I do recall one time mentioning to a friend that I was thinking of trying cloth pads (such as lunapads). When I explained to her what they were after her repeated requests for clarification, she screwed up her face in utter revulsion and declared THAT’S DISGUSTING! I found her response somewhat contradictory considering that she was quite prepared to wash the most vile smelling shit out of her baby’s cloth nappies, but the idea of washing menstrual blood out of cloth pads was to her completely repugnant. I know which one I’d prefer.

Having amused my doctor about the lack of discourse on menstrual blood among my circle of bleeders, he prescribed a three month course of progestin (synthetic progesterone) to help induce a more regular cycle. This was several months before I was diagnosed with PCOS (because I was not overweight it did not occur to him to consider the possibility of PCOS at this time). Within one cycle the progestins kicked in and I was shocked to discover what a normal level of bleeding looked like – I was a bleeding (and scoffing) mother fucker no more.

Every bleeding lady I know likes to joke about how our hormones are like a roller coaster, but this is in fact how the hormones associated with the reproductive cycle ride; they’re meant to ebb and flow. Although I should point out these fluctuations ought not to be any more dramatic than a kiddie roller coaster – so if you feel like you’re on the the big dipper, lady, you’re on the wrong ride.

Progesterone needs to reach a certain level in order to trigger menstruation. My progesterone levels were taking too long to hit their peak, which not only adversely effects bleeding but also produces a prolonged pre-menstrual phase. This discovery was significant for me because it explained why years earlier when I had PMDD, the duration of the PMDD symptoms were sometimes a full 14 days and then some.

With PMDD, depression and other symptoms only occur during the pre-menstrual phase, which should be no longer than 14 days. The fact I was sometimes experiencing symptoms longer than 14 days lead me to question whether I had PMDD and not some other kind of depressive illness. In fact it delayed my seeking professional help because I was unable to determine whether my mental health decline was restricted to the premenstrual period or was more permanent. In the end, after several months of monitoring my mood, I knew I wasn’t in a constant state of depression and figured near enough was good enough.

If I had known about this issue with progesterone back then, I would have sought help for PMDD earlier. It’s amazing to me that even years after recovery, the mysteries of my experience with PMDD are still being revealed.

Many PMDD-like signs have resurfaced during the course of my last few periods, sending off red flags in my mind which I’ve cautiously been monitoring. I am unsure how to decipher what is going on in my head right now. One thing I do know for certain though is that “the switch” is back.

The Switch is a term I coined back in the PMDD day to describe the change over that occurs mid cycle, signaling the commencement of the pre-menstrual phase and the onset on PMDD. When I had PMDD, the psychological/emotional symptoms of it arrived with a thud with the switch, eased up for a few days, and then continued to get progressively worse and more intolerable until I started bleeding. The onset of menses, of course, turned the switch off and I returned to being my normal self.

It is no secret why I called this the switch. When the PMDD symptoms started to kick in it was as if someone had flicked a switch. Switch off – normal, content, stable me. Switch on – hyper sensitive, lethargic, depressed, intolerant, angry as hell. So while the switch is back, the power that generates it is on a low voltage. I’ve not descended into PMDD hell by any means. But having been through it all before, I just know when things don’t feel right. We all have our ups and downs, and just because I’m down during the pre-menstrual phase doesn’t instantly mean the PMDD alarm bells ought to be sounded. I’ve had plenty of down days and even weeks in the past two years, but PMDD did not accompany any of them.

So what’s different now? Anyone who’s recovered from any form of mental illness (while I don’t characterize PMDD on the whole as a mental illness, on one level, that’s kinda what it is, at least in my experience) faces the challenge of staying well and figuring out when signs of mental unwellness are symptoms of relapse, or part of the normal range of human experience. As the mental health profession seeks to narrow the range of emotional experience that is considered normal and broaden what is considered mentally ill and disordered (example – doctors prescribing anti-depressants for grief) one could be forgiven for interpreting any sign of emotional upset as relapse or illness.

So, am I just going through a rough patch, or are these PMDD red flags that I should be acting on? Unfortunately this question is too complex to have much clarity on, so the answer is simply: I don’t know. There are too many variables that could be contributing to my state of mind right now. Some are health related (PCOS, vitamin deficiencies, virus) and some relate to what’s been going on in my life recently (death of a friend, financial stress, PhD stress). PMDD might not be part of the picture, but it might. It would be unwise to jump to a PMDD conclusion, but it would be equally unwise to ignore the red flags which suggest it could be so.

Perhaps all of the health and life circumstances are creating fertile ground for PMDD to surface again. Considering the life stessors around at the moment, I suspect that is the case. If it is, it helps confirm for me that PMDD is attributable to what’s going on in my life and mind as much as to what’s going on in my body. All I can do at present is proceed with extreme caution and take some preventative measures.

Three cycles ago I had a particularly bad premenstral phase, so I took vitex for a month and the next period was significantly better. I’d like to take the vitex again (which was instrumental to helping me recover from PMDD and get off anti-depressant meds two years ago – I highly recommend trying it if you have PMDD) but my financial situation does not permit it right now. I can’t really afford to buy more supplements, I’m already dishing out dollars for PCOS and other meds for my numerous health woes, but I guess the bigger question is – can I afford not to, if the specter of a PMDD relapse looms?

The one upside to feeling a strong sense of premenstrual crazy again, is a bit of mild mania. I don’t recall mania being part of my premenstrual craziness when I had PMDD before, but it’s certainly hanging about now. I know mania is seen as a bad thing, but as someone who likes being ridiculously productive, I freakin’ LOVE IT! If only I could figure out a way to quarantine the PMS and keep the mania, I’d be happy.