Premenstrual Dysphoric Disorder

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Premenstrual Dysphoric Disorder
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    Community Voices

    hellooo

    hii i'm sleebyreeby! i'm a neurodivergent 25 year old with a variety of chronic health symptoms that are largely undiagnosed. seems like they're always evolving, really hard to pin down or get a doctor to pay any attention to. feeling particiularly lonely about it all today, i decided to download this app.

    i'm interested in talking to folks with similar symptoms, as well as just being able to talk openly about how i'm feeling without thinking i'm annoying or disgusting anyone 😅

    #MightyTogether #HidradenitisSuppurativa #IrritableBowelSyndromeIBS #ADHD #Autism #PMDD #PremenstrualDysphoricDisorder

    3 people are talking about this
    Community Voices
    Kateland Kelly

    When I'm Pressured Not to Call Out Sick as a Medical Professional

    My fingers hovered anxiously over the screen and I closed my eyes tapping the fatal message, “I can’t come in to work today.” I held my breath, waiting for the inevitable response from my manager or regional manager in our group text before one finally floated through cyberspace, “Is there any chance you can come in later today? If you don’t, we’ll have to close both clinics.” My eyebrows shot up but before I could respond to the text, another wave of nausea gripped me and I vomited mucus onto the towel lining my bathroom floor. Her text was filled with subtext: If you don’t show up, no one will get paid and patients will suffer. This is not an uncommon dilemma for medical providers: if we get sick, who looks after our patients? I looked up at the sky, praying for an answer, and asked myself what would I tell a patient in a similar situation. How would I counsel them? I would counsel them to take a sick day, curl up in the bedroom with a hot pad, take their prescribed medication, and hydrate. I would counsel them to enforce boundaries with their employer because: Sick people can’t heal sick people. While it is true I am an urgent care/emergency Physician Assistant, I’m also a human, and I live with multiple chronic health conditions including primary dysmenorrhea (which results in severe cramping, heavy bleeding, vomiting, and syncope during active menstruation). My employer doesn’t need to know the specifics of my health conditions but in America, we often sacrifice our medical privacy for a modicum of understanding. The sad thing is, the chronically ill are rarely understood, and unless we are productive (like a clinician that can rake in high numbers on an outpatient shift), then we are dismissed as “bad employees.” The implicit suggestion in the text from my boss suggested I take additional ownership in the clinic for support staff: it is my responsibility to keep it staffed no matter what. Except, it’s not. Three years ago, I would have literally killed myself working through pain, illness, or injury but things have changed since the pandemic. I value my own body more since realizing I’m only a diagnosis away from death. Sounds dramatic, but when you’ve lived through a few active gunmen, you start to realize what is and isn’t important anymore while on the job. The concept of quiet quitting has been floating around as the topic du jour, but I like to think that calling out sick when you need to is simply being a human. Quiet quitting is defined as, “a response to the burdensome demands of employment. It is often linked to employee burnout and involves deliberate disengagement from work. Employees are performing the absolute least necessary and establishing clear limits rather than quitting their employment,” according to Sociology Plus. The reason I push back against this concept is that we aren’t products and we aren’t robots. Sometimes we need the tincture of time to heal. That shouldn’t be labeled as a deficiency or a withdrawal of any kind, it should be recognized as a factor in working with other people. Life happens, or at least, that’s the lip service our human resource officers spout whenever they hold a company meeting.  However, as a clinician, tincture of time is one potion we’ve never got enough of but we can start setting healthy examples for our patients when we start acting in our best interests ourselves. Let me illuminate just how difficult it is for those of us being choked by white collars to call out sick. Have you ever considered what happens when your doctor calls out sick? Your physician assistant? Your psychiatrist? We feel immense guilt even considering a day off. This is reinforced by systemic abuses of clinical staff and a general lack of humanity in human resources: the bottom line matters more than our health bottoming out. I pushed through my guilt this time and I responded to my regional manager, “I wouldn’t call out if I didn’t need to; I’m sorry but I can’t come in today.” I