures, and the delicious smell of spring in the air. I had worn a sleeveless dress on my hike, relishing the warm sun on my bare skin and feeling happy to be alive.
But suddenly, without warning, the feeling of contentment flipped upside down, from happiness to panic in 0.4 seconds for no reason whatsoever. The blue sky didn’t look blue anymore - my mind added dark smoke to it, dipping the sun into the ominous red haze I’ve seen so often over the last few summers. The wind smelled of smoke and ash, turning the gently rustling, still leafless trees into wildly thrashing fire sticks whipping back and forth, tinderboxes just waiting to be ignited. The pretty day had turned menacing, as if evil was lurking just around the corner. I was lying in a lawnchair on my sunny porch, paralyzed by fear. The thought of summer suddenly terrified me. Everything would burn again! There would be a drought, a water shortage, a heat wave! The ice caps were melting, forests were burning, our entire planet was imploding, and there was nothing we could do! Tears were streaming down my face. Where should we go? Where could we go? Was there anywhere safe on a planet that was being destroyed by the stupidity and greed of humanity? Did we even deserve to be saved for all the evil we’d done, were still doing, and would be doing until the day we died?
Death. The thought of death calmed me. Ah yes, there was always a way out. Can’t forget about death. My mind split in two, simultaneously fretting about my husband’s impending death (an old favourite intrusive thought of mine) and the reassuring notion that death exists. As a way out. Just in case.
I’m not suicidal. I don’t want to kill myself, and I don’t want to die. But when I’m in the throes of PMDD, the thought just shows up in my head, uninvited. “Hey, remember that suicide exists? Think about that.” And I do. I’m not making plans or contemplate how I would do it; I don’t have “suicidal ideation” (the term we use in the hospital for someone with suicidal thoughts). I just can’t stop thinking about its existence. It’s like an annoying fly buzzing around my head, not leaving me alone.
Sunday night found me stretched out on my bed, bawling my eyes out. The cat, with the infinite wisdom of cats, settled her warm, compact body smack-dab in the middle of my chest, licking my tears with her sandpaper tongue and looking steadily at me with her beautiful green eyes. She stayed there until I quieted before jumping off me, taking a well-deserved nap.
I have a conflicted relationship with PMDD, maybe because no doctor has ever officially diagnosed me with it. My all-male doctors have gone as far as saying “it’s possible” when I described my symptoms and asked if PMDD could be the diagnosis, but that’s all I’ve ever got. I go through times when I will mention it to people somewhat regularly, and I can never read the expression on their faces. Depending on my mental state, I’ll read it as derision (“you have regular PMS, don’t make such a big deal out of it”), doubt (“I’ve never heard of it, is that even real?”), or disinterest (“a woman complaining about hormones, yawn”).
Nobody has ever said these things to me; that’s what my mind conjures up. Having a disease affecting your mental state is a bitch when you try to use that same mental state to make a sound judgment call.
Because of that there are many times when I downplay PMDD, in front of myself and others, like I did last Monday when I told my co-worker I was “just dealing with hormones”.
It’s much more than that. Here’s a helpful chart showing the differences between PMS and PMDD:
I’ve googled PMDD countless times over the years to reassure myself that it does, indeed, exist, and is not just a figment of my imagination. Here’s some good news: the information about it gets better and better. For example, PMDD is classified as a chronic illness that has been classed as a disability by the Equality Act 2010 (applicable in England and Wales; not sure about Canada or the US) due to its chronic and repetitive nature.
Before knowing of and self-diagnosing myself with PMDD 6 years ago (thanks to a dear friend) I believed I was irrational, ungrateful, illogical, manic, depressed, self-indulgent, prone to mood swings I didn’t even try to control (because of my selfishness), difficult, lazy, and unlovable. Basically, the worst person ever. The shame that came with it is something I don’t wish on anyone; it’s an unbearably lonely and isolating feeling.
Prior to this latest episode I didn’t have a really bad episode for several months (I had symptoms, but deemed them manageable), giving me the giddy hope that perimenopause was canceling out PMDD. After the horror I just lived through I’ve made a decision I’ve thought about for over a year: I want to start taking hormones to induce menopause. The friend I’ve mentioned above has done it and recommends it highly. It might seem like a drastic step for some, but for anyone who suffers from PMDD it will make perfect sense.
The reason I’m sharing this decision with you is that I want to keep myself accountable. Too many times in the past I thought I was ready, only to experience the instant relief you get when your period comes, convincing myself that “it wasn’t that bad”. Self-denial is a strong component of my mental illness, which I come by honestly since it’s a robust family trait.
PMDD is a severe, debilitating chronic illness that kills people. One global study has found that a shocking 34% of people with PMDD have attempted suicide.
Please spread the word about PMDD, share this article, and tell someone who you think might have it that there’s a name and support for their condition that makes them feel crazy: PMDD.
It’s still much too poorly understood, woefully misdiagnosed or undiagnosed, and too often downplayed as “normal”. PMDD needs to become recognized, much better understood, and supported by mainstream medicine and our collective consciousness.
Women’s health matters. Women matter.