PMDD is real

Living with PMDD: PMDD - They Only See Our Failures

2012-01-14T22:36:00.000-08:00

I read the post I linked to below at Living with PMDD earlier this week and ended up with tears running down my face, because it's so true. No matter how hard I try to stay "normal," to keep it all under control, to be always perfect — I will fail, simply because I'm human and I have PMDD. And people who only see those failures must think I'm batshit crazy, bi-polar, or just incredibly unstable and untrustworthy.

And trying to act "normal" when I feel anything-but is exhausting.

This is definitely worth a read: Living with PMDD: PMDD - They Only See Our Failures. As is the rest of her site — this woman can write!

I especially appreciated this part:

... silently we slog through our PMDD days, knowing we feel fragile inside, but with no visible way to communicate that to the world—other than our emotions. All through our lives, we’ve been socialized to believe emotions are bad for everybody but actors and actresses.Real people need to suppress their emotions. Emotions get you in trouble. Emotions are counterproductive. Emotions are messy and scary. Don’t make a scene, don’t make a fuss, don’t get hysterical, and for God’s sake, don’t ever cry.
...
Anger is the accepted emotional outlet for men, but there is no acceptable emotional outlet for women. Women are not supposed to get angry. If we get angry, there’s something wrong with us—we’re being countercultural. Little girls are sugar and spice and everything nice. Women who show anger are frowned upon, called all sorts of derogatory names, dismissed, discounted, deterred and destroyed, one way or another.
And so most women turn that anger inward, where it manifests as depression.

This reminds me of a quote from Albert Einstein that I heard this week for the first time:

"The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift."

Also from the end of the post:

... even when I make it through 90% of the day without weeping or snapping or snarling at someone, even when I’ve spent the day protecting others from myself and my moods, moods I have as much control over as I would an allergic reaction, even when I’ve done everything I can to make sure I don’t ruin their day…
There’s always the chance the dam will break.
And that is all they see.
Do not let anyone define you by your failures. It’s not right, it’s not fair, and you wouldn’t do it to them.

Thank you, Liana. Thank you for speaking for us and with us. You made me at least 1% braver about speaking more openly about PMDD. And you reminded me that I am not my PMDD.

How common is HSP + PMDD?

2012-01-09T07:00:00.000-08:00

I'm curious and would love input on this post in particular.

Several years ago, a therapist introduced me to the concept of the Highly Sensitive Person, a term coined by Dr. Elaine Aron. (For detailed info and an HSP self-test, see www.hsperson.com.) Since then, I have been constantly rediscovering how this sensitivity impacts my daily life.

I had no idea that I was more sensitive than average, although throughout my childhood my Dad would say things like "You're too sensitive! Don't be so sensitive!" Gee, how could I miss that? I could never deal with teasing, even meant with friendly intentions. I can't watch movies with violence or suspense — or if I do, I have to plan a lot of recovery time. I have a hard time getting to sleep, and I do not thrive under sudden pressure (although I can kick a deadline's ass if I know that it's coming up).

I've learned to plan at least one weekend day where I don't have to leave the house if possible. A friend recommended some excellent ambient nature music on Rhapsody, which I listen to at work on a regular basis. Being HSP also explains some of my reaction of caffeine. I'm constantly developing new coping, soothing, and pre-emptive calming methods. I've discovered that taking a bath will completely re-set my day. (Water is extremely soothing, at least to me.)

So I'm curious how many other women with PMDD are also HSPs, and how it affects your life? I'd love to talk to other women with this particular confluence of biology.

And as a last note, I just read this article on "survival tips" for HSPs. Enjoy!

Hooray for feeling better.

2011-10-10T10:31:00.001-07:00

The excellent news is, bupropion SR is effective and I feel like I'm back to being really "me" again. The less excellent news is, I still have to deal with PMDD and anxiety on a regular basis. It will never just go away.

Also on the good news side of things, my current therapist is so helpful, practical, and warm. Such good suggestions and analogies. She repeatedly reminds me that PMDD and being HSP are not character flaws, just biological facts. Latest example: in response to my realization that I often believe I should just suck it up, quit whining, and power through PMDD/sensitivity, she asked me, "You have fair skin — would you go out in the sun and just try to 'power through' a sunburn? Just 'suck it up'?"

I've also started taking 2.5-5g of diazepam on days when the "emotional sunburn" is just too overwhelming and/or I can't get to sleep because of PMDD + anxiety. I've had to retrain myself to be more willing to take it — I was trying so hard to prove that it wouldn't be a problem (i.e., I'm not going to abuse drugs, ever), I didn't take it when I needed to. I'm getting better at realizing I should take it before I'm a weepy stressed-out mess.

So hooray for all of that. Not 100% better, but a significant improvement.

Thiamin & Riboflavin — from food, not supplements

2011-09-09T13:39:00.002-07:00

A study published this year concluded that "Intakes of thiamine and riboflavin from food sources were each inversely associated with incident PMS." Meaning, women who eat foods rich in thiamine (B1) and riboflavin (B2) had lower incidence of PMS symptoms.

Note, food sources, not vitamin supplements. B vitamin intake from supplements was not associated with a lower risk of PMS.

This article recommends these food sources:

Red meat
Legumes (beans)
Milk
Enriched bread and rice
Oranges (thiamine)
Green leafy vegetables (riboflavin)

I'll do some more research on foods that are rich in these two vitamins later, but what a find. No wonder my B-complex supplement never seemed to help!

ETA: This site has long lists for B1-thiamine and for B2-riboflavin.

Yeah, it's been a while...

2011-08-04T16:28:00.003-07:00

It's been quite a while since I've posted regularly because it's been a really tough year.

I still have a job (and I know I'm lucky to have one), but the economy has definitely hit our company fairly hard, so I spend a lot of time (too much) worrying about my job security and money. At the same time, the nature of our client engagements has changed, so my job is nowhere close to as satisfying as it was when I started working here. I still like the people and the company, but I do wish I could do "real" work again. So I'm alternately happy to have a job, and frustrated to be doing unsatisfying work. But — I know — I have a job, I should be grateful. Guilt trip #1.

I'm also still 50 lbs over my previously-average adult weight. We adopted a dog so that I could go on walks with him to help me be active, both for weight issues and because exercise helps with mood, right? Except that he was not socialized as a puppy, so when we encounter a stranger or especially another dog, he goes a bit nuts. If we encounter an unaccompanied, off-leash dog, all bets are off, and I'm terrified someone will get hurt. So... solo dog walks are rather anxiety-inducing, and I just don't go out with him by myself. Guilt trip #2.

Between the cost and time commitment of dog training, seeing a therapist, and rehearsals, I decided to quit my voice lessons, which were going really well. Then I had to quit the dog training sessions (we did make a lot of progress), and now that rehearsals and shows are over, I'm trying to really focus on getting better so that I can get back into the activities that I love (next year or ... whenever). I've been focused on planning our vacation coming up, and once that's done, I think I will be able to think about some alternative activities: piano, volunteering, etc. But first, get me back to some measure of equilibrium.

It's so frustrating to constantly have to plan around the 7–10 days of PMDD, to make sure that I get enough sleep, have snacks, don't have to do anything too demanding, etc. It's exhausting to try to "keep it together" while I'm around other people, and then if I do lose it, there's no pulling it back from the deep end... As you can tell, I'm tired.

I've been seeing a therapist regularly since February, which has been helpful, and I started looking for some pharmaceutical/natural support options. The hard part is, most SSRIs cause weight gain. I tried St. John's Wort, but it didn't do the trick. My ARNP had me try lamotrigine (Lamictal), which is actually usually used for bi-polar or seizure disorders, but she said it can help with depression, too, and doesn't cause weight gain. It didn't help.

So now I'm seeing a specialist in mental health and psychoactive medications, and just started (today) on bupropion (Wellbutrin SR), with clonazepam (Klonopin) for "emergency use" on the 3-5 days per month that my PMDD+anxiety* are unmanageable. I'm hoping this will get me back on an upward trend, so that I can get off the twisted merry-go-round of worrying about my job, my weight, money, the dog, the world, etc. I'm going to continue seeing my therapist for the forseeable future, but expect that a time will come when I'm back to balanced, and better off than before. Fingers crossed.

* Seriously, how did I get to age 34 without realizing I had anxiety? I think my depression overshadowed it, and I was always just trying to feel not-sad without realizing that anxiety was there in addition. It's really become evident to me after my therapist was able to provide a highly believable answer to the "Why me?" question I've been asking myself since 5th grade. That question was one of the most pernicious roots of my depression, and now that it's been dug up and addressed, I'm able to focus on some other roots that I didn't even know were there, like my constant level of stress caused by unrecognized anxiety. Whee!

The "Cycle Diet"

2011-04-17T11:31:00.000-07:00

I've wanted to read the information on TheCycleDiet.com for a while now, and finally made time to go through all the pages. The most enlightening information for me was the page about Carbs and Depression, and how our bodies process amino acids, including tryptophan (which becomes serotonin).

I also went ahead and bought the The New Cycle Diet Weight Loss Program Workbook, but haven't had time to sit down and read it. My impression, though, is that I need to focus on getting the right vitamins, minerals, and especially complex carbohydrates. And surprisingly, less protein, not more. Counter-intuitive, but hey, what I'm doing now isn't working...

Although — I've been making lovely strides in the area of depression (through seeing a therapist), and because a friend recommended the book Women, Food, and God by Geneen Roth. I highly recommend this book to EVERYONE. It has been life-changing for me.

Keeping caffeine at an absolute minimum (not terribly difficult for me, since it doesn't agree with my system) has kept me off of SSRIs, and keeps my PMDD down to a more PMS-like level. But it still makes me weepy, irritable, and unstable, which is no fun. I want to get my symptoms to less than 10%! Right now, I'd say they're about 30%. Considering they used to be 100%.... improvement is good.)

PMDD and "down days"

2010-07-27T15:22:00.001-07:00

I've been successfully losing weight on the The Johnson UpDayDownDay Diet™ — last summer I lost 20 lbs, and I've lost at least 4 lbs since the end of June 2010. (Winter is tough — not enough daylight to walk the dog.)

But I've discovered that eating nothing or next-to-nothing, as I've been trying to do, is not a good strategy for PMS down days. Last Friday and Sunday I had major, distressing, crash-y, crying jags. I felt awful.

So I need to find snacks that are high-protein, low-calorie, and taste good. Next to impossible... So far I've settled on nuts or jerky. Today I've had V8 and crackers, some Mint Medley tea (like candy for down days!), and later I will have some cheese and cherries, and maybe yogurt.

But next month (in a few days!), my husband and I are going to try cutting out dairy to see if I/we have any allergy there. Which means no yogurt, unless I want to spend more for goat milk yogurt, which I don't even like. But I can still have goat cheese (which is also more expensive... boo hoo). Better than no cheese at all.

Yep, still got it... and not in a good way.

2010-06-15T07:24:00.004-07:00

Caffeine sensitivity rears its ugly head again.

I went to Colorado to visit my best friend, and while there, we went for afternoon tea. I figured one afternoon of black tea couldn't ruin me (could it?) and ordered the China Rose Petal tea that our server recommended. It was so yummy, I took home 2 ounces of it. And the past few weeks, in an attempt to have successful "down days," every other day I've been having a 16 oz mug of China Rose Petal or Earl Grey. (The last few days, I had decaf Earl Grey, but still.)

Aaaaaand... Saturday: a good, if intense, morning; okay afternoon; drama-soaked (watching SYTYCD Vegas results) evening. Sunday morning = bad bad BAD day. The closest I've been to a crash in a long time. Seriously — teetering on the edge of the abyss, this close to the whirlpool of I-hate-myself-nothing-will-ever-be-okay-I-want-to-die.

My voice lesson (or rather voice teacher) on Sunday helped; he helped me pull out of it by being quite complimentary and encouraging. I managed to pull myself back together and go to a social event in the evening in a fair mood with a good act.

Then Monday morning, I found myself right back in the thick of it. I cried at home, got pissed and left the house in a huff, cried in the car on the way to work, cried at work. I'm lucky that working on projects in the office is distracting and helps me feel better. I ended up okay by lunch, doing pretty well in the afternoon — and then got pissed off at my sweet, undeserving-of-wrath husband once I got home.

This morning, I feel more clear-headed than the past few days, and I'm hoping that I've gotten the caffeine residue out of my system. Even as I was drinking all that tea, there was a little voice in my head asking "Is this really a good idea?" I wish I didn't love proper tea so much... :(

So hopefully I'm back to normal. And a little wiser, if worse for the wear.

In other news, my husband got me a set of Corinthian Chimes for my anniversary present. It's hanging outside our bedroom window, and he recorded the sound so I can use it in my morning wake-up alarm app. So pretty.

There is hope for women with PMDD

2010-03-29T11:20:00.000-07:00

Or at least, there is if it turns out they are sensitive to caffeine like I am. I can say that I have not had PMDD symptoms in months — almost a year.

I definitely still experience PMS. Hormonal acne (better thanks to meds), breast tenderness, clumsiness, irritability, mood swings, fatigue. But it is about 10% of what full-on PMDD was like.

When I do feel crappy, I take my lovely L-Theanine "Calm-Plex," which helps. And I make sure I get enough to eat. Nothing worse than being hungry to make me unhappy.

Oh right... that's what PMDD feels like.

2010-01-28T08:58:00.000-08:00

Yesterday was a reminder of why I should take my L-Theanine/GABA/5-HTP "Calm-Plex" for the week before my period. No major meltdown, but a definite minor one.

I was cranky all day (and it was a down day, to boot), wanted to watch the Apple event liveblogging, and my darn co-workers kept interrupting me with actual work — can't they see I'm watching tech news happening?!? ... um, mostly kidding. But I was overly irritated all day long.

Then 4:30 rolls around and I got an urgent email project and call from my boss, and I ended up taking my laptop home to get some of the work done.

At home working on it, I was freaking out more than a little about how I didn't know what I was really doing, and this was a waste of my boss' time because I had to ask her a question every 5 minutes, blah blah blah. DH and I both realized that L-Theanine earlier in the day would have made a big difference. So, took it first thing this morning.

PMS + down day + no l-theanine = bad day.

Success: No caffeine, no zoloft, moderate PMS, and losing weight

2009-12-19T18:17:00.000-08:00

Caffeine-less life is still working for me. I can have some chocolate on occasion, but I am conscious of not overdoing it. I also don't crave it except for sometimes during the week before my period — but even then, it's not like it used to be.

I haven't had zoloft in months. I can definitely tell when it's the week before my period, because I do get somewhat irritable, and I have had some one-day breakdowns — but again, it is about 10-20% of what it used to be. I have no suicidal days, no fatigue, no depression... it's amazing. I actually feel normal.

Normal me, of course... which means I'm still impatient, demanding, and high maintenance — but also fun-loving, fairly happy, generous, and loyal. :D

Life is good, even in the midst of Christmas insanity.

Oh, and I've lost 20 lbs. following the "Alternate Day Diet." Read the book, started the diet in August. It was a long adjustment period, but now I find that on down days, I'm not terribly hungry, and on up days, I'm almost surprised at how much I get to eat. A new discovery — hot V8. Super nom. And I hardly exercise, and I just keep losing weight. So that's quite nice.

No caffeine is working for me... I hope it works for other women, too.

2009-08-22T09:07:00.002-07:00

It's been a while since I've posted simply because I haven't had any news to share... I've had no PMDD symptoms for months. I may get slightly more upset than usual every once in a while, but on the whole, I'm doing great — and I haven't taken any zoloft for months. Not a scrap.