curled up in bed, but not without missing a text and two phone calls from the clinic asking for clarification on various patients. I stared at my phone blinking, confused. Didn’t I just call out sick? Even though I called out sick and even though I’m paid hourly, I was still contacted during my sick time to manage other patients. I made a conscious decision to not answer any of the calls, as I had already taken some pain medication and once I pull that trigger, I don’t practice medicine. I spent the day praying to the porcelain gods but I pulled myself through the fog and came to work the next day. Regrettably, I saw 53 urgent care patients all desperate for someone to listen to them and while I did my best, by the next morning I was up at 5 a.m. vomiting profusely and doubled over with diarrhea. My period was vengeful and it was not done with me yet. I texted my manager and regional once more, deja vu washing over me as I felt like a little bit of a failure, “I can’t believe I’m doing this again and I’m so sorry, but I  need to call out sick. I’ve been vomiting since 5:00 a.m. and the diarrhea won’t stop. I can’t come in.” This time the response was more intimidating, “I hope you feel better but this time we need a doctor’s note.” Aren’t I the person people come to for doctors’ excuses? What the what? I responded quickly, referencing Connecticut state law which states employers can only ask for a note explaining three consecutive days off of work in a row. I had not called out multiple in a row, but I did realize it was a holiday weekend, Labor Day to be exact. I understood she was suspicious but I wasn’t trying to score a day down by the lake, I was just trying to get my symptoms under control so I could get off the toilet. My regional responded, “It’s the weekend.” So what? My internal dialogue screamed at me. The irony of the weekend was not lost on me, but I don’t think she appreciated it considering how chronically short-staffed our urgent cares were. I couldn’t help but reflect on the dark origins of Labor Day and how it began after American laborers were tired of being taken advantage of by their employers. Labor Day, at its very core, is a celebration of the achievements and contributions of American laborers, but sadly, there is no rest for the clinically inclined.  Apparently, I needed an excuse to take the day off even though there was nothing in my contract to suggest that kind of documentation was needed. I imagined myself as a medical assistant making a fraction of what the clinician makes and I realized just how scary that text was to a sense of job security. Staring back at the black mirror, I refused to back down. “Is that company policy or law?” My heart pounded waiting for a response, but the funny thing is, she never responded. I called her bluff.  And I didn’t drag my tired self to go sit in a waiting room where someone less qualified than I would nod, agree with me that I was ill and needed the day off, and write me a performative note, wasting their time and mine. What I did was curl back under the covers once my prescriptions kicked in and I realized why I was so upset about the subtext in our conversations about calling out sick: Are we not adults? What happened to the sanctity of someone’s word? I’ve seen support staff, medical assistants and receptionists, blue collar workers that lack the clout to call out, nurse their own illnesses in shame while on shift because the pressure to keep working is so high. When people scorn us saying “no one wants to work anymore,” I can’t help but laugh, and then cry, when I realize it’s because no one wants to work in these conditions anymore. We deserve better. We deserve to be treated like adults, not children trying to play hooky. When I call out sick as a clinician, I am doing so because I know my body and I know the risks that I can and can’t safely take. I will never put my patients at risk and now that I know my worth, I won’t continue to put myself at risk. So consider this my white coat endorsed professional opinion. If you think you need to take a day off to recover from an illness or injury, take the day off and let the corporate overlords figure out how to staff your absence. That’s their job, after all, not yours, even on Labor Day.

    Community Voices

    Every 28 days #PMDD takes 18 days.

    40% of the year is spent being me.
    Don't be fooled into thinking that being me is filled happily dancing around, singing, holding hands, filled with the joys of spring, drinking in those good moments.

    Being me means spending time picking up the destruction left behind after each episode, trying to piece my life back together, trying to hold my family together once again from the damage thats been caused.

    It means the exhausting cycle of putting old plans in place & figuring out new plans to try and minimise the damage that the impending next episode is going to cause closest to me.

