Women all around the world can identify with each other on one thing, the dreaded arrival of our most hated aunt, Flo. As if bleeding wasn't enough, our period comes bearing gifts including cramps, irritability, bloating, moodiness and much more. For the majority of women, these symptoms arrive a week prior to their period and get better as their menstrual cycle comes to an end. For about 3 million women however, these symptoms are significantly worse, lasting longer and causing severe physical and psychological impairments including severe depression, panic attacks, and even suicidal ideation. Premenstrual Dysphoric Disorder (PMDD) is a diagnosable condition in the DSM-5 affecting about 3-8% of women, and is much more severe than Premenstrual Syndrome which affects about 90% of women.
To be diagnosed with PMDD, you must meet five or more symptoms from criterion A, one or more symptoms from criterion B, and one or more symptoms from criterion C.
In addition to meeting these criteria, The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home) and the symptoms cannot be associated with another medical or mental health disorder.
Your period comes monthly and if you are someone who suffers from PMDD, you may feel defeated and uncertain how to cope. Not all is lost, below are a few things you can do to ease your symptoms by category.
How to Alleviate Depression and Anxiety
When was the last time you had some time for yourself, or did something you wanted to do or like to do? Most people have a hard time coming up with an answer to this question. It's no secret that out lives are jam-packed with things we need to get done however, taking time to do something that feeds your mind, body, and spirit is an important part of mental health, especially when experiencing debilitating symptoms. Some examples of self-care include:
Meditation: Meditation has been shown to rewire the emotion regulation parts of our brain! Regular meditation can has been shown to reduce symptoms of anxiety, depression, and physical pain due to illness
Yoga: This is one of the best things you can do for your body. Yoga incorporates meditation, breathing, mindfulness, and unique stretches and poses that have been shown to decrease symptoms of anxiety and depression while also eliminating menstrual cramping!
Exercise: Much research shows that participating in regular exercise such as cardio helps improve mood reduce overall bloating. If you’re able to, try and get in extra cardio the week before and if your symptoms
Listening to music: Play your favorite songs, dance, reflect on the lyrics, or just enjoy!
Spending time with family and friends: Sometimes we want to isolate ourselves when symptoms occur, but that can often make things worse. Seek out someone you can trust and confide in, even if it’s just to watch Netflix with them
Read a book
Take a nap: Make sure to set alarms so you don’t sleep too much! Sleeping during the day for hours at a time can cause you to feel more groggy and exacerbate symptoms of depression
Take a few minutes to just be still and breathe
Take a bath: The ultimate relaxation, warm water, music, maybe a bath bomb and candles! Aside from the relaxation, warm baths can help ease cramps and remove the excess pressure on your body. Not to mention aromatherapy has been proven to relax the body and the mind. So whether your favorite scent is lavender, vanilla, or coconut, consider investing in scented candles or oils.
Meet with a counselor: Counselors can help determine if your symptoms are in fact related to PMDD and can provide you with a diagnosis and a referral in instances where medication may be required. Additionally, mental health counselors can help you explore emotions and build skills to cope with your symptoms.
Some experts say that PMS symptoms can be attributed to a magnesium deficiency. It has been shown that magnesium is greatly diminished during the time of menstruation . Due to this deficiency, many women find themselves craving chocolate around this time of month. Our cravings can be said to be related to a nutrients we are lacking, and dark chocolate is high in magnesium, giving our bodies just what it needs. If you are also watching the calories, cacao powder is a healthier and calorie friendly alternative. Cacao powder can be used in many ways below are a few ideas:
1 tablespoon in your smoothie
For an extra dose of magnesium try this funky monkey recipe: 1 banana, 1 tablespoon of cacao powder, 1 banana, 1/2 cup of unsweetened almond milk, 1/2 cup of ice. Mix in a blender and enjoy!
Add cacao powder to fruits
If cacao powder doesn't sound appealing to you, you can always snack on a dark chocolate bar, but make sure it is at least 70% cacao!
Sunflower seeds are also a great source of magnesium!
Sun or Vitamin D
Some research has shown that many individuals with depression also have vitamin D deficiency. It is estimated that at least 40% of people are deficient in this vital star nutrient. One of the main sources for vitamin D is the sun. Why not kill two birds with one stone and do some self-care outdoors? If you are unable to do so, sun lamps are available online. Check in with your doctor to see if you’re low on Vitamin D, you may need to take over the counter supplements!
How to Alleviate bloating
As if depression, anxiety, and bleeding weren't enough, women also have to deal with feeling like they’ve gained a significant amount of weight.. Some women can gain 10-15 pounds! Bloating is uncomfortable but can be managed. Below are a few ways to reduce bloating:
Eat bananas! Bananas are rich in potassium which helps your body regulate fluids
Exercise: Especially cardio, which can help you eliminate excess water weight
Hydrate! It may sound counter intuitive because the last thing you would think to put in your body when you carrying around extra water weight, is water! Your body retains water when it is dehydrated- therefore drinking your 8 glasses daily can help you regulate and eliminate excess
Cut down on salt and carbs: Excess salt and carbs cause our bodies to retain more water
Cut down on caffeine and alcohol: Caffeine and alcohol actually increase water retention. It may be tempting to keep chugging cups of coffee when you’re so exhausted, but unfortunately too much caffeine can worsen fatigue
Epsom salt bath: Place 2 cups of Epsom salt in your bath and soak for at least 12 minutes. This one also takes care of the self-care section!
Green tea: This acts a diuretic and can also help with cramping
Dark chocolate: Another benefit? Absolutely!
How to Alleviate Fatigue
Exercise: Working out, releases endorphins, which make you feel happier and more energized. It can be difficult when you feel like you have no energy, so try to increase the amount of cardio you do leading up to when you usually PMS.
Birth control: Birth control regulates your hormones to keep you from ovulating. It has been found in recent studies that women with PMDD could possibly have an intolerance to progesterone, which rises when we undergo ovulation. Ask your OBGYN for birth control that can help suppress progesterone levels, or test your hormone levels to see if you’re too low in estrogen.
Clean eating: Certain foods such as cherries, potatoes, rice, and soy have been found to naturally suppress progesterone (if this is indeed your problem), although no studies have been done to prove if this is effective with PMDD. Processed foods contain many added chemicals and preservatives that can increase bloating, fatigue, irritability, and depression. Try to shop on the periphery of grocery store and eating foods rich in fiber and antioxidants that can help your body feel more energized. Keep your plates colorful with greens and keep your diet rich in healthy carbs and protein.
Finally, if you have tried most of these and your symptoms are still not being managed, seek help. PMDD is under-diagnosed and unknown to many medical professionals, so don’t be discouraged if you’ve been dismissed by your primary doctor. PMDD has also been known to be managed with SSRIs (a form of antidepressants), so get a referral to a OBGYN and psychiatrist. Half the battle is realizing this isn’t just all in your head, the other half is the will to find the answers. You shouldn’t have to settle with living like this, there is help out there. You are not alone, and hopefully with time PMDD will get the spotlight it deserves.
Micheline Maalouf, M.S. is the founder and owner of Serein Counseling, LLC in Orlando Florida. She specializes in working with individuals who are dealing with anxiety including: generalized anxiety, social anxiety, post traumatic stress disorder, and obsessive compulsive disorder. Micheline is certified in mindfulness and incorporates these practiced into all her sessions with clients to ensure they achieve the best results. Follow her on Facebook, Instagram, Twitter, and Pinterest. Call today for a free 20-minute consultation (407) 721-6453