PMDD: When Your Period Is More than a Period

In June 2015, I sat in a women’s circle in my college town. It was a place of solidarity, a venue to air our grievances. We talked about struggling with gender roles as children and not being taken seriously as adults. For an instant, the topic turned to female “craziness.”

“Have you heard of PMDD?” one member asked. “People call it a mental illness, but it’s just your period.”

I wanted to jump at her with the same ferocity as someone who’s been told to “get over” clinical depression. The dialogue changed, but to this day I hold my grudge: How were women supposed to get proper medical care if even someone in a feminist club was brushing it off?

Am I trying to negate the endurances that come with an active uterus? Of course not. But the mentality that any sort of reproductive pain is “just your period” is irresponsible and infuriating. If someone fell, possibly fracturing or breaking a bone, you wouldn’t tell them to get back up and tough it out. You’d encourage them to seek or even help them obtain accurate medical treatment.

Seven summers ago, I found myself speaking to a therapist I’d never met in the midst of my worst anxious fit yet. It wasn’t until days later, on the eve of my release from “observation,” that I realized my cycle—that scoundrel!—was a factor. Major episodes were linked to past menses, and it actually wasn’t normal for periods to be that bad. My period wasn’t just making me uncomfortable, it was also making me crazy. It turns out there was something more.

Premenstrual dysphoric disorder (PMDD) is a type of depression directly associated with the menstrual cycle. People who suffer from PMDD are more sensitive to hormones and hormonal changes. It’s estimated that between 2 and 5 percent of women have it, with gene irregularity, preexisting mental illness and postpartum depression being factors. Certain types of birth control can also trigger it. Physically, PMDD is PMS on overdrive. Cramps are more severe and longer-lasting, and other parts of your body get sore from fluid retention. Your digestive system will likely go out of whack or your appetite insatiable. Some people vomit or have heart palpitations. The psychological impact is even worse: although my PMDD is far more manageable than before, I still feel helplessly depressed for a few days every month. If I forget to refill a prescription in time, those few unmedicated days can add extra despair.

To be formally diagnosed with PMDD, you have to exhibit at least five of the 11 symptoms listed in the DSM-5 and experience them on a monthly basis for at least two cycles. People who are diagnosed with PMDD also experience increased feelings of depression or hopeless, anxiety or paranoia, persistent, intense anger and sudden mood swings (affective lability) that abate shortly after their actual period starts. While PMDD and depression or anxiety can coexist, the symptoms have to be unrelated for the diagnosis to count. If you don’t fit the exact diagnosis, then you might be suffering from a different mental disorder or reproductive issues such as endometriosis, fibroids, hormone problems or even menopause instead.

People say you can treat PMDD with antidepressants, but I didn’t feel any better until I got on a low-hormone birth control, and finding the right pill took years. Other women have had luck with Gonadotropin-releasing hormone analogs, calcium, vitamin B6, magnesium and vitamin E supplements and changes in diet and exercise.

As with any other illness, you should seek medical attention, whether it be a general practitioner, shrink or OB-GYN. However, a general doctor or even a psychiatrist may not catch the diagnosis or provide the treatment that fits with your body and cluster of hormones, which is, of course, why the services by organizations such as Planned Parenthood and access to birth control are more crucial than ever. It may be unfathomable for certain politicians, public figures and their followers, but there’s more than one reason people use birth control.

It’s already shitty to be a woman in this “reformed” America. If you’re not going to let women have reproductive rights, at least let them have bearable periods.

Sarra Sedghi is Paste Food’s and Paste Science’s assistant editor. Thanks for taking a few minutes out of your day to read about her uterus.