Outside of the conditions I’m most well known for having, people are sometimes curious about the everyday stuff, the bad days that anyone can have; what’s it like to have a cold when you’re already on so much medication? Or just to be grieving or feeling dejected when you have a major depressive disorder?
Well, as unappetising as the subject may be, the most persistently scary of those ‘little things’ is PMS. Again, I don’t pretend that this is something other women don’t have to deal with but it’s pretty staggering just how wrong it can go.
PMS being something that’s more dangerous than ‘just your period’ is an idea that’s been around since the late eighties. What’s interesting is that this attention was first drawn to it when the third version of the Diagnostic and Statistical Manual of mental health conditions was published – when we often then (and still do) thought of having a bad period as being something that’s a physical ailment. None the less, there were a cluster of researchers who insisted that PMS could have serious implications in mental health. They published the collections of symptoms they had identified under the name of Late Luteal Phase Dysphoric Disorder. People didn’t buy it. Yes your period was allowed to hurt, you were allowed to feel irritable and bloated but a mental illness? Unlikely. Female physicians were, as a matter of fact, amongst the first to criticise and a persistence that the illness was ‘all in women’s heads’ remained – but wasn’t that the point?
What we know today is of an illness called Premenstrual Dysphoric Disorder and it’s symptoms are as punishing and various as anything you might hope to pick up from
bad food or a stressful week. Physically it all sounds very familiar; a big painful tummy, generally feeling like hell, ready to sleep at a moment’s notice. The mental effects are profound. Such is the depth of depression that PMDD manages to conjure that patients are often issued anti depressants in addition to analgesics – something usually reserved for the most complex and debilitating illnesses known to the medical profession. Women with the illness are powerless to know if their pain is being generated by their physiology or by what’s happening somatically. Usually the onus is then placed on women to report these problems to the male-centric medical profession, unsure of just what exactly is going on or where the flow of symptoms is coming from.
Things got more esoteric still when women sought answers from psychological sources. It was impossible for early theory in that field not to point to the lunar cycle, something which had played a part in interpreting the nature of mental illness – lunacy – for centuries. Hidden within the lunar cycle was an important diagram of hormonal cause and effect which explained, among a number of other conditions, the pattern that PMDD follows.
The truth is that even without this condition, women are subject to a different arrangement of hormones and internal chemistry that affects them throughout the natural process of the month. PMDD and severe PMS exacerbate the toll this takes, unfolding like a ‘worst hits’ list of the symptoms.
Once it was granted that the exclusively female bent of the illness made is difficult to identify and diagnose I was concerned as to how someone with my pre-existing condition would go about getting proper treatment. After all, I don’t think there really exists any one woman without some kind of complication making her unique. On the one hand, it was true that the last thing I needed was more pain and complication and that there was something very threatening about having a condition which could further my low mood and depression. On the positive side, every woman in the world was engaged with this issue to some degree or another! What’s common is what’s got a mandate to be treated and be treated fast and well and – unlike many other conditions – these complications are something that can be substantially medicated out of.
I would say, by the way of closing remarks, that the reason PMDD and severe PMS got enough traction to be properly, was because they were, eventually, openly discussed. And as unattractive as some of these issues may seem, suppressing them is to the detriment of every woman in the world.