Human brains naturally look for patterns. Patterns can bring us peace because they allow us to make predictions. This is crucial for survival, reproduction, and learning as a species. But through my years of living with PMDD, I’ve learned that predictability can be a double-edged sword, especially when your body doesn’t always stick to a strict schedule. 

PMDD Progression

When I was first diagnosed with PMDD in my early twenties it felt so validating to see my symptoms appear in a pattern. It confirmed that my physical and emotional struggles were tied to natural hormone changes in my body. At that time, I would have 2-4 “bad days” a month. My emotional symptoms were much more severe than they are today, but I was empowered by their predictability because I could plan and prepare for them in advance.

It is generally accepted that PMDD can change and worsen with age, and that’s been the case for me too. As I’ve gotten older, the number of days I’m impacted by PMDD symptoms each month has increased dramatically. Now I experience 3-4 days of symptoms around ovulation and 3-4 days before my period. The emotional symptoms have improved but my physical symptoms have worsened, which can take a mental toll as well. 

It can be emotionally devastating to see your illness increase in frequency and severity. And on top of that, with the progression of PMDD, you may lose the predictability that you learned to work with to manage your symptoms. 

As my bad days stretched from 2 days to 4 days, I would question myself: Why am I feeling this on day 12 when I’m not supposed to feel bad til day 14? What if this isn’t PMDD? Am I just being weak and letting things get to me that shouldn’t? Why am I getting worse after all the work I do to stay healthy? Did I forget my supplements? Am I not exercising enough? This self-judgment made me feel so much worse because it made me question everything. 

These questions surrounding the change in timing and frequency of PMDD symptoms can feel incredibly defeating and discouraging because they make us feel like we’re not doing enough or trying hard enough to get better. 

Cycle Variations

The second way PMDD becomes unpredictable is through normal cycle variations. With PMDD, we have a tendency to get very attached to our scheduled cycle. But just like anyone else with a menstrual cycle, things can fluctuate from month to month. Stressors, sleep, diet and lifestyle changes can all impact our menstrual cycles. Even the most regular menstrual cycles can fluctuate by a couple days each month. With PMDD, these small fluctuations can be difficult to manage because it changes the time we expect to have certain symptoms. For example, maybe you’re going through a really stressful time at work and your body responds by delaying ovulation, making your period come late. This can really throw you off if you plan your life around your cycle, as many of us with PMDD do. 

These cycle variations can also trigger self-judgment and blame. Why was my last cycle regular and this one is not? Why was my PMDD so much less severe last year? These judgemental questions only serve to make us question and blame ourselves for something that is ultimately out of our control. I know that sometimes we can feel like we have some control over our symptoms when we experience improvement after certain supplements, diets, or lifestyle changes. But if those changes were ALL that mattered, then we would all be cured. There are physiological processes that change and vary from month to month that are completely out of our control. These variations can cause changes in symptoms and symptom severity. While there are treatments and lifestyle changes that can offer relief, it’s important not to blame ourselves for unexpectedly experiencing symptoms of a physiological disorder. 

Importance of letting go and allowing in a cyclical chronic illness 

In a sense, there’s relief in knowing that PMDD is cyclical because it is predictable and inevitable. We know that we can’t stop our hormones from fluctuating (*without certain medications or treatments), so it’s going to arise as our body does what it does naturally. But as we get comfortable with the predictability and the patterns we notice, it can cause panic when things don’t go as scheduled. It’s kind of a ridiculous thought - we feel comfortable when we can expect something out-of-control but we feel panicked if the out-of-control experience happens unexpectedly. Either way - it’s out of our control! We might feel better when it happens right on time because predictions give us a (somewhat false) sense of security. But the only thing we are actually controlling is how we feel about PMDD, not how it is expressed in our body or when it comes. And the truth is, we can always choose how we feel about PMDD - even when it comes up unexpectedly.

When PMDD symptoms arise unexpectedly, the best thing we can do is acknowledge them and accept them - without judgment. You can’t control when estrogen decides to rise in your body - just like you can’t control when your heart beats or your stomach digests. It’s not your fault -  even if you forgot your supplements, had more stress, or ate less healthy that week. Your body is responding to hormone fluctuations and your only job is to find comfort and relief to see it through. 

Here are some ways to let go of control when experiencing unexpected PMDD symptoms: 

• Express your feelings about unexpected symptoms through journaling or release them by running, walking, or doing any physical activity that feels good. It’s okay to feel angry or frustrated about unexpected symptoms.

• Listen to a “letting go” meditation. I like this one on Spotify

• Give yourself permission to adjust your schedule for self-care. Clear your night and get a massage or cancel plans and watch Netflix. Get a babysitter or ask for help with the kids. 

• Give yourself a cheat meal that feels comforting

• Go on a long walk and listen to a positive podcast or relaxing music

As hard as it is, we can release the need for control over our bodies to always perform on time and on schedule. Our bodies are constantly adapting to ever-changing circumstances, experiences, and stimuli. They’re working 24/7 to keep us going and sometimes that means shifting things around like our hormones and menstrual cycles. The best thing we can do is let go and ride the waves. 

MEET ALYSSA

Alyssa is from Chicago where she works as a Creative Director for several online brands. She has over 10 years of experience managing and treating her own PMDD through a variety of traditional and holistic modalities.

Follow Alyssa on Instagram @alyssamattero