The vicious cycle of PMDD and auDHD

Navigating three complex conditions

Yesterday I lay in bed wailing into my husband's warm, soft body: “I want to go away!” Any attempt he made to quieten me down was met with even greater resistance and increasingly loud wailing until I finally settled down and went to sleep. This happens every month without fail - a week or 10 days before my period I crumble into a crying, wailing mess, usually only to return to my former self once my period has started.

I appreciate this may not be a topic of interest for the men amoungst us - but if you're a man reading this, I encourage you to stick around! I'm sure you know lots of women (maybe you're even married to one), some of whom probably suffer with this even though they might never let on the extent to which they're struggling. So I encourage you to stick around and see what you can glean from this (somewhat awkward, but definitely important) topic.

I affectionately call my period ‘TOM’ (for Time of Month). I can't claim that it was my genius that came up with this idea because I first saw it on a period pad company’s branding. TOM comes to call every month and he is a bit like an unwelcome relative who, although you're relieved when they finally come to stay, you also can't wait to get rid of - and you secretly hope they will stay away for a bit longer between visits next time. But alas, the next month rolls around and sure enough TOM turns up on your doorstep.

I don't mean to sound degrading about periods; I get that they're an essential part of women's physiology and wellness. I once saw a book called A Brief Theology of Periods but I never read it because I didn't want to read what I assumed it said: that God made periods because of their function for childbearing and His plan and purpose to populate the earth. As a Christian I know that this is likely true, but still, do we really need to contend with them every month when the world is already populated enough? (notwithstanding falling birth rates).

Aside from the crying and wailing, which tend to hit about eight to ten days before any bleeding starts, there is also the mood swings. Then there's the suicidal ideation, the mild depression, the hot flushes that wake me up in the middle of the night, and the anxious feeling of restless legs like I need to run a mile before I can settle to anything. Any of these symptoms are frustrating enough to deal with on their own, but throw them all together and it makes for one hell of a week (or two).

Recently I have woken up to the fact that although these symptoms are common for women to experience, they're certainly not normal. It's not normal to experience a dizzying array of physical, mental and emotional symptoms in the leadup to your period - even if doctors try to convince you otherwise. Nobody seems to talk about how to have an easy cycle (apart from people like Lara Briden, who has written several helpful books on periods and women’s hormones).

I also recently realised that these converging symptoms had a name - Premenstrual Dysphoric Disorder, or PMDD for short. There is a lot of information online about this disorder so I'll leave you to do your own research, but basically it's a much more severe version of PMS that's probably caused by hormonal imbalances. Most women struggle with PMS to some degree (again, not normal but very common), but PMDD goes way beyond that to include debilitating symptoms such as suicidality, huge mood swings and/or and physical changes such as severe bloating or acne.

I struggle with a combination of physical, mental and emotional symptoms, as many women who suffer from PMDD do. And it's no surprise - throughout our monthly cycle, from beginning to end, there are all sorts of fluctuating hormones. For some women like me, this tends to be worst in the week or so before the period actually starts, and this is where PMDD comes into play.

Let me reassure you that my periods have never been particularly heavy, painful, or otherwise annoying: it's the leadup to it where I have the most problems. But there's also the struggle of navigating life with autism and ADHD (sometimes known as auDHD) alongside the intense emotional highs and lows of PMDD. As someone who is neurodivergent I am already more sensitive to these kinds of things than the average person, so as you can imagine raging hormones flooding my body is not a fun thing to add on top of that.

For full transparency, I haven't had my PMDD officially diagnosed. You might be wondering why I've never discussed this with a doctor, but the truth is that I don't tend to think about it when I'm in a doctor's appointment, and they don't tend to ask. I have noticed that doctors and nurses don't usually go beyond the basics of “Do you have a regular cycle?” and “Is it heavy?”. In my last doctor's appointment I even took a written list of symptoms in with me, and I still somehow managed to forget to mention the possibility of PMDD! I haven't even brought up PMDD with my gynaecologist, the emotional highs and lows or the crushing fatigue that can accompany my period. It just hasn't really occurred to me, which might seem really strange to you considering that it’s obviously a problem that’s affecting my life because here I am talking to strangers about it on the internet.

There is a lot more research I want to do on PMDD and a lot more I could say about it. But for now I hope that you found this post helpful, and if PMDD is something you struggle with, or you would like more info on, then please do let me know in the comments.

Some research estimates that over 90% of women with autism and nearly half of women with ADHD also have PMDD. So given that so many women are affected I think it's a topic worth talking about and educating ourselves on so that we can better care for ourselves as well as support others. As neurodivergent women we need all the help and support we can get - even on sensitive issues like this.