For as long as I can remember, I’ve lived with chronic depression and anxiety. Because my baseline for mental health has always been feeling bad with positive spells, rather than the other way around, it was harder for me to notice when I was sliding from bad to worse.
It’s hard to identify, “Hey, I think I’m actually struggling more than usual,” when life feels like pretty much just a haze of constant unhappiness. But in my junior year of college, that changed when I was diagnosed with Premenstrual Dysphoric Disorder (PMDD).
That year, I was hurting and angry all the time, but I was also getting into a lot of fights with my friends, which wasn’t normal for me. I was stuck in an especially toxic cycle with a close friend. We would fight, make up, and immediately hate each other again every 3 weeks like clockwork. It was exhausting, but I clung on, attributing it to general college stress and our progressively more messy history just making us both incapable of being good to each other.
It wasn’t until he finally got sick of me and dropped me, telling me that I wasn’t me and that he couldn’t handle my mood swings and predictably unpredictable reactions anymore, that it occurred to me that something wasn’t right, that it might be something more.
At first I was sure he was just gaslighting me again, as he had in the past. But the more I thought about it, the more his words cut into my brain. There were times where I really wasn’t me, and there was a definite strange pattern to it all.
I vividly remember lying on my bed, staring up at the ceiling, running through all my different known mental health conditions and their symptoms, as well as the antidepressants I took and their associated side effects, trying to figure out why my brain was cycling like a self-destructive machine. I didn’t understand how I was switching back and forth between being on a rampage and begging people for forgiveness overnight. All I could think was, I am going insane.
Then I spotted my birth control pack on my desk.
I did some quick mental math – it lined up frighteningly well. Every fight I had with any of my friends over the past 7 months since I’d started birth control somehow fell in the two weeks right before I got my period. I would be the angriest, most vulnerable person for 2 weeks straight, then try and apologize for a brief truce as soon as the feeling passed – maybe not just coincidentally with the arrival of my period. The only month that hadn’t been as bad was the one month that I’d forgotten to refill my prescription. I knew PMS was a thing, but this was something else.
My journey to mental stability ultimately hinged on a chance Google search.
I googled “birth control making PMS worse,” and there it was: an article about how the birth control pill could potentially worsen “premenstrual dysphoric disorder,” or PMDD. After internet rabbit-holing for a while, I made an appointment with the health clinic for the next day. As my doctor and I talked, I didn’t know whether to laugh or cry: I had 10 of the 11 symptoms associated with PMDD, and she agreed that birth control could definitely be negatively impacting it to boot.
Getting diagnosed with PMDD of course didn’t cure me overnight – it took two more years and hitting rock bottom a few more times to find both a treatment plan that actually worked, and the discipline to stick with it. Not being on the birth control pill isn’t really an option for me because it helps manage other aspects of my period, but with the help of my doctor, I now know to increase my antidepressants for the two weeks before I get my period, and alert my loved ones that I might need a little extra emotional support and patience during that time.
I’m also not saying that I’m a perfect person without my PMDD – unlearning toxic behaviors is necessary, ongoing work for me. But not knowing PMDD was a thing didn’t make doing that necessary work any easier. I still get angry, nearly 4 years later, that PMDD and the potential side mental health side effects of the birth control pill weren’t topics we talked about openly in my communities, and that my journey to mental stability and relief ultimately hinged on a chance Google search.
Talking about PMDD specifically can be a difficult line to walk, because women are constantly gaslit and demeaned about “outbursts” or sneeringly asked if we might be on our periods when we do have valid concerns – sexism that weaponizes our periods is indeed alive and well. But denying that our periods can actually contribute to the deterioration of our mental health is also harmful, as it erases very real conditions that can significantly impact our decisions and our quality of life.
We need to openly talk about reproductive health, and do so universally. Health conditions do not discriminate by race or religion – so neither can our education about them. I am not ashamed of my PMDD; I’m ashamed of how not being able to treat myself for it affected how I behaved. It might be deeply frowned upon to go into so much detail about two “taboo” topics – periods and mental health – but I am not going to stop talking about it, because I never want another person to feel that way.
If you’ve ever felt like you’re mentally cycling, take a few deep breaths. Try and keep a mood diary in conjunction with your menstrual cycle to see if there’s a correlation, and have it ready to talk about with your doctor. PMDD doesn’t have to destroy your life – it does, indeed, get better.
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