PMDD

[miamiamia869]

Anybody have PMDD who could help. I am convinced I have this and have been for a few years. The weeks coming up to my period I'm like a completly different person. I feel in a black hole with no desire or energy to do anything. The rage is completly out of my control I feel deeply sad depressed like I'm balancing on a nail in the middle of the ocean in a storm. It is dark and all I can think is "I want to die I wish I could die right this second. Without reasoning. I know the real me does not want to die, I know I would never leave my baby and I know deep down i will feel better for a week before it starts again.

When I was pregnant I had none of this. I was happy for 9 solid months. Each month since birth it's getting worse.

What can be done to help I am someone who hates any form of medication so anti depressants I don't want. I won't do therapy and I also won't go on a pill. Clearly my hormones are already messed. I want to go to the Dr for help but also too scared to take anti depressants. If I could I'd have it all out tomorow. I have my baby I won't be having another I don't need it. It just ruins my life.

So treatment options are the pill or mirena coil - which I would really recommend

However, if you don't want to go that route, then the other main treatment is a medium dose of antidepressants from after ovulation to when your period starts again. Anti-depressants are often life changing for this, and the benefit from taking them compared to not, is huge. They are perfectly safe if you have worries ask those specific questions, and ask for the most detailed information from your GP.

PMDD is caused by an abnormal brain response to normal hormone fluctuations, particularly in the luteal phase, when progesterone levels fall sharply. In PMDD, the brain’s sensitivity to these hormonal shifts is greater than in people without PMDD, which is why the pill or Mirena can help by stabilising hormones (the Mirena often works better).

It’s also why SSRIs are the most effective non-hormonal treatment, because serotonin levels and receptor sensitivity are biologically affected more than environmentally or due to a traumatic event etc contributing to rage, anxiety, low mood, and suicidal thoughts. SSRIs work directly on this serotonin dysregulation.

Therapy can however be extremely useful to compliment antidepressants, especially for coping strategies, emotional regulation, and relationship impact.

Why don't you want to go on antidepressants? Do you not think they are safe, or is it the stigma about it or or doubts they’ll work? It’s important to talk that through with your GP because the evidence for SSRIs in PMDD is very strong, and leaving PMDD untreated carries real risks; relationship breakdown, job difficulties, and suicidal thoughts. The risk of it continuing over you not treating it because you don't want to take antidepressants, is much greater than the risk of anything from the antidepressants.

Depending on your age, I'd ask your GP about starting a low dose of vaginal oestrogen as well to help with the low libido, energy etc. Then get a good vitamin D and vitamin B6 supplement, to help with the emotional side and cognitive/brain fog issues as well. Take it every day, but definitely in the week leading up to and during your period.

You can self-referral to local IAPT for therapy or or via your GP. If symptoms are severe, which they sound like they are, ask your GP to refer you to psychiatry or perinatal mental health services as they are very equipped with PMDD. Perinatal services will treat you even if you don’t want to get pregnant, as many perinatal mental health teams also manage PMDD and hormonal mood disorders outside of pregnancy.

I've attached some links which should be useful on treatments you could have. The first is about getting a diagnosis.
https://www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/getting-a-pmdd-diagnosis/https://www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/treatment-for-pmdd/

@TheLivelyViper thanj you so much for your response I was not expecting anything on that level of expertise but just reading it has felt like a form of release.

The reason I don't want to take anti depressants is more a form of being stuck on something un natrual for life. I have never been on the pill or anything as I have a bit of a fear of putting stuff in my body that nature didn't put there. I have had vaccines and take Paracetamol and eat a huge amount of crap so I'm far from a conspiracy theorist type person. it's nothing like that just a kind of want to keep things as un medicated as possible. I guess mainly fear of relying on it for life..

I am going to have a read through of your links and research some of your suggestions and strongly considering a trip to the gp. It has ALWAYS massively affected work and relationships and my life but I have a baby now and feel so unfair when I am like this around him. Plus the stress of motherhood hitting the pmdd is like fuel to a flame!

Honestly thsnj you so much xx

Antidepressants are simply promoting your body to take up more of a natural chemical in your body, which is serotonin. Also you aren't stuck on them for life that is a myth, some people take them for years, then stop, others don't. Its all relative on the person and their situation, but even if you are on them for decades it is harmful or unnatural, those ideas are just spread to bring a sense of shame around a medication which is tested numerous times, in blind trials for years, and peer-reviewed science, and that us before even considering all the other meds people take for years and for life which don't receive anything like the same stigma.

It's better to actually life a healthy life, be happy, not put yourself at risk of further mental harm (SI, job loss, trigger other mental illnesses etc) than obsess over something 'unnatural' which as I have said is actually natural anyways. This us the same for the pill or mirena btw, it increases your progesterone which many women actually need because they need higher levels, or their body already has lower levels. But progesterone is a normal and natural hormone, and being unmedicated is not necessarily better than being medicated, for many conditions. If you have further questions many just ask your GP (ask them to convince you or just to explain it, because they actually are experts and can give you reliable, scientific info which is likely the better path so you can make an actual informer decision). But right now you aren't doing that because some if the info you've said isn't accurate and its only right to have a fair picture of all the outcomes from someone with expertise. They won't criticise you either, they'd rather you actually asked because then you can make an informed choice.
But not even being willing to try meds, on the basis of staying unmedicated = healthier, or better, is really lacking a lot of nuance and depth.