How therapy has helped PMDD

and helped me realise I have ADHD

I've got my 20th therapy session tomorrow. I started back in August last year after overthinking it for about 2 years (hello, undiagnosed ADHD).

I started it initially to help with the PMDD. It is thought, but not well researched (due to a historical lack of funding in women's health) that unresolved trauma is the reason people suffer with PMDD. So, after trying a lot of other things, I thought I'd give it a go.

I've spent the last 10 or so years digging deep, reading and trying to help make my symptoms easier and felt like I really knew myself.

But I have to say therapy has helped me understand my life and myself on an even deeper level. I know it’s a bit of a cliche, but if you find the right person to work with, it really does unlock a whole new level of understanding.

Big claim, but therapy has really helped my PMDD symptoms.

I’ve had three cycles with minimal symptoms. I’m actually writing this on day 21 of my cycle, one of the worst typically. This time last year day 21 probably would have meant complete avoidance of work, life and everything in between. It would have meant extreme fatigue and hunger plus a feeling of needing to double screen (my term for watching rubbish TV whilst compulsively scrolling my phone, basically doing anything to keep my brain completely occupied so it can’t think or, worse, ruminate) all day. I would have felt hopeless, useless and unable to escape those feelings. It was bad.

But not anymore. Today I feel a bit tired, and it took me a while to get into anything, but I recognised this feeling and had a long bath.

Therapy is what really helped. It helped me in so many ways…

It helped me realise I have ADHD and always have.

One session, about three in, my therapist said, ‘Do you know over 45% of women with ADHD also have PMDD?’ I laughed and said, ‘Yes, I do; I actually think I might have it; I’ve done the prescreening assessment form.’

She went on to say she couldn’t diagnose me as she wasn’t a psychologist but that as someone who works with neurodiverse people, I am sharing similar things with them. She then asked me a series of questions about my life, and it became pretty clear I have a neurodiverse brain.

In our following sessions, she helped me to see things I was frustrated with are all part of having a neurodiverse brain. And that being frustrated with something I couldn’t control created a lot of issues. So we worked on me letting them go, and I now see them as just part of who I am.

It helped me eat differently.

Finding out I have ADHD made me look at my diet. It is thought that a higher protein diet with iron, zinc and magnesium can really help with the dopamine issues. So I’ve been focussing on these things, and I can see the difference.

Also, decreasing sugar and alcohol has greatly impacted my energy levels. I gave up caffeine nearly two years ago, which also instantly impacted me.

It helped me to get into a regular exercise routine.

This was a biggy. I wanted to get into Reformer Pilates for at least a year but would always overthink and procrastinate on joining a class. During my sessions, we talked about this and unpicked a lot of stories I was telling myself. I committed and joined and have been going pretty much twice a week for 6 months.

In a recent therapy session, I was saying how strong I felt, not just physically but mentally. That weekly commitment has felt like committing to myself every time I go to a class.

It’s helped me lose weight.

I’ve had a complicated relationship with food my whole life. Using it for reward and punishment in various ways. Therapy has helped me work through the issues that made me gain weight and relearn how to see food as food. As a result of this and many other things, I’ve lost weight, a lot of weight, 27 kg to be exact.

I read somewhere that estrogen is stored in the fat cells and that estrogen dominance (too much estrogen) can be a factor in PMDD. So, I figured carrying excess weight surely wouldn’t help PMDD and set out last year with a goal of reducing my estrogen dominance.

This also fits with my PMDD getting worse as I gained weight. The interesting thing about PMDD is it makes you, in my case, hungry and unable to leave the house at its worst. I gained most of the weight in the 10 days of my luteal phase through overeating, not moving and self-medicating with wine.

It helped me learn to use a state change

This was something I came up with between my earlier sessions. When I was in a funk (PMDD depressive state), I got really frustrated with myself and decided I needed a state change: to take an action that changes how I feel.

It could be anything…

Take a shower/ bath

Talk to someone

Go for a walk

Listen to some loud music

Go to the gym

Just something that removes you from your current situation/state and breaks the thought cycle.

It helped me to process unresolved things from childhood

I’d done quite a lot of work on this; there was a lot of work to be done, to be fair, but working with a therapist helped me look even deeper and probe things I hadn’t thought of in different ways.

Being able to look at things in a different way took the power out of how I think of them. It gave me a different angle and broke the cycle. I’d often ruminate on the same things in my worst moments, but I now feel like there isn’t really anything to ruminate on, so I don’t get the deep depressive states I used to get.

It helped me understand that it is ok to talk about how I feel

I’m from Yorkshire; you probably know this as I always bang on about it! I’m incredibly proud of it, but growing up in the 80s in Yorkshire meant keeping your feelings inside. Yorkshire grit is about resilience, but it’s also about keeping a stiff upper lip and not getting too emotional. So I spent the first 30 years of my life being ‘fine’ whatever happened, even with those closest.

But I now talk about when I’m feeling a bit down, or something has bothered me, and this means things don’t snowball into huge problems that keep me in that depressive state for days on end.

Reading that back, it’s clear how much of an impact therapy has had on my chronic illness. I wouldn’t dare say it’s fixed or healed or whatever you’d say, but it’s minimised and in control, a state I couldn’t imagine before working with a therapist.

I hope that by sharing this, others with PMDD might find some way to navigate their symptoms, as I’ve been in the mud with it, and may go back there in the future, and what I needed then was some hope.