Hello friends. This week I’ve written about PMDD. A trigger warning, I do make brief mention to extremely sensitive topics relating to mental health, so if it’s not for you, feel free to ‘nope’ out of here, protect your peace and I’ll see you next time.

Imagine waking up in the morning and thinking to yourself, unprompted:

‘I feel like destroying my life today. Burn it down.’

This is a common thought of mine.

These days, when the thought occurs, it’s usually followed by a realisation.

‘Ah, these aren’t my true feelings. This is the PMDD talking.’

PMDD stands for Premenstrual Dysphoric Disorder. The mental health charity Mind defines PMDD as ‘a very severe form of premenstrual syndrome (PMS). It causes a range of emotional and physical symptoms every month during the week or two before your period.’1

Every month, for one week before the big event, I am despairing and exhausted. This is more than burnout. For me it feels like depression multiplied by a million. It’s accompanied by swells of anger at nothing, and a strong sense of overwhelm at pretty much everything. I am inert, I am dazed, I am sick.

The sensory side of it is nausea-inducing; as if I am trapped on a rollercoaster, at once boiling hot and ice cold. Everything becomes too loud, too bright, too much. The texture of most materials feels offensive on my skin.

It used to always catch me off guard. I would forget that this had happened before and be swept along with the thoughts and the emotions, until it would click.

Hmm, this is curious. Yesterday I felt fine but right now I feel such a sadness inside of me that I want to yeet myself off a tall building.

Then I check what date it is and it would all make sense.

It’s a week or so until my period, gotcha.

It still creeps up on me occasionally, despite me trying to be more aware. Sometimes I convince myself that it isn’t the PMDD and I really am a terrible person whose life is crumbling around them. It’s an all-consuming feeling of total hate, total rage, total sadness. It frightens me no end. When it’s bad, it’s exceptionally bad.2

I’m know I’m not alone. Scores and scores of people experience this vastly under researched condition (of course it’s under-researched, it isn’t related to cis male health!). Interestingly, although a study published by the National Autistic Society did not find a prevalence of PMDD in their sample of autistic people, the authors of the study noted that ‘reported prevalence rates vary so immensely (14.5%–92%) that it does appear that PMDD is something that autistic people who menstruate should be aware of'.’3.

It makes sense that autistic people can be susceptible to something that can drastically mess up your perception of the world around you, including your sensory profile. The world is already high definition enough for us as it is. PMDD just turns everything up to 4k.

I try to be more prepared for when it hits. Looking ahead on the calendar and knowing that on a certain week I will feel all the extremes - at least I have a chance at making sure I can put in place what I need that will make my life easier, and myself safer, during that time (maybe one day I’ll elaborate on that a bit more if people are interested).

The problem with me is that my ADHD-related object impermanence struggles extend to PMDD. I am constantly forgetting that it will appear in my life again. I also forget just how bad it can be, so it still floors me every time.

I recently spoke to a GP about it, who suggested, with an apologetic tone in her voice, that all they could offer were two things that I would loosely describe as ‘treatments’. Without doing a full deep dive into my medial history on this newsletter (I overshare a lot, but that’s where I draw the line!), neither of these options are fantastic, so onwards we go. Every month a challenge.

Take it easy - I plan to do the same,

Ren

You can also click below to browse other things I have written, if you fancy.

Read more of my stuff here

If you liked this, you might also like:

The Importance of Being Selfish - by Ren Riley

Recovery from autistic burnout means something has got to give.

Menstruation and menopause in autistic people

Dr Annabeth Groenman discusses whether autistic people may experience more difficulties during menstruation and menopause