Great big tears spew out of me, forming rivers with the snot I can no longer be bothered to wipe away. I can’t stop sobbing and my breath is short and shallow. The world is awful. Climate change. Donald Trump. Lockdown. It’s all just so pointless and in the middle of this vacuous existence is me, on my bed, crying into a pillow and refusing to leave my darkened room.
“Shall we check your app?” my partner asks, wrestling my phone out of my hand. “Ah, yeah. Your period’s due in a few days.”
PMS was never something I suffered with, and I confess that, previously, I didn’t really understand when friends would forego nights out or weekends away because their period was due. But a year on from a miscarriage, I’m struggling.
Since the first lockdown, I’ve been grieving, learning to live with the loss of that first pregnancy. And as I have, each month, my extreme mood swings, anxiety and sudden onset of depression have made it worse. What I didn’t realise was that post any pregnancy – be it full term, miscarriage or abortion – an extreme version of PMS called premenstrual dysphoric disorder, or PMDD, can take hold.
More than a mood swing
“I just remember feeling so angry and like, rolling around on my bed, screaming and crying, saying to no one in particular ‘make it stop’. I felt crazy,” says 31-year-old trainee doula Lucy Hannah, who began to feel extreme PMS symptoms two months after an abortion in 2019.
“I was absolutely not prepared for it and there was no information about this out there,” she tells me, comparing her post-abortion mood dips with the tantrums she’d only previously experienced as a teenager. Throwing herself on the bed, hitting pillows, screaming into them – it all rings true to my own experience, including the suddenness with which it all subsides once the period finally arrives.
“PMDD is an extreme form of PMS and its symptoms can include depression, extreme irritability, anxiety, suicidal thoughts, feeling overwhelmed, panic attacks and bouts of crying one week before the period starts,” says women’s health practitioner and author of Period Power, Maisie Hill. An estimated eight per cent of women suffer from this disorder, which is usually triggered by a pregnancy or miscarriage and is believed to be genetic.
Following the birth of her first son in the spring of 2020, Sarah Heeley, 31, thought she had postpartum depression. “Before my period, I compare myself to others and it kills me. I feel extremely jealous, incredibly insecure, I have no patience and my temper makes me so nervous and snappy. I felt like I had depression at one point, but then it fell in line with the PMS timeline,” she tells me. “It just feels completely out of my hands. I can’t control it and it’s tough.”
For those of us left unable to control our emotions, the onset of extreme PMS combined with the major life events that caused it can leave women feeling incredibly isolated and ill-equipped to deal with the new situation their bodies find themselves in.
“With the combination of massive psychological and physiological changes in the year after childbirth, lack of support and sub-optimal self-care, it’s no wonder that so many of us experience mental health issues,” says Hill, who explains that women who’ve had mental health problems before a pregnancy are 50 per cent more likely to experience PMDD postpartum.
There are, however, things we can do. In her book, Period Power, Hill recommends a prescription of selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline and paroxetine, to be taken at the point in the cycle in which PMS symptoms begin.
Serotonin is a hormone that is key in balancing our mood and instilling a feeling of wellbeing and happiness. “If your hormones are out of balance, it will effect serotonin production. If we gradually increase the amount of serotonin we have in our body, that can help significantly with these extreme symptoms,” says Naturopath Colleen Grassnick.
Of course, SSRI prescriptions require a GP appointment – something many of us are struggling to access right now. Grassnick’s advice is to take St. John’s Wort as a herbal antidote to low moods in the meantime, as well consuming herbs like Melissa and Camomile in tea, tinctures or tablet form. “A good quality magnesium (magnesium glycinate or citrate) and vitamin B6 are also essential in creating a feeling of calm in the body,” she says.
As for me, after a month of avoiding all things delicious (sugar, basically) and taking magnesium every evening, I’ve completed my first cycle sans breakdown – and I’ll happily give up my pre-menstrual Dairy Milk binge in favour of my sanity. I had a teary five minutes the night before this month’s period arrived – but I was watching the episode of Friends where Ross and Rachel break up. Totally acceptable behaviour.