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What to do when you experience extreme PMS

Does your mental health plummet in the days before your period? Then you might have PMDD or PME – and you’re not alone.

Most people with uteruses get Pre-Menstrual Symptoms (PMS) before their period which can include things like cramps, mood swings and getting headaches. But Premenstrual Dysphoric Disorder (PMDD) is when you get extreme health or mental health symptoms right before your period starts, which can include symptoms of depression, anxiety, and feeling suicidal. PME is when you have a pre-existing mental health condition which is made suddenly worse when you’re premenstrual. I didn’t learn either of these terms from my GP – I Googled ‘What to do when you get extreme PMS’ because I was desperate.

I started getting my periods when I was 11 years old, and yet it didn’t clock that I was getting extreme PMS symptoms until I was around 16. Every month in the days before my period I was getting incredibly upset and having wild mood swings. Mostly I had a perfectly happy home life and was a pretty “normal” teenager. I did have anxiety disorder and depression, but it never made me act in extreme ways. But when I was premenstrual I would have arguments with my parents, throw my phone against the wall, smash plates, and once I even tried to run away. I also got very heavy periods that made me borderline anaemic, so after a chat with a doctor I started on ‘Yasmin’, a combined pill. This was mostly to try and get my periods to be lighter, I think, although my doctor may have mentioned how the pill should control my hormone levels so I wouldn’t experience PMS so badly.

When I was premenstrual I would have arguments with my parents, throw my phone against the wall, smash plates, and once I even tried to run away.

This worked okay for a few years, although I was getting side effects like regular headaches. I think I even got a migraine once, and if you get a migraine on the pill you are meant to come off it straight away, but I was so scared of getting extreme PMS again that I continued. Then Yasmin just seemed to stop working. I was getting overly emotional before my periods again and the side-effects of headaches, back pain, and spotting were all becoming too much. I came off it, and when I got my PMS symptoms, I found that they were even worse than before.

I’m 21 now and since then I have come off and on four or five more different types of pills, all with varying effects. None of them seemed to lessen my PMS symptoms and one of them even made my PMS last longer. And my PMS symptoms have only been getting worse and worse over the years. At the extreme I have almost quit university, nearly left relationships, and even self-harmed and become suicidal. At the less extreme I have cried in seminars in front of my peers and professors (several times) and have had to take time off work. I fear those few days before my period every month because it’s like becoming a werewolf without the glamour. I suddenly feel like a different person and the world seems like it is ending. And although I always suffer from low moods and anxiety, it’s suddenly heightened, so a tiny little thing can set me down a path of self-destruction.

If you feel like this before your periods or experience different mental health issues during PMS and think that you might have PMDD or PME, then this is what you can do.

First, talk to your doctor. Although the pill hasn’t helped me, taking one or using the implant or injection has helped some of my friends, so it might be worth trying. Everyone reacts differently and sometimes it can have a very positive outcome. It did help me for three years before the positive effects faded. Also, mention to your GP that you think you might have ‘PMDD’ or ‘PME’ so they take you seriously. I’ve had quite bad experiences with doctors no taking me seriously but every doctor is different and yours might be more helpful than mine.

But if they aren’t, then the next thing you can do is research it yourself. Mind have some really good self-care tips on what to do if you suffer from PMDD which has helped me out some and there is also a website devoted to telling you everything you need to know about PMDD and PME.

One of the things I used to struggle with most is that when you are in that mind-state you often don’t make the connection between what you’re feeling and PMS – you just think that something is very wrong.

Also, something that I’ve started doing is tracking my periods with an app called Flo. This period tracker is quite useful as you can log your symptoms and it gives you advice and some facts about everything period related. What I use it for is to map out when my periods are and work out when I will next be pre-menstrual. I often experience my PME from five days before my period, and if I am aware of when this will occur then I can put it in my calendar and make sure to try and take it easy that week and have a safety plan in place. Of course, it can be hit and miss since my periods are often irregular, especially since coming off the pill, but it’s still useful to know why you are upset. One of the things I used to struggle with most is that when you are in that mind-state you often don’t make the connection between what you’re feeling and PMS – you just think that something is very wrong. So now I make sure I am aware of what is happening, so I know what to do.

Something I am also planning to look into is having CBT directly focused on PME. Cognitive Behavioural Therapy is a type of practical therapy which focuses usually on one aspect of your life that is affecting your mental health.I’ve found CBT helpful in the past when it comes to my anxiety so I’m hoping it might be able to help with my PME too and am currently on the waiting list for it. I’ll let you know how it goes!

Finally, if you experience PMDD or PME like me and you sometimes find it hard to function at all or you self-destruct or even feel suicidal, here are five self-help tips that have helped me:

Make a safety plan.
Sometimes when you are in this mindset it is very hard to know how to help yourself, so at a time when you are feeling better, make a plan of what to do, which should include some self-help tips and people to reach out to. Here is the template that I used, that you can print off or use as guidance and the following suggestions can also go on your safety plan.

Reach out.
If there is someone you feel comfortable talking to, reach out to them. I often go to my girlfriend or my best friend or call my mum if I’m really struggling with PME because sometimes I just can’t help myself and I need someone else to help me. Asking for help is okay and it can really be beneficial.

Have some snacks or simple meals around you prepared for the week before your period. I often find when I am suffering from PME I don’t have the energy or mental capacity to cook for myself and if I miss meals then my mood gets even worse.Eating regularly is important for helping your mental health.

Distract yourself.
When I am really upset from PME I often get stuck in a thought-loop of catastrophic thinking, so to break this cycle, try and focus on something else. Watch a Disney movie or a comedy, read a book, take a bath, talk to a friend, practise mindfulness, go on a walk; anything to try and help you to re-focus.

Be kind to yourself.
When I am experiencing PME I can become incredibly hard on myself and blame myself for feeling like this. Being kind and looking after yourself is incredibly important. It sounds weird, but I’m trying to train myself to mother myself when I am in this situation. Often when you are so upset like this you almost become child-like; someone incapable of looking after themselves, who gets very over-upset and thinks the world is ending and is desperate for help. When there isn’t someone else to help you, you need to help yourself. You can show yourself kindness in small ways like stroking your hand or telling yourself it’s okay or making a cup of tea or tucking yourself into bed. It sounds silly but mothering yourself can really help to know that you are not your own enemy and to start to make yourself feel better.

I hope this has helped and that maybe you understand more about your experiences with PMS now and how to help yourself. Good luck!

Have you been affected by PMDD? There is support available. Mind, Samaritans and Off The Record can help. Let us know your experiences in the comments.