Once More, With Feeling š¶
Hello, Monday and hello, readers! As some of you may know, I've tried my hand at creating and regularly publishing a newsletter a few times during my career, on a few different platforms and in a few different ways. Unfortunately, all of those attempts failed, but the last few years have changed my writing practice significantly and I think this time might finally be the right time for me to pull this thing off.
The Verbal Thing Comes and Goes (version whatever attempt I'm on now) has humble beginnings. To start, I'll be cross-posting writing from my blog, sharing some media recs, book lists, playlists, and whatever else feels right each week. Oh yeah, I forgot to mention: This newsletter will go out every Monday, assuming all goes as intended. Eventually, I'll move to newsletter-exclusive content, some of which will be behind a paywallābut don't panic! I'm nowhere near ready for that commitment just yet.
Thank you for being here from the start! If you have comments or questions, feel free to reply to this email, leave a note on my blog, or send a message through my contact form. š
Shalene Guptaās The Cycle Highlights the World-Shattering Impact of PMDD
Itās Not Monsterism, Itās PMDD
In 2017, an acquaintance who eventually became my boss posted on social media about being diagnosed with Premenstrual Dysphoric Disorder (PMDD). She described it as having extreme anxiety and panic symptoms the week leading up to her period, all of which disappeared the moment she started bleeding. The post lingered in the back of my mind for months as I navigated my own menstruation issues, namely the irregularity of my period and the mood swings I experienced leading up to my bleeding days. The latter had been getting worse, compounding my general anxiety into something acute and sometimes frightening. I cried at work. I had gaps in my short-term memory. I fought more often and more intensely with my then-partner. I couldnāt sleep. I struggled to manage my usual task load. And because my periods were so irregular, theyād last between 2-7 days and could occur as close together as two weeks or as far apart as several months. I never knew when Iād turn into a monster, only that when I did, it meant my period would arrive in a few days.
Iād been seeing a therapist for almost two years at that point and weād talked about medication to treat my anxiety and CPTSD, but I said no each time because I worried medication would somehow change meā¦ or make things worse. I grew up in a family where mental illness wasnāt discussed, let alone medication for managing it.
I distinctly remember the day my ex asked if I had considered I might have PMDD. We were in their momās car on the way to Trader Joeās, me in the front seat to prevent motion sickness and them in the backseat playing an episode of My Brother, My Brother, and Me over the car speakers. I donāt remember how we got on the subject or what led to them asking that question. But something clicked in my mind and I promised Iād talk to my therapist about it at my next session. In the meantime, I reached out to the acquaintance who wasnāt yet my boss about her diagnosis. She told me the only way I could even possibly have PMDD was if I didnāt have any other kind of anxiety. I did a little research and decided she was misinformed, and that I would still ask my therapist about it.
At our next session, I asked about PMDD and my therapist said I was a candidate for diagnosis, but I would have to talk to my general practitioner about treatment since she wasnāt a psychiatrist and couldnāt prescribe medication. I expressed my hesitation about medication (again) and she said something that changed my entire attitude: āWhen youāre physically ill, you can take medicine to feel better. When youāre mentally ill, you can also take medicine to feel better.ā Now, it seems like such an inconsequential thing to say, but at the time, it was life-changing. Literally.
When I visited my general practitioner, I worried he wouldnāt believe me, or that heād make me jump through flaming hoops to āproveā I had PMDD, if he knew about the diagnosis at all. I didnāt know it at the time, but Premenstrual Dysphoric Disorder had only been added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013, just four years earlier. Per the diagnosis criteria, you must experience at least five of the following symptoms in the week before your period, and they must decrease or disappear at the onset of menses: mood swings; increased interpersonal conflicts or irritability/anger; depression/hopelessness; anxiety; difficulty concentrating; decreased interest in activities; marked lethargy/lack of energy; change in appetite; sleep issues/pattern changes; sense of overwhelm; physical symptoms such as join/muscle pain, breast tenderness, bloating, or weight gain. I dealt with seven of the symptoms from that list and prepared myself to defend each one to my GP.
Luckily, I didnāt have to. He immediately agreed with my therapist and prescribed me an SSRI that he encouraged me to take all the time both to help my generalized anxiety and to help my PMDD symptoms. Going on medication turned me into a person again. I experienced a slight uptick in anxiety right before my period, but I no longer cried at the drop of a hat or lost control over my life. I couldnāt believe Iād been dealing with something I had never even heard of for so long, nor that Iād been so aggressively against taking medication that could help me move through life in a safer, less stressful way.
The Cycle Makes PMDD Research Accessible
In The Cycle: Confronting the Pain of Periods and PMDDāthe first non-academic text about PMDD to hit shelves (as far as I know)āauthor Shalene Gupta traces her own PMDD journey and explores the history of menstruation stigma, mainly in the West. Gupta writes that her PMDD manifests as āan implacable storm of anxiety, depression, and rage. I scream; I throw things; occasionally, I attempt suicide. Then, just as suddenly as the storm appears, it vanishes only to come back next month.ā Gupta received her diagnosis in 2020 and had never heard of PMDD beforehand. For most of her life, she writes, āI assumed I was simply a bad person.ā
This sentiment is shared amongst the people interviewed in The Cycle. Some of the people Gupta talked to chose to isolate themselves completely, leaving their partners and families because they didnāt know how to control their explosive emotions and rage in the week leading up to their period. Many reported a decrease in symptoms when they were alone. Others attempted to or considered dying by suicide. According to the International Association for Premenstrual Disorders (IAPMD), founded in 2013, 34 percent of people with PMDD reported suicide attempts and 72 percent reported suicidal ideation because of their cyclical, debilitating symptoms.
