How do I manage PMDD and bipolar? TW feeling suicidal

[Lolarowan]

I have PMDD and bipolar. Because of the bipolar I can’t take antidepressants, they make me manic without fail. The pill makes me rage and gives me acne. I haven’t tried any other contraception but from my experience with the pill I doubt it would help.

My PMDD is severe and every month I have 1/2 weeks of lashing out at everyone I’m close to, damaging friendships, deep depression and self hatred. This past week, I have caused irrevocable damage to my relationship with my best friend and I’ve emotionally terrorised my parents. I absolutely fucking hate myself for it. Some months are worse than others particularly if my period is late, and right now I’m feeling suicidal. I have a toddler so I can’t feel like this.

Im honestly this close to breaking. I don’t know what to do anymore. I don’t feel like I can cope. I have a lot of stress right now as I’m also doing professional exams so I can’t just check out. Please does anyone have any experience with this and any advice?

There's some information on treatment here for PMDD. Is your bi polar controlled? Have you tried DBT in order to help with emotional regulation?

My advice is to go back to your GP and let them know about your suicidal ideation. You can contact NHS Direct option 2 if you feel like you're in crisis.

You can contact the Samaritans or CALM; they have a webchat and helpline.

The bipolar is controlled but the PMDD can trigger bipolar episodes so it’s all such a mess. I haven’t tried DBT. I would go to the GP but as I’m a single mum when I did that before they have to speak to social services I think so I’m wary of that. GP has offered the pill, and sertraline and escitalopram both of which made me manic. Sertraline did help me and made me feel like there was a barrier between me and my emotions which was amazing, but the longer I took it I inevitably ended up going manic and had an episode in November. Since then it’s been a comedown and this months PMDD has been genuinely intolerable, I don’t know if I can live like this anymore

Ideally you need to see a specialist and your GP sounds like an idiot. It's well known that people with BP can't take SSRIs. Do you have a psychiatrist? I would change GP.

I will go back and ask if I can see a hormone specialist I think.

right now I feel like I need to be in hospital. My head is dizzy and sick and I cant concentrate on anything. I feel like I need to be unconscious for a very long time.

any tips on getting through PMDD

Are you close to perimenopause because some people find hrt helps for pms? Have you had a look at the work of dr john stood? Can you take anything off your plate at the moment to priortise your health?

No im in my 20s. I will look into that thank you. I have childcare so theoretically I should be fine to study all day til exams but being alone with my own thoughts is making me feel more ill.

I would contact NHS Direct. Explain about the suicidal feelings and that you feel overwhelmed.

Do you have any support? Please contact a friend or relative for your child.

My advice is to change GP and see about a referral to a specialist. A psychiatrist can advise on appropriate medication.

I have pmdd alongside unsupported/undiagnosed Autism and Adhd (until recently) and I know exactly how you feel in the PMDD week of hell. I am lucky enough that I can take Rigevidon plus Sertraline, but wondered if you could put things in place for the luteal phase until you get better meds/support?

The pill makes me rage and gives me acne. I haven’t tried any other contraception but from my experience with the pill I doubt it would help.

I read a bit about pmdd re. antidepressants being inappropriate (or at best not ideal) for treatment of it; because it's hormone/cycle related.

The appropriate treatment is apparently hormonal. If the (combined?) pill didn't improve things, it may be worth trying other possibilities like implant/injection....I don't know.
(I know you're pessimistic/apprehensive about other contraceptives but it might be worth trying other options).

I had bad pms, occasionally verging on pmdd, for years ... now - since taking tamoxifen due to a family history of breast cancer - I have virtually nothing. (It turns off estrogen receptors). I'm not suggesting you take it as I'm not sure you'd even be prescribed it without a family history of breast cancer and also because many women experience shit symptoms on it ....but I'm just mentioning the fact that a hormonal medication, as such, most definitely changed my pms.
So it might be worth continuing to look into what possibilities there are and whether any of them help.

The other thing that I felt affected pms (I know pms is extremely minor compared to pmdd but ...) is daylight, vitamin d, serotonin etc.

This time of the year is the worst because, presuming you're in the UK, you've been deprived of sufficient natural light for 5 months now.

We're all supposed to be taking vitamin d supplements and I found trying to get some natural light every day helped.

I think the best time is supposed to be around 11am.

*implant/injection.

Just thinking - probably not injection as it would be better to have something reversible/removable.

Several women online have recommended supplements for vitamin b6, magnesium, calcium, and iodine.

(I think B6 is one you have to be careful not to overdo).