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deborah · 2020-03-11T14:10:50Z

The overlooked condition that can trigger extreme behavior THE HEALTH GAP HEALTH Open share tools It affects the health of up to 8% of women and has even been linked to outbursts of violence, but premenstrual dysphoric disorder, or PMDD, is still poorly understood. Christine Ro asks why. By Christine Ro 15th December 2019 As a 30-year-old, Caroline Henaghan was busy. She was working for the UK’s Home Office while training to be a barrister and wondered if the frequent stress and anxiety she was experiencing were just products of overwork and getting older. “It felt like getting on a hamster wheel and not being able to get off,” she recalls. Eventually, work got to be too much and she took an uncharacteristic short leave of absence. But Henaghan’s mood didn’t improve. She woke up each morning with enormous anxiety, leading to social withdrawal. “I would essentially do a disappearing act so I wouldn’t have to be around people,” she says. She was never suicidal, she stresses. But she did fantasize about leaving things behind. “It would be a case of if I could go to sleep and never wake up. That’s how dramatic it was for me.” Though the psychiatric symptoms were the strongest, there were odd physical patterns as well. Henaghan would get bloated and fatigued, sleep excessively, and – as a keen gardener – shop erratically, for instance buying plants that were out of season. Her family noticed her increasingly strange behavior as well. She thought it might be bipolar disorder, given the cyclical nature of her ups and downs. For instance, she might spend two weeks each month putting right the damage from the previous week: the fights with loved ones, the untidy home, the slippages at work. Eventually, after what she calls a “mini-breakdown”, she realized that the recurrence of all these symptoms was linked to her menstrual cycle. Her doctors dismissed her concerns. She visited five GPs, all male after the first one commented: “Oh, it’s just PMS. My wife gets that.” But it wasn’t “just” premenstrual syndrome (PMS). Henaghan had to do what many women overlooked by the medical establishment do: her own research. Through her online study, she learned about a condition called premenstrual dysphoric disorder (PMDD). You might also like: • How the menstrual cycle changes women’s brains• The effect of childbirth no-one talks about• The sexist myths that won’t die PMDD is much more intense than its better-known relative, PMS, with physical symptoms including fatigue and migraines, while the psychological symptoms can include the severe mood swings and anxiety that plagued Henaghan. The disorder can be so debilitating that 15% of those with PMDD have attempted suicide, and some young women affected are opting for hysterectomies. The cyclical nature of PMDD is what often distinguishes it from other mental health conditions that can trigger similar symptoms (Getty Images/Javier Hirschfeld) Henaghan is one of them. When she was ultimately diagnosed with PMDD by a specialist, unusual experiences she’d been having since puberty finally made sense. Henaghan tried estrogen therapy (which didn’t help) and high doses of progesterone (which helped a little). After being hospitalized for her erratic behavior, she approached her doctor about having a total abdominal hysterectomy and bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes). “He was very open and willing to acknowledge my own experiences,” she says. So in 2015, at the age of 36, she underwent the surgery, effectively inducing early menopause. PMDD is a cellular genetic malfunction in response to hormone changes, and it should be treated as the serious medical condition it is – Tory Eisenlohr-Moul The menstrual cycle can affect the brain in both positive and negative ways as women’s hormones fluctuate. It can make them more anxious and irritable at certain points but also improve their spatial awareness and communication skills. Various studies have indicated that PMS, the symptoms some women get in a week or two before their period, is at least partially influenced by genetics and can be passed on from mothers to their daughters. And research published in 2017 also found unusual gene expression in people with PMDD that makes them unusually sensitive to estrogen and progesterone. “PMDD is ultimately a cellular genetic malfunction in response to hormone changes, and it should be treated as the serious medical condition that it is,” says Tory Eisenlohr-Moul, who studies women’s mental health at the University of Illinois at Chicago. But a lack of consensus and knowledge around symptoms, whether they’re biologically, psychologically or culturally rooted, leads to PMDD being commonly misdiagnosed. The disorder was only included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2013, after plenty of debate. PMDD is so murky partly because women’s health is understudied. Some skeptics are nervous about attac...

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Melissa Landers

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October 4, 2024 3:58 pm

@karyssamarleriectskin-com I agree Karyssa, we must be diligent and not give up if we get the old brush off. Hormones are real, we are affected greatly in many ways by them.

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Melissa Landers

(@melissalandersiectskin-com)

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October 4, 2024 4:00 pm

@madisonmauldiniectskin-com Yes, I agree. It can be uncomfortable to be very direct with providers, especially if it is something to do with how we are "feeling" We know what is normal for us and what is not.

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