So if you have PMDD, I highly recommend trying to cut caffeine from your diet entirely. It might make all the difference in the world.

L-Theanine Calm-Plex

2009-07-18T17:09:00.003-07:00

I was talking with someone about various treatments I've tried for PMDD, and I realized that I've never posted about L-Theanine Calm-Plex. (It's also available at Amazon.)

I tried this for a while before I finally tried Zoloft. The upside is, not a pharmaceutical, and I could actually feel it working — felt like my bad mood was a grey cloud being burned off by the sun. Pretty awesome. The downside is, it didn't do quite enough to help me with PMDD. It worked, but not enough. Boo hoo.

For short term or less intense mood issues, though, I would highly recommend it. In fact, I might get some more, now that I just have PMS symptoms. Probably would do the trick on those PMS-y days.

I feel so vindicated

2009-06-27T15:13:00.000-07:00

I realized last night that since I gave up caffeine and have had only normal PMS symptoms, I have not had one day of lying around, wanting to sleep the day away. I used to get very fatigued and apathetic on a regular basis, esp. at the worst PMDD times. Now? Doesn't happen.

Even though I recognized the PMDD pattern, there was a little, niggling voice in my head saying, "Maybe you're just a lazy slob, ever consider that? Maybe all this lying around is just your way of copping out of life, and it has nothing really to do with PMDD."

But since I've stopped having symptoms (and no more zoloft withdrawal, YAY!), that fatigue and apathy have gone away, too. So I feel much better about myself and my previous lack of energy and "I care" factor.

Yup... definitely not PMDD anymore.

2009-06-14T10:13:00.000-07:00

So I had one day of overreactive emotions (when the dog was having diarrhea and pooped on the deck and I felt like I wasn't getting any help from anyone else with taking care of him), and I had one week of mild (but easily recognizable) irritability.

What's most important is that I did NOT have even one second of lying in bed, unable to face the world, wanting to sleep away the week, etc.

I took 50 mg of zoloft on Tuesday, simply because Monday was so unpleasant and I didn't want a repeat. But previously, I would have been taking 50 mg last week, and at least 100 mg this week, every day.

Better, but still PMS

2009-06-09T16:35:00.000-07:00

So it appears that even though I have cut caffeine almost entirely from my diet, and even though I don't crave it at all anymore (YAY!), I still am going to have emotional PMS issues. I've had a couple of down days, and last night I was weepy and over-emotional and trying not to make any decisions because I knew that I wasn't being reasonable.

So I took 50mg zoloft today, and hopefully tomorrow will be better.

When I wasn't taking any zoloft at all, I was definitely having withdrawal symptoms. Minor, but still there, and quite disconcerting. Halfway between dizzyness and a jolt of electricity to the brain. Especially in the afternoon, especially if I hadn't had enough sleep, especially when I moved my eyes or turned my head quickly.

I know you're supposed to taper off — but seriously, I was taking 25mg, I don't see how much more of a taper I could do. But if/when I try to go off it again, I will take 25mg one time and see how long it takes for the "brain zaps" to come back, then I will take another 25mg. Hopefully the increments between zaps will get longer.

Progress update

2009-05-26T15:59:00.000-07:00

I've discovered (thanks to Mom) that Nestle Quik mix is 99.9% caffeine free. Yay for chocolate milk.

I have successfully had a few (days apart) 3 Musketeers fun size (itty bitty) treats with no ill effects. I also had about 1/3 of a can of Coke Zero with dinner one evening, with no apparent effects.

I haven't taken my vitamins or zoloft for at least a week, and I'm starting to feel odd and somewhat light-headed at times. This might be a zoloft withdrawal symptom... Not sure. Hoping it goes away soon.

6 days till my period, and things are looking really good...

2009-05-09T13:10:00.000-07:00

Maybe this caffeine allergy thing is true... It's 6 days till my period is due to start, and normally I would be up to 75-100 mg of zoloft by now — but I'm still just taking 25 mg, and mostly as a precaution. Get this. In the past 7 days, I have felt:

No irritability.
No irrational anger.
No depression.
Not even a little bit down.

I will keep posting about this over the next week, but at this point... it seems pretty believable that if I don't have caffeine, I won't have PMDD symptoms.

!!!

Wait, let me repeat that: If I don't have caffeine, I won't have PMDD symptoms.

This is amazing. I could have my life back, without medication. Maybe if I can cut out zoloft, I could lose weight! I could have sanity all month long... all year long.

And hopefully this could work for other women with PMDD. This post on a forum was what started me on my research. And this article seems like a really good source of information for PMDD sufferers.

And according to the information I read online, it's not just PMDD, either, it could be for depression, OCD, ADD, schizophrenia, etc. From http://mentalhealth.about.com/library/yourturn/uc091602.htm

Caffeine toxicity may be mistaken for bipolar disorder (1,12). Symptoms include: chattiness, repetitive thought and action (resembling obsessive compulsive disorder, OCD), restlessness, psychomotor agitation, alternating moods, anger, impulsiveness, aggression, omnipotence, delirium, buying sprees, lack of sexual inhibition, and loss of values.
Allergy can mimic Attention Deficit Disorder (ADD) (13). As far back as 1902, T. D. Crothers noted that many caffeine consuming children "exhibit precocity" and "functional exaltation" (14).
Caffeine poisoning may also resemble schizophrenia. One woman's conversational topics wandered from subject to subject. She screamed, and believed that she was in prison. Natural judgement was impaired (1). In 1931, a truck driver brought to the hospital in a confused and irritable condition, complained of being attacked by flies. Flies were never present. Examination revealed that he'd consumed large amounts of cola (15). One gentleman ended his political speech with predictions and threats, out of the ordinary for his personality, stunning the audience (14). Another case describes a man, who imagined himself very wealthy, and assumed that his mental state was normal (14).
Caffeine toxicity may also masquerade as depression, and anxiety. In 1925, Powers described nervousness, visual problems, and dizziness, in patients he discovered suffered from caffeine toxicity (16). In 1974, caffeine toxic patients, experiencing the same symptoms, were erroneously admitted to a psychiatric hospital, for treatment of anxiety (16,17). In other studies, depression and anxiety are also correlated with caffeine intake (18,19,20,21).

From http://www.copperwiki.org/index.php/Caffeine_allergy#Symptoms

Symptoms of person with severe caffeine allergy are such that a person can be mistaken as depression, obsessive compulsive, schizophrenia, attention deficit order (ADD), manic depressive or bipolar disorder. The symptoms may range from delusions, mania, frantic behavior and other symptoms that closely resembles mental disorders.

Nine days without chocolate...

2009-05-04T16:59:00.002-07:00

...in an attempt to see if PMDD is caused/exacerbated by a caffeine allergy.

I almost lost today, but husband managed to keep me on the "straight and narrow." Would have ruined the experiment.

Argh.

2009-04-29T16:13:00.001-07:00

My iPod Touch Period Tracking software predicts ovulation tomorrow, and this confirms my hypothesis that my PMDD symptoms follow the Peak and Spike"/"Peak and Mesa" patterns described on pages 36-37 of The PMDD Phenomenon.

This morning I couldn't even contemplate finding something to eat because every time I opened the refrigerator door, I wanted to scream because it's so disorganized. I looked in the pantry, and the mess in there just made it worse.

Then I got an email alert from our bank that our joint account dipped below $250. While trying to investigate that, I again wanted to scream because our internet was so slow — since my husband was downloading huge files. Yargh. Then he asked if I was going to shower, and I just about lost it... albeit very quietly and under control. It was an interesting moment.

Solution: I gave up on the financial stuff, postponing it to the do-while-at-work list. Husband offered to make me breakfast, which ended up being an egg-and-sausage sandwich, which I ate in the car (along with my 100mg of sertraline). I also did make up in the car. Nice to be able to commute with someone else driving...

Now I can feel a blemish developing above my right eyebrow, and the one on the left side of the bridge of my nose is still not going away as quickly as I'd like... But I need to make an appointment with the dermatologist, now that I have a referral.

I had SERIOUS carb cravings all morning, and all I wanted at lunch time was a chocolate chip cookie, and I CAN'T HAVE ONE! Thankfully, my husband heated up my lunch, which was yum, and all was better after I'd eaten.

This article is why I write here.

2009-04-27T14:25:00.003-07:00

From Ms. Magazine, Summer 2008:
Pathologizing Your Period
Despite a lack of evidence, the psychiatric establishment has made extreme premenstrual distress a recognized disorder—and a boon to Big Pharma.
By Paula J. Caplan

Are you unhappy? Bloated? Is it hard to concentrate? Do you have food cravings? Breast tenderness?

If you read the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, you will find your symptoms listed under “premenstrual dysphoric disorder” (PMDD). In other words, because of those symptoms, a therapist or doctor could label you as having a mental disorder.

The DSM is the bible of psychiatric diagnosis, used by nearly every hospital, clinic, doctor and insurance company, as well as Medicare and Medicaid. Since PMDD first was mentioned in the DSM in 1987, people have received the mistaken impression that it’s real and that it’s a mental illness. With the manual’s fifth edition currently in preparation, that notion seems likely to be strengthened rather than discouraged.

Except that the "impression" is NOT mistaken, and I (plus many other women) can attest to that. PMDD is REAL, it is debilitating, and we need to have ways to treat it.

Contrary to popular opinion, the creation and use of psychiatric categories is rarely based on solid science, as I learned when I served on two DSM committees. The absence of science leaves a void into which every conceivable kind of bias has been found to flow—including sexism. The DSM’s own PMDD committee reviewed more than 500 studies for the 1994 edition and concluded that no high-quality research supported the existence of PMDD, yet PMDD was placed in the manual anyway.

Do some women report feeling worse before their periods than at other times of the month? Certainly, although in some countries and cultures more than others. Premenstrual discomforts are also more often reported by women who were sexually abused as children, are struggling with abuse or harassment, or are just plain overburdened. But that is worlds away from a mental illness.

Two powerful DSM authors proposed adding PMDD in the mid-1980s and proposed adding it to the next edition of the manual. It would represent an extreme form of PMS—the popularly accepted “syndrome” of physical and emotional symptoms between ovulation and menstruation. To qualify, it would have to include five familiar PMS-type symptoms, at least one of them a “mood disorder” such as feeling hopeless, “on edge,” self-deprecating, irritable, angry or tearful. No one keeps comprehensive records of how often a PMDD diagnosis is given, but based on PMDD committee estimates, approximately half a million American women could be given the PMDD label.

Hundreds of researchers have tried unsuccessfully to prove that women are more likely to have mood problems premenstrually than at other times. University of British Columbia researcher Christine Hitchcock says, “Something like half of women say they have premenstrual problems, but when you ask them to keep daily ratings of their moods, the data don’t reflect that.” Another study showed that men identified PMDD symptoms in themselves as commonly as women did.

Do all women have PMDD? NO.
Do some women have PMDD, even if it is only a small minority? YES.

Despite this, when Eli Lilly and Company's patent on antidepressant Prozac was about to expire, the pharmaceutical giant successfully asked the Food and Drug Administration to approve it to treat PMDD, providing a patent extension worth millions. Eli Lilly repackaged Prozac in pink and purple and rechristened it the feminine-sounding “Sarafem.” Other drug companies rushed to market similar products. They deliberately listed physical problems associated with menstruation for some women, such as breast tenderness or bloating, and added a list of mood problems from the PMDD list that virtually every human being experiences.

The PMDD mood symptoms are also listed for menopause, although they are supposedly caused at menopause by deficiency in the hormones whose increase supposedly causes PMDD. I half-jokingly predicted that we would soon hear about premenarcheal dysphoric disorder between a baby girl’s birth and her first period, thus pathologizing women’s moods from birth to death.

Women should be wary of believing claims that high-tech research has now proven that PMDD is real. We should also advocate a national conversation—even congressional hearings—about the often hidden, devastating consequences of simply being given diagnostic labels such as PMDD. Finally, we should stop pathologizing ourselves and other women and help each other look at what’s really behind our feelings.

The full text of this article appears in the Summer issue of Ms. magazine, available on newsstands or by joining the Ms. community at www.msmagazine.com.

PAULA J. CAPLAN, Ph.D., is a clinical and research psychologist, currently a nonresident fellow at the DuBois Institute, Harvard University. She is author of They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal (Da Capo Press, 1996).

Ms. Caplan, let me tell you about my experience. I am a feminist. I am smart, I am self-supporting, I have been single for much of my life rather than dumb myself down to keep men and boys from feeling threatened by my independence and intelligence. I have walked my own path.

But I have PMDD.

Before I found a treatment that worked, I had bouts of rage and suicidal depression. I wanted to kill myself on a regular basis. I wished I had never been born. I threw things; I screamed at my computer and DVD player; I laid in bed, sobbing and wanting to die. I threatened to kill myself, my cats and my (wonderful, loving, supportive) fiancé. I took off one night in my car, intending to drive off a bridge. I didn't, because I have always had a very strong survival instinct — which is why I have made it through my struggle with PMDD. Not every woman is so lucky.

And let me tell you, PMDD is not just a little bit of pre-menstrual discomfort and irritability. It was like someone else was in control of my body, while the "real me" cowered in fear of the out-of-control person that I had become. I could hear and see what I was doing — and I couldn't stop. I couldn't be ME — I couldn't be strong. I was trapped in emotional agony, but once my period started,things got better.

So, as much as I appreciate the idea of not pathologizing ALL women — because all women do NOT have PMDD — don't sit there on your high horse and tell ME that I do not have a problem... I have a safe, loving marriage; I have a good job; I am a smart, independent woman; I would consider myself a feminist — and I have PMDD.

Yes, I agree that not all women have PMDD. But for the 3–5% of us who do, please give us a break and DON'T say that it is not real. Because it is.

PMDD = caffeine allergy?

2009-04-26T10:23:00.005-07:00

Whaaaa?

Caffeine allergy and premenstrual symptoms
by Ruth Whalen
Townsend Letter for Doctors and Patients
Nov, 2004

After caffeine allergic women diagnosed with a mental disorder remove caffeine from their diet, the women experience PMS and PMDD relief, including the alleviation or elimination of abnormal psychological symptoms, which may have been confused with a mental disorder.

...

After reading around a bit, this seems entirely possible. Caffeine and I have never had a solidly friendly relationship, and I know that the zinc/copper relationship that I have already discovered involves the adrenal system... which relates to caffeine as well.

And I crave chocolate during PMDD time. Chocolate has caffeine.

The first thing I think is "No more CHOCOLATE??? NOOOOOO!!! No nonononono."

Never to have Tillamook Mudslide ice cream, chocolate chip cookies, Twix bars, Reese's peanut butter cups, hot chocolate, Nutella... the list goes on and on. Chocolate and I are BFF.

And then there's chai tea, mochas, Excedrin (for my infrequent migraines — are these caffeine related?), Coke zero (not that frequent). All of these have caffeine, too.

BUT...

Trading chocolate/caffeine for SANITY seems worthwhile.

Still... it will be the hardest thing I have ever done. I will have to look into this.

The weekend with the in-laws went fine

2009-04-10T16:39:00.000-07:00

I just realized I never checked in after my weekend with the in-laws. Overall, it went really well. Whenever I felt overwhelmed, I went and hid in my room, and the cats were super-duper cuddly, so I usually had someone soft and warm to pet. It was a good weekend.

Even the flying went all right. I managed to sleep on the red-eye out there, which seemed nothing short of miraculous to me. The time change didn't seem to affect me much.

Thank goodness for vitamin Z.

