What Every Woman of Color Needs To Know About PMDD

At 16, my mom found me on the floor, crying. “I just don’t want to do it anymore—I can’t live like this anymore,” I told her in tears. My cramps were making it impossible for me to stand up straight, and I kept having mood swings ranging from being completely ecstatic to, like the above, being unable to stop crying and finding a will to continue with my day-to-day routine. I had recognized that this had only happened in the week or sometimes weeks leading up to my period. I would spend that whole week in a body that did not feel like mine. I would sleep for days, cry for hours on end, and end up binge eating everything in sight. My sex drive would heighten and drop immediately. I knew that this had to be more than PMS. I went from doctor to doctor, hoping that they would diagnose me. It wasn’t until I finally saw a doctor that asked if I had heard of PMDD. At that moment things became clear, this went beyond the depression and anxiety I was previously diagnosed with, this was specifically tied to my menstrual period.

PMDD stands for Premenstrual Dysphoric Disorder. In short, PMDD is a heightened, more severe version of PMS. Where PMS feels like an uncontrollable monster, PMDD is that that uncontrollable monster’s all-knowing, evil older sibling. It affects 3-8% of women, and is fully defined as when a woman experiences five or more PMS-like symptoms during most cycles, and that these symptoms interfere with doing day-to-day activities. PMDD symptoms can include psychological symptoms (the most common symptoms I experience) like difficulty concentrating, crying spells, and paranoia, skin problems including acne and skin inflammation, or additional symptoms like appetite changes and hot flashes. A full list of PMDD symptoms can be found here.

Psychological Medicine conducted a study earlier this year, citing that in a study with 1600 black women (including Afro-Caribbean) and over 900 women (including Latinas), black women’s risk of PMDD was 50% less than that of Caucasian women. A study also showed that women of color who are exposed to American culture over time are most likely to have PMDD—stating that “a substantial percentage of ethnic minority women suffer from PMDD in their lifetimes.”

There are many times where, especially women of color and more specifically black women, are told by doctors that they are fine when there’s something wrong or are completely misdiagnosed. Though the above study has shown that WOC have less of a chance of being diagnosed, that does not erase the historical evidence that their symptoms are highly ignored. In The Girl Who Cried Pain, the authors noted that “the health-care provider’s bias toward psychogenic causes of women’s pain is problematic on two levels. First, women are more likely than men to have their pain attributed to psychogenesis whether or not that is in fact a cause of their pain. Second, for those women whose pain is exacerbated by emotional disorders, the health-care provider’s bias against psychological contributors to pain may lead them to undertreat the pain.”

Whether it’s PMDD or a diagnosis that is more serious, it’s vital that women and women of color, particularly black women, are treated seriously and efficiently by all medical professionals and that their points of views and concerns are considered valid.  PMDD, in particular, is very hard to diagnose, with some doctors dismissing it or misdiagnosing it as depression. The key link is this—the depressive episodes occur only during a menstrual cycle and only during this period of time. Some claim that PMDD should be diagnosed as a mental disorder and there’s controversy surrounding this diagnosis.

“I think any time a disorder occurs more frequently in women or only in women, there’s going to be a group of individuals who have concern that this will diminish women’s role in society, their sense of being capable,” says Dr. C. Neill Epperson, who directs the Penn Center for Women’s Behavioral Wellness told NPR. 

The stigma that I faced when I openly admitted to having PMDD didn’t surprise me, but I was still disappointed. Many of the women I told met it with understanding, or hadn’t heard of the condition. Others asked, “aren’t you just being dramatic? It’s just your period! We all go through it!” The most difficult explanation always comes when I am dating someone long-term. The difficulty lied in telling someone who has no real grasp of PMS about PMDD, and then explaining how they differed. It truly didn’t sink in until I finally felt comfortable enough to spend time with them while I was experiencing symptoms. It wasn’t until some partners saw me first hand, walking around, looking unfocused, falling asleep during every date, or threatening to never talk to them again in angry, loud tones, that they realized that this was not as simple as “being cranky on your period.”

Now, my PMDD is more manageable thanks to birth control. It took a few different pills and a lot of emotional support from my mom to get through my symptoms. I still experience some mood swings, but I’m able to maintain a normal, day-to-day experience with that help. I’ve also found that my meditation practices and an approach to holistic healing including using essential oils has helped in conjunction with taking the pill. Dr. Elizabeth Trattner, an Integrative Medicine Specialist and Doctor of Chinese Medicine, talks about her approach to treating PMDD: “It takes a good integrative approach dealing with PMDD. Patients need a support system both medically, psychologically and personally to deal with the extreme symptoms. This is what integrative medicine is all about. The intense lows and physical symptoms need medical attention. Patients need to own their part in their responsibility in getting well but with the coordination of their doctors and support system.”

My birth control helped level out my hormones, and is a pill that only gives my my period once every three months, making it more manageable. It doesn’t, however, “cure” my PMDD. I still feel like I’m walking in a cloud during this week, and continue to have to rally and get out of bed during this time. I have to work harder to focus on everyday tasks, and have worked with my coworkers in order to make sure that I’m accomplishing that week’s goals. PMDD still takes planning, effort, and conscious decision making so I can make it through those few days that sometimes, feel like a lifetime. My hope is that in sharing my story, women who feel like they’ve been gaslit to thinking that they have normal PMS symptoms or have constantly been misdiagnosed, find the strength to conquer their condition as much as possible. And hopefully find a trusted doctor to help them through their PMDD. I want women to know that it can get better, and that the darkness that you feel when hit with PMDD is eventually overcome with light—there are ways of treating this, living with it, and coping.