Sunday, July 29, 2012

PMDD

About 6 months ago, I started noticing some pretty crazy things going on in my mind and physically. I'm a bit nervous to share all of this, but I figure it'll be good to get out there if anybody is experiencing the same thing. Or maybe you've hung out with me recently and felt I was a bit "off". Also, if you believe that PMS is just a lame excuse some women have, maybe this will change your mind.

I noticed feeling some really intense ups and downs a few months ago. I would feel so on edge and anxious at times and some months, I'd even have fleeting suicidal thoughts. I felt crazy!
I basically fluctuated between this
...and this
 It was such an interesting experience for me to have. I'd think things like, "I am so anxious right now. I just want to cut or go run around." or thoughts like "I can't do this anymore. Everybody would be better off if I were dead." Then shortly after thinking these thoughts I'd think, "Lauren, what the heck! You know that's not right! Why are you having thoughts like this? What is going on? Of course, your life is worth living. You have great family and friends. You are having a hard time right now, but you will get through it." I remember feeling like my skin was crawling because I was so anxious. I was so embarrassed and ashamed to even be so overwhelmed and having such thoughts. I think I had some increased guilt because I am a therapist and help people through these issues daily at work. Aaron could obviously tell something was going on and would ask if I needed to get out of the house for a bit- which I felt guilty for saying I needed. I was already in school and seeing clients and then he was sensing my anxiety and depression and offering for me to leave more. I couldn't believe it.

I have a Period Tracker on my iPod that can track moods, cravings and I could put in notes so I started tracking days of the month when I was feeling especially low- something I often advise my female clients to do. I just wanted to see if it was correlated with my cycle or not. I should also add that I've had a Mirena IUD in since 6 weeks postpartum (almost 2 years ago) so I hadn't recently had any changes in medications like birth control. I couldn't believe how obvious the pattern was!! My really hard days of depression or anxiety were always 2 days before starting my period. Always. Some months were harder than others, but on any given month I could guarantee that 2 days prior to my period's arrival, I would be on edge and easily breakable and pretty crazy feeling.

I finally talked to Aaron about it. I was so embarrassed. He expressed to me that it was really hard for him and Aidan. He suggested I go talk to a doctor because "Aidan and I don't like this Lauren. We want the other Lauren." It broke my heart to hear it, but I knew it was true. I wasn't being as good of a wife and mother to them as I could. The next day, I talked to my mom about what I was experiencing. She asked if I was working out, eating well etc. Of course, I'm not as good about these things as I used to be and have been trying to work them back into my schedule. I scheduled an appointment with a new doctor later that day to check out my symptoms and get an opinion.

I was terrified for this appointment. I just switched insurance with my job so it would be my first time meeting this provider and I was going to have to tell her about these crazy thoughts I was having and then "Oh, and by the way, I'm a therapist." I was worried about how she would react and what she would think. I worry a lot about what other people think. Aaron drove me to my appointment and dropped me off and picked me up. My doctor was really great and understanding. I felt totally comfortable with her.

The diagnosis- PMDD (Premenstural Dysphoric Disorder). I'd heard about it a few years ago when we had cable or at least seen some birth control commercials that said they helped with PMDD "a more serious form of PMS that affects 5% of women". My doctor suggested I try to exercise more regularly, eat a healthier diet and also asked if I wanted to take medication. I felt more shame and guilt. But then again, I tell my clients to take medication if it will help them function and do better. We talked about it and since I was just starting to wean Aidan I wanted something that wouldn't interfere with breastfeeding. She prescribed a very low dose of Zoloft for me to take for the 13 days prior to my period starting. Luckily my period is pretty consistent.

The first cycle after that appointment, I did my best to work out and have a good healthy (ish?) month. I was still super agitated 2 days before my period. Not as bad as before, but seriously, I could tell. It's just that on edge icky feeling. I figured that the following cycle I should actually take the zoloft as prescribed since the workout/sleep/eating regimen didn't totally cure the symptoms.