I wrote this last night when I couldn't sleep

2009-03-21T13:12:00.002-07:00

Think of a sunburn
Think of how your skin feels
Paper thin
Hot
How the slightest touch feels like a slap
The softest fiber like coarse grit sandpaper
Press on the red and leave white welts -- that's not right.

EVERYTHING HURTS.

If a butterfly were to alight on your arm, you would scream.

Hold that memory

And apply that feeling
To the inside of your brain
Every month
For ten or so days.

Go on

Tell me that PMDD is imaginary.

A long weekend with the in-laws ... during the height of "winter"

2009-03-17T16:11:00.005-07:00

Oh boy oh boy oh boy... Off we go to the in-laws' for my husband's grandmother's memorial.

Don't get me wrong, I love my husband's family. They are truly wonderful, and I feel very included when I'm there. I know they like me, and I like them... for the most part. But it's hard to integrate into anyone else's family.

AND... it's the height of winter (and I'm not talkin' the weather, folks), code red — my face is breaking out, my filters are non-functional, and I want to stay home with a blankie and some chamomile tea — not make the trek to the airport, struggle through the lines of idiots (hearing Henry Rollins' "Airport Hell" rant in my head), take a red-eye flight to the East Coast, and spend 3+ days in a house with relative strangers (strange relatives?), trying to get over lack of sleep and jet lag just in time for equally unpleasant journey home.

There will be babies (sweet, but YIKES), lots of people, and — bonus! — I will get to sleep on a fold-out couch, oh yay.

Plus-side, there will be lots of cats.

I will be taking extra "vitamin Z," perhaps 150mg a day. Let's hope I survive with family relationships (and sanity) intact.

How many acronyms can I get?

2009-03-12T12:53:00.000-07:00

PMDD = Premenstrual Dysphoric Disorder
BDD = Body Dysmorphic Disorder
OCPD = Obsessive Compulsive Personality Disorder (perfectionism)
BFRBs = Body-focused Repetitive Behaviors
SI = self-injury
OCD = Obsessive-Compulsive Disorder
HSP = Highly Sensitive Person

Add in reactive hypoglycemia due to copper overload (which seems to be managed by taking a zinc supplement) and hormonally-aggravated acne, and stir until blended. Bake 32 years and top with SSRIs as necessary/to taste.

Pretty typical "crash" this weekend...

2009-03-08T22:35:00.000-07:00

... Still doesn't make it fun.

Saturday morning, I woke up early-ish, fed the cats, and came back to bed. I didn't eat breakfast, couldn't figure out what would be tasty, lower-cal, and worth cooking just for myself, as my husband got up and had cereal.

So then I was lying in bed, hungry, feeling fat, lazy, worthless, worried about my not spending time on the treadmill like I was hoping, trying to figure out why my lower back hurts (probably because I'm fat and out of shape), trying to decide whether I should make a doctor appointment with my new PCP that I don't know and don't know if I will like, whether I should try a chiropractor, or massage therapy, or physical therapy, which led me back to my PT saying that I'm "slightly swaybacked," which makes me feel like shit, which brings me back to feeling fat and disgusting......... All of which leads to a very unhappy me.

And all of this happened between about 7:45 a.m. and 11:00 a.m.

By the time my husband realized something was going on (when I wouldn't get out of bed and wouldn't get on the phone with the in-laws), I ended up crying and having a very tiny (level 1.5) freak-out.

And I know it doesn't work for everyone, and I know other people have side effects, but all I can say is thank god for zoloft. If not for that little blue pill, I would have been at the bottom of the depression-whirlpool wanting to die, crying and maybe screaming and completely non-functional. As it was, I went to my afternoon commitment with a modicum of sanity, and even went out to dinner (craving steak, which is very out of the ordinary for me) and to the local Vagina Monologues show in the evening, which was pretty good.

Today, we got chores done in the morning after my husband made French toast (oh, so yummy), and then he left for work. I tried to convince myself to go over to Mom's house for birthday dinner with the family, but managed to sit around watching Friends for about 3 hours before I was able to drag myself into some semblance of social preparedness. And I got there and still didn't want to be social... But everyone was understanding and I ended up having a really good time, laughing and telling stories. Yay for family.

Now I'm tired, but waiting up for the husband to get home. He will hug me and things will be better. Not perfect, but better.

PMDD is genetic

2009-03-06T15:49:00.002-08:00

Following on this post, here's more information on the genes behind PMDD (from Elsevier via Wikipedia's PMDD article). (Emphasis mine.)

In 2007, the first significant genetic finding in premenstrual dysphoric disorder was reported, which represents an importance advance in understanding PMDD.

Previously, researchers have shown that women with PMDD have an abnormal response to normal hormone levels, and, thus, are differentially sensitive to their own hormone changes. In a study, Dr. Liang Huo and colleagues, found variants in the estrogen receptor alpha gene that are associated with PMDD. Women with these genetic variants were more likely to suffer from PMDD. They also discovered that this association is seen only in women with a variant form of another gene, catechol -- o -- methyltransferase (COMT), which is involved in regulating the function of the prefrontal cortex, a critical regulator of mood.

These findings were published in an "Risk for Premenstrual Dysphoric Disorder Is Associated with Genetic Variation in ESR1, the Estrogen Receptor Alpha Gene" by Liang Huo, Richard E. Straub, Peter J. Schmidt, Kai Shi, Radhakrishna Vakkalanka, Daniel R. Weinberger and David R. Rubinow, in Biological Psychiatry, Volume 62, Issue 8 (October 15, 2007), published by Elsevier.

I just had my period — shouldn't my symptoms be gone now??

2009-03-06T15:30:00.000-08:00

Stupid hormones.

I just had my period, it's "summer time," and yet, I am cranky, paranoid, fearful, easily upset. This sucks.

This also follows a pattern that I have seen before, where for some reason "summer" = PMDD symptoms, specifically mucho crankiness.

I've also been more than usually snackish, getting hungry this AM at 10:45, instead of waiting till lunch to feel hungry.

On the plus side, I realized the other day that I've actually kind of forgotten what it feels like to "crash" — to start down that whirlpool towards suicidal, depressed, non-functional. I have been pretty okay (with ups and downs, of course) for about two years now, and that feeling is a memory instead of a constant threat on the horizon. I never thought that I would be able to say that. It's pretty amazing.

PMDD still gets in the way

2009-02-03T09:06:00.002-08:00

A college friend came to visit last weekend, and I was so disappointed in the timing of it. I had no energy, just wanted to lie around on the couch the whole weekend. Monday afternoon my period started, and Tuesday I was rarin' to go — but by then, he was on his way back home.

Taking comfort in small victories

2009-01-21T16:12:00.004-08:00

Code orange-red here, and wishing I could just stay home in bed cuddling with the cats. But I have to give myself (and sertraline) credit where it's due...

Yesterday was not the best day, but I made it through without crying at all. I had computer problems all day long, and my office could be rented out as a meat locker. I couldn't have a heater going because of power issues, so I was freezing and feeling unproductive and limited.

Then, on the way home from work (later than I wanted to be leaving), I stopped to get gas, but the auto-shutoff didn't work and the tank overflowed. Not a lot, but enough to be a mess and a bother.

Nevertheless, I didn't freak out, I just cleaned up and headed home. About 2 minutes away from home, I called my husband and said "Please bring my slippers to the garage door." He brought them to the car, and I was able to take off my shoes with gasoline on the bottoms and leave them in the garage.

But I didn't cry, and I didn't even get very upset. Before sertraline, all of that would have made me a quivering mess by the end of the day. I'm sure I would have been crying by 11 am, in fact.

Doot-n-doo-doo, Feelin' Shitty...

2009-01-05T09:36:00.001-08:00

(For those that didn't get it, the title to this post would be sung to the tune of the 59th Street Bridge Song.)

Wow I feel like shit this morning. It doesn't help that this is my first real day back to work since some time before Christmas (due to snow days), and it's also my first evening of rehearsals on a show that makes me nervous for so many reasons. And I feel fat, and I miss wearing my wedding ring, and I still haven't lost any weight, in spite of the oh-so-promising start a while back. My clothes are looking like crap on me, and I need new bras, and my skin is erupting, and I just hate being me.

Lesson learned: Don't go off your meds, even if you think you're fine.

2008-12-14T00:53:00.001-08:00

Last week was my period. Building up to that, I was also sick for almost two weeks. So I got lazy, and at the end of my period, I stopped taking my vitamins and zoloft, just for a few days, because I was so tired of taking such good care of myself, and taking all the different pills and remedies.

Well... the other morning, I had a ridiculous hissy fit over a website not behaving properly, and then had a crappy rest of the morning. I ended up practically in tears by 10 am. Not a good start to the day.

So I took 50 mg zoloft, came home for a long lunch hour, and hit the "reset" button on my day. But I just need to remember that even when I think I'm okay, I should still be taking my little 25 mg every day, because it helps. Even when I think I don't need it... I still should take it.

Zinc, food, weight, and blood sugar

2008-11-14T21:30:00.002-08:00

This is just incredible.

I've been holding off posting about this for a while because during the 10-14 days before my period, I was more snacky than I have been recently, and I didn't know if it was because of the B vitamins or hormones. I also wasn't losing any weight, and had a hunch that it was the estrogen/copper/water retention combo keeping it that way.

BUT

Now that my period is over, I'm back to 3 small-to-reasonably-sized meals a day, or 2 meals and some snack food. I can wait till later in the morning to eat, I can eat a small lunch, and I can skip dinner if I want. I still get hungry at appropriate times, where I used to have to eat every 2-3 hours OR ELSE.

AND... the scale says I've lost another pound. I've lost 4 lbs. since 10/16.

I'm sincerely hoping that I will be down to under 200 in a few months... at least by next summer. And then hopefully the trend will continue and I can get back to that svelte-voluptuous 175 that I was when I used the bodybugg.

That said... I can't believe I gained 50 lbs in 18 months... Yikes. I kept expecting the gain to level out, but it never did. I'm SO excited that it has reversed direction. And all because of ZINC!! Who knew? Certainly not my NP.

But I will just know that pre-menstrually, I will be not only cranky in the head, but also snacky and crave-y in the body. And I won't lose weight during that time, but that's okay as long as it doesn't go up. I get to be nice to myself during that time, but not indulge too much.

This is SO EXCITING.

Emotional extremes

2008-10-28T12:45:00.003-07:00

Oh, that wacky amygdala... going all over the place.

I could hardly get out of bed this morning, I was so sluggish. I still feel foggy, and my head is a little stuffed up, so I'm trying to keep warm and drink my vitamin C. I hope I sleep well tonight.

But now at work, I'm so happy it's almost silly. And not for any specific reason, although discovering one of my best friends is also a guru at the slightly mystifying coding language that I'm trying to learn is enough to make me a little high. I'm just happy.

The feeling of happy without strings attached is still a bit of a novelty to me — and I don't trust it, because who knows when it will change to not-happy? — but I'm trying to enjoy the feeling anyway. Breathe deep and just ride the roller coaster, because it will go away in 10 days or so.

Weekend crash

2008-10-27T16:39:00.006-07:00

Friday night I came home from a long, active day to a lovely soak in the tub, set up by my husband, including candles. Saturday morning was high summer, but Saturday afternoon/evening led to a classic post-ovulatory PMDD crash. (My symptoms seem to follow the "Peak and Spike"/"Peak and Mesa" patterns described on pages 36-37 of The PMDD Phenomenon.)

Sunday morning, I was catching up on financial stuff, started to worry, and ended up sobbing on the bed, stressed out about everything.* I talked things through with my husband, and once again found myself so utterly grateful that we both know what is behind the insanity.

This may be TMI, but we ended up taking a shower together (no, not as foreplay), and it is amazing how soothing it is to have someone else soap your back and rinse your hair. I felt utterly pampered, and it helped me get calm and grab some perspective. I spent the rest of the day doing very little, watching Slings and Arrows, and generally being as nice to myself as I could be. Cuddling with the cats helped.

I also took 75 mg sertraline on Sunday, and this week I will be taking 50 mg. I should have taken more sertraline on Saturday evening... but I ignored my better judgment. Maybe next month I'll pay attention.

*On top of the fact that when I'm crashing I worry about every possible thing, my face decided to 'splode. I felt like the elephant man because I had a huge underground zit right on the bridge of my nose and one closer to my eyelid, and it not only hurt like hell but actually impinged slightly on my vision! And another on my jawline, and another on my chin. And this follows closely on the heels of the last round finally healing up, almost — say 85% healed.

So I used all the weapons in my arsenal: Clean & Clear Advantage, Bliss Spa Steep Clean mask, Thermaclear, etc. This morning at least it all didn't hurt as much, but I still feel like a disgusting freak.

B complex update:

I still can't tell if the brand name B complex is better than the brand X vits. I'm going to keep alternating weeks and see if a trend emerges.

Those brand-name B vitamins might be key after all...

2008-10-21T15:15:00.001-07:00

Been feeling hungrier today; no crashes, but definitely snacky all day long.

I'm going to get some of my friend's Schiff B-complex and see if I can get back to energetic again.

The need-to-know facts of zinc supplementation

2008-10-20T13:56:00.003-07:00

Excerpted from Zinc, Tinnitus, and Immune System Health, by Barry Keate

Despite the many benefits of zinc supplementation, it is possible to take too much of the mineral. High doses of zinc can lead to toxic reactions such as abdominal pain, nausea and vomiting. Zinc competes for absorption with copper and manganese and high doses can result in deficiencies of these necessary minerals.

The National Institutes of Health has prepared a document outlining the perils of too little or too much zinc in the body. They state that, "Intakes of 150 to 450mg of zinc per day have been associated with low copper status, altered iron function, reduced immune function, and reduced levels of high-density lipoproteins (the good cholesterol). They have also established an upper limit of daily zinc intake that is not associated with any adverse health effects. The limit for infants and children under 18 years old ranges is from 4mg to 34mg daily, depending on age. The upper limit for adults and pregnant and lactating women is 40mg daily. Above this level, zinc should be taken with small amounts of copper and manganese. The general rule is to take 1-2mg copper and 2-3mg manganese for every 10mg of zinc above a 40mg daily dosage. Therefore, someone taking 60mg zinc daily should also take 2-4 mg copper and 4-6 mg manganese.

So... Eventually I will probably go back to my multivitamin that has both zinc and copper. But for now, I'm doing great without copper supplementation.

Zinc, zinc, zinc — or, "How I stopped being tired and learned to love household chores."

2008-10-20T08:02:00.007-07:00

Off topic from PMDD, I know, but this is a huge change for me, and hopefully my experience might help someone else.

For the past few weeks, I've been taking a zinc supplement as an experiment to see if copper overload was a part of my problems. I noticed a gradual improvement in my hunger/blood sugar levels, and then suddenly, everything was spectacularly, wonderfully normal (see previous post).

So, an update from this weekend:
Yesterday after breakfast, I emptied the dish drainer, washed all of the dishes (without any of the usual, utterly necessary sit-down breaks), thoroughly cleaned the stovetop, and windexed the inside and outside of my car windshield, all without stopping. I also went grocery shopping in the afternoon.

I woke up this morning when my alarm went off, instead of 45 minutes later when I would usually have dragged myself out of bed.

I have had so much energy this past week, and I've gone from 231 lbs. to under 229 lbs. in a matter of days without trying. I'm eating less because I'm not having blood sugar crashes, and I'm just not as hungry as I used to be. Today I waited until 1 p.m. to have lunch, with no consequences other than mild hunger. No shaking, no headache, no brain fog...

