PMDD, Not Just DD for a Day

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.

PMDD It's not Just PMS Orange Image_n.jpg

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?


It’s Been a While…

It appears it’s been well over two years since my last original post. Since then, there have been a lot of good times along with some not-so-good times.  Thankfully it was all those good times that originally took me away.

I learned in these recent years that it is a good “work”/life balance that keeps me emotionally stable and functioning well.  Working too much or too little and I would find myself getting more depressed.  But once I hit that “sweet” spot of about 25 hours, it gave me the right amount of time to volunteer and spend time with family and friends.  I had reached a point of wellness with my depression.

During that time, I spent my volunteer time essentially doing intensive casework with two gentlemen with disabilities.  Some days it seemed more like work than just something I enjoyed doing; that’s when going to work became my “down” time.  For over a year, I “worked” with my two guys and “relaxed” at work.  This was the most fulfilling my life had felt.

Slowly, though, I volunteered my way out of helping my guys.  The first guy finally got set up with an official case worker that worked well with him.  The second guy, after I did all the hard things for him, decided he wanted to do things on his own.  It’s with mixed feelings that I admit that he hasn’t completely messed things up yet.  Regardless of the reasons, I knew once my time with my guys lessened, I had to pick up something else or the depression was likely to come back with a vengeance.

I reached out to two difference agencies offering my time and skills.  I had a meeting with one of them and we made a plan for what I would do.  For whatever reason, that person just really didn’t want to be as aggressive as I did, and that fell through.  The second agency just didn’t get back with me. Honestly, I think I intimidate some of the people at that second agency based on some past interactions.  Either way, it was their loss…and ultimately mine since I was really counting on these opportunities and took it personal when they fell through.

sink draining

Imagine a sink draining.  At first it seems to drain very slowly; but as there is less and less water, it seems to drain extremely fast.  That’s kind of what happened earlier this year.  I was on a slow spiral down into a deeper depression and all of a sudden I found myself not leaving the house except for therapy and the grocery store.

Besides not volunteering, I started missing more work due to PMDD, Premenstrual Dysphoric Disorder.  Then I got diagnosed with Inflammatory Bowel Disease.  So, less work + more stress = increased level of depression.  By the end of July I found myself inpatient in a psychiatric unit for a week.  When I didn’t see any improvement two months later, I checked myself into an Intensive Outpatient Program (three hours of group therapy, three days a week).

So that’s where I am now.  Once IOP is complete (12 sessions), I do have some volunteer activities lined up to keep me busy for a bit.  Before I know it, it will be Dec 18 and I’ll be having my hysterectomy to help with PMDD.  I’ll share more on that next time.