Imagine that your life is like driving a car. For most of the month, you’re in control and driving safely in the right direction. The rest of the time, however, you find yourself in the backseat while a dark alter ego takes the wheel.

The new driver is angry, frightened, and desperate, and you feel helpless, even though you are fully aware of what is happening. You can only hope that she calms down as soon as possible and doesn’t hurt you or anyone else in her way. Some months are easier, but sometimes she just wants to drive off a cliff.

Welcome to “Hell Week,” the mental low point before menstruation for women suffering from PMDD. 

PMDD (Premenstrual Dysphoric Disorder) is a mood disorder associated with women’s menstrual cycles. PMDD affects approximately 5-8 % of menstruators. It is defined as an oversensitivity to hormonal changes, in which the 1-2 week period preceding menstruation becomes cumulatively stressful both physically and mentally.

PMDD is essentially the more severe big sister of PMS (premenstrual syndrome), which affects a larger percentage of women. Depression and rage are common symptoms, as well as an increased sensitivity to voices or rejection. These can be accompanied by cramps, back pain, fatigue, migraines, or binge eating. Symptoms typically disappear when the bleeding begins and do not return for two to three weeks. Everything returns to normal, but a bad conscience and interpersonal damages may remain. Many women with PMDD were probably labeled as hysterical in the Middle Ages, and many are now misdiagnosed as bipolar. After all, like bipolar syndrome, PMDD is characterized by a personality switch. The difference is that this “two-facedness” works hand in hand with the female cycle in a predictable framework. 

PMDD, like any other mental problem, can be measured on a scale. At the lower end of the scale, women with PMDD are faced with a higher-than-average level of difficulty. In these cases, the symptoms are usually only experienced by the sufferer or those closest to her. Quality of life and human relationships are more severely harmed at the middle of the scale. Unfortunately, at the extreme end of the scale, the dark alter ego can drive off that cliff. According to some studies, women with PMDD are nearly seven times more likely to attempt suicide.

PMDD was only added to the World Health Organization’s list of mental illnesses in 2019, and to this day very few people know about it, and there is hardly any wider discussion on the subject.

This is no coincidence, given that the lovechild of mental illness and female bleeding is both taboo and stigmatized. Out of curiosity, I’ve asked many of my Hungarian friends if they’ve ever heard of it, and so far, no one has. I first stumbled upon the definition about half a year ago and immediately recognized myself. I rewound my recent worst days, arguments, and depressive episodes and discovered an undeniable pattern: once a month, typically 6-10 days before my period, I hit some kind of a low point. It’s as if a red mist is pouring over my body, tearing it apart from the inside. In this suffocating fog, everything is seen in a much worse light: frustrating, ugly, and depressing.

When I realized that this was a legitimate medical condition, I felt a strange sense of relief:

  1. I’m not alone in this, and I can easily connect with others.
  2. I know where to look for information and solutions. 
  3. If this condition arises, I am aware of its cause and I can be confident that it will pass. 
  4. I can forewarn those close to me because the symptoms can be significantly reduced with patience and empathy. 
  5. By planning ahead of time, I can reduce the potential stressors of the PMDD period.

It’s important to mention at this point that my own diagnosis of PMDD is still pending due to a lack (or at least extreme rarity) of available diagnoses in Hungary, so this article is based on months of research, an in-depth interview with an officially diagnosed American woman and the testimonies of women at an international PMDD group meeting that I attended. So, while I am neither a formal patient nor an expert on the subject, I believe it is crucial to bring PMDD into the conversation and attempt to de-stigmatize it. This could help women recognize their own patterns,  which I believe is one of the most important steps: awareness alone can lead to better symptom control, while online PMDD communities can provide significant emotional support. However, in more serious cases, immediate medical assistance should be sought.

People often blow this condition off as “it’s just your period, get over it,” or even worse, when other women say, “well, I have a period too, I don’t understand why it’s so difficult for you, there must be something wrong with you,” which feeds into the notion that we are crazy. And then there’s the healthcare system, designed to gaslight us from every angle, so it’s no surprise we think it’s all in our heads. If I could sum up what I want people to know about PMDD in one statement, it would be that there are beautiful, talented, powerful, determined, etc. women who, no matter how hard they try, will feel that life is not worth living because this struggle is so tough,” revealed Michelle (42) in our interview session.

In addition to a lack of public awareness and specialized professionals, the possibility of PME (Premenstrual Exacerbation) can make diagnosis extremely difficult. PME denotes the presence of another mental illness in addition to PMDD. For instance, if a woman with depression also has PMDD, PMDD is not completely responsible for her issues; however, the pre-menstrual period becomes incredibly challenging for her, far beyond her primary condition. Additionally, post-traumatic stress disorder or simply a more stressful life situation can trigger or exacerbate symptoms as well. When looking for a solution, it can be helpful to remember to address and manage these as well.

Intriguingly, PMDD can also function as a double-edged sword. Of course, there may be times when truly unrealistic fears and doubts arise during this phase, but my interviewee discovered that PMDD had also brought out her subconscious, real feelings.

I am convinced that our PMDD sheds light on aspects of our lives that aren’t working for us. I can look back and realize that while these feelings appeared to be coming from an unstable place within me, they were actually revealing the instability of my life around me, whether that be work, friends, or partners. I regret how I handled the majority of the situations, yet I am grateful that I left so many things behind because of PMDD. In retrospect, it appears that my body was attempting to guide me to where I needed to go on a psychic level. And I wholeheartedly believe that during difficult times, women’s intuition is heightened and that society has gaslighted us into not listening to what our bodies are telling us,” shared Michelle.

Do these symptoms sound familiar? 

  1. Do some research! For a start, check out these resources: IAPMD, Her Mood Mentor, The PMDD Collective
  2. Download the M v PMDD app and begin keeping a day-by-day record of your symptoms. If you do it regularly, you may notice a pattern of PMDD-related lows after a few months. 
  3. Try to be patient with yourself, but if you want to make a significant change, you must devote considerable energy and self-reflection to the case. 
  4. Take it seriously, but keep a sense of humor about it. 
  5. Discuss it with those closest to you so that they are aware and can assist you. 
  6. Discuss it with as many women as possible. On the one hand, they may be suffering from it but are unaware of its existence; on the other hand, bringing it to the public’s attention is critical.

What can you do if someone close to you is affected? 

  1. Do your own research! Resources recommended in the previous list. 
  2. Be patient and open to conversation with the other person. I know this is difficult for you as well, but keep in mind that you too have flaws that the other person must put up with. Cooperation regarding PMDD can make things much easier for both of you.

Written by Lilla Gollob. 
Lilla is a Budapest-based freelance cultural journalist. She focuses on architecture and interior design, but she wants to show a different side of herself on the Lazy Women platform and write about female-related issues. Writing is a true vocation for her, and she wishes to explore it in as many forms as possible, with a short story collection and a children’s book on her bucket list. She prefers to spend her free time in nature but also enjoys cooking, yoga, ceramics, and reading.

Illustrated by Hanna Gollob.

If you prefer, you can also read this piece in Hungarian on our website.

This piece took us about 19 hours to make. All of the Lazy Women team currently works on volunteer basis – if you like what we do and support our contributors, you can do so on our Ko-Fi page.