I'm convinced that within 6 months, I could be back to a normal clothing size, and maybe in a year, I could even weigh the 160 or so lbs. recommended for my height and frame! (I have weighed more than than 170 since I was 17.) I so miss my wonderful clothes.

Don't get me wrong — I think I'm beautiful as I am, and I know without a doubt that my husband loves me and finds me sexy — but I'm so tired of not having anything to wear! My mother has spent countless hours making me wonderful clothes, and I am a careful shopper. To be missing out on my favorite items because I'm a size 20 instead of a size 16 is enormously frustrating.

I'm lucky that even at 230 lbs., I look pretty good — natural hourglass figure, decent proportions — but even I'm aware of the dangers of diabetes, heart disease, etc. And I don't WANT to be this size... and I was afraid that I would just keep getting bigger and more unhealthy for the rest of my life.

I am amazed, too, that I never heard anything about zinc from any of the various doctors (including naturopaths!) I have gone to over the past 5 years. They suggested herbs, tinctures, wacky diets, insane amounts of exercise, diabetes drugs, and more... Nobody ever even suggested copper overload as a possibility. Did they just not know?? Make no mistake about it, I will be telling everyone I can about this change in my life.

Hypoglycemia... gone??

2008-10-16T16:34:00.004-07:00

An update in the same vein as this post from September: my reactive hypoglycemia seems to be gone entirely.

I'd been noticing that my hunger crises had been less and less intense, and then 2 days ago, I had breakfast as usual, and then work got crazy. When I finally noticed I was getting hungry, I thought, Oh, here we go, time for a snack — and then looked at the clock. It was 11:44, not 10:30. Actually lunchtime! And I didn't get hungry again till dinner. Then it happened again yesterday, and again today.

I spent most of yesterday evening in ecstatic shock, because this means I might be able to actually lose weight now, just by eating and exercising normally. I've also been more energetic, moving around when I get home from work instead of crashing on the couch and staying there. I haven't had to wear my glasses while driving for a few days now, too. I don't need them for driving, but when my eyes are tired, it's easier to wear the glasses than trying to keep my eyes focused.

I was reading about adrenal fatigue and hypoglycemia going hand in hand. I have always been a very high stress person, and undiagnosed PMDD added a lot to that. Now that I know what's wrong with me, I'm less stressed out about that — but still, I can see where adrenal fatigue would be a likely problem for me.

Some of the info on this page resonates strongly with me:

There is a very close relationship between adrenal function and blood sugar levels. ... people who suffer from low blood sugar frequently suffer from Adrenal Fatigue. ... With lowered blood cortisol, the liver has a more difficult time converting glycogen (stored blood sugar) into glucose (active blood sugar) which is necessary for energy production. ... during stress, insulin levels are increased because the demand for energy in the cells is greater. ... Without adequate cortisol levels to elevate blood sugar levels by facilitating the conversion of glycogen, fats and proteins to new glucose supplies, this increased demand is difficult or impossible to meet.
People with Adrenal Fatigue are in a real bind because when they are under stress ... demand for blood glucose increases, but their fatigued adrenals cannot produce enough cortisol to generate higher glucose levels from reserves.
... They can almost feel it hit the back of the brain [[YES!]] as their blood sugar moves out of the basement and shoots for the stars, relieving their hypoglycemic symptoms for about 45-90 minutes.
... Low blood sugar times are most likely to occur at around 10:00 AM, 2:00 PM, and from 3-4:00 PM.
Hypoglycemia, without proper snack and meal placement, also encourages overeating when food is available. This overeating causes rapid weight gain because the increased levels of insulin circulating in the blood usher that excess energy (glucose) from the extra food into the fat cells where it is stored as fat.

The only difference I can ascribe all this to is that I've been taking zinc supplements for the past couple of weeks. I've also been taking a different B-complex this week, borrowed from a friend of mine. I'll update next week when I switch back to my regular B-complex to see if there's any significant difference.

But if I can actually make use of the energy that is currently stored in my body as enormously excess amounts of fat, I could actually get back to a "normal" weight, and wear my regular clothes again!!!

Yay, Christina Hendricks!!

2008-10-14T09:04:00.003-07:00

I don't follow celebrities in general, but someone recently told me that I reminded her of Joan, the "sexy secretary" on AMC's Mad Men — played by Christina Hendricks (also YoSaffBridge from Firefly). I am completely flattered.

This morning my coworker sent me a link to this article. And now, I adore her.

I love the writer's description of the twig-with-a-head type of girl, too: "90210 pogo sticks."

Sertraline wears off, apparently

2008-10-09T09:25:00.005-07:00

Interesting thing happened yesterday/today. Tuesday, I took 50mg of sertraline. Yesterday, I didn't get around to taking my vits (including sertraline), and in the AM I was fine, even happy. At lunch time, neutral; as the afternoon wore on, I got more and more vaguely sad for no reason at all.

This morning, I felt like crap — could have cried if I'd had a trigger.

So this morning I took 75mg, and hopefully I will feel better by lunch.

Of course now, since I took the pills without food/drink, my stomach is trying to have some acid reflux. Time go to get some juice!

Update 2:15 p.m.

Sooo sleeeeepy. Don't know if it's because my office is cold, or because of PMDD or because of other reasons, but I'm having the hardest time keeping myself energized. Of course, probably having lunch would help.

Also, my face is breaking out in typical painful fashion. The combination of the Thermaclear and my new Clean & Clear stuff (which I use very sparingly) is keeping me relatively sane, because it clears up quicker. But OW.

The day after crazy

2008-10-03T12:50:00.004-07:00

Yesterday ended much better than it began. I was able to get the project finished with the help of my oh-so-understanding coworker, who also let me vent and helped calm me down. I took 100mg of zoloft and spent the rest of the day recovering. My sister-in-law came by to give me great hugs, and I spent the evening doing some chores and watching TV. I found out that I can self-refer to anyone I want for "women's health issues," and I do have refills on my prescription, but she wrote it as "PRN x 1 year," so the system doesn't know how to put a number on that. But I DO have refills.

Now I'm sitting at my desk and contemplating yesterday's emotional roller coaster. It seems like a bad dream, like it happened to someone else... I can't believe I reacted like that — and yet, at the time, it seemed entirely reasonable.

That's what it's like having PMDD; you don't know that your emotions are out of control because every little thing seems like a boulder instead of a pebble. It's like in that episode of Firefly, when Simon Tam says that River's amygdala has been stripped, and "she feels everything — she can't not."

Speaking of the amygdala, this article says that

Recently, a variation in the ESR1 gene, which codes for an estrogen receptor, was found to distinguish women with PMDD from women without it (Psychiatric News, August 17). ...it's possible... that PMDD could be due to a surge in progesterone exciting the amygdala and then to the prefrontal cortex not being able to halt the excitement due to altered estrogen sensitivity.

Interesting that they have actually found genetic evidence that proves that some are more sensitive to estrogen, and that there really is a difference between women with PMDD and women without. It's not just that I "can't deal" — it is a real problem.

But mostly I'm just amazed to think back on yesterday from the perspective of today. Yesterday I was hopeless, frightened, despondent, and angry. Today I feel perfectly normal.

Crazy.

SAM-e, no.

2008-10-02T10:04:00.011-07:00

The SAM-e experiment is a miserable failure. I even took 1200mg this morning because I've been pretty unhappy lately. But nothing. So I'm going back to zoloft — I've been taking 25-50mg, but I'm upping it today to 100mg.

For the record, though, this is what it's like to live in my PMDD-brain without any SSRI support. Read this as fast as you can and then double that speed. This is the crazy-talk in my head:

I got up this morning, managed to take a shower, my face is still dry from trying out this new Clean & Clear Advantage system, which has dried out my normally baby-butt-smooth face to the consistency of tangerine skin. I weighed myself, down to 231 from 233 yesterday — who the hell knows why — and tried to get dressed. I don't know if it's the compression shorts I put on under the pants or just that I've gained that much weight or maybe it's water retention, but the pants that I just bought at Old Navy a couple weekends ago now feel too tight — and I know they fit when I bought them. So then I consider reactivating my bodybugg subscription, which leads to searching in vain through the office boxes (still unpacked from the move) for the bodybugg-plus-receiver-plus-miniUSB cable... I found the bodybugg and receiver, but not cable. Ok, well, I have one at work for charging my phone, so I'll just swap them out. I end up crying in the kitchen about how frustrated I am that none of my clothes fit, that I can't go to the doctor that I want because she's not on my insurance, and the one that I am seeing is going off my insurance so I have to find a new one anyway. I grab some food for breakfast (still haven't eaten), find something for lunch that will be healthy, even though it's not what I want (I don't want anything!!!), and I was supposed to be out the door at 8:10, it's now 8:25, but seriously, why does it matter if I'm at work at 8:30 vs. 9 am?? So then I freak out about that, crying again because I hate that I'm supposed to be at work at 8:30 and I can't make it, and why does it even matter, I almost never leave at exactly 5 pm anyway!!! I get my shit together, head for the car, and I can't find my car keys. They're somewhere in the house, my watch is also somewhere in the house, so I take my husband's key to my car and we discuss the option of calling my insurance (oh great, more time on the phone that I don't have to spare) to see if I can get the NP that I really want on my insurance. I drive to work, still trying to let the tears dry on my cheeks so that I don't smear my make up so I can arrive looking somewhat professional, and I try to make a phone call on the way in to talk to my insurance, but the reception is spotty so I give up. I'm also worried about the possibility that I'm heading towards pre-menopause at age 32, which indicates that there might(?) be something more wrong with me, and wondering if menopause might not be such a bad thing, except that women with PMDD are particularly in danger of post-partum depression and serious depression at menopause, like I need another thing to make me feel like crap. If I'm 32 and pre-menopausal, I'm worried there's something bigger going on. I get to work, try to concentrate on the project, but chat with my friend about how horrible I'm feeling and how disappointed I am that I need zoloft to keep me happy, but I'm worried it's making me gain weight. Google "SSRI appetite" to see which SSRIs are supposed to suppress your appetite... Looks like prozac, but I didn't experience that when I was on it years ago. I'm gaining weight like crazy, I have acne and oily skin, which are evidence of testosterone? I get insane every month with my period, I have hypoglycemic symptoms but my blood sugar is supposedly normal. My NP tried me on a drug for diabetes, and it didn't do anything. She thought maybe I had polycystic ovarian syndrome, even though I didn't have many of the symptoms. AND I got an email this morning from my mail order pharmacy that my new prescription has shipped (THAT was a PITA to get done, a whole other story) but I have "no remaining refills" even though my NP indicated on the written Rx that I could have refills "x1 year." So OH YAY, more time on the phone with idiots who won't be helpful!!!

Oh yeah, and I want to kill myself.

/end crazy/

Re: that last sentence. I will not act on that thought, don't worry. I know that this is PMDD, I know that it is treatable, I know that that thought is irrational overreaction to my messed up brain chemistry. I'm just saying... this is what it feels like to live in my brain.

So now I'm having my breakfast sandwich, yogurt, OJ, and 100mg of zoloft (plus my vitamins). Hopefully this will all have settled by mid-day.

Update on the crazy

I'm working on this project for my boss' boss, and I can't find what I need and I'm not getting any help and I'm actually sitting here at my desk CRYING because I'm so stressed out and afraid that if I can't get this done they'll FIRE me.

Are you "highly sensitive"?

2008-09-25T13:34:00.005-07:00

An article by Jenna Avery, CLC, Life Coach for Sensitive Souls: Are You Highly Sensitive?

Some criteria/identifying traits for Highly Sensitive Persons (HSPs):

1. You are deeply affected by all aspects of your life.
2. You have heightened perceptive skills.
3. You have a lower tolerance for stimulation than others.
4. You are highly conscientious and thorough in all your undertakings.
5. You have a strong relationship with aesthetics and art.
6. Your inner life is just as intriguing and inspiring as your outer life.
7. You absolutely require private time alone in order to feel replenished.
8. You have a strong spiritual connection and depth.

And Jenna Avery's website: http://www.highlysensitivesouls.com/

And another very interesting website with lots of useful sections: http://talentdevelop.com/

A self-test to see if you are an HSP: http://www.hsperson.com/pages/test.htm

These pages also led me back to the Keirsey temperament sorter personality tests (I think I'm between INFJ and INTJ, but I haven't done it in a while). I also discovered the Enneagram personality concept, which I'll have to look into some more. Intriguing... but ultimately just tools on the path.

Rage and self-punishment: cutting as a teenager

2008-09-23T14:41:00.005-07:00

CAVEAT: Any and all of the content in this post could "trigger" anyone who self-harms. If you do cut or injure yourself, know that you are not alone, and you are not "crazy." Self-injury is just a way to cope with emotions that you can't handle any other way, and you can get past it. Here are a few resource pages, but there are lots more, too.

I don't remember when it started, but probably after age 12. I would get extremely depressed and/or angry*, then suicidal, and then (after I had talked myself out of suicide, usually because I knew it would hurt my mother immeasurably) I would numb my wrist with a piece of ice and start cutting with my pocketknife, scissors, a razor blade, whatever was handy.

I never went so far to dig holes or carve words in my flesh, though... I've read about that, but at the time, I knew that people would notice anything large or strange-looking, so I always had to keep the marks as unobtrusive as possible. And for me it wasn't as much about the pain as it was about punishing myself for being fat, lazy, a coward, worthless, etc.

*I see depression — in my case, at least — as self-directed anger, so being depressed and angry most often go hand-in-hand.

I didn't do this all the time, though, and I think it's highly likely that my cutting episodes coincided with my PMDD episodes, as there were some times (not often) that I felt normal and fairly happy, and didn't cut myself. But when I was in that black hole space, the only thing I could do was to punish myself for being such a crappy, worthless human being.

I don't even know when it stopped... I don't remember doing it in college, but I know I did it in high school. I had some pretty low points in college, but somehow I had moved past the cutting. In college, I took a pottery class, and was left with quite a few pieces that I didn't like. I would go out behind the dorm and throw these pieces at the concrete wall until all of the shards were as broken as I could make them. That was a good way to relieve my anger and frustration.

So in the past few days, I've been researching this topic, and I've found a lot of interesting insights.

Amy Studt, a singer from the UK, was extensively bullied in school. She said, "When I cut myself there was something to show for the hurt I was feeling." (Thanks to Gabrielle at http://self-injury.net/ for her excellent research. She has collected and verified quite a few stories of celebrities who SI, and the commonalities are striking.

Here are some interesting quotes from the Wikipedia article on self-injury:

The person who self-injures is not usually seeking to end his or her own life; it has been suggested instead that he or she is using self-injury as a coping mechanism to relieve emotional pain or discomfort.
...females who self-cut are more likely than males to explain their self-harm episode by saying that they had wanted to punish themselves.
...self-injury often becomes a response to profound and overwhelming emotional pain that cannot be resolved in a more functional way.

From http://www.mayoclinic.com/health/self-injury/DS00775K

self-injury is an unhealthy effort to cope with overwhelming negative emotions, such as intense anger, tension and frustration... Self-injury may accompany a variety of mental illnesses, such as depression, eating disorders and borderline personality disorder.

From the FAQ on http://www.selfinjury.com/resources_faq.html

Self-injury used to be an obscure psychiatric symptom. Most therapists didn't ever think they would be treating clients who engaged in these behaviors. The escalation of these behaviors has been so rapid that school, hospital, criminal justice, and mental health professionals have been caught off guard without the appropriate resources.

...While very few people actually die from self-injury, and it is most often not an attempt at suicide, the two behaviors are correlated. ... a good portion of kids who injure report also experiencing suicidal ideation [thoughts about suicide] (40-80%).