    It means forever living with crippling guilt, shame, embarrassment because of things I've said, ways I've acted & a gut wrenching fear that one day I won't ever be able to claw myself out of that hole of continous thoughts and feelings of wanting to be unalive that each #PremenstrualDysphoricDisorder episode brings.

    It means plastering in on a smile for my family while really I'm still crying inside for the days, hours, minutes, I missed with them, whilst a rising anxiety lurks inside me as I know what is coming.

    The rest of my time is spent living as my alter ego, in #PMDDhell .
    Angry, depressed, withdrawn, fatigued, in pain, disassociated from the world around me, in a constant state of self loathing & planning my own demise.

    Even when PMDD is not present, it makes its presence known.

    If you know someone with PMDD, please don't ever tell them it's just #PMS .

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    Community Voices
    Community Voices

    Its been almost a year since I banished her out of my life.
    I cast her out like she was discarded rubbish. I often wonder if she deserved that.

    Was it really that bad? Was she really that bad?

    I miss her. I miss the comfort she bought. I miss her presence. The way she made me feel so in tune with my body. How she intensified every emotion I felt.
    I dont want her back. She was destructive. She broke my soul with her venomous words, her twisted dreams & poisonous thoughts. I was broken when she was near.
    But, I loved her. I needed her. I still need her. Without her I am not whole. Now she is gone a part of me feels lost, trapped in a bleak void forever falling further and further away from me.
    The world seems scary without her. I'm not sure who I am or where I belong. Life is less colourful & more stagnant somehow.
    I want to reach out to her, feel the bitter sting of her impact on my life once more.
    I want to know that she is ok.

    But, I know that she is ok. For she is my PMDD alter ego. I am her and she is me.

    #PMDD #PremenstrualDysphoricDisorder #hormonesensitivity #MenstrationMatters #WomensHealth #mentalhealthmatters #menopause #PMDDthoughts #MentalHealth

    Community Voices

    PMDD and why we need to talk about it

    I have PMDD. I have been suffering with this since I was a young teenager and I believe even before that. PMDD stands for Premenstrual Dysphoric Disorder and it is considered a mood disorder that is caused by hormones and the neurotransmitters not taking these hormones well during your luteal phase. Basically my brain freaks out when certain hormones are going through my body during this time of my menstrual cycle. Most people experience symptoms such as anxiety, depression, rage, bloating or inflammation, muscle pain, intense food cravings, increased sensitivity to rejection, self-critical thoughts, and sometimes suicidal ideation.

    I got my menstrual cycle when I was 10 years old and I remember being really scared. I was told that they were so painful but I was not sure what that would look like. My mom did her best to make sure I understood the foundation of menstrual cycles and what I would need each month but nothing could have prepared her for the years to come where each month I would be filled with rage, depression, suicidal ideation, and all of the other challenges that came with it and no clear diagnosis.

    I did not get a clear diagnosis until about a year ago when I started to do research on menstrual cycles and found out about PMDD. My mom told me how she mentioned it to my pediatrician because she could see that I had issues when I was about to start menstruating but nothing ever came of it and he said to take Advil 3 days before I started to menstruate. She thought back to when she was in her early 20’s and would always be filled with rage and anger before getting her period but didn’t realize this was not a normal reaction. Even before I got a clear diagnosis she was always able to help me realize that it was my ‘PMS’ that was causing me to feel this way. We did not realize this was something other women experienced and that it was in no way PMS and it was a completely different issue causing me to feel this way. It was isolating, lonely, and frustrating not knowing exactly what was going on with my body and mind. I would go to therapy for anxiety and depression and try to track everything but we weren’t solely focusing on one mental health condition because we did not know that’s what it was. I went to the doctor multiple times to get my hormones and thyroid checked and everything always came back normal. It wasn’t until I did research on PMDD and found that no blood test will be able to tell you if you have PMDD because it is not a hormone imbalance it is a mental health condition caused by hormones.