The latest data from a group of researchers led by Dr. Thomas Reilly at the University of Oxford suggests that 1.6 percent of people who menstruate meet the strict criteria for PMDD, which is equivalent to approximately 31 million people globally. The study also suggests that a higher percentage of peopleā3.2 percentāare suspected to have PMDD, but their symptoms havenāt been tracked long enough to confirm diagnosis.
Although PMDD was only added to the DSM-5 in 2013, Gupta notes in The Cycle that researchers have known about it since the 1950s. Treatment is relatively straightforward for most people with either birth control or SSRIs. So why did it take over half a century for PMDD to have its own listing in the DSM? There are several reasons, some of which are rooted in the social stigma of menstruation and others of which are centered on feminist concerns that listing PMDD as a true disorder would make people believe that all women experience severe psychiatric symptoms in the week before menses, thereby further fueling misogyny and thickening the proverbial glass ceiling.
āResearching the history was challenging because a lot of the people who were around for that whole debate about whether or not PMDD should be an official diagnosis were quite a bit older, and some of them had passed,ā Gupta tells me over Zoom. āAt one point, I was just googling the online white pages and calling phone numbers and leaving messages, hoping I had the right people. I was lucky someone got back to me. I was stunned. I was not expecting that. In another case, I did an interview where I ended up deciding to scrap the answers because the person kept repeating the same sentence over and over again. They were quite a bit older, and I just felt like maybe it wasnāt fair to quote anything. That was really tough. They were a key decision maker.ā
Another source mailed Gupta a VHS tape, which sent her on a hunt to view its contents. She called libraries all over Massachusetts to rent a VCR-to-DVD converter, then had to track down a DVD player. When she finally inserted the disc, she discovered it was in Frenchāa language she doesnāt speak.
Gupta says she wanted a global representation of menstruation stigma and reached out to multiple experts from around the world. She started with China and India, which are both part of her heritage: āMaybe that informs my perspective on menstrual stigma. I quickly realized thereās an entire book about the world of menstrual stigma.ā Unfortunately, her leads didnāt go anywhere. āI emailed so many professors and a lot of them said, āWeāve never studied the history of menstrual stigma in India,āā she tells me. The only person willing to go on record from China was a white person with no academic affiliation, which didnāt feel like the right move to Gupta.
Although The Cycle chapter āThe Periodic Silence Around Menstruationā is Western-focused, itās packed with information about how pop culture treats menstruation to how Reddit users discuss it online. When I ask Gupta what surprised her during the research phase of writing this book, she says, āReally anything about the history of menstrual stigma. That entire chapter was mind-blowing. I think the experiments with injecting mice with menstrual blood and then they die and itās like, āOh, poisonous,ā instead of determining there are other reasons that the mice are dying.ā She also cites the debacle around Serafem, a new application of fluoxetine released by big pharma corporation Eli Lilly in the early aughts to protect its patent on Prozac. The company marketed it as a treatment for PMDD, which was accurate, but it failed to differentiate between PMDD and PMS, muddying the waters significantly for researchers, doctors, and patients alike.
Game Thoughts: Princess Peach: Showtime!
We played by these rules in Princess Peach: Showtime! and had the time of our lives. With 40 stages to complete, multiple costumes to collect for Peach and her companion, a magical floating star named Stella, and sparklas (method actors) to rescue, as well as a delightfully wicked villain with henchman (Mme Grape and the Sour Bunch), the only problem with this game is that itās so short. We could have spent several additional hours exploring the theater, completing themed levels, and rescuing characters. I get that shorter games have their place and that Princess Peach: Showtime! is an exceptional example, I just want more Peach-centric games immediately.
What I'm Reading
On audiobook, I'm listening to Piglet by Lottie Hazell. Next on my list from Libro.fm is It's Not Hysteria by Dr. Karen Tang.
In physical form, I'm reading But the Girl by Jessica Zhan Mei Yu. Next up is Long Live Queer Nightlife: How the Closing of Gay Bars Sparked a Revolution by Amin Ghaziani.
As for ebooks (don't look at me), I'm reading Lessons for Survival by Emily Raboteau.
āØ Media Recommendations
Vesper Henry and Ari Dennen wrote about The New York Times' absolute failure to cover anti-trans legislation from an "objective point of view" for Media Matters: "Seen but not heard"
Parker Molloy wrote about the increasingly obvious parallels between Marvel's X-Men and real-life treatment of trans people for her newsletter, The Present Age: "Space Camp and The X-Men-ification of Trans People"
Julie Miller profiled Anne Hathaway for Vanity Fair and it's honestly a treat: "Anne Hathaway on Tuning Out the Haters and Embracing Her True Self"
The April Nonbinarian Book Club pick is Freedom Is a Constant Struggle: Ferguson, Palestine, and the Foundations of a Movement by Angela Y. Davis. If you purchase through Bluestockings Cooperative, you can get 15% off with code BOOKBIKE.
Speaking of The Nonbinarian Book Bike, are you subscribed to the monthly newsletter? If not, what are you waiting for?
I've really been enjoying two podcasts lately: Happy Wife, Happy Life, co-hosted by engaged Internet comedians Kendahl Landreth and Jordan Myrick, and Secret Histories of Nerd Mysteries, co-hosted by friends Austin Taylor and Brenda Snell.
š Cat Tax
When you have a cat named Shrimp and Target releases a cardboard cat scratcher shaped like a food truck marketed as "Chef Shrimpy's," you do what must be done.
Thank you for visiting The Verbal Thing Comes and Goes! If you like what you read, please consider sharing and/or leaving a tip! āØ
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