Apparently people didn't know much or hear much about cutting until Princess Diana admitted to it in a 1995 BBC television interview. Now, there's a documentary about cutting and self-harm in teenagers called "Cut: Teens and Self-Injury."

This is a contribution that someone wrote and submitted to http://www.coolnurse.com/self-injury2.htm that resonates a lot with me:

I hurt myself because I feel so shitty that I want to die but I can't let myself do that yet. I hurt myself because I am so angry I know that if I don't hurt myself I'll start destroying things, and I hate it when I do that...
I don't want people to notice me. I don't want people to know. I don't want to cause trouble or worry. I want to be quiet. I want to be invisible. I know that all of my problems are my fault. I know that cutting is just a bad coping mechanism. I am a weak person and I can't deal with life. I don't believe that I'm mentally ill, I just need to get a grip and grow up...

When I was in junior high and high school, I wanted to be invisible, I just wanted people not to notice me — but at the same time, I desperately wanted to be noticed, appreciated, loved, to have attention lavished on me for good reasons.

The sad irony for me is that the way that cutters punish themselves for being horrible people is just another nail in the coffin for them — "I know that cutting is just a bad coping mechanism. I am a weak person and I can't deal with life." I always thought that I was just weak and cowardly, that I wasn't strong enough to just get it over with and kill myself, but I also couldn't be happy.

This idea is very interesting to me... from http://eqi.org/cutting1.htm

The people who cut and self-injure have the same emotional needs we all do. The problem is that more of their needs are unmet. And they often are people who are more emotionally sensitive than average. This means they feel the pain of the unmet needs more than the average person, just as a person with sensitive hearing feels pain from loud noises.
...
By listening to those who are in intense emotional pain, rather than telling them they have a disorder, such as the all-too-popular "Borderline Personality Disorder," we can see what changes are needed in the homes, the schools, and the workplaces.

From Amazon.com, a very brief excerpt of a well-written review of "A Bright Red Scream: Self-Mutilation and the Language of Pain," by Marilee Strong (emphasis mine)

Answers The Question Of "Why" From Many Angles, December 28, 2003
By Renee C. Yates "naecya" (Long Beach, CA)
...you are given the message while growing up that control and perfection is crucial and any overt, yet healthy and normal, form of emotional expression is not okay for whatever reason.

From another review by Kathryn Walker on Apr 17th 2001:

...eating disorders can be understood as a type of self-mutilation. In both of these behaviors a profound alienation from the body and hatred towards the body can be discerned. The connection between eating disorders and self-mutilation in emphasizing the peculiarities of these experiences of the body also points to desires to control the body, dissociate from the body, speak through the body, and deny the body.

Beyond being an extremely illuminating and informative analysis, A Bright Red Scream presents a sympathetic, emotional, personal encounter with self-injury. Strong abandons the cold objectivity of science but in doing so loses none of the insight.

Another insightful review of this book is here. These two paragraphs describe my entire adolescence:

People who practice any form of SIV [self-inflicted violence] are not people who are at ease with themselves or with the others around them. They often feel trapped; inadequate, alone in constant emotional upheaval and pain. They very likely see no ending at all to their situation. Imagine living every hour of every day hating yourself, hating the situation you are in, and knowing that you are trapped in that situation. ...
Self-injurers are also not people who are stupid. "Self-injurers are often bright, talented, creative achievers-perfectionists who push themselves beyond all human bounds, people pleasers who cover their pain with a happy face."

This comment explains why I wanted to be invisible and yet desperately wanted attention, too:

...the self-injurer, at some level, really wants help but their fear of getting close to someone and trusting them can be the very thing that prevents them from getting the help they need.

Thinking back, my childhood set the stage for my insane adolescence. I had a decent family life — my parents were married but fought plenty, and my dad has his own serotonin issues. But the real problems started outside our home with all of the kids in our neighborhood who hated me and my brother for no reason that I could fathom. Then the girls in my fifth grade class made my life a living hell, again, for no apparent reason — but by then, and continuing on through junior high and high school, I was continually trying to figure out why me, what was wrong with me that I was such an outcast?

I couldn't ever really trust any of my peers, although I desperately wanted love and friendship. I certainly didn't fit in, so there must be something really wrong with me, it must be my fault. It was the only thing that made sense. I was constantly torn between self-hatred and seeking approval, and on top of this my hormones sent me into a suicidal black hole on a regular schedule. I had acne, I was not thin, and I was too smart to ignore all of it. I remember wishing more than a few times that I could just be stupid so that I wouldn't feel this never-ending emotional pain.

On top of all of this, the Jekyll-and-Hyde part of PMDD made me feel like I was evil, and the "nice" me was just a front, just an act that people bought into without knowing what was behind it. And this continued into my thirties... Until I read "The PMDD Phenomenon" and started on sertraline.

It's a wonder (to me, anyway) that I'm alive. It's even more wonderful that I'm relatively sane now. I can't believe that I'm employed, happily married, and so entirely functional.

I just wish I could be there for everyone else who has gone through this kind of insanity themselves. I hurt for the world.

It's only Tuesday?!?

2008-09-23T13:51:00.003-07:00

A brilliant article from The Onion (Oct. 2007) sums up exactly how I feel today.

A new wrinkle in the PMDD schedule... don't know if this is related to my strangely short cycle lately, but this month and last month, 2-3 days after my period finished, I have found myself extraordinarily cranky. And my last period was 24 days instead of 28, and the 2 before that were 23-25 days. Good grief, like I need more periods in a year!!

All my life my schedule has been regular as clockwork. Now it wants to change?? Grr.

SAM-e to methylation to copper overload

2008-09-15T20:50:00.008-07:00

I know, you read the title and you're thinking "What??"

No, I haven't gone crazy and started making up words. And I'll apologize in advance for the length of this post. If these issues don't affect you directly, you probably won't want to take the time to read it all. The payoff is information for people who deal with depression, OCD, eating disorders, PMDD, etc.

So last week, I was talking to my sister-in-law about St. John's wort (SJW), and she suggested SAM-e. Commence the research!

In looking up SAM-e, I came across some complaints about SAM-e on this website, which scared the crap out of me.

...insomnia, anxiety, fear, shakiness, and restlessness (especially restless thoughts)...

...For the first two months I took one 200mg tablet per day, and initially experienced a lift in mood and energy. This then changed to a feeling of irritability and sleeplessness. I then doubled the dose, thinking perhaps I wasn't taking enough. I now frequently wake up in the morning feeling very dizzy and disoriented. I have continued irritability and have started to be rude and snappy to my co-workers which is out of character. I read that someone else descibed a speedy feeling...

Yikes!

But about two-thirds of the way down the page, I read this comment:

I do have a theory of why SAM-e has such fantastic results for some,and is awful for others, it is the theory of methylation, Dr. William Walsh has done a lot of research on this at his clinic... My suspicions are that these bad reactions posted here are from low histamine people, who Dr. Walsh says will do terrible on SAM-e. If you want to check out this for yourself, go to www.alternativementalhealth.com, look for the articles link, Dr. Walsh, an article on methylation.

Okay... new direction.

Under the section titled "Depression," Dr. Walsh says this:

Associated with under-methylation, which results in low levels of important neurotransmitters such as serotonin, dopamine and norepinephrine. Treatment focuses on the use of antifolates such as calcium, methionine, SAMe, magnesium, zinc, TMG, omega-3 essential oils, B6, inositol, and A, C and E... Choline is anti-dopaminergic and often makes undermethylated patients worse. Also bad are DMAE, copper and folic acid. Three to six months of nutrient therapy are necessary to correct this chemical imbalance.

Interesting little side note, something that I will tuck in my bag of things-to-consider: "Another indicator of B-6 overload is the onset of vivid, troubling dreams."

Also on this site, information regarding copper overload:

The most common depression phenotype for women. History of hyperactivity, tinnitus, and skin sensitivity to metals. Females with this condition usually have significant PMS and are prone to heightened depression during hormonal events such as puberty, gestation, childbirth and menopause.

Interesting, because in The PMDD Phenomenon, the authors said that it is more likely for women with PMDD to also have significant post-partum depression and menopausal depression. Hmm...

Most get worse after chocolate which is very high in copper. This condition is non-existant in males... Nutrient support is zinc, manganese, vitamin C and B6. Nutrients should be introduced gradually to avoid side effects.

Under "Methylation":

One thing that is absolutely certain is that methionine and/or SAMe usually harm low-histamine (overmethylated persons)..... but are wonderful for high-histamine (undermethylated) persons. The reverse is true for histadelic (undermethylated) persons, who thrive on methionine, SAMe, Ca and Mg..... but get much worse if they take folates & B-12 which can increase methyl trapping.

Nearly all severely undermethylated persons have low serotonin levels and present with a history of depression, internal anxiety, and OCD. Many have a history of perfectionism and high accomplishment in the early years.

He's describing exactly what I've gone through... Almost scary, except that it's such a relief to have an explanation! It all fits so well. I was a super-over-achiever throughout school, even in kindergarten. I once came home from school crying because I couldn't cut in a straight line. I was six!! My mother always said she had no idea where I got it from — except that both my parents are also perfectionists, although my dad is worse than my mom. (The serotonin problems seem to run in his side of the family.)

Regarding the connection between eating disorders and OCD:

We have found that nearly all anorexic and/or bulemic patients are very undermethylated, low serotonin persons. Most of then respond very well, albeit slowly, to aggressive doses of methionine, Vitamin B-6, and calcium. A positive response can usually be achieved more rapidly with SAMe...
...In my experience, most anorexics are perfectionistic, obsessive-compulsive, high-histamine, low serotonin persons. Most have a history of high accomplishment in school and were never discipline problems.

Funny that all through high school and college, I thought I was a lazy anorexic... And I guess, if you look at BDD sideways, I was.

A quick way to test for need for methylation therapy is to carry out a cautious trial of SAMe. Within a week or two you should have your answer. If she clearly is improving on the SAMe (which is frightfully expensive)... you can get usually the same benefits (albeit more slowly) using methionine plus calcium, magnesium, and B-6... SAMe is likely to cause great worsening of symptoms, including mania, if given to an OVER-methylated person.

Sorry for the list of links, but there's just so much information out there. This is not even a tenth of it, just a jumping-off point.

Some more information about the effects (and side effects) of SAM-e: http://www.nutrasanus.com/sam-e.html
Information regarding the estrogen/PMS/copper relationship: http://www.drlwilson.com/Articles/PMS.htm
Copper Overload article: http://www.melissadianesmith.com/Articles/CopperOverLoad.html
"Why Am I Always So Tired?" by by Ann Louise Gittleman (on Amazon)
Information about Copper Toxicity: http://www.custommedicine.com.au/blog/2007/03/30/copper-toxicity/ — including the following list (just a partial excerpt):
1. Hormone Imbalances
2. Fatigue
3. Anxiety/Depression
4. Joint Pains
5. Poor Immunity – viral, fungal and yeast infections
6. Poor sleep
7. Hypoglycemia
An article on iron/copper overload: http://www.consumerhealth.org/articles/display.cfm?ID=19990303204921

So, I'm very sorry for the informational overdose, but welcome to my world for the past week or so! I'm fascinated by all of the interactions of minerals, vitamins, hormones, neurotransmitters, etc. And I'm surprised that so much of this information is out there, and yet no one I've ever talked to knows anything about it. Doesn't sell pharmaceuticals, I guess, so no one wants to bother? Except that I did see a naturopath a few years ago, but she just wanted to put me on some special diet and have me go to the gym an ungodly amount of hours a week — she didn't offer me a solution, which is what I really want. Even sertraline is not a solution, just a crutch.

And since I don't have a doctor that I'm happy with yet, I'm experimenting with some new things on my own. I wish I did have the support of someone with more knowledge than me, except that I generally bring a lot of new ideas/information to my doctors when I do go see them... But it's nice to have professional support.

Right now I'm trying 400mg of SAM-e every day, plus zinc supplements with magnesium and calcium, and cutting out my multivitamin, which has copper. I take 1000 IU of vitamin D, plus calcium, a B-complex with iron and vitamin C, and I think my diet is healthy enough that I'm probably fine as far as other things go. But I'm going to keep a careful watch on my health and see how it goes.

So far, the SAM-e seems to have worked wonders for me today. I felt great all day long. Will keep posting.

Day 1 on SAM-e

2008-09-15T08:49:00.007-07:00

So yesterday morning I took 200mg of SAM-e as a trial. I've read some horror stories about racing heartbeat and anxiety, but I've also read some things that make me think I'm in the "under-methylated" category* which supposedly tolerate SAM-e very well.

By way of comparison, I'll tell you that Friday, all afternoon, I just wanted to cry. For no reason. And Saturday wasn't the greatest day, ending with an evening of sullen crankiness.

Sunday, I took 200mg, and I had a pretty pleasant day. Even with all of the errands we ran, I did pretty well, and we had a good dinner.

This morning, I took 400mg as soon as I got up, and by the time my husband was done with his shower, I was positively bubbly — and this is before I've taken any zoloft. I still haven't taken it... And I'm only going to take 75mg instead of the 100mg I would usually take.

Cross your fingers that this helps long-term.

*From http://www.dr-bob.org/babble/20030525/msgs/229704.html (emphasis mine):

Undermethylation: This condition is innate & is characterized by low levels of serotonin, dopamine, and norepinephrine, high whole blood histamine and elevated absolute basophils. This population has a high incidence of seasonal allergies, OCD tendencies, perfectionism, high libido, sparse body hair, and several other characteristics. They usually respond well to methionine, SAMe, calcium, magnesium, omega-3 essential oils (DHA & EPA), B-6, inositol, and vitamins A, C, and E.

Also see:
http://www.nutritional-healing.com.au/content/articles-content.php?heading=Major%20Mental%20Illness%20Biochemical%20Subtypes

Update @ EOD: Still going strong with the happy mood.

Copper and zinc imbalance?

2008-09-10T21:11:00.003-07:00

I was talking to my sister-in-law a couple of days ago about St. John's wort (SJW), and that led to discussion of SAM-e. Research on SAM-e brought me to methylation, which led to the idea that a copper/zinc imbalance could, maybe, potentially, possibly... be part of the root of my problems? And maybe some of my family's problems?

I don't know much yet, but I will be working on a blog post this weekend detailing some more of what I've found. It's really interesting stuff.

Medical shtuff

2008-09-09T11:51:00.008-07:00

Speaking of zoloft, I'm looking into St. John's wort as a possible alternative. Now that I'm not on birth control, my options are a little wider, and I think zoloft might be contributing to my massive weight gain. That, and laziness... But my last blood test results showed my liver is stressed, so there's another reason not to be on meds if at all possible. I also found a site selling Amoryn, which is supposed to be SJW plus other good stuff, and I might try that.

The most frightening thing I've read about SJW so far is that it gives off free radicals which can damage proteins in your eye, contributing to cataracts?? Yikes. That and photosensitivity, but since I'm already fair-skinned, that won't be much of an adjustment.

I'm also looking for a new doctor, since I feel like my latest NP hasn't done a whole lot to help me and isn't very sympathetic. She has a sort of "Okay, next!" attitude, and I really need someone with more knowledge who can help me see if all these puzzle pieces I have going fit together in any sort of sensible picture.

