Premenstrual Dysphoric Disorder (PMDD) is a severe mood disorder which affects approximately 5.5% of people assigned female at birth. PMDD is a suspected cellular disorder in the brain causing severe negative reactions to normal fluctuations in estrogen and progesterone. Similarly, premenstrual exacerbation (PME) of an underlying disorder can also occur, wherein the symptoms of conditions such as bipolar or even diabetes are made worse by normal fluctuations in hormones. Living with PMDD can be extraordinarily isolating. The symptoms are inherently disruptive to interpersonal connection, and challenge our ability to socialize and maintain relationships. There is already little space to talk openly about psychiatric illness, much less about those based in the female reproductive cycle. The long history of the hysterization of women, and the continued normalization of female suffering compound the misunderstood nature of this topic. But PMDD awareness is suicide prevention, and gaining support, community and the ability to talk about the impact of one's cycle is absolutely critical to managing it. The experience of living with PMDD without sufficient treatment is one of ever increasing powerlessness over our ability to feel okay, an experience which amounts to consistent monthly or even bi-monthly re-traumatization. We may feel as though we are held hostage by our cycle, waging an endless war –increasingly depleted of the resources and the will to keep fighting.

In order to treat PMDD, it is necessary to address the biological, psychological and social aspects of this disorder. This might include finding a helpful doctor or psychiatrist who can prescribe appropriate evidence-based treatments, setting more realistic self-expectations, building your schedule around your cycle, learning to advocate for your needs and boundaries with your partner, friends, family, and employer, practicing radical self-compassion, developing coping skills, creating a individualized PMDD support plan, and healing trauma incurred from living with this disorder. Further, many individuals with PMDD have dual diagnoses (ex. PMDD and ADHD, PMDD and PTSD), and addressing those additional challenges is critical to managing life with PMDD. Therapy alone is inadequate to manage some of the biological realities of PMDD. Conversely, medication alone cannot address the trauma incurred by the experience of living with PMDD, provide compassionate understanding or help you explore the coping skills necessary to successfully manage this condition long term. As a counselor living with PMDD myself, I am ready to meet you where you are, to validate your experience, and to support you in finding grounding, meaning, and direction as you steer your ship through the storm that is PMDD, towards a life that is not only tolerable, but truly worth living.