Updated: Jun 26
Today I choose to be vulnerable, to talk about a part of my story that I haven’t yet talked about on this blog. Vulnerability feels messy and raw, uncomfortable; but it’s also beautiful. Today I’m choosing to be vulnerable, because vulnerability fosters connection, vulnerability allows others to not feel alone, vulnerability says it’s ok to struggle and if you are struggling with these same struggles I want to tell you that you’re not alone.
**Trigger warning: does include mention of suicidal ideation, no specific details are used.**
I struggle with premenstrual dysphoric disorder (PMDD). PMDD is a hormone-based, cyclical mood disorder suspected to be a sensitivity to the hormonal fluctuations during the end of the menstrual cycle. (1)
In general, PMDD occurs in the week to two leading up to a woman’s period and subsides within a few days of menstruation. According to IAPMD, symptoms can include mood/emotional changes, depressed mood, irritability/anger, increased interpersonal conflict, anxiety/tension, difficulty concentrating, tiredness/low-energy, changes in appetite and sleep, difficulty concentrating, decreased interest in usual activities, and physical symptoms including breast tenderness/swelling, joint or muscle pain, bloating. (1)
I’ve had PMDD for about the last 3 years and experience most of the symptoms above. For me this looks like 3-6 days of intense anxiety, depression, and overwhelming fatigue leading up to my period. Feeling empty and hopeless. Experiencing suicidal thoughts. Random crying spells, panic attacks. Feeling extremely overwhelmed and lost. Being overly sensitive to rejection, strong feelings of anger and irritability. Feeling my heart racing like its going to burst, canceling plans because I don’t have the mental or physical energy left, trying to keep it together and not burst into tears at work, feeling so fatigued that I can only lay on the couch, uncontrollable episodes of crying, having to remind myself of reasons to stay alive.
PMDD takes away my light, my energy, my spark; the things that make me, me. And to be honest, it sucks. For those that know me I’m an extremely joyful and happy person, I love laughing and bursting into song, and am easily excitable. But during a PMDD episode I become empty, sad, irritable, not myself.
There is no single treatment option that works for individuals struggling with PMDD. Lifestyle changes such as increasing sleep, exercise, and decreasing stress levels (can be through meditation, yoga, journaling) may help to lessen symptoms. Other options include medication- SSRIs, mood stabilizers, oral contraceptives, or chemical menopause. And in more extreme measures surgical menopause.(1)
It took a little while to determine that I have PMDD. At first it seemed like severe PMS but I began to have suicidal thoughts in the days leading up to my period which was a strong indication that this was not PMS. About two years after I began having symptoms, I started an antidepressant as the intensity of the suicidal thoughts became too much for me to handle. While the antidepressant completely stopped the majority of my symptoms for a year (which was amazing!); it appears the stress associated with moving to a new city and starting a full time job have triggered the symptoms again. (And yes, I do continue to take an antidepressant and have taken one for the past year and a half, I share that because I feel the stigma associated with taking medication for mental health needs to be stopped. I’m not ashamed to take an antidepressant and 100% support medication for mental health. Medication may very well have saved my life; it definitley gave me my life back.) I’m just ending a PMDD episode and it’s been less intense than last month which gives me hope for future episodes.
While having PMDD is difficult to say the least, I try to see the beauty. Romans 8:28- “And we know that in all things God works for the good of those who love Him, who have been called according to His purpose.” I choose to see the wonderful PMDD warriors and community that I‘ve been able to connect with. I choose to see the reminder of the struggle that there are individuals struggling with anxiety, depression, and suicidal thoughts that feel this way each and every day; a reminder to continue to advocate for them and support them. I choose to see the beauty in decreasing stigma associated with suicidal ideation and to be reminder to those struggling with those thoughts that they are not alone and that they deserve help and support. I choose to see that the darkness of PMDD allows me to feel more fully alive and more fully see and feel the beauty and joy of this world once the episode is over. Living with PMDD sucks and is challenging but I also choose to see that beauty can come from the struggle as well.
Why do I share my story? Because PMDD is not well known but affects an estimated 5-10% of women of reproductive age and many women struggling may not know that they are actually struggling with PMDD. According to IAPMD, “30% of women with PMDD will attempt suicide in their lifetime while a larger percentage experience suicidal thoughts and self-harm.” This statistic displays the necessity for raising awareness about PMDD as a form of suicide prevention . (2)
If you believe you may be struggling with PMDD please click this link (I Think I Have PMDD) to be taken to the IAPMD (International Association for Premenstrual Disorders) website to learn more.
If you are struggling with PMDD, PME (an exacerbation of another mental health difficulty in the days before your period), or think you may be struggling, please check out some of these resources below.
IAPMD website– includes helpful information on PMDD/PME
IAPMD Support Groups- Facebook groups
IAPMD Peer Support– Virtual groups, allows others to not feel alone. I’ve attended before and found it to be very beneficial as I had not known anyone else with PMDD before.
Suicide hotline (800-273-8255)- If you are struggling with suicidal thoughts please contact a hotline, contact 911, call and stay with a trusted individual and/or go to your local emergency room. If you have a suicide plan in place please call 911 right away, your life is so precious and you are needed here on this earth and are deserving of help and care.
Local emergency room/911
PMDD provider directory
For those struggling with PMDD or PME please know that I love you, support you, and am here for you. And that you are needed here on this earth. Stay strong PMDD warrior. I’m rooting for you!
Psalm 23:4- “Even though I walk through the valley of the shadow of death, I will fear no evil, for You are with me; Your rod and Your staff, they comfort me.”
John 1:5- “The light shines in the darkness, and the darkness has not overcome it.”
Psalm 34:18- “The Lord is close to the brokenhearted and save those who are crushed in spirit.”
Deuteronomy 31:8- “The Lord Himself goes before you and will be with you; He will never leave you nor forsake you. Do not be afraid; do not be discouraged.”
Genesis 50:20- “You intended to harm me, but God intended it for good to accomplish what is now being done, the saving of many lives.”
John 16:33- “I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.”
Psalm 9:9- “The Lord is a stronghold for the oppressed, a stronghold in times of trouble.”
Matthew 11:28- “Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light.”
1 Peter 5:7- “Cast all your anxiety on him, because he cares for you.”
Isaiah 40:29-31 “He gives strength to the weary and increases the power of the weak. Even youths grow tired and weary, and young men stumble and fall; but those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint.”
Romans 8:28- “And we know that in all things God works for the good of those who love Him, who have been called according to His purpose.”
Megan Ludke is a woman of God, Founder and Executive Director of Live RecoverED (formerly RecoverED Athletes), a school-based physical therapist, and a current PSU graduate student (M.Ed. Health Education & Promotion concentration in Eating Disorders). She is recovered from anorexia, orthorexia, depression, OCD, and social anxiety. Megan is deeply passionate about her work at Live RecoverED, having felt the pain and darkness of struggling with an eating disorder. When not working, Megan loves spending time with her boyfriend and family and loves being outside- hiking or reading in a hammock.