Prior to 2008, I was really struggling to get my depression stabilized. I kept having major dips in my mood followed by an elevated mood. Initially my psychiatrist brought up the possibility that I might have bipolar disorder. That would seem the likely conclusion given my cycling mood changes. For some reason, that just didn’t seem right for me. Deep inside I felt the changes in mood needed to be more extreme for that diagnosis. Regardless of what I thought, I was prescribed a mood stabilizer.
In an effort to prove her wrong, I decided to really track my mood for a few months. Sure enough, I began to see a pattern that led me further away from a bipolar diagnosis. Each month my mood would dip deeply just prior to my menstrual cycle followed by the elevated or “regular” mood once my cycle started. This happened month after month. Now that I had established a solid pattern I started doing some research. That’s when I learned about PMDD, Premenstrual Dysphoric Disorder.
Some would say that I just had typical PMS, Premenstrual Syndrome. But PMDD is much more than that. Symptoms are similar, but with a much greater intensity followed by almost immediate relief once menstruation begins. Because PMDD is about a hormonal imbalance or inability to adapt to hormonal changes, PMDD leads those who still have their ovaries to extreme depths of depression; even to the point of attempting suicide or other self-harm behaviors. A key marker of PMDD vs a mental illness is that the symptoms subside with the start of menstruation. If a person doesn’t feel better within a day or so of menstruating, it’s more likely to be a mental illness than PMDD.
Over time I was able to get off of the mood stabilizer. My PMDD symptoms had alleviated for the time being. My depression was bad enough at that time that I’m grateful the PMDD took a break. But some good things come to an end.
That’s when I wrote my post “DD for a Day” over two years ago. With over seven years between major symptoms, it didn’t immediately register that the PMDD might be making a comeback. It would be at least a year before I connected the dots again. By this time, I would be back with my original psychiatrist. This time I was ready to really fight a bipolar diagnosis and needless psychiatric medication. Thankfully she had updated her knowledge and supported my going to a gynecologist for treatment.
The first gynecologist I consulted essentially told me it was just PMS and I would have to learn to deal with it. I was beyond devastated! My symptoms had come back stronger than before and she’s telling me to “deal with it.” I was already crying talking about my symptoms and this only made me cry harder. She ended the appointment with no suggestions on how to “deal with it” on my own.
On to gynecologist number two. NIGHT AND DAY!! What a difference Dr. G is!! I absolutely LOVE her and her approach! She was not only knowledgeable, but extremely personable and compassionate. She immediately ordered several blood tests, not just for hormone levels, but also my Vitamin D levels since no other doctor had checked that despite my regular struggle with depression. It turned out I had almost no Vitamin D in my system. Getting that regulated has made a huge difference in keeping my deepest depression at bay for the most part.
Dr. G started me on a different birth control and prescribed it to be taken continuously so that I did not have a period each month. The goal of doing this is to level out the hormones and keep them from fluctuating each month. Sounds logical and works great for some people. The first birth control had me crying each day. We quickly dropped that and switched to my current one.
This latest birth control has worked well for the most part. But, as the year has gone on, we have learned that I am extremely sensitive to either missing a dose or even just taking the dose a few hours late. Dr. G became convinced that it was time for a hysterectomy thanks to this sensitivity and the fact that I was recently very suicidal and hospitalized for a week.
While this should provide a great deal of relief, it is not without its own complications. I will immediately go into surgical menopause and will have to start taking estrogen. I’m praying it doesn’t take long to find the right amount that is going to keep my mood balanced without the extreme changes.
To read more about PMDD, visit WebMD: What Is PMDD?
(https://www.webmd.com/women/pms/premenstrual-dysphoric-disorder#1)
Embracing life: 4/29/10 
Thanks, so much, Criselda, for teaching us all about PMMD. My daughters have been on the continuous pill to decrease their menstrual cramps. Sorry to hear about your body’s sensitivity to the timing of the doses. So good that you found a gynecologist who had some better ideas than “deal with it”! And very interesting about Vitamin D.
Thank goodness you were hospitalized and protected during that recent week. I hope the hysterectomy won’t have too big an impact on your body’s hormonal levels. I had one at age 57 or so and it was fine. But I was already menopausal at the time. Prayers for you!
Your blog is important work! Keep it up.