A couple of weeks ago, when my colleagues and I were discussing themes that we should cover for our In My Head week, a series exploring mental-health issues and women, I suggested PMS. You know, the debilitating kind: when tears come scarily easy, when you feel paranoid and sad and really bloody ferociously angry. When you know that you’re not just imagining the wretchedness because it’s also accompanied by a weird hollow feeling in your legs that you’ve come to recognise as an along-for-the-ride symptom. When you think, If this were my life all-month-round, I don’t know how I’d go on.
But then, this week, period having come and gone, I’m almost sheepish looking back: was I that dramatic? Did I really cry tears of hot anger because my boyfriend hadn’t moved his bike from the hall? Did I actually cancel those plans because the pretence of being a smiling and sociable member of a dinner party was simply unachievable? Did I honestly lie there, scared that this cloud would never lift, that I’d never feel happy or skittish or fun or like myself again?
I feel fine today. I’m drinking a green juice as I write. I’m meeting a friend after work. I haven’t cried in a week and I’m pretty confident that it would take a major personal disaster to set me off.
That is how I know I have PMS. That is how I know that PMS exists.
Everything I know about PMS, I learned from pure experience – and taking that experience to my girlfriends or to Google
I certainly don’t know it because a doctor or nurse or teacher has told me about it. Everything I know about PMS, I learned from pure experience – and taking that experience to my girlfriends or to Google.
A doctor has never mentioned PMDD or premenstrual dysmorphic disorder – the newest classification to describe the most severe, intense type of premenstrual syndrome that affects five to eight per cent of women – to me, but I know about it from the internet and women’s media. I gobbled up a Guardian article on the subject earlier this year, nodding along as it described “women [who] are praying for death on a cyclical basis, seeking help on forums, giving up on science”.
On one of the very few occasions I did bring up my symptoms to a doctor, when I was in my early twenties, she didn’t relate them to premenstrual syndrome, but asked if I’d like to be prescribed anti-depressants, and even though I recognise that they might be a solution for some women, it didn’t seem like the right choice to me. I was happy most of the time, so taking medication would have felt counter-intuitive. And so I carried on, feeling dreadful, then fine again, until I finally connected the once-monthly awfulness with PMS, perhaps PMDD.
Today, I ask a psychiatrist friend whether he sees many cases of PMDD in his work and if GPs diagnose it. He answers, “I've rarely seen it in referrals and, even when GPs identify menstrual symptoms, they'd rarely make the diagnosis.” So no, not really then.
The problem, I think, with diagnosing PMS, and admitting to suffering from PMS or PMDD, is the sense that there are some people out there, men and women, who will use it as a way to belittle women. Don’t say PMS is a real thing, people (often other women) seem to implore; that will just make them all think we’re crazy, crying, bleeding shrews who can’t be trusted to run companies and countries.
There should be no weakness in admitting that you suffer from PMS; it’s complicated to break down stigmas and difficult to dismantle stereotypes, but let’s give it a shot
That thinking is actually the entire basis of a very popular, viewed-well-over-a-million-times Ted Talk (of course there’s a Ted Talk on PMS) called “The Good News About PMS”. A psychologist called Robyn Stein DeLuca, a woman who probably means well, seeks to explode what she calls the “PMS myth” by announcing, in that blithely chatty Ted Talk way, that “after five decades of research, there’s no strong consensus on the definition, the cause, the treatment or even the existence of PMS”.
Instead of seeing this as an alarming neglect of women’s physical, psychological and emotional health, she argues that this means that most women don’t suffer from PMS and so we should stop perpetuating a stereotype of once-monthly moody women – a stereotype that is damaging and unhelpful.
“The PMS myth contributes to the stereotype as women as irrational and overemotional,” she argues. “When the menstrual cycle is described as a hormonal rollercoaster that turns women into angry beasts, it becomes easy to question the competence of all women… When we think about who makes for a good CEO or senator, someone who has qualities like rationality, steadiness, competence, come to mind.”
She admits that a small proportion of women do suffer from PMS or PMDD, but announces as a tidy and upbeat conclusion: “Let’s walk away from the tired old PMS myth of women as witches and embrace the reality of high emotional and professional functioning [lives] the great majority of women live every day.”
As someone who gets PMS once a month and lives a pretty high-functioning life, I say let’s aim little higher than that, eh? There should be no weakness in admitting that you are in the minority of women who suffer debilitating PMS; it’s complicated to break down stigmas and difficult to dismantle stereotypes, but let’s give it a shot – by being honest, by carrying out more research, by helping to treat people.
And, if I can pass on one piece of advice after 20 years of menstrual cycles, it’s this: know when that bastard is coming. Keep a diary or download a period app today. That way, when the tears prick because the 10 o’clock news was particularly brutal tonight or your sister didn’t return your missed call or whatever, you can check in with your dates. You can say to yourself, Ah, I feel that way because I’m PMSing. It’s not a perfect solution, but it’s a nice way of keeping everything in perspective, of knowing that soon this heavy feeling will pass. And, for the moment, as we wait for science and psychology to catch up, that’s really all we’ve got.