The first day I took a zoloft I was scared out of my mind. I took it on a Sunday and was worried about how I might start acting at church in front of other people, if symptoms would appear out of nowhere or what. For  those taking Zoloft for PMDD, it's supposed to work instantly. I remember feeling like things were rolling off of me and I wasn't so stressed and overwhelmed- even just by watching Aidan during sacrament meeting. It was crazy to realize that I could have a reaction that wasn't so tense and agitated. Who knows, it could just be placebo affect, but I'll take it if it works! Placebo affects have been shown to help heal cancer so helping PMDD is totally awesome, too ;-)

This has been a very humbling experience for me.

First, to know that some mental issues can come out of nowhere after a long time without them. There isn't always a hint. Sometimes they just hit out of nowhere.
Second, to know that even if I do all that I can in my control, I may still need help of medication and others around me.
Also, it's just great to know that I do have a good network of support around me to help me through anything I might need.
It was good to get some honest feedback from Aaron even though it was pretty hurtful to realize how I was acting was affecting those I really love and care about. I'm glad Aaron and I have a relationship where we can talk openly with each other.

I'm glad I've had this experience because I feel like I get a little more the struggle my clients go through when struggling with a mental/physical illness, having to try medication and not knowing what to expect.

17 comments:

Tara said...

I had a similar experience when I started taking citalopram when I was pregnant with Hailey. It was so humbling to realize that I needed help like that. I'm glad it is working for you! There was a lot of withdrawl symptoms when I went off of citalopram though--have you researched that with zoloft? maybe you're on a low enough dose that there won't be any problems?

Karen said...

Thanks for sharing this. From what I have been told my mom's mom had terrible PMS. My mom had PMS and I have it now, too. Not just the bloating and "ugh, why do I have to be a woman?", but the anger, anxiety...a lot of what you described. I totally related to what you said.

My dad encouraged my mom to see a doctor about getting medication and she didn't want to. She talked to her dad about it (my grandma had passed away from breast cancer at this point). She was concerned about "being medicated" and he said, "listen to your husband". My grandpa went through a lot for many years with my grandma. My mom tells me about this just to let me know and for me to be aware so that if there ever is a time I feel that I need the help of medicine that it has also run in my family.....

Anyway, thanks again for sharing!

Maria Bone said...

It has been very tough, but the lessons we have learned and continue to learn about mental illness should be shared. So much happiness, time, peace and strong relationships can be lost without an understanding of mental illness. When I see the signs in others around me it is so hard to contain my feelings of, "No! Don't let this ruin your life and the lives around you!", but I do not think that would instill trust in my judgement. It is hard to get around the shame and misunderstanding surrounding mental illness that others have to talk to them freely. However, we must continue to educate each other in any way we can. I love you, sweetheart!

Chelsea said...

Lauren,
I just want to say you are awesome. Just sharing this could save someone's life. I know you were prompted to share this message, one I needed to hear. Thanks for being so brave, open, and honest.

Guyann said...

Hi Lauren,
Enjoyed your post on your feelings and fears. As a 30 yr veteran of PMDD I think I can speak to you about it, from my experience. First of all PMDD is not mental illness. It is hormonal, ( a physical result from a physical output) and it has always bothered me when people lump it into that catagory. I have worked with three wonderful & understanding doctors over these years. Ask Carly what I have suffered with. I too started out with Zoloft, but after feeling "foggy" for years my new female doc switched me to Lexapro. IT changed my everyday living...really! I just recently had a hysterectomy...and my doctor removed my ovaries as well, check into what those little "girls" can do to you! they are a huge factor in hormones and your physical and emotional well being. I now know what being "normal" is supposed to feel like. One word of caution. NEVER let anyone use your condition to blame you for THIER behavior. Trust your instincts and learn to defend yourself when you know better. Anyone that truly loves you would never use it to hurt you. You will go through enough living with this "condition" without having people use it against you. That is just cruel and selfish. Good luck darlin. finding the right meds for you will make all the difference in the world. Never feel ashamed. This is not your fault. I'm so glad you went for help...life is good! Even with this nasty little intruder. ;) Again, best of luck!

Anonymous said...

