To ask how you know it was PMDD and not PMS

[Calvinlookingforhobbes]

Just that really. Thanks

Sorry what's PMDD?

The intensity of my negative thoughts, suicidal thoughts, anxiety, extreme rage, no concentration everything just very extreme. Crucially it only ever started about 10 days before my period and would build up until immediately stoping as soon as my period started. I'd have 2 'normal' weeks feeling good again before the negative thoughts etc started building up. It was really intolerable. Before I was sure I kept a diary for about 3 months of 'symptoms' and clearly showed it was all related to my cycle. I'm on sertraline now and it's literally changed my life.

Very much what @Yaty said, but I had terrible paranoia and no rage. It was just awful and totally unlike me.

I second @Yaty. It's the intensity of rage, anger, depression and inability to concentrate in the few days before your period.

My reactions to what should be minor setbacks or annoyances were disproportionate during the 5-7 days leading up to my period. Then my period would come and I would be rational again.

I am not menopausal (I am in my 30s), but I have HRT to manage it, as ostrogen levels can reduce the severity of PMDD symptoms. It's worked fantastically well for me. They won't prescribe HRT for PMDD on the NHS though, so I have to go to a private clinic in London.

Following this. I'm pretty sure I have PMDD but although I've said it to a few GPs they've never explored it. I was on sertraline for years, my moods had always been very cycle linked but then other things happened breakdown etc which took over.

I've been off medication for a while now but struggle. The GP just suggest a different SSRI but tbh one of the main reasons for coming off was the lack of sex drive and inability to orgasm on them so I can either have flatter, less pronounced mood swings and no sex or I can be mental but have sex.

I relax completely into a normal person the instant my period starts and I'll be OK for a bit. Then around ovulating I get bone tired, absolutely exhausted and drained to the point other people notice, colleagues tell me I look peaky. Then I get really weepy and cry constantly, can't think or talk about anything emotional without crying. Then the intrusive thoughts, I can't drive without seeing myself crashing straight into the car coming towards me, or the pedestrian on the pavement falling in front of me. I can't walk down the stairs without seeing myself crumple and fall. I get vivid, exhausting dreams, the kind where you wake up feeling like you've run a marathon or full of anger and rage because you were arguing in your dream. Then I get really tense and angry with an incredibly short fuse. Because my periods like to play silly buggers this can last a while but at least it is the last stage. In an un PMDD related note It will be accompanied by bloating, farting like crazy and pooing a lot. The farts will be the most foul smelling things you have ever encountered. I'll get cramps too. Sometimes that stage can last a week just to completely take the piss.

Then the period starts and all of a sudden I'm a perfectly reasonable human with a balanced mood and decent energy levels. Even though my entire uterus will be getting to turn inside out and I'll be soaking through my protection.

I was prescribed Prozac for the two weeks before my period and it worked wonders. Seemed to reset something, and I was only on it for a while. The relief was incredible

Has anyone found contraception to help?

I use the pill and escitalopram (low dose of 5 mg). It works really really realllllly well (just ask my DH and DC). I am so glad that it works and I can take it. Wish I had seen a GP earlier.

It took me ages to realise that not everyone had such extremes of mood it wasn't a matter of needing to pull myself together and cope better. I had a friend who also had extreme PMS and that encouraged me to go to the GP. I only have a 23 day cycle so that was 1 week of nightmare moods, 1 week of trying to fix the damage and 1 week of normal life. I was given antidepressants and it was amazing, I had a stable baseline for once!

Hm good question. I do not get classic PMS at all, never had any PMS or period problems at all. My anxiety hits the roof for 2 weeks and takes a week to get my life back on track afterwards so only one normal week. I think PMDD is much more extreme. My GP has a special interest in PMDD and I take sertraline 2 weeks out of 4 which has been life changing. You take a far far lower dose than you would for depression, and they don’t know why but it is shown to really help, my doc say. Obviously won’t he’ll EVERYONE but a lot of people including me!

*extreme than PMS I mean

How does that work taking sertraline but not all the time? When I'm on it it takes me several weeks to get over the side effects of starting or increasing my dose.

@OakleyStreetisnotinChelsea

Following this. I'm pretty sure I have PMDD but although I've said it to a few GPs they've never explored it. I was on sertraline for years, my moods had always been very cycle linked but then other things happened breakdown etc which took over.

