Serenity, where have you been?

I watch the ocean while I take my usual Monday morning walk. I feel as calm as the ocean's waves after a rough storm. My head is clear as the blue sky. The birds sing in harmony. The world seems perfect. It isn't filled with monsters. My feelings seem to be synchronised with the peaceful rhythm of my heartbeats. As I walk, I realise that I don't remember the last time I felt this way. I look inside my head for a word to describe this feeling. Serenity. 

I know the immense serenity I feel is due to the little baby growing inside me. The PMDD symptoms are temporarily gone. The hormonal shifts in my body have made me a new person. A person I haven't seen in a long time. A calm version of me, a person in peace. A person who doesn't snap, overreact, yell, cry, or get anxious during ovulation time. I am living in harmonious balance with my emotions.

Calmwater by Sofia Fortunato

But unfortunately, I know that after the pregnancy is over, and sometime after my body recovers its normal menstrual cycle, PMDD will be back to attack. And as you can imagine, I don't want PMDD symptoms back in my life.

I was diagnosed with PMDD three years ago, but I've been battling PMDD for more than that (obviously without even knowing I had it). I feel proud of myself because I've found ways to accommodate my life so PMDD doesn't affect me as much as it used to. But just because I managed to tame my PMDD, I still don't want it back in my life. 

So, what else can I do? How can I put an end to PMDD? 

The last time I visited my doctor, I shared this feeling with her. I told her that I hadn't realised how bad I'd been in the last four years until this pregnancy and how much PMDD had taken away my sanity and energy. I told her that I don't want to feel PMDD symptoms ever again. I don't want to feel this way for the rest of my time as a reproductive woman.

My doctor looked at me and sighed. I was waiting for her to say, "Okay, Sofia, let's schedule you an appointment to consider surgery [hysterectomy and oophorectomy] after your pregnancy." Instead, she turned to the computer and showed me a list of pills I could try when the pregnancy was over.

I couldn't hide my disappointment. I don't want to take that path again.

I have already tried almost every possible treatment.

It all started back in my 20's with oral contraceptive pills. Although back then, I didn't know anything about PMDD. I reacted poorly in one way or another to every single contraceptive pill. The worst reaction was depression. I remember once I spent an entire Christmas night crying in bed hopeless because my boyfriend at that time couldn't make it to our place. The trauma of a previous unfaithful relationship still lingered. And I was young and probably overreacting. Who knows? But my mum was certain that my crying wasn't normal for me, the strong woman I was by then (Mum knows best, as they say). So, my doctor ultimately decided not to prescribe any other contraceptive.

In my mid 30's when I was diagnosed with PMDD in Australia, considering my medical history, hormonal treatment wasn't an option. When the symptoms started to take over my life, another doctor recommended SSRIs as treatment. It had been shown that taking a lower dose of these antidepressants before ovulation helps to improve the symptoms. However, research also shows that women react in different ways to SSRIs. And that was the case for me with the fluoxetine group. It didn't work! Instead, I ended up feeling even more tired and sleepy, unable to deal with the world. I had children, and I needed to be able to be there for them, not asleep in bed. So obviously, this wasn't an option for me either; therefore, I decided to stop taking that type of antidepressants.

After my experience with hormonal treatments and antidepressants, I took another path: Cognitive behavioral therapy (CBT). CBT is often used to treat psychological disorders like anxiety. It helps you take a task-based approach to solving problems. So, I thought, "Okay, let's try that route." I found a few good books on the topic, read them all, and over time my attitude towards PMDD changed. I began to feel acceptance. I accepted that I had to live a life with PMDD. I had to learn how to deal with it. You can read about the impact the CBT approach had on my life here.

The list of books on CBT can seem endless, so it can be helpful to consult a specialist. Or to start learning more, I'd recommend The Book of Knowing by Gwendoline Smith.

Serenity by Sofia Fortunato

But let's go back to my recent day at the doctor's office. 

After discussing my long road of dealing with PMDD, my doctor recommended I try yet another SSRI after pregnancy. What? Okay. Really? I felt my head burning inside…

I went home with a strong desire to share this experience with other women and to write a blog post.

So, what else is there for us women suffering from PMDD?

Why not take the ultimate option instead? Surgery!!! Why do doctors refuse to take us into surgery? What are they afraid of? I don't understand. Is it perhaps inducing women to early menopause? If that is the case, I don't see what is wrong with having early menopause. I'll go through it anyway in my 50s. To me, it doesn't really matter when. I know surgery is the very last resort, but why not use that resort for women like me, with severe PMDD, with children, and not planning to have more? Must we live a life trying to surface from rough waters each month, only to slip back under again and again? Must we keep trying the same old things?

It's exhausting!

Yes, using a CBT approach indeed improved my well-being; PMDD no longer takes me down (must of the time), but to be honest with you, I want to put an end to it. I wish this serenity could last. 

All this being said, I hope that more awareness will fund more research studies on PMDD. And this, in turn, will lead to the development of new treatments someday soon.

Thanks for reading!