So far, I've got the following list:

Borderline anemia (blood test a few years ago)
Extremely low vitamin D (blood test more recently)
Physical symptoms indicating pre-menopause? (recent subjective assessment — since stopping BC pills)
Normal hormone levels (recent blood test)
Normal blood sugar levels
Reactive hypoglycemia symptoms that go away after eating
Regular, monthly PMDD symptoms
Body dysmorphic disorder, possibly some slight OCD tendencies
Steady weight gain — 50 lbs since June 2008

In fact, I've struggled with weight all my life, but I do have muscle, and I do have a very defined, curvaceous figure. One site I found determined that I'm an endo-mesomorph. Endomorphs have lots of loose tissue, and mesomorphs have muscle.

My hip-to-waist ratio is .66, I believe. Of course, that's 35" waist and 52" hips... Yikes. I do miss all my fun clothes.

Well, that's what the treadmill is supposed to help with, right? Exercise is also supposed to help with PMDD.

My latest NP had me try metformin at a very low dose to see if I had PCOS; I lost 5 lbs immediately without trying, and have since gained that back plus 6 lbs. Oh well, so much for that. I stopped it after my refills were up because it wasn't doing anything besides upsetting my digestive system and stressing my liver even more. Who needs that?

But I do wish I could find someone with more medical knowledge who could help me determine if there's something larger than the PMDD/zoloft/hypoglycemia-that-isn't-hypoglycemia going on. Here's hoping...

PMDD dreams

2008-09-09T11:27:00.006-07:00

I had a dream this morning that two guys (played by Nathan Fillion and Adam Baldwin) were trying to shoot me and my husband.

It started out that I was trying to get directions on my iPod Touch, but Google maps was being really stupid and giving me dumb directions. It was late at night, and I vaguely knew where I was going, so I just started driving in the general direction. I met up with my husband at some sort of old fashioned gas/service station, where we saw these two guys. They suddenly decided that shooting us was a good idea, but we had guns, too, so we fought back, but mostly had to hide.

Somehow this segued into the next dream, which was that one of my cats got out and someone found him, but didn't bother locating us. They decided that he should be a "therapy cat," so he was featured on the news where I saw him. I went down to the TV station and got him back, but then discovered that while he was becoming a therapy cat, they discovered that he had urinary problems and would have to be on special food for the rest of his life. On top of all of this, I kept trying to explain to people that these guys had been shooting at us, so I was more than a little upset.

The night before, I had a dream that my mother-in-law and sister-in-law were being themselves, which sometimes irritates me. The stuff they were doing wasn't even important, but somehow I was off-the-charts irritated, and I was being completely psycho about it.

Every month I can count on at least 4 nights of disturbing dreams. Not usually scary, but really unpleasant and not restful at all. It makes me not want to go to bed, which leads to some pitiful minor arguments with my husband.

My friend suggested red wine as a solution, but drinking before bed makes me groggy in the morning — plus there's the whole alcohol-and-zoloft-don't-mix aspect. So far, my solution involves "junk" TV (usually sitcoms) to turn off my brain, pzizz sleep tracks, and my wonderful husband rubbing my back, which helps relax me.

Weird periods and even weirder PMDD

2008-08-31T22:57:00.004-07:00

So the past two months, my period has started about a week earlier than I expected it to. Then this month, AFTER my period was over, instead of going through spring, summer, fall and winter, my body switched things up on me.

I went through about 2 days of spring, and then straight back into winter. BAD winter. I went from 25mg to 100mg and stayed there. My face broke out like crazy, and I was totally unprepared for all of it.

My husband and I also went through a little flu bug, very mild, but still not fun. I don't know if that screwed up my hormones, or what, but I wish it would all settle down!

In other news, I now have a treadmill and TV in the bedroom, so hopefully the exercise regimen will commence. I did 10 minutes the other morning before work, which was nice. I don't have huge goals, just want to be more active while watching TV. It would be very nice to fit into my favorite clothes again, and exercise is supposed to help moderate PMDD and even out blood sugar levels.

PMDD B.S. — before sertraline

2008-08-31T22:55:00.002-07:00

More following in this vein... The following are some of my strongest PMDD memories:

When I was editor of the yearbook, I remember calling the yearbook advisor, crying my eyes out, to say "There's not going to be a yearbook, is that okay?" I'm sure he had no idea what to do with me...

I remember sitting, huddled on the bathroom stall floor in my dorm, sobbing and scared to death because I had to go be in charge of a staff meeting.

I slept in my yearbook office a few times because I was so furious at my roommate that I couldn't deal with her at all.

One time, I woke up at 4 in the morning when she came home late from being out with a guy I didn't like. I was in a photoJ class, so I headed off to the darkroom to develop film while listening to NIN. It was really weird that the CD lasted exactly as long as it took me to develop the film.

I remember screaming at a living room full of people in the dorm. I stopped, realized I was acting like a crazy person, and ran off to my room to cry. I had no idea at the time why I was so insane.

I missed out on most of the wonderful experiences on choir tour because of PMDD.

I spent much of my time in high school and college trying to figure out why I could never be happy, why sometimes I wanted to kill myself and the rest of the time I just existed. While I'm happy that I figured out the problem and found a way to treat it, I am so sad that I missed out on what should have been the most exciting years of my life. I never had a plan, I never thought "I want to do this when I grow up" — because I never thought I would grow up. I thought I would be dead before 30.

Random tidbit

2008-07-29T10:52:00.004-07:00

If you have an Apple Mighty Mouse (with scroll "pea"), it will likely end up not scrolling at some point. Or (strangely!) scrolling up, but not down.

There are plenty of sites out there telling you how to take the thing apart, or to clean it with alcohol, etc.

What worked for me: unplug the mouse, turn it upside down on a clean piece of paper, and roll it around to get the gunk off. I read this on one forum, and it worked SO well, I'm posting it here in the hopes that someone will be helped by this. I didn't have to take anything apart, and it was really easy.

On a side note... (continued)

2008-07-25T15:14:00.004-07:00

The talk with the teenagers went well. I wasn't sure at first that what I was saying would matter to them, but their director asked some good questions, and they started to open up. Several of them have had similar experiences, and there was a lot of good discussion. I told them all, if they ever need to talk, I'm here to listen. They're good kids, and thank goodness they all have theater to support them. Drama kids are always the most accepting, most comfortable, and most emotionally supportive, in my experience (at public schools, anyway).

I hope that I can do more of this kind of thing in the future. It never occurred to me till today that the girls in 5th grade were getting a power trip out of targeting me.

On a side note...

2008-07-22T14:28:00.004-07:00

I've been asked to come speak to a group of teenagers about my experience in fifth grade – classic "mean girls" experience, or "relational aggression," as they now call it. I'm nervous, but not because I have to talk about what happened to me. I'm nervous because these are 14-15 year old kids that I don't know at all, and I have to try to get the point across to them, try to say something meaningful, relevant, interesting... and this is my own personal hell. So if they don't care, that's going to hurt.

For third grade, I transferred to a different school to be in a gifted program. I only knew the 30-40 kids in my program, so I had a limited social circle. In third grade, I had a few friends who dumped me when we got to fourth grade for the cooler girls. In fourth grade, I became friends with two girls, S and C. We were very close, had lots in common, and had the same circle of friends. In fifth grade, however, they turned on me, and not in a small way.

At age 10, I became an outcast. Of the 30 or so kids in my class, two would speak to me, at least 10 were out to get me, and the rest didn't care if I existed. S was the general and C was her lieutenant, and the rest followed their lead. They formed "hate clubs" about me, which they claimed — when the teacher confronted them after I complained — were really animal lovers' clubs. They came up with the stupidest insults based on my name, took away the few friends I had left, and made my life a living hell.

I walked home crying from school every day. I tried to tell my parents, but they didn't understand. Their answer was always "Oh, they're just trying to get a rise out of you. If you ignore them, they'll go away." My teacher didn't believe me, and S&C would lie when he asked them about it.

By the time my mother realized that this was really a problem, it was way too late. I was emotionally scarred for life. She took me out of the program and I went back to my original elementary school, where I tried to become invisible. I hit puberty, developed mild acne, body dysmorphic disorder, and PMDD.

In junior high, I worked even harder at becoming invisible, until in high school I was convinced that people couldn't see me — not literally, but they didn't remember my face, would bump into me in the hall, and just generally ignored my existence.

I also struggled mightily with suicide, especially with PMDD layered in on top of BDD. I wanted so badly to kill myself for so long, and I thought it would never be possible for me to be happy. I cut myself, thought I was a lazy anorexic, and generally hated my existence.

For the next 10 years I tried desperately to figure out why they had picked me, what was wrong with me that made them single me out. Finally one of my close female friends — one of two, since I don't trust girls at all — said "Maybe there was no good reason." I had quite a struggle with that idea, but finally realized that she must be right, because it's just what girls do to each other, and I happened to be the weakest in the pack, I suppose.*

But now it's my personal, quiet crusade to try to keep this from happening to any other girls. I know it will continue to happen, but whatever I can do to prevent it, I will. I ended up talking to my aunt and uncle about it when my lovely, sweet teen-age cousin was experiencing something similar in junior high.

* 08/04/11 ETA: A couple months ago, my therapist suggested that these girls picked on me because I am highly sensitive. As my friend put it, "You were the toy that squeaked the loudest." This fits so well that I can't believe I never thought of it, but it has radically changed my understanding of who I am, what I have to offer, and how I fit into the world.

For years, I assumed that these girls picked on me because there was something fundamentally flawed in me that I needed to hide from the world, but I didn't know what it was. Now I believe that it was simply because of my sensitive nature, which I have learned can be a useful tool but also needs to be protected. (It also explains why my Dad would constantly tell me "You're too sensitive!" "Don't be so sensitive!") Sadly, the adults in my life didn't know how to protect me, and it's taken me 20+ years to recover.

This is a related post from 04/15/08 about my first memory of PMDD-induced insanity.

The joys of extended PMS

2008-07-21T07:35:00.001-07:00

So my period won't start till 8/1 or thereabouts, but Saturday my skin decided to break out in force — a huge crop of zits sprouted all over my forehead, hairline, beside my nose and on my chin, of course. Three were extremely painful, and one was the classic hormone-induced under-the-skin volcano really painful variety. The mother lode...

Yesterday I had a narrow miss with a serious emotional crash. My regular hairstylist* is out for a few months because her husband is going through chemo and a bone marrow transplant. Yikes.

So that means my haircut appointment this Wednesday is cancelled; and then I heard that the local salons were doing a benefit for her yesterday, all proceeds from haircuts and color appointments would go to them. So yay, haircut appointment PLUS helping her out. Sign me up.

I knew going into it that it would not be the greatest haircut in the world... But I was prepared, I even brought a picture of me on the day of a haircut, with the style exactly as I'd like it. But alas, no dice. She cut my bangs way too short, and then tried to PULL them into the flippy thing that my hair does naturally with enough length. Grr.

So I went home and tried not to be too disappointed. It's a good cut, well-executed, but just too boring and bland for my tastes. But later in the evening, I looked in a mirror — big mistake for someone heading down into hormone hell with a history of body dysmorphic disorder...

I could feel the crash coming, so I grabbed my husband, cuddled up on the bed with the cat, and tried to overcome it. He knew what that meant, and just held me till I could talk, which thankfully wasn't long. We talked about what was wrong and negated the "I'm a horrible, ugly person" thoughts. After a bit (bless my sweet cat!), I was feeling better and we went back to work unpacking.

But it was close, and it's still 10 days at least till my period... I will have to be careful this round.

The thing I'm most grateful for is that I am so stable these days. I know what's wrong with me, and I know how to combat it. It's still there, and it still threatens to hit hard sometimes, but I'm so much more sane than I used to be. When I didn't know that it wasn't me, I consistently wanted to kill myself, or at least die, because I was fine sometimes and not other times, and it seemed like there was no predictable pattern. Just knowing that I'm actually a good person makes a huge difference my identity/self-esteem/will to live.

*What do you call the person who cuts your hair? I don't consider her a hairstylist, although technically I suppose that's correct. Coiffeuse? Hair-cutter? "The woman who cuts my hair" seems a little unwieldy, and hairstylist seems pretentious.

Pretty good month

2008-07-03T22:11:00.000-07:00

This month has gone by quite smoothly, except for a weird little hiccup in the middle that I still don't understand. I felt almost like I was getting my period 2 weeks ago (2 weeks early); I felt awful for most of the afternoon, then felt like I had cramps, cried, was clumsy, and couldn't figure it out.

Other than that, though, this month went really well. I only got cranky 4 days ago, which is 6 days later than usual. My skin is breaking out like crazy, but the thermaclear does help noticeably (and the batteries are still going!)... if only I could keep me from making it all worse.

And it's been a crazy month, with the show, the new house, moving, and work being crazy. My sweet husband is just more and more amazing; he takes care of so many things, and me. Our anniversary was lovely. Lately I feel like I've been slacking off, so I need to start pulling my weight more. Not that I do nothing, but he's been doing a lot.

But my eyes are closing, so it's time to head to bed. Of course, on 7/3 in the U.S., that's kind of difficult... fireworks, fireworks, fireworks. I'm going to ignore them and go to bed anyway.

Chocolate cravings

2008-06-19T13:13:00.001-07:00

Let's see... before lunch, I wanted to go home and curl up in a little ball and not face the world. After lunch (yum! Chicken and wild rice casserole from Mom), I ate 4 snack-size KitKat and Crunch bars. Pre-menstrual much?

Also, my skin is breaking out something fierce, but luckily the ThermaClear seems to be working. It's not a miracle worker, but those painful underground zits do go away pretty quickly. My batteries are almost dead, though — but they've lasted a while.

More success in weathering PMDD

2008-06-05T16:43:00.000-07:00

So this time around, I have managed to stay relatively positive, happy, and controlled. My skin has broken out some, but the Thermaclear seems to be helping a lot. Yay, Thermaclear.

I did have an incident the other morning where I was late getting going and at the last second before leaving the house decided that I wanted coffee after all. I spun the carafe lid too far, and when I poured it, the coffee went everywhere. I lost it, literally screaming and crying, and I knew at that moment that it was completely PMDD-induced.

I was able to calm down fairly quickly, although there was some yelling and plenty of crying. My husband is wonderful, helped me clean everything up and told me that it was all going to be okay. I couldn't stop crying until about halfway to work, and spent the rest of the day feeling tired and down, but not depressed.

Overall, I'm doing so much better than before sertraline. I'm so grateful to have a solution.

Oh, and we finally got the house!

In other news, I got the results of my blood tests back, and other than my liver seeming stressed (which might be from sertraline/the pill/other reasons), everything seems pretty normal. My LH level was slightly above normal, but not a lot. The weird thing is that I lost 3 lbs the first week on metformin. I dunno... need to talk to my doc.

Paranoia

2008-05-30T12:37:00.000-07:00

Oh, what a fun symptom of PMDD... Today I feel like everyone at work is looking at me through squinty eyes, as if to say "You're not working hard enough, you don't belong here, and we don't like you anymore."

It doesn't help that I can't seem to get to bed on time these days, which means I really don't want to wake up in the AM, so I get to work usually around 30 minutes later than I'm supposed to. But it's also hard to get to work on time when it's not busy, and it's been not busy for a while. It just adds to my fear that they're going to think I'm not as wonderful as they had expected.

In reality, I've exceeded their expectations, they love my work ethic, my attention to detail, and my talents. I know, intellectually, that they couldn't be happier with me as an employee, but emotionally, I expect the axe to drop any moment. And I know that that feeling is artificial, so I'm going to take another 25-50mg of sertraline, even though I'm at my usual max of 100mg already. I think the extra stress of the house situation, not to mention sleep debt, are making things a little worse this month.

And overall, I'm doing really, really well, for PMDD. I'm positive, focused, and generally clear-skinned. I can sleep, I have some disturbing dreams, but I'm doing all right. I'm not crying or screaming, not angry at people (just a bit irritated), and I don't want to kill myself.

