I don't know what to do about work (MH, PMDD related)

[JustSoHard]

I've NCed for this. I don't know where to begin but really appreciate you reading this and maybe offering some support.

I suffer from PMDD and some months, pre-period, I'm absolutely crippled with anxiety and sometimes suicidal. So much so that I can't manage to leave the house to go to work. Despite seeing numerous specialists (gynaecologists and psychiatrists), the only thing they can offer me is anti-depressants.

For background, I've been on them at various points in my life when depressed but after spending many years in therapy I no longer suffer from depression, just PMDD which is hormonal. I can't take the pill (TTC, plus it sends me crazy) and I really don't want to take ADs for the rest of my life when I'm not even depressed (plus I had a terrible experience with SSRIs). I am healthy, sleep enough, etc, but it makes no difference.

So here is the thing. I am self-employed and my job involves being very "on". I go from office to office, training people so there is no hiding and my job depends on me being dynamic and charming. Some days I just can't face it and end up calling in sick. You would think it would be easier because I'm my own boss but, although I can afford to take some time off, I hate that they may think of me as flaky and I hate letting them down.

Anyone who knows me thinks I seem very put together and professional, and I love and am great at my job, but inside I feel pathetic and weak, like I can't cope with life. The only light at the end of the tunnel is getting pregnant for some PMDD respite, which is proving difficult tbh.

I took off a week with anxiety a few months ago and I take the odd couple of days off every few months because of this. I have to make up a different illness every time. I've thought of signing myself off for weeks/months (I'd have no income) but I might lose my clients and also there would be no point because this happens every month because of my PMDD.

Really I just wanted to know if anyone has been in a similar position. I've read a lot about people signed off work for months but does anyone feel so bad mentally every month/few months that you can't face work and, if so, what do you do?

I feel so alone in this and don't know how to cope.

I'd really love to hear from anyone who has any kind of recurrent MH issues that means that you can't face work regularly, not just PMDD.

Anyone?

Hi there, I'm not in exactly the same boat, but not too disimilar. I've had depression off and on since my teens. It is particular bad premenstrually and I went through trying the pill and various supplements to damp it down.

When pregnant with my second child I went back into antidepressants and while I have changed through various different types in still on them 6 years later. I've tapered them down as much as I can, but in order to keep functioning in the way I need to, to juggle work, kids etc, I've accepted that this is what I need to do.

When I reduce the dose too much the impact on how I cope with life is quite apparent, and if I could live alone on a desert island I could probably survive with my moods, the reality is that I don't!

Mindfulness has been the other factor which I have found helpful as a non medicinal option, it takes practice, but it's worth the investment.

Thanks so much for replying tatyr. Were there any times when work was just too much for you or did you always manage to face it?

I always found work to be a helpful thing to me as I feel better when I am doing things. There were a few times when the doses of my AD's were being changed that I found I was not able to focus enough or was not able to pull myself together enough.
As I worked in the NHS I was always very open with my line manager about my MH difficulties because I am in a patient contact job and if I was not up to scratch I would want then to be able to know why/support me/send me off sick. It was like a safety net.
If you are self employed it is obviously more difficult. Are you able to schedule your work so you will have an easy week/not client facing when you know you're going to feeling rough, but you can crack on in the weeks you feel best?

Would you be willing to give a different sort of antidepressants a go?

That's great that you could be so open with your line manager when you were really struggling. I actually feel that work can be helpful for me too but it's the thought of going in that absolutely cripples me with anxiety. I've been known to have panic attacks on the way out my front door or when arriving. There are no negative thoughts, no catastrophising, just a physical and mental block that makes me feel I can't face it and would rather die. It only happens before my period though - normally I'm fine!

I've thought myself about whether I could not work during my premenstrual week because I'm so desperate that I'd rather do that and have it structured than have to call in sick anyway. However, the training I give is in weekly sessions so I couldn't miss them, they have to go with another supplier.As it stands, I normally have to make up the ones I miss on another day which is really stressful so I try to miss as few as possible.

I took Mirtazapine for years which worked much better for me but SSRIs are the ones recommended for PMDD and also pregnancy. Unfortunately, I had horrendous side effects for the first month on Sertraline, a hideous withdrawal and other side effects like stuttering, confusion and dizziness which aren't good in my line of work!

At the moment, I'm close to giving up my job and living off savings but DH is convincing me that all will be well by Monday when my period comes. Until next month, that is...

That above post was done by me!

NC fail.

Hi OP, I too think I have PMDD (self diagnosed) and it has got worse over the past year. I am just trying sertraline (only a week in) to see if it helps as was wary of progresterone/pill.
It is awful and has left me dreading 2 weeks out of the month. I don't really have anything helpful to add I'm afraid!
I had seen on these forums that there are private consultant gynaes based on London that specialise in severe PMS but it is so expensive to see them I am trying SSRIs first. Did you have any luck with gynae investigations?

It's so nice to hear from someone who is going through the same as me! Although I'm so sorry you have to put up with it too.

All the specialists just refer me to another one, i.e gynae to psych and psych to gynae. They have nothing to offer except the pill and Sertraline. I tried both but can't go back to them so that's that. I just have to live with it.

Do you always manage to face work when you're premenstrual?

Btw, I hope Sertraline works well for you. Most people seem really happy with it.

Maybe a bit too alternative for you, but I also had some success with Chinese herbal medicine with regards to the PMT I had. Not sure if the effectiveness if you have severe pmdd but may be worth considering.
As the Chinese medicine system is completely different it does take some getting your head round (I had damp heat in my liver!) But it is particularly good for menstrual issues.

I really appreciate the idea, tatyr. I never considered Chinese medicine but anything is worth a try!

It is also quite effective for some with TTC issues x

Hi, I know this is an old post but I’m you! Please if you find this message can you tell me if you ever found peace, I was searching and searching for someone in my position, this is truly breaking me, even down to the ttc, iv also been off work with this condition, then you have to face going back to work, please if you find this message plz reply as I know you understand me!