I have horrible pmdd. I have seen several doctors about it and they all wanted to put me on an anti-depressant like zoloft as well, but i didn't want to go on an anti-depressant because I'm generally a really happy person. Just not 7-10 days prior to my period - during that time my mood fluctuates quite a bit. I have crying fits, extreme depression over absolutely nothing, and it just seems like the end of the world. Even when I would tell myself - it's just because you're going to start your period, it wouldn't matter - it's still how I felt. I have found a couple of things to help a lot. Yes, working out (running and yoga) almost daily seem to keep me generally feeling great, but I started taking St. Johns Wort and it helped me a lot. It didn't help right away - i had to give it about a month or two, but then i just started feeling generally level and good. I still have pmdd but my symptoms are not as extreme as they were before. I take almost double what you are supposed to take though. If you do research there's an amount that you shouldn't exceed, and i am pretty much at that point. My doctor also prescribed me a low dosage of xanax for anxiety before my period. I realized that I usually get the depression and craziness when I am overwhelmed or upset about something, so if i feel something like that coming on I will take half of the pill (i don't even take the full amount the dr prescribed) I don't take it regularly because it's easy to get dependent on. I just keep it in my purse in case I feel it coming on before my period. i hope this helps! I definitely recommend the st. johns wort but check with your doctor first!

Heather said...

Hi! I found your blog through Pinterest. good post on FHE with toddlers. Just wanted to throw this out there: Have you considered having your Mirena removed? In a very small percentage of women, it can cause major anxiety. It did with me! I had ALL the same symptoms you described. My doctor didn't think the Mirena was the problem because the hormone dosage is so small, but as soon as I had it removed and the extra progesterone left my system, I was a new woman.

Heather said...

Hi! I found your blog through Pinterest. good post on FHE with toddlers. Just wanted to throw this out there: Have you considered having your Mirena removed? In a very small percentage of women, it can cause major anxiety. It did with me! I had ALL the same symptoms you described. My doctor didn't think the Mirena was the problem because the hormone dosage is so small, but as soon as I had it removed and the extra progesterone left my system, I was a new woman.

Bethany said...

Thanks for your honesty Lauren, it's funny that as a therapist (or me, as a nurse) we see everyday people who have symptoms/illnesses/etc yet we never expect any of it to apply to ourselves. I hope you have found something that works for you!

Marci Dorman said...

I was diagnosed with PMDD about 5 years ago, a year after the symptoms started. I've "attacked" this issue from every angle: physical, emotional, spiritual. I've been on various SSRI's, gone to therapy (Cognitive-Behavior and Talk), taken classes on depression, focused on exercise and diet, changed things in my spiritual life, taken up meditation and yoga, and read extensively on hormones, stress, and mental health. I have seen more doctors than I can count, and counseled with my brother, who is a psychiatrist who has treated women with PMDD.

Here is what has helped me the most:

1) Keep track of your moods. It is critical to be aware of the condition and what it can do to your thoughts, beliefs, and feelings. Since the symptoms of PMDD are cyclical and can come on gradually, I would often forget that I had PMDD, and instead believed my negative feelings were "real" with causes outside myself. Thus I began to see serious "problems" in my marriage, my family, my life choices, etc. I considered divorce, suicide, and running away. Suddenly, my period would start and it was like waking from a nightmare: I felt like myself again; I was glad to be alive, loved my husband, loved my daughters, and felt horrified that I would consider leaving them. Keeping track of my symptoms helped me keep my feelings in perspective. I'm not one to believe that feelings should be completely discounted (there's usually some kind of basis or trigger), but it's helpful to look at a chart and see: "Okay, last month and the month before that and the month before that on this same day in my cycle, I felt like my marriage was falling apart and my husband hated me and that I didn't feel anything for him anymore and felt completely despondent and depressed. And two days later, it was fine again. Maybe I will try to keep that in mind."

Here are two very useful tools to keep track of symptoms:
A PDF chart from Facts for Health to track PMDD specific symptoms: www.pmdd.factsforhealth.org/drsp/drsp_month.pdf
Optimism: a mood tracking app, not specifically for PMDD, but you can manually alter it to fit your needs. It's also online as well: Findingoptimism.com

2) A book called, The Triple Whammy Disorder, by David Edelberg. Very good, despite the dumb title. It approaches the issue from three sides: seratonin, stress, and lifestyle and how those three can combine to positive or negative effect.