Once again, yay for sertraline.

The PMDDragon rears its ugly head

2008-05-27T19:13:00.000-07:00

I spent most of yesterday wondering why I couldn't focus, couldn't get anything done, couldn't just buckle down and do something! I spent the morning walking from room to room, starting and stopping projects because I kept needing something from another room, where I'd start another project until I left that room for some necessary item. I was so frustrated, so foggy, so tired all day long.

I managed to do laundry, go to the craft store, and do some other random things. I did not manage to do the dishes, fold the laundry, go to the grocery store, or clean up the house. I felt like crap.

When my husband came home, I told him about my day, and I was almost crying, trying to figure out why I'd been so useless. As we were talking, I realized that it was all very PMDD-like, and he agreed. Suddenly, just knowing the cause, everything got better. I took another 50mg of sertraline and stopped being so hard on myself. I managed to enjoy the barbecue at my brother's house and had a decent rehearsal.

I do tend to have a PMDD spike at or just after ovulation, and then it dips and builds back up towards the end of the month. I just forget about this pattern, because before the spike I have summertime! And things are so good. But it's fall now, and I will keep on top of my dosage for the next 10 days.

Yay for sertraline.

Summertime, and the livin' is easy...

2008-05-25T17:05:00.000-07:00

Yes, it's summer again (both literally and hormonally). This month it took me a little longer to get out irritation station, probably because I'm impatient about the house we're waiting to buy. We're so very, very close to closing on it, and yet... We've been waiting for so long, it feels like it will never happen. So there were a few extra days of higher-dose sertraline to deal with the cranky me.

And then there was the doc appt for my annual exam, which instead turned into a big crying-fest about my weight problems. My NP is doing all sorts of blood tests because she thinks I might have PCOS and/or diabetes and/or some other endocrine problem. Apparently parts of me seem almost pre-menopausal, entirely too early (I'm 31!) ... yikes.

So I had to do a fasting blood draw (4 vials), and my veins are nearly impossible to find, plus entirely uncooperative once they are found. The poor NP and assistant had to spend quite a bit of time with me and take samples from 2 sites. The post-prandial draw was just 1 vial, and seemed much easier.

So now I await the results... I don't know what to think. It seems like diabetes is an unlikely diagnosis, since I really struggle more with (reactive?) hypoglycemia. But I've also never been diagnosed with this, just figured it out on my own... and don't really understand the differences between all of the different terms. All I know is, if I don't eat every few hours, I will get shaky, tired, dizzy-feeling, and light-headed, plus I lose a lot of my verbal capabilities. Soon as I eat, everything is fine.

We shall see... we shall see.

Newsflash: PMS is unpredictable!

2008-05-15T10:29:00.000-07:00

From The Truth About Premenstural Syndrome - Myth Or Real?

Emphasis in 2nd paragraph is mine.

In the 1970s, a vague cluster of physical and emotional symptoms associated with the days preceding menstruation, including fatigue, headache, irritability, and depression came to be thought of as an illness, and was given the label PMS.

Right, because no woman before 1970 had ever had any symptoms related to her period... suddenly, in the 70s, this "vague" cluster just appeared! with no warning! What will we do?? Quick, give it a name, because it's obviously never existed before, it's a brand new discovery with no historical evidence!*

So what does the evidence actually show? During PMS women will experience certain physical symptoms, including cramps, breast tenderness, and water retention, and of course these physical symptoms can make some women feel grumpy or unhappy, just as pain can make men feel grumpy or unhappy. But emotional symptoms associated with menstruation – notably, irritability and depression are rare. In fact fewer than 5% of all women have such symptoms predictably over their cycles (source: Brooks-Gun Differentiating Premenstrual Symptoms and Syndromes. Psychosomatic medicine, 1986; Reid, R. L. 1991 Premenstrual syndrome. New England Journal of Medicine).

If the mood swings associated with PMS are so uncommon, then why do so many women think they have it? According to a Canadian psychology text; one of the reasons could be because women tend to notice the feelings of depression or irritability when these moods happen to occur premenstrually but overlook times when such moods are absent. Or may label symptoms that occur before a period as “PMS” and attribute the same symptoms at other times of the month to a stressful day or a low grade on an English paper. Cultural attitudes and myths about menstruation can also influence a woman’s perceptions of her own emotional ups and downs.

So let's see... fewer than 5% of all women have such symptoms predictably over their cycles. So some women do have these symptoms predictably (fewer than 5%).

One assumes that the other 95% might have some of these symptoms one cycle but not the next (unpredictably) — which seems pretty consistent with my friends' experiences with regular PMS. Some months are worse than others. There are infinite factors to consider that could affect anyone's mood and physical health.

But that 5%... that seems to correspond with the numbers that I've heard for PMDD (anywhere from 3-9% of women). So is this article trying to say

that PMDD is real only for that 5%?
or that, because 95% of women don't have "predictable" PMS/PMDD, it doesn't exist at all?

Just because something is rare doesn't mean it doesn't exist.

I appreciate the argument that dismissing any woman who exhibits any crankiness/anger/irritation/etc. with "oh, it's just PMS" is a horrible thing. Women get irritated, frustrated, and angry for many valid reasons.

I know that much of my anger, sadness, irritation, etc., are not caused by PMDD. I can recognize the normal kinds of anger and the out-of-control PMDD-caused anger because I've been through it long enough to know. It's very clear when my actions are totally out of sync with my normal self, and knowing that it's PMDD helps me stop and reassess the real reasons for my words and behavior.

The main difference is, when I'm angry and in control of myself, I can use that anger to be effective and make appropriate changes in my life. I can be powerful.
When I'm angry and out of control (PMDD), I want to kill myself. I am powerless, depressed, and suicidal.

If anger is warranted, I will get angry. But screaming at my cats for meowing while I get their food ready is unreasonable.

*Re: Historical evidence for PMS/PMDD:

An excerpt from The PMDD Phenomenon, by Diana L. Dell, M.D., and Carol Svec — one of my favorite books, and the one that helped me turn the PMDD corner and get well.

Premenstrual Dysphoric Disorder (PMDD) is a new name for a condition that has been described both by physicians and by women for centuries. ... The concept of difficult premenstrual symptoms has been around longer than there has been formalized medicine. Since the time of Hippocrates, healers and physicians have described women's premenstrual discomfort in terms that are still being used today: mood changes, sadness, depression, weepiness, anxiety, irritability, psychosis, impatience, and nervousness.

Code Red once again

2008-05-07T12:45:00.000-07:00

No sooner posted than proven wrong.

At least the emotional symptoms aren't even close to as bad as pre-zoloft. But over the last few days I've been:

furious (as in wanting to yell and honk the horn) at my husband for taking more than 30 seconds to drop something off
brain-fogged and fatigued
unwiling and uninterested in sleeping in my own bed
and inundated by mild acne (more on this below).

This morning I was so befuddled that I couldn't figure out what to eat, and just kept opening and closing the fridge door. I also couldn't figure out what to wear, and did likewise with the closet door. I desperately want to bring my cat to work for comfort, and I feel tired all the time. I feel like it can't possibly be just Wednesday... hasn't it already been a week since Monday??

I can't handle anything that doesn't go exactly as expected — including attempting to open a particularly difficult tupperware container! I realized that it was going to make me scream, stopped and closed my eyes, and just handed it to my husband.

Thank goodness we both know about PMDD and I can have him take over things with no explanation necessary. He is so sympathetic. He can tell when I need him and he just holds me. I am so grateful for his help.

I'm also trying out Thermaclear... literally a zit-zapper. I researched both Thermaclear and Zeno, and I'm just not interested in spending 2.5 minutes per blemish, plus the 30 second recharge time.

I had read lots of reviews of both devices, and it sounded (from some people) like the main drawback to Thermaclear was a horrible electric shock feeling, like one of those dog collars for invisible fences. That's what I expected... and I found out that it's next to nothing, even on the top setting.

I tried it on my arm first, and almost couldn't feel it. The feeling certainly is stronger on my face, and the more times I use it, the more intense the feeling is because the tip heats up a little. There's a warning on the device itself not to use it near your eyes or lips, and I definitely agree with that. Even the tender skin between my nose, cheek and lip (you know, mustache zone) is harder to do than elsewhere.

But even after the tip has heated up a little, on the most sensitive part of my face (not eye or lip areas), the strongest reaction I've had is to flinch ever so slightly. So now it just remains to see if it's effective on larger, hormone-induced acne.

Doing pretty well this month

2008-05-04T20:13:00.000-07:00

This month has gone pretty smoothly so far. I've had one evening of minor irritation, a weekend of general sleepy laziness, and a little bit of general frustration — plus the one night of inexplicable crying that I posted about before. But my skin is fairly clear (for me, this time of the month), and I've been pretty calm and happy in general.

I don't know if this is due to a low stress level this month, or the fact that our house purchase is finally proceeding, or just general fluctuations in the weather, hormones... whatever. I'm glad, and my husband is glad. Let's hope the trend keeps going this way!

Google: PMDD is real (part 2)

2008-04-30T15:31:00.000-07:00

Interesting (slightly technical) information from the Australian National Prescribing Service website*:

Diagnosis: PMDD is not the same as PMS

PMDD is an extreme manifestation of premenstrual syndrome (PMS). While PMS is experienced by many women, the more severe disorder is experienced by relatively few. It is characterised by:
severe mood changes premenstrually, which abate after menstruation
significant functional impairment disrupting work, social activities, and/or relationships.

Is PMDD a real disorder?

There are debates about the validity of the disorder. Supporters of the PMDD classification argue that better recognition will allow treatment of distressing and disruptive symptoms. Others argue that inclusion of menstruation-related mood changes in DSM-IV stigmatises women and encourages drug treatment of a normal experience.

This I find particularly interesting:

There may be therapeutic value in recognising that the symptoms are distressing and affect women’s lives. The fact that trials provide ongoing follow-up and discussion of symptoms may account for high placebo effects in both drug and non-drug trials.

One of the main things that made my life significantly better after reading The PMDD Phenomenon was just knowing that my problems didn't stem from a lack of physical or mental fortitude, or from some moral failing. I learned that this monthly insanity was not me, it was my off-kilter brain chemistry. Just knowing that helps me so much, I can imagine that women participating in a study would improve with regular care, and the researchers would see it as a placebo effect.

*From their website: "NPS is an independent Australian organisation supporting the quality use of medicines."

Sad for no good reason

2008-04-25T23:51:00.000-07:00

I'm working stage crew for a show, and for some reason, at the end of this particular show each night, I feel sort of vaguely sad. So far, it hasn't had a huge impact on me, but tonight was a different case. People hung around afterward, socializing as usual, and I felt totally alone, isolated and unconnected with the group. I started to feel like I have no friends, that no one loves me except my husband, and I have no connections with anyone at all. I drove home feeling incredibly down, and when I got into the house, I just started weeping inconsolably, apropos of almost nothing. Even though I know that it's not true (and what a wonderful thing to know!), it doesn't change the feelings. But at least I don't believe them, and I know that it will pass. Today was 50mg, tomorrow I will up my dose again to 75mg. Well... maybe 50mg in the AM and 50mg in the PM, since there's another show tomorrow night.

Code Yellow kids... the zits are invading.

2008-04-25T07:38:00.000-07:00

Dreams are staying vivid and weird, although not as disturbing as I had feared anymore.

But the painful hormonal acne has started. Yech. I haven't even totally healed from last month!! There's one right at the bottom corner of my nose... can you say OW?

I'm going to order a Thermaclear and see if it helps any. I've read good and bad reviews, so I guess the proof is in the pudding.

The bad dreams are starting...

2008-04-21T12:41:00.000-07:00

I forgot, another symptom of PMDD for me is very vivid, weird, disturbing dreams.

This AM it was a mish-mash of murder, mayhem, religious fanatics, and weird slimy creatures — possibly even aliens, I'm not sure. None of it made any sense, none of it had anything to do with my real life, and all of it was sad-making. I did manage to evade the people who were trying to do me harm, but I woke up feeling extremely unsettled.

It gets to the point where I don't actually want to go to bed because I know I won't sleep well. But the "sleepy tea" (a combination of Tension Tamer and Sleepytime/Sweet Dreams tea) helps me have a more restful night.

Definitely heading towards Fall/Code Yellow.

Things I've done under the influence of PMDD

2008-04-20T20:20:00.000-07:00

Kicked shoeboxes, breaking the frame of a wall mirror, and almost breaking a window

Broke a computer peripheral by throwing it at my desk

Broke a cat litter scoop handle

Screamed at my cats, my VCR, my computer, my DVD player, and my husband

Freaked out on a fellow cast member in a show (Her words: "Whoa sweetie... you just went from zero to sixty on me and I have no idea why.")

In high school in the midwest, I went for a walk in the dead of winter in a tank top and sat under a tree, hoping I would freeze to death.

More than once, I have not eaten for more than a day in an attempt to punish myself for being fat.

Also more than once, I have slept on the floor or the couch (to punish myself) after having a PMDD-instigated argument with my husband.

Once, I got so angry and despondent that I left the house without telling my husband and drove off, intending to jump off a local bridge. Thankfully, I have a very strong survival instinct and I ended up going to my parents' house instead. I told my parents not to call my husband because I was so angry that I didn't want him to know where I was. Of course, they didn't listen to me, and bravo to them.

This was actually a major turning point in our relationship, because before this, my husband tended to just leave me alone when I "shut off." I felt like he didn't care, but he really didn't know what I was going through.

The way I explained it to him, it's like a whirlpool.* Something sets me off and I get mad at myself. I start to feel like I'm a horrible person, and I find that talking, expressing myself in anyway, is next to impossible. It's like my mouth is glued shut. My thoughts head into an ever-worsening spiral of self-loathing, and I end up curled up on the bed, wishing I were dead, and sometimes actually trying to act on it. Before I was able to explain this to him, he didn't know what to do and tended to just leave me alone till I came out of it. But that led to me leaving the house and driving off on my own, headed for that bridge.

After this experience, we had a long talk. I promised that I would never leave the house like that again, and he promised that he wouldn't leave me alone to deal with it on my own.

The next PMDD event after this, I was sitting on the bed, unable to talk, heading down into the whirlpool. My dear, sweet husband was sitting on the floor next me, rubbing my arm, trying to do anything at all to help me (but feeling pretty lost). For the first time, amazingly, the whirlpool feeling dissipated, like cloud cover burning off. I was able to rally and get back to my somewhat-normal self — at least enough to talk to him.

I told him that it had stopped, and that I thought it was because he was rubbing my arm. With further experimentation, over the next few times that it happened, we discovered that if he touched me, if there was any sort of physical contact at all, then I wouldn't end up in a black hole of suicidal despair.**

Since I can't talk, it's become a signal to him that if I curl up on the bed, I need him, right then. He drops whatever he's doing and curls up around me, holds me and lets me know that he's there, and it makes everything bearable. Sometimes I manage to come out of it, and sometimes I cry, but it means that I won't end up in that black hole. It's absolutely amazing to me how supportive and wonderful my husband is. He has taken the brunt of my screaming, crying, insane-asylum-quality episodes, and yet he still loves me unconditionally and supports me in whatever way he can. Now that I have some better coping mechanisms and the support of sertraline, I'm myself probably 90% of the time, and the other 10% is at least not as bad as it used to be.

*Interestingly, my dad has told my mom that the same kind of "whirlpool effect" happens to him when he gets depressed. Our personalities are remarkably similar, but his emotional problems aren't based on a monthly hormonal cycle.

