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Premenstrual dysphoric disorder is a little-known but devastating condition that can have strong links with problematic substance use , says Lisa Yambo


Premenstrual dysphoric disorder ( PMDD ) is an endocrine disorder that causes an extremely severe form of premenstrual syndrome ( PMS ). It can lead to a range of significant emotional and physical symptoms every month , during the week or two before a person ’ s period ( known as the luteal phase ). PMDD is also categorised by a sudden alleviation of negative symptoms at the onset of bleeding .

For women living with PMDD , symptoms including mood swings , total loss of self ( dissociation ), rage , anxiety , tearfulness and fatigue can have a serious and detrimental impact on their lives . Experiencing PMDD can make it difficult to work , socialise or maintain stable healthy relationships .
In some cases , PMDD can also lead to suicidal thoughts – a staggering 34 per cent of women with PMDD have attempted suicide , according to the International Association for Premenstrual Disorders ( IAPMD ).
One in 20 women who menstruate have PMDD , yet most people have never heard of it . However , I ' ve lived with the symptoms of PMDD for over 20 years – this is my story of PMDD and addiction :
All my life I suffered really badly from debilitating anxiety , flaring up during the weeks
leading up to my period . It was horrendous , and crippling to the point where I didn ’ t feel that I could function . I couldn ’ t do day-to-day tasks , I was entirely overcome with anxiety . I went from not being able to function , leave the house , or get out of bed just before my period , to literally feeling that I could run a marathon as soon as my period started . It was like something had washed over me and I suddenly felt amazing .
To cope with the periods of anxiety , I began drinking . This would make me feel more relaxed and the alcohol would dull some of the anxiety . Sadly this was the beginning of what would become a very problematic relationship with alcohol . Between these periods of anxiety – that I would later come to understand as PMDD – I would stop drinking for two or three weeks then all of a sudden that anxiety would come back and I ’ d start drinking again . At the time I didn ’ t know what was happening – I didn ’ t associate the two .
What started as daily drinking only in the evening , escalated to binges . Realising my drinking might be a problem , I tried to stop but after three days I found that I