    When I found out about PMDD it only brought a small amount of relief for me because I started to think about the journey that would be ahead trying to learn how to manage it. I was in undergrad, living on my own, and working full time on top of having these symptoms. I was stuck in survival mode until I graduated recently and now I have been left with no choice but to face this. I started to experience more intense suicidal thoughts during my luteal phase and would have intense emotions where I would tell myself I was not good enough. All of the stress I had experienced throughout school and life in general finally caught up and making itself known it was there and it needed to be dealt with. PMDD causes so much emotional and physical turmoil each month that I had to accept I needed to heal from all of the trauma my body had been going through. I have been dealing with anxiety and depression since I was 14 years old and suicidal thoughts were not a new occurrence for me but this level of mental imbalance was new and I needed to learn how to manage it.

    I currently am going back to therapy and I have found a lot of support through the IAPMD (International Association for PMDD and PME) Facebook page and support groups. They offer a wide range or resources and information if you are needing help with guidance. 1 in 20 people are impacted by PMDD and it is not just cis-gendered women. It’s important to stay aware that there are non-binary, gender fluid, trans, and others who don’t always identify as a cis woman but they still get a menstrual cycle. This inclusivity is important to stay aware of because it can help researchers find how this can impact specific populations too. There is help and support out there and talking more about your experience is the first step to educating not just other peers but professionals who may not be aware of this condition.

    #PMDD #Anxiety #Depression #BansOffOurBodies #RoeVWade #Period #MenstrualCycle #MentalHealth

    4 people are talking about this
    Community Voices

    Parenting with PMDD

    As a parent living life with PMDD, it can be diabolically hard. There's days when I cannot stand my children's voices. The sound of the innocent laughter, the shouts of 'mum' slice through me as harshly as the ear piercing sound of glass against a knife & when I'm already at the mercy of my hormones, that are so viciously attacking me in every possible way, it simply only heightens my irritability towards my own self.
    I know my children depend on me for love, care, time; they rely quite solely on my existence.
    I often find myself disassociating from my children during these PMDD times in order to survive. Time passes, essentials get done, but I have no recollection of the who's, how's, when's or whys.
    Its scary losing any sense of time, but its even scarier that its become necessary to keep myself alive.
    PMDD takes the best bits of me & leaves me broken, but it has also shown my children a side to life that they may have never gotten to experience.
    They've seen real, raw emotions. They've learnt first hand about how menstruation can impact people & they know the signs to look out for in others & how to have those conversations that their friends find awkward & uncomfortable.
    They aren't ashamed of my disorder & for that I'm so proud.

    #PremenstrualDysphoricDisorder #PMDD #PMDDParents #ChronicIllness

    What Helps a Young Woman With Premenstrual Dysphoric Disorder

    With our ongoing “What Helps Me” series, The Mighty is leaning into what sets us apart from other health sites: We aim to provide real health advice from real people who live it. In this spirit, we asked our community for the best insights and tips they’ve developed for managing their conditions. As always, they responded with their unique health stories and we are happy to pass along their well-tested resources to you. Responses have been lightly edited for clarity. Today, we meet Mighty member Liza. She is 19 years old and lives with premenstrual dysphoric disorder (PMDD). Liza, what helps you? THE MIGHTY: What helps you most when your condition affects your physical health? LIZ: Nothing beats a nap! Drifting off to sleep on the sofa with my furry friend and some music playing is so helpful. What helps you most when your condition affects your mental health? Being able to talk about it calmly to my partner, a friend, or a family member and being reminded that I’m safe and grounded helps me. Simple reminders to ground my mental state, such as “You’re safe here” or something similar is a huge help. How do you cope when your normal self-care isn’t working? My self-care looks different every day. I just have to keep trying until something works. One day it might be a hot bubble bath; the next, it might be starting a book or TV series I’ve always been meaning to begin or taking a walk outside. If nothing works, turning to someone I trust to do self-care with me is a massive help. Thank you to Liza for her contributions to our community. Did you find this helpful? Add your gratitude in the comments. If you want to tell us what helps you, you can complete our survey here .

