The Monster Inside: Living With Premenstrual Dysphoric Disorder

There’s a strange fascination in our culture with monsters, whether that fascination is rooted in the pure curiosity towards something so far removed from our everyday existence or rooted in the comfort in the inevitability that the monster — no matter how formidable — will be slain by the hero. Who, in any theater across the world, did NOT cheer when he-who-must-not-be-named was — after EIGHT horcruxes — finally slain?

 But there’s no such fascination when the monster lives within you. 

The Monster 

It’s estimated that 5-10% of women of reproductive age suffer from PMDD, or pre-menstrual dysphoric disorder. Characterized by extreme psychological and physical symptoms prior to menstruation, it’s essentially a chronic and severe negative reaction to the natural rise and fall of estrogen and progesterone. 

PMDD is a chronic and severe negative reaction to the natural rise and fall of estrogen and progesterone.

It bothers me whenever I hear a comment — on tv, film, or in person — that makes light of women being “moody” because of PMS. Hormones fluctuations do affect mood, and it’s not at all comedic when you feel like you’re on an emotional rollercoaster. For women with PMDD, these hormonal fluctuations are nothing short of terrifying. About 30% of women with PMDD will attempt suicide in their lifetime. 

Hell Week 

It’s tragically ironic that I was an English major with a focus on Gothic literature. Jekyll and Hyde, Dracula, Dorian Gray — characters with tales that chronicle terrifying experiences of transformation and psychological schism — were the fodder for my analytical essays. Now, for a quarter of each month, I truly do not speak dramatically when I say that my life, too, becomes a story of Gothic horror. 

Numbness and exaggerated fatigue descend over my body and my mind.

There comes a day, 7 to 10 days before my period, when the switch flips. It, in actuality, feels like I’m a ballerina in a music box whose lid has been violently shut. Numbness and exaggerated fatigue descend over my body and my mind, and I feel as if I’m sitting at the bottom of a well in impenetrable darkness, miles underground. 

Each minute that passes is a haze; there have been days when I have stared at the wall for hours in an inexplicable fog of loss, hopelessness, and terror. My memory is nonexistent, and I can’t track my thoughts from one moment to the next. There are days when I can’t remember some of my most treasured moments with my fiancé. I carry his old handwritten notes to me in my wallet to remind me. 

The most horrifying symptoms I experience are the ones that exacerbate anxiety. When all is normal, I’m already a very internal person. I lived alone in Los Angeles for six years, working from home, and it wouldn’t bother me that I often wouldn’t speak a word for days at a time. I thus ruminate very deeply on my thoughts, the downfall of which is that I can overthink, which can sometimes lead to anxiety (albeit very infrequently). During my PMDD week — which many women correctly deem “hell week” — I’m constantly plagued with periodic panic attacks. My heart races, and my entire body convulses. At night, I have visceral nightmares filled with murder and gore and molestation. 

At night, I have visceral nightmares filled with murder and gore and molestation. 

I won’t exhaust you with a paragraph description on each of my symptoms but will just say that migraines, hypersomnia, and low libido are also components of this monthly transformation. I’m not present. I’m not myself. I, truthfully, am taken over by a monster that wants to steal anything and everything from me. 

Figuring It Out 

It’s important to note that PMDD can present differently in different women. When I first spoke to my Ob/Gyn about feeling like my PMS was debilitating and disruptive, he told me to track my symptoms for a few cycles and to keep a journal of how I felt on what day to determine if there was a cyclical pattern. I found the app “Me v PMDD” to be incredibly helpful in aiding me to keep a detailed journal that I was then able to present to my Ob/Gyn before he confirmed my diagnosis. 

Searching for Treatment 

When I was diagnosed, I breathed a momentary sigh of relief knowing that there was, in fact, something wrong. It wasn’t in my mind; I had a legitimate disorder. However, as any woman with PMDD will tell you, the search for treatment and symptom management is often exhausting. Because every woman is different, there’s no guarantee as to which treatments, if any, will fully mitigate your symptoms. 

Because every woman is different, there’s no guarantee as to which treatments, if any, will work.

Options range from SSRIs to hormonal birth control to a hysterectomy. Many women explore the homeopathic and therapy-based avenues. I myself have switched treatments many times and am still, several years into battling this disorder, trying to regain some kind of normality during hell week. As a woman who also suffers from extremely heavy, painful, and long periods, it’s demoralizing to spend two weeks out of my month — each month — in some kind of physical or psychological distress.

Communication Is Key 

It’s essential to remember that, if you struggle with PMDD, it probably does not only affect you. Inform your family and your close loved ones and educate them on the disorder, so they can be prepared. Also, having a support system during the onset of your symptoms will be key to helping you through them. 

Remember that you’re not your disorder. You’re not the monster. 

My fiancé and I, for instance, have a shared google calendar tracking my cycle, around which we plan our trips and our activities. We know exactly when “Kraken week” (a scarily accurate description) is coming. When I have panic episodes, he knows what music helps to bring my heart rate down. He has carried me home when I have fainted in the park. He reads every new piece of medical literature that’s released. But most of all, he’s patient with me and loves me through the struggle. 

Closing Thoughts

Remember that you’re not your disorder. You’re not the monster. Don’t isolate yourself. Don’t be ashamed. Get help. Find a supportive community. You’re not alone. 

For information on PMDD, including information on medical literature, self-screening, specialists in this disorder, and support groups, please visit IAPMD.org