Living With: Premenstrual Dysphoric Disorder

Sharing a life and a home with someone who has premenstrual dysphoric disorder can be a challenge if you are unprepared. The symptoms of PMDD, if left untreated, can be disruptive to the sufferer’s life and the lives of everyone she lives with. Fortunately, there are studies, treatments and support to help everyone cope with the disorder that can be debilitating. To understand how to live with PMDD, you must first know a bit more about the disorder and how it is managed.

How it Works

PMDD is more than a little bloating and cramping before a period. It is a mood disorder that accompanies the other premenstrual symptoms. The PMDD gets more severe as the period draws near, escalating the sufferer to a state of very high tension, anxiety and aggression. It enhances other coexisting mood disorders to complicate any treatment for several days during the month.
PMDD is thought to be a brain chemistry malfunction that is triggered by ovulation. Symptoms usually begin after ovulation and last into the first days of the period. This cycle repeats itself every month. PMDD is tied to the hormonal changes triggered by ovulation, so it does not occur without this part of the menstrual cycle.
The condition affects up to 8 percent of women. It begins any time after the first period occurs in adolescence and until menopause occurs.

About the Symptoms

The condition involves much more than a bad time during a period. It is cyclical, occurring at the same point in the menstrual cycle each month. PMDD does not take over the entire month, however. Each sufferer must experience at least 7 to 10 days of no symptoms to qualify as a true PMDD patient. Coexisting condition symptoms are excluded from this.
The symptoms of PMDD are severe and usually life altering. Doctors require sufferers to have at least five of the following symptoms to support a diagnosis:

• Depression of hopeless feelings
• Feelings of anxiousness, tension or edge
• Irritability that increases as period nears
• Oversleeping or insomnia
• Lack of interest in favorite things
• No motivation
• Loss of energy
• Difficulty focusing and concentrating
• Loss of control feelings, feeling overwhelmed
• Severe physical manifestation of PMS symptoms like tender breasts, cramping, bloating, muscle pain and weight gain
• Suicidal thoughts

Any of these five symptoms show up after ovulation begins. They intensify to the point of overwhelming the patient until the period starts. During the first or second day, the symptoms subside and the patient begins to feel normal. This lasts up to 10 days before starting again.

Coping with the Condition

Once diagnosis and treatment has occurred, work still needs to be done at home to alleviate symptoms until the proper treatment is found. Sometimes it takes two or three cycles to figure out if a treatment works. During that time, the patient and family can make changes to make the symptoms more bearable.
Lifestyle changes can help get rid of some of the factors that can intensify PMDD symptoms. Turning to a healthy diet, giving up cigarettes and starting an exercise regimen are just a few things that can help. Obesity, smoking and poor diets are all common complications for the disorder. By changing these factors, you can help alleviate some of the physical and a few of the mental symptoms of the disease. Making these changes may also help the depression, seasonal affective disorder and bipolar disorder that often coexist with PMDD.
Relaxation techniques can help alleviate the anxiety and tension that are common in PMDD patients. Yoga, meditation and soothing hobbies are examples of relaxation techniques that can help dial down the tension after ovulation begins.
Keeping a journal helps you to understand the condition while helping the doctors see into every day of the condition. A PMDD journal can help pinpoint the start and finish of your condition as well as the triggers for the more severe episodes.
Combat the depression and overwhelming feelings by interacting with family and friends in therapy or group meetings. Sometimes, just knowing that you are not the only one going through condition can help tremendously. Try online chat rooms and groups, public support groups and talk therapy to find the best venting option for you and your situation.
Above all else, remember that this is a disease of the brain, and the sufferer has no control over it. Simply being supportive and accommodating through the days when PMDD symptoms surface can help everyone.
Regular visits to the doctor and medication dosages are also important to having a safe home with a PMDD sufferer. Take all medications as prescribed, even if there are no symptoms. Some drugs have a cumulative effect on the body and must build in the blood stream to work. The doctor’s appointments are meant to check on your progress and to detect any new symptoms. Keep these appointments to maintain a stable treatment process.

Not a Simple Condition

PMDD affects many women in many ways, so no one treatment or coping technique is perfect for all patients. By taking charge of the condition during medical treatment, you can begin on the road to living happily with a person who has PMDD. It is a disease the affects everyone it touches, but modern medicine and a few coping techniques makes sure that those contacts are not incendiary. After all, they never should be. The doctor will want to look for other coexisting conditions that the sufferer may have. Keep these conditions in mind when trying to plan on a way to change your lifestyle and life to fit around your PMDD treatment.

For more on the topic of Living with PMDD, we’ve included the following expert consensus documents as reference materials:

• Premenstrual Dysphoric Disorder: A Guide for Patients and Families

View Resources

• Wishard – information about PMDD
• SPU – PMDD and issues of quality of life
• NYU – general info about PMDD
• WomensHealth – more references about PMDD