3) I highly recommend trying medication, and sticking with it until you find one that works (this can be a long process). I tried for a long time to "do it myself" through lifestyle changes (diet, sleep, sun, exercise, spirituality, etc), to no avail. Although all of those are vital to achieving and maintaining good mental health, it can be nearly impossible to find the motivation and energy to do them if things are really bad, which just made me feel like a failure--adding to my depression. It was important for me to recognize that I needed outside help to get me to where I felt good enough to be able to help myself through other means (lifestyle changes like good health, positive thinking, stress-reduction, etc). But none of that would have been possible for me unless I'd taken medication first.

4) Left untreated, PMDD can get worse. At first, I only experienced 3-4 "bad days", more what you'd think of as an intense form of PMS. It eventually turned into 2-3 weeks, leaving me feeling really good only while on my period and a for a few days after.

I know this was a long message, especially from a stranger, but it's not talked about much, and I was alone in it for a long time and VERY confused.

Marci Dorman said...

Oh, and by the way, on a non-PMDD related note: I got a Mirena about 2-1/2 years ago, and my symptoms (depression) started coming back, so I had it removed. I now have a non-hormonal copper IUD, and I'm doing much better.

Brittany Goodyear said...

I just found your blog via Pinterest and reading this is what I needed. I've been struggling with those same thoughts this weekend. Usually I have them around my period or ovulation. I want to find a doctor thanks to this post and the comments. Thank you.

Kristin said...

Thanks for your post. I also have PMDD. When I realised what it was, my husband joked about me always being a high achiever (only 5% of women affected). I also found that the Mirena made mine a lot worse, although it hadn't when I used one a few years ago. What has helped me the most is a combination of B vitamins (mostly B6) that I have prescribed by my naturopath. I'm a different woman. Good luck sorting it out.

Anonymous said...

I am so glad there is an LDS forum on this disorder. Struggling or not, you have stumbled on a need for many of us. As LDS women we suffer alone often because we feel a need to be "perfect", although the tenants of our faith say to "strive for perfection". Also, out on the web there are many forums, but people's language and harshness seem counter-intuitive to the Spirit. I have been looking into finding an LDS exclusive place to share where we can be honest, but not necessarily using language that is coarse.

I have been struggling with this for about 4 years now. Each month is a nightmare for me and my family. I often feel very alone.

I wasn't blessed with a female support system with no sisters and no mother and in a new town...not many close friends...at least friends that I could ever share this with.

I hope as a counselor you will take this challenge and maybe turn it into a grander thing that could help many of us silent sufferers who want to hold to our faith and yet need to share some pretty rough things.

I feel for you and empathize for the "good person/bad person" comparison. I feel I am an integrated person who has bad days. It also makes me feel badly that one side of me is less accepted that another, although I understand my family's feelings.

My husband is mostly supportive. He struggles because he takes things very hard when I am struggling.

I often just say, "I just need you to listen to me..." He will hear the first irritated sentence and then he shuts down. I understand the limitations for him. That's why I am seeking female support in an LDS forum.

Hope this continues on as a place to share.

Annie

Valerie said...

It is great to find others dealing with these things. I noticed mine started 7 months after the birth of my daughter. I thought it was postpartum depression but thought it was a little strange for it to come so late. Your story sounds identical to mine.

Anonymous said...

I have many of the comments. I feel like of off PMDD sufferers we are sisters.
Well I could not say for sure for how long I suffered from PMDD maybe my teenage years? But it sure got lot worse after having my kids.

I must disagree with theory of mental illness and hormonal. I have been following a Dr. That cures PMDD ,he lives in Chile and his name is Dr.Jorge Lolas , he affirms the main issue : the inflammation of the Cervix(uterus) he injects straight to the uterus antibiotic and antiflamatories and also could do surgery to remove tissues around. Once he gets a healthy uterus to the patients, these are cured. There are so many testimonies of this. Be sure I will be in line to go and see him. All the best to all of you

Anonymous said...

I was just diagnosed this a few months ago. It was completely debilitating. Note that I take the medicine. I'm myself all 4 weeks instead of just 2 good weeks and 2 crazy weeks.