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When PMS “Goes Big”

“Oh, come on, this is totally normal, this is just PMS!” I assured my worried friend, Kate.

“Rhea.” Kate placed a hand on my shoulder.  “You tried to cut me off for no reason. That’s definitely not PMS. I think you might have PMDD.”

I knew that around “that time of the month”, many go through the emotional rollercoaster of PMS. Yet was PMS so bad that I would spend days holed up in my dorm room? That I’d be snapping from mood to mood faster than Jekyll and Hyde? Thankfully, my friend helped me understand that I can get help, and so I was diagnosed with PMDD.

What is PMDD?

PMDD is a severe form of PMS that causes depression and other serious psychological symptoms around menstruation. These symptoms typically occur one to two weeks before menstruation and typically relieve themselves once the period starts, but those weeks can be debilitating. 

Symptoms are often:

  • Higher levels of anxiety and emotional/rejection sensitivity (an increased fear of rejection, often by loved ones
  • Lower energy levels, often causing fatigue
  • Paranoia and self-isolation
  • Depression symptoms: issues with coordination, memory, and suicidal thoughts

Before I was diagnosed, I didn’t even know PMDD existed. It seems like no one really talks about PMDD, despite the fact that the WHO declared PMDD as a global health concern. Why did it take so long? It could be due to the disorder often being miscategorized as PMS. Or it could be the duality of stigmas: the stigma of openly talking about menstruation combined with the stigma of mental health. It could even be due to stereotypes: how many of my fellow women out there have been told you’re “PMS-ing” when you’re feeling upset or angry? 

Regardless, it’s a painful experience for people, for those who are suffering and their loved ones, but it doesn’t have to be that way. There are plenty of great tips to help reduce its impact on your life! 

Know your cycle

Since PMDD symptoms are correlated with the menstrual cycle, it’s helpful to take note of when your cycle is going to begin. This is especially important if you have stressful events coming up, such as finals.

Self-care everywhere

Of course, self-care is important 24/7! However, it is especially important when you’re feeling down. 

  • Eat right: PMDD can cause unpleasant physical symptoms like bloating and cramping, so make sure to regulate your diet. Eating foods with a lot of tryptophan can help your serotonin levels, like eating lean meat, fish, and nuts.
  • Rest up: Be sure to get plenty of sleep, especially if you experience sleep deprivation
  • Work out: When you’re feeling low, time to bring up the endorphins! Take time for a brief exercise break in your day, even if it’s going on a simple walk.
  • Destress: Indulge in relaxing activities. If you want to hit two birds with one stone, think about meditating for 30 minutes a day for a destress-workout!

Seek help

If your PMDD is engulfing you to the point it’s affecting your relationships, lifestyle, and mental health, it’s important to seek help from professionals. They can help you back on your track in a variety of ways.

  • Therapy: Cognitive Behavioral Therapy (CBT) and psychotherapy can help you with the depression and anxiety that comes with menstruation, and help you manage your PMDD in the long run.
  • Medicines: While treatments are still being looked into, there are two main PMDD medicine types that are often given to patients: anti-depressants to help with depressed moods, and birth control to help regulate hormone levels.

You are supported

PMDD is still yet to be discussed in the public eye. That’s why for many, including me, we didn’t even know we had PMDD until years later! However, no matter how early you’re diagnosed with, or how familiar you are with your cycle and your mental health, you deserve to be supported and listened to. 

I took this selfie around my diagnosis, when I was feeling the worst of my symptoms. Even when someone is smiling, they can still be struggling through a rough time.

And for those who have loved ones with PMDD, check on them. Whether they’re smiling for the camera, going to work, or isolating themselves from everyone, they are still fighting and need your support, especially those two weeks before their period.

So now when that time of the month rolls around, I’m ready to bare my claws, therapy strategies, and medicines in hand, and roll with whatever punches my disorder is going to throw at me!  



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