April 29, 2020

Content – Discussion of female cycle, Premenstrual Dysphoric Disorder (PMDD), mental health.

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PMDD.

I’ve talked about this a handful of times, mostly in passing. But since this is a page I set up to talk about autism *AND* mental health. PMDD is a huge part of what affects my mental health, aside from general anxiety disorder and social anxiety disorder. I mentioned at the beginning of the month that I wanted to make a post about PMDD, and I had yet to be able to do that.

For years, I’ve known that I experienced “PMS” to a pretty strong degree. In my early teens it was once stated that I was “PMS’ing all the time”. When I got my first iPhone, I finally had a calendar in my pocket all the time – I started tracking when my period started, and when I expected the next one to start. I knew that my mood was affected by my cycle, and I finally had an easier way to track it. If I noticed I was getting irrationally moody or something, I would check my calendar and see how close I was to starting my cycle. Bam! There was the explanation right there!

Before I continue, I’m sharing the diagnostic criteria copied from (1) The National Center for Biotechnology Information. Scroll down below the ~ marks to continue reading my notes.

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Table 1, Diagnostic Criteria for Premenstrual Dysphoric Disorder (PMDD)

Timing of symptoms

A) In the majority of menstrual cycles, at least 5 symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week post-menses.

Symptoms

B) One or more of the following symptoms must be present:

1) Marked affective lability (e.g., mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection)

2) Marked irritability or anger or increased interpersonal conflicts

3) Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts

4) Marked anxiety, tension, and/or feelings of being keyed up or on edge

C) One (or more) of the following symptoms must additionally be present to reach a total of 5 symptoms when combined with symptoms from criterion B above

1) Decreased interest in usual activities

2) Subjective difficulty in concentration

3) Lethargy, easy fatigability, or marked lack of energy

4) Marked change in appetite; overeating or specific food cravings

5) Hypersomnia or insomnia

6) A sense of being overwhelmed or out of control

7) Physical symptoms such as breast tenderness or swelling; joint or muscle pain, a sensation of “bloating” or weight gain

Severity

D) The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others.

E) Consider Other Psychiatric Disorders The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia) or a personality disorder (although it may co-occur with any of these disorders).

Confirmation of the disorder

F) Criterion A should be confirmed by prospective daily ratings during at least 2 symptomatic cycles (although a provisional diagnosis may be made prior to this confirmation) Exclude other Medical Explanations.

G) The symptoms are not attributable to the physiological effects of a substance (e.g., drug abuse, medication or other treatment) or another medical condition (e.g., hyperthyroidism).

From: Premenstrual Dysphoric Disorder (Formerly Premenstrual Syndrome)

Copyright © 2000-2020, MDText.com, Inc.

This electronic version has been made freely available under a Creative Commons (CC-BY-NC-ND) license. A copy of the license can be viewed at http://creativecommons.org/licenses/by-nc-nd/2.0/.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

I can mark down all 4 symptoms, not just one of them. I experience the symptoms of suddenly being tearful, and the increased sensitivity to rejection, increased interpersonal conflicts, self-depreciating thoughts, and anxiety to an overwhelming degree. I will literally cry over a song I hear, or something I think about from some distant memory, or a feeling of being forgotten, or rejected, I will be quicker to think I’m doing a horrible job at everything, and I will overthink everything and freak out at the smallest things.

As far as the other symptoms, I will get so tired that I can barely make it through the day without wanting to just go to sleep. It feels like I don’t have the energy to even breathe some days. I just try to stay caffeinated on those days and push through it. The brain fog is horrible, and concentration goes out the window. I tend to eat more carbs, especially the week before my cycle starts. “A sense of being overwhelmed or out of control” – Yes, all of that symptom. Feeling bloated, gaining weight. Muscles being sore and achy for seemingly no reason. My knees not only tell me when the weather is changing, but also when my hormones are shifting during my cycle.

When my FitBit app got updated a few years ago and added the female health tracking, I noticed that the mood changes and everything I experienced happened both when I was going to start my cycle, and during the ovulation window. I’ve looked up a few things on this, and it appears that the change in hormones during both of those times during the monthly cycle are similar, and my body and brain are incredibly sensitive to the ups and downs of those hormones.

I’ve discussed all of this stuff with my therapist, and I meet the criteria for the diagnosis. I have discussed it some with my doctor. PMDD symptoms are the reason I tried Wellbutrin XL a little over a year ago. It made the symptoms 10x worse than they were originally, and I had to quit the medication before it destroyed me. I haven’t chosen to try a different medication for it at this point. I’m not sure if I want to.

I wanted to write this post to raise awareness. Sometimes I know exactly why I’m experiencing things the way I am, or feeling things how I do, but I feel like I can’t do anything about it. Some people probably think I’m crazy. It’s like when I’m experiencing the symptoms and then my period finally starts, a switch is flipped, and I feel normal again.

Similar to my sharing my diagnosis of autism, it isn’t an excuse, it’s an explanation. I’m sharing this information because I hope it helps others to understand the things I go through, to understand some of the why behind things.

For more information on PMDD, you can visit the International Association for Premenstrual Disorders website here: https://iapmd.org/

References:

(1) https://www.ncbi.nlm.nih.gov/books/NBK279045/table/premenstrual-syndrom.table1diag/

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