Progress not perfection: Mananging Your Pmdd
As we come to the end of April, so too do we come to the end of PMDD Awareness Month. This year's theme is 'Progress Not Perfection' which, as someone who has PMDD, hits hard. Perfection rarely exists when good habits, behaviours, thoughts, creativity or social abilities seem to float away for a large section of the month (or even an unknown amount of time – IYKYK). So today I wanted to chat about some things that can help shift to a softer, progress-not-perfection mindset – from someone who has been trying to grapple with the fun mistress that is PMDD for five years.
Note: I AM NOT A DOC – so please always speak to a GP or gynaecologist when it comes to medication or supplementation.
Tracking
Now, if you have PMDD or suspect you do, you no doubt have been given this advice before: TRACK YOUR CYCLE. And not just when you're bleeding and when you're not, but how you feel physically and mentally. I personally use Clue+ for this (the paid version allows you to create custom notes), but there are tonnes of great apps out there for this. Tracking not only allowed me to get diagnosed (as I could cyclically see that my mood and mental health were going in the bin) but has also helped me to better understand how well different treatments are working. What's more, a classic sign of a PMDDer is a denial of reality. This is literally me. I deny that my shift in mood or physical symptoms are hormonal, and come to the conclusion that I must "just be crazy" or "lazy". It must be a personal defect, right? Almost 100% of the time, I am just around the corner from the rivers running red. Tracking helps to validate that and gives your PMDD brain factual evidence as to why the self-hatred simply isn't valid.
Be Mindful with Movement
Next up is movement. Now, you might have seen tonnes of discussion around cycle syncing. And whilst I don't think having a strict formulation of what you can and can't do at different times of your cycle is necessary, if you suffer with PMDD it is worth noting how different forms of movement make you feel. Rather than following a certain workout routine, it is more a shift of mindset and acceptance. Ultimately, with your brain and body being highly sensitive to hormonal shifts, it's likely you'll also feel the effects of these hormones when it comes to strength, fatigue and recovery even more acutely. So what do you actually do?
Before you work out: Ask yourself what you're in the mood for. Does jumping around sound awful? Have you got some rage to expel with some heavy lifting? Do you want to be inside or outside? Alone or around others? Ultimately, it's about giving yourself the choice rather than always sticking strictly to the programme.
During the workout: Check in with your energy levels and enjoyment. Do you need to change things up to suit where you're at?
For me, around the premenstrual phase I am much more physically fatigued but also have a much more intense urge to really push myself. So I always try to temper both with heavier lifting sessions with fewer reps, or more chilled-out runs rather than speed sessions. I'll also opt for more nourishing practices like yoga nidra instead of intense hot yoga flows. But again, you have to find your own way with this. The key is radical acceptance of what your body and mind are telling you – this is not a time for self-punishment but self-nourishment.
Slow the F Down
This nicely moves us on to slowing down. During the premenstrual phase, the PMDD brain becomes much busier. Intrusive thoughts might come to say hello, old memories or self-destructive behaviours come out of the woodwork, and what would usually wash over us might cause us to spiral. Whilst the tendency is to push these feelings and thoughts down with distraction – whether that be doom-scrolling, constant podcasts, TV, or even being constantly around people we have to keep a face on for – the mind often needs the opposite: an opportunity to breathe, rationalise and contextualise during the PMDD phase, seeing that the thoughts and behaviours are ghosts rather than real monsters.
Offline activities like reading, chilled music, guided meditations, or longer films and cinema trips can help during your PMDD decline phase – giving your brain a break whilst still maintaining gentle stimulation that doesn't add to the load.
Of course, this is not the case if depressive thoughts or anxiety are significant – it's more about changing the stimulation to better manage some of the more annoying but not clinically threatening thoughts or behaviours.
Reshifting Relationships
This is a big one. Almost every month I would seek to break apart my relationship with my partner. I am not kidding. Pre-diagnosis, I saw this as just a personal defect, something I needed to work on. But over time, and after being diagnosed, I understood that I only felt that way some of the time – and it would only come up when we were having conversations about our future, chores, or generally any life and relationship matters in the latter half of my cycle. A conversation over something as simple as the washing up or dinner would spiral into me asking him to leave me, find someone more worthy, or listing all the ways I essentially sucked. Which, ironically, made me suck as a partner – ha! Needless to say, we have become much better at managing this together, but it took effort, communication and education on both sides.
And this isn't the first I've heard of this – so many women with PMDD that I have spoken to have described the same thing: how their relationship and attitude towards their partner or loved ones massively shifts during those PMDD-heavy weeks. Whilst I am not a relationship expert, here are some things that have worked for me:
No heavy conversations during that time period. Obviously these can't always be avoided, but really try to steer away from in-depth conversations.
Share where you're at. Whether that's a shared calendar so your partner or the people you live with know where you are hormonally, or having a shared language to communicate how you're feeling.
Choose different activities. For us, that means low- or no-talking activities like the cinema, reading our books, or doing something that requires concentration
Ultimately, living a life with PMDD is always about progress, not perfection. Acknowledging that whilst every month might not be perfect, it will always be an improvement on those pre-diagnosis or pre-treatment days. Every small edit, change or development in how you communicate will not only mark progress in how you manage PMDD, but in how you move through the world. Give yourself the grace to be messy, ask for what you need, and be radically accepting of the challenges – but ultimately the growth – that can come from living with a chronic condition. If you have any questions, feel free to get in touch, or to check out more of my blog, head over here.