**I think it's because of two things: 1) if I have physical contact with him, it helps get me out of my head, back into the real world, and 2) it shows that someone actually cares about me, and makes it harder to believe the negative thoughts that "I don't matter, and I should just die." I also learned from my therapist that talking about my feelings helps engage my logical brain and helps stop the emotional whirlpool.

Success in spite of it all

2008-04-18T16:12:00.000-07:00

Sometimes I look back at my life and feel amazed that I succeeded as well as I did, in spite of severe depression, layered with body dysmorphic disorder (BDD) and PMDD.

I managed to keep up an impressive GPA in junior high, high school, and college, including honors classes and some pretty tough projects. I had a scholarship, worked on a major project that succeeded quite well, and held down several different, stressful jobs.

I've also done many things that I'm totally ashamed to remember, but I know that most of the time, I was not in my right mind...

No wonder I thought I was evil or insane, when I could be so successful and yet so out of control, with apparently no way of knowing what was going to happen next!

Knowing what I know now, I wish I could go back and do it all over again. I missed out on so much, and I probably hurt and confused so many people. I wish I could have that time back.

My monthly "seasons"

2008-04-15T22:31:00.000-07:00

Hedonistic Pleasure Seeker characterizes her level of PMDD symptoms with "Code Orange" and "Code Red," which I thought was very clever. But then my husband reminded me that I came up with the metaphor of seasons a while back, which is entirely appropriate. Here's the breakdown of my monthly "seasons":

Period Week:

Code Orange to Code Green
My physical and emotional symptoms subside with the onset of my period, and my libido switches from first gear to third — but I have to wait till Aunt Flo leaves town. I know, some people are okay with sex during their period, but I'm just not interested in the mess.

Sertraline dosage: 100mg to 25mg

Spring to Summer:

Code Green!
Heading towards ovulation, my libido kicks into overdrive. Summer summer summer time, summer time! My husband and I like this week. My skin is clear and I'm a happy girl. During "summer," I always think of the character of Chameleon in the Xanth novels that I read as a teenager.

Sertraline dosage: 25mg to 0mg

Summer to Fall:

Code Green to Code Orange
I start getting minor acne breakouts, especially around my chin and nose. Code Yellow starts when I come home from work one evening and find myself irritated at Every. Little. Thing. Especially at my husband, who is the picture of patience and doesn't deserve my unreasonably snappish behavior.
I'm good enough at recognizing this now to stop myself before it goes too far and apologize for the snapping that I've already done. He's also very understanding, for which I am grateful.
Code Yellow can last from one to three days, depending on the month. Then it's straight to Code Orange.

Sertraline dosage: 25mg to 75mg

Fall to Winter:

Code Orange to Code Red
Things head very quickly downhill from here. I am easily irritated, easily depressed, and very easily worried. I will often lose half of a Saturday because I just don't want to get out of bed — usually from fatigue and/or apathy, but sometimes from sadness or worry. I get cystic acne, which is incredibly painful, plus my semi-dormant BDD makes me obsess about my appearance. I retain water and my breasts swell, which means none of my clothes fit. I have spent mornings in bed, despairing of ever finding something to wear to work.
Thankfully, when I am at work, I can focus on work and forget about other things. But sometimes work can be the problem, and I can easily freak out about little things.

Sertraline dosage: 100mg

My experience with side effects of sertraline

2008-04-15T18:44:00.000-07:00

Surprisingly, both fluoxetine and sertraline have helped me sleep better. I've had trouble getting to sleep all my life because as long as there's any sort of stimulus, my brain wants to see what's going to happen next. Also, I have a hard time winding down. But SSRIs seem to help me "shut off" at night, which is really quite nice. My husband also makes me "sleepy tea," which is a combination of Tension Tamer and Sleepytime/Sweet Dreams tea. It seems to help me sleep more restfully.

During the first month or so that I was on sertraline, my hands itched like mad, but I can't say for certain that it was because of the meds. It started at least 2 weeks after I started the meds, and went away after about 6 weeks.

The weirdest side effect is what I call "chemical yawns" — completely different from normal yawning. I feel absolutely compelled to yawn as wide as possible, over and over again. If I don't yawn, or if it gets interrupted, I'm distinctly uncomfortable until I "finish" the yawn. It seems to be worst when my blood sugar is low and goes away as soon as I eat something.

Lately I've been having night sweats, which is pretty icky. I wake up drenched, lying in what feels like a puddle. As soon as I wake up, it goes away, but it takes a while for the sheets to dry out. Still, I feel like this is still a small price to pay for sanity.

Thankfully, I haven't had any problems with my libido — it's actually improved a bit because I'm not so hard on myself and I can feel interested in sex more often. I really enjoy my physical relationship with my husband and felt like I was missing out before.

I also don't feel like a zombie or a Stepford wife. I experience normal highs and lows in my emotions, and I feel like myself for a bigger portion of the month than before.

So my experience with sertraline has been very positive. I'm going to keep a watch on it, of course, because I've heard enough horror stories — but overall, it works for me.

A Note About PMDD

2008-04-15T12:52:00.000-07:00

Excerpts from "A Note About PMDD" by Paula Green:

Many people still believe that the emotional symptoms caused by PMDD are not real, and that a woman should be able to shake off the symptoms if only she tried hard enough. Because of these inaccurate beliefs, women with this depression either may not recognize that they have a treatable disorder or may be discouraged from seeking or staying on treatment.

Some believe that it is just mother nature working and that every woman will experience symptoms similar to PMDD in her lifetime, so why label it a disorder. "Having a period is no different than having a bad hair day! So get over it. This whole disorder thing is nothing but a medical term for the monthly curse."

When I was younger, my dad (who is now very sympathetic) told me "You're just not happy unless you're miserable," and "Don't be so sensitive!"

A friend in college told me to "just smile and act happy, and you'll be happy."

People who have not experienced it have no idea what PMDD is really like.

Google: PMDD is real (part 1)

2008-04-15T11:35:00.000-07:00

This is an interesting article discussing the ramifications of PMDD being diagnosed as a mental disorder. It has some good arguments (the same arguments I see everywhere), and I can see both sides of the discussion. But this part stood out to me:

Joan Chrisler, PhD, a psychology professor at Connecticut College and president of the Society for Menstrual Cycle Research

…agrees, noting that not only is the diagnosis part of a "backlash against feminism," it undermines women's self-concepts and feeds into stereotypes about women. "It's convenient for women to use this," says Chrisler. "The discourse is me, not me, my real self, my PMS self. It allows you to hold onto a view of yourself as a good mother who doesn't lose her temper."

Except what Joan Chrisler doesn't know is that I'm not a mother, I'm not a cheerleader type, and I'm not a "good girl." I can be blunt, honest, and totally undiplomatic as my real self. I have never liked to back down, and I sure as hell don't water down my attitude to be "nice."

But what happens with PMDD is that I literally become someone else, someone who utterly can't deal with life, with people, with anything. I scream, cry, rage, break and throw things, and am totally ineffective. I wish that I had never been born.

When I'm myself, I'm strong, smart, coherent, well-spoken, and powerful. I'm not always happy, and things irritate me. I speak up when something bothers me, but I do it in a way that gets results. And I don't want to die.

I understand the argument that saying "It's just PMS," is convenient and belittling. I can see that it has potential to be over-diagnosed because our culture thinks that women should be "nice."

Do these symptoms sound like "just PMS"?

Markedly depressed mood
Decreased interest in usual activities
Lethargy/fatigability/lack of energy
Hypersomnia or insomnia
Depression
Anger
Irritability
Anxiety
Social withdrawal
Difficulty concentrating or thinking

Further, does a woman suffering from the above symptoms sound like she's powerful?

Mental and emotional symptoms

2008-04-15T11:00:00.000-07:00

My mental / emotional symptoms used to include the following, usually — but not necessarily — in this order:

Extreme irritability, starting at ovulation
Unpleasant, disturbing dreams
Poor sleep quality / not wanting to sleep
Feelings/thoughts that I am completely, utterly worthless and unlovable
Frustration at any major or minor thing that goes wrong (especially technology)
Rage — this usually includes throwing and/or breaking things
Major depression
Suicidal thoughts

Caveat: the following description is disturbing, but did not end in tragedy.

I knew that I had hit rock bottom when I decided (yet again) that the only solution was to kill myself — but this time, because my suicide would make my fiancé sad, I decided that I had to kill him and our two cats, and then kill myself.

I remember sitting on the couch with him, discussing this. I won't say discussing calmly, because I know I was depressed and angry and wanted to die. But I remember saying that I knew the only solution was to to kill them and then kill myself. (Monthly suicidal tendencies... How did I ever live to 30??)

Thankfully, by that time my fiancé (now husband) knew enough about how to handle me during PMDD that he helped me weather the storm. It was a very frightening moment, though, and I'm so sorry that my husband had to go through two years of untreated PMDD with me. He's a saint, and I know now that he will never leave me when he's stuck around through this much hell.

Now that I'm on sertraline, my symptoms are so much more bearable.

I still have 7-14 days of irritability, higher stress levels, and sometimes crying easily. I have what I call "no filters," where little things that I can ignore the other two to three weeks of the month will bother me immensely, and I can't stop the worry cycle. I worry about everything incessantly, even things way off in the future, and things that I can't control. I get scared and anxious, worry that I will lose my job, etc., and feel extremely sensitive to any sort of criticism.

But I don't want to die anymore.

PMDD in junior high school

2008-04-15T10:15:00.000-07:00

I remember vividly one experience from seventh grade that conclusively proves to me that I've had PMDD since adolescence.

To set the stage:

In fifth grade I was singled out for ridicule and exile by two girls who had been good friends the year before (the "mean girls" / relational aggression experience). This made me totally paranoid about my relationships with my peers.

In sixth grade I went back to my original elementary school, where I didn't have any solid friendships — plus I hit puberty, which led to mild acne and some really serious body/self-image problems (body dysmorphic disorder, anyone?).

In seventh grade, I was able to lose myself in the crowd, but I also wanted the typical teenage things: friends, attention, and a boyfriend. Because of my experience in fifth and sixth grades, I was obsessed with my flaws, whether real or perceived. I'm sure my acne got worse during the latter half of my cycle, and I have never been a skinny girl. (I come from solid northern European roots, built like a brick outhouse, but with great curves that I couldn't appreciate at the time.) I just thought that I was hideously ugly and fat, and nothing anyone said could change my mind.

The scene:

This particular day, I was sitting in front of the school during lunch hour with some of my friends, getting more and more upset that I was so ugly and fat and would never be loved by any boys. I remember repeatedly asking my friends, "What's wrong with me?" I wanted them to tell me "the truth," to agree that the problem was that I was ugly and fat.

Their answer to my perennial question was always the same, that I was pretty and not fat and that nothing was wrong with me. I never believed them, I just thought they were lying to be nice to me, or even lying because it was funny to watch me suffer.

This time, however, instead of just keeping these thoughts to myself, I remember crying and flying into a rage, eventually jumping up on the bench that we were sitting on and screaming "WHAT THE HELL IS WRONG WITH ME?!?"

When I saw the alarmed looks on everyone's faces, I ran away from them and cried until I was out of tears. I wanted to die.

I can remember thinking in the back of my head as I screamed at them, "What the hell? Why am I acting like this?" I came to recognize this feeling, after my diagnosis, as a very common and easily identifiable symptom of PMDD. The "insane bitch" takes over, while the "normal" me is shoved to the background wondering who the hell is screaming and throwing things?

Hormonally-aggravated acne

2008-04-14T19:16:00.000-07:00

As if being irrationally irritable, out-of-control angry, and/or suicidally depressed wasn't enough to handle, I also have some physical pre-menstrual symptoms. The worst of these is regular, hormonally-induced acne, the incredibly painful, under-the-skin kind that doesn't surface for days, and doesn't heal quickly. OW.

I have really oily skin, which is now turning out to have one benefit — apparently I look young for my age. Other than that, though, it sucks. And acne? I'm over 30, ferchrissake!

I've had acne since I hit puberty, and it has gotten worse and better at different times and with different products.

Right now, I use Aveda's All-Sensitive line — cleanser, toner and moisturizer, plus their salicylic acid treatment. I also use Bare Minerals make-up, which is helping control the oily skin problem quite nicely.

L-Theanine plus 5-HTP worked a little bit

2008-04-14T17:47:00.000-07:00

Before I started on sertraline (generic zoloft), I tried many different remedies. L-Theanine plus 5-HTP seemed to help a little bit, but not enough. But it was the only thing that I tried that actually had any immediate effect. When I felt the worst, I could take one or two of these, and I could actually feel the cloud in my brain lift a little bit.

Biofeedback games

2008-04-14T16:04:00.000-07:00

Before I realized that PMDD was running my life, I thought I was just a ridiculously high-stress person.

At one point, when my job had become more stressful than usual, I started getting migraines on a regular basis. I needed to do something to get my life back under control. In researching migraine treatments, I came across an intriguing biofeedback game, The Journey to Wild Divine.

I promptly bought both The Passage and Wisdom Quest, and started playing the game at home. I had always thought that meditation would help me (I loved my Tai Chi classes when I had time for them), but couldn't seem to get into it. I needed something that would be practical at work, in the car, wherever and whenever I needed it. I didn't want to have to take time every day to sit in some quiet room, pondering the universe. I got stuff to do!

The objective nature of the game's feedback helped me concentrate on relaxing and lowering my stress level without feeling inadequate for not achieving some sort of enlightenment. It was very practical, and only minimally "woo-woo," as my Auntie V would say. I could focus on each exercise as a challenge and congratulate myself for achieving each goal.

After I had "played the game" for a while, I noticed that when I got stressed out and upset at work, I would instinctively start breathing deeply without even thinking about it. My body learned how to reduce my stress level on its own, I didn't have to concentrate on it. But if I did concentrate, that helped.

I have had one migraine, total, since I bought the game, and I think that was probably because of dehydration. I haven't played Wild Divine in over a year, but I still am totally in love with the biofeedback aspect of it. I should pick it up again... The same company also has new products that are more self-directed, but seem to be based on the same interface. I would highly recommend them.

This book changed everything for me

2008-04-14T10:11:00.000-07:00

This book changed my life last year.

Between The PMDD Phenomenon, seeing a therapist, and starting on sertraline, my life has become not just bearable, but pretty darn happy. I still have bad days, of course. This is going to be a lifelong battle, no doubt about that.

But as I told my husband the other day, I used to range from somewhere around zero to negative 50 on the "I want to live" scale, and now it's all in the positive realm.

Thanks to this book, I know that my behavior is not caused by a) a lack of mental or physical fortitude, or b) a moral failing. I simply have a serotonin problem, and I have to be aware of it in order to manage it.

I used to think that I was evil, that I had everyone around me fooled into thinking I was a nice person, when really I was this horrible, evil, worthless creature inside. Now that I have information, coping tools, and meds, I know that I am actually that wonderful person that everyone else sees, and that the evil bitch was just a consequence of imbalanced brain chemistry.

This does not mean that I'm now a "nice girl"... I'm still as feisty and bluntly honest as ever. I just get to be me (almost) all the time, instead of crying, screaming, raging, and breaking things two weeks out of the month, and wishing I were dead for all of it.

More to come...

2008-04-14T08:30:00.000-07:00

For those who doubt that PMDD is a real problem with real symptoms, consequences, and treatments: let me tell you that it is very real, and I've been dealing with it since adolescence. Just because it only affects a small percentage of women doesn't mean that it's imaginary.

For those who deal with this very real chemical imbalance, I hope this blog can offer some support.

More to come!