    Finding The Right Therapist Saved My Life With PTSD and PMDD

    In September of 2021, I was diagnosed with post-traumatic stress disorder (PTSD) due to a two-year battle with premenstrual dysphoric disorder (PMDD) and childhood trauma I didn’t realize I had. Having PMDD in itself was like constantly being at war with myself. One that I eventually ended up losing. Even though it’s now over, I lost my family, my friends, and my sense of self all in one fell swoop. Having to deal with PTSD and trauma responses after finally being physically free from PMDD is devastating. It’s like thinking my world is never going to see the sun again and I’m never going to be the happy, carefree woman I used to be. PMDD and PTSD have a lot of similarities when it comes to symptoms, at least for me. Feelings of shame and guilt, difficulty controlling my emotions, headaches and stomach pain, distancing myself from friends and family, marriage problems, destructive and risky behavior, and the worst one of all, suicidal thoughts. Before PTSD, I had never in my life thought about suicide, but I didn’t have any support and when I would reach out to family they told me to “get over it.” They didn’t care what I was going through, told me they’d been through worse and that my situation and experience didn’t matter. My husband didn’t understand, and even though he tried to support me in his own way, it wasn’t in the way that I needed. A way that would have been beneficial and helpful to me. He never actually asked me what happened or what any of this has been like for me. Feeling like he didn’t care enough to take the time to ask and spend alone time with me just drove us farther apart and made me resent him. I felt like he could be there for everyone else but he couldn’t be there for me, and I had a hard time with feelings of inadequacy, worthlessness, and not being good enough for him. When I reached out to my best friend of over 15 years, she said, “I don’t know how to respond to any of this,” and then just up and disappeared from my life. I haven’t heard from her since. The lack of support and not having anyone to be there for me left me feeling like I didn’t know how to get from where I was to where I wanted to be. I didn’t think it was possible and at the time, I didn’t think I was deserving of a life. If no one else thought I was enough to put in any kind of effort for, how was I going to think that about myself? I had already been in therapy for over two years for help with PMDD and things my husband’s ex-wife was doing that was adding to the strain of our already crumbling marriage, but that therapist wasn’t as helpful as I wanted to believe. She kept telling me to “connect” with myself when in all honesty, I was overly connected. It was part of my problem. I knew what was wrong, how I was feeling, why I felt the way I did. I just needed the guidance to navigate these things so I could come out positively on top of them all. And then I met my current therapist. When I switched therapists in October, that’s when things really started to change for me. I’m not saying it was an overnight fix, far from it. At first, I was closed off and when I would talk about certain situations, I would flip the script from me to the other person and I would shut down the possibility that anything was my fault. I never laughed and spent the majority of my sessions in tears. My anxiety never eased up and my panic attacks were prevalent. And then one day my therapist told me she’d noticed a difference. One I hadn’t seen or noticed in myself. I had managed to go through several sessions without crying, I was laughing and using sarcasm, I was making her laugh, and the most important change was I was starting to take accountability for my part in things that had happened. I genuinely wanted to apologize to people I had hurt and I was taking it upon myself to read about cognitive behavioral therapy (CBT) or other ways that could be beneficial to my mental health and growth. While I’ve had a couple of friends who have genuinely cared about me and my situation, it’s hard to completely open up to someone. Right now, it doesn’t feel safe to me because in my experience, it’s never been safe. But switching therapists and finding the right one for me literally saved my life. I don’t know where I would be today or if I would have made it during those dark days had I not had her. I owe her a lot and I’m extremely thankful for her and the changes she’s helped me with. She’s taught me that no matter how hard things get, even if I don’t have the support I need from the people I love, sometimes the best support you can get is from yourself. And even though things may look like they won’t get better, they always do. Maybe not today, or tomorrow, but they always do eventually.