I've been off medication for a while now but struggle. The GP just suggest a different SSRI but tbh one of the main reasons for coming off was the lack of sex drive and inability to orgasm on them so I can either have flatter, less pronounced mood swings and no sex or I can be mental but have sex.

I relax completely into a normal person the instant my period starts and I'll be OK for a bit. Then around ovulating I get bone tired, absolutely exhausted and drained to the point other people notice, colleagues tell me I look peaky. Then I get really weepy and cry constantly, can't think or talk about anything emotional without crying. Then the intrusive thoughts, I can't drive without seeing myself crashing straight into the car coming towards me, or the pedestrian on the pavement falling in front of me. I can't walk down the stairs without seeing myself crumple and fall. I get vivid, exhausting dreams, the kind where you wake up feeling like you've run a marathon or full of anger and rage because you were arguing in your dream. Then I get really tense and angry with an incredibly short fuse. Because my periods like to play silly buggers this can last a while but at least it is the last stage. In an un PMDD related note It will be accompanied by bloating, farting like crazy and pooing a lot. The farts will be the most foul smelling things you have ever encountered. I'll get cramps too. Sometimes that stage can last a week just to completely take the piss.

Then the period starts and all of a sudden I'm a perfectly reasonable human with a balanced mood and decent energy levels. Even though my entire uterus will be getting to turn inside out and I'll be soaking through my protection.

This is exactly how I feel! I’m quite sure I have PMDD but not sure how to go about getting a diagnosis / treatment. I have taken sertraline in the past and really didn’t get on with it so am reluctant to try that again. I feel like I need something hormone related rather than an antidepressant.

When I was having IVF I had to take some drugs which essentially switched off all my hormones and I have never felt so good in my life! I have wondered whether it’s possible to take something like on a permanent basis but when I have spoken to the GP about it they just try to push me towards sertraline again.

I can highly recommend two weeks of Prozac 🤷🏻‍♀️

Can I ask how you all went about raising this with your doctors? I'm pretty sure I have pmdd and it's actually ruining my life, for half the month I'm basically a monster and now it's affecting my children. They shouldn't have to live with Jackyl and Hyde for a mum but every time I try to picture bringing it up with the doc I realise I don't know where or how to start.

@ByGrabtharsHammerWhatASavings try keeping a diary of mood any symptoms etc for a few months. If it's pmdd then you should see a clear pattern related to your cycle. Then you can take it to your gp and show them. Mine was really good when I went in, I think it is becoming a bit more well known about now.

Prozac here too and it was life changing and progesterone suppositories as well.

@OakleyStreetisnotinChelsea

How does that work taking sertraline but not all the time? When I'm on it it takes me several weeks to get over the side effects of starting or increasing my dose.

In the words of my GP, they don't know why yet, but it does!

I only took 25mg, so half a tablet, for 2 weeks, so as I mentioned before, so a much lower dose than for other ailments. I did have side effect of dry mouth but it gradually wore down every month. I'm pregnant now so not taking it hence past tense.

@ByGrabtharsHammerWhatASavings , my GP was useless when I tried to explain that I thought my mood issues were hormonally driven and related to my cycle.

In my case, my issues arose when I came off the combined pill. I had had some depression and anxiety in my teens and thought that I grew out of it, but it appears that the ostrogen in the combined pill that I started taking at 18 was actually preventing the monthly extreme mood issues from PMDD.

I had been on the combined contraceptive pill from the ages of 18-30. However, I was told by my GP that I had to change to the progesterone only pill around the time I turned 30 because new research had come out about the risks of developing a stroke if you were on the combined pill and suffered from migraines.

My mood and mental state was dire on the progesterone only pill (unsurprising, as PMDD sufferers get their symptoms due to an unusual reaction to the spike in progesterone in the days or weeks leading up to menstruation). I went off the progesterone only pill, and got some relief (my mood was no longer constantly extreme) but then began to notice the cyclical depression pattern and the link to my menstrual cycle.

I explained the cyclical pattern to my GP, how I had felt much better on the combined pill, and I really felt the problem was hormonal. He ignored this completely and tried to push anti depressants on me. I refused, identified a private clinic in London where the doctors actually did academic research on the hormonal drivers of PMDD, and have been treated by them with HRT ever since. It's expensive, but worth it to have my mood be far more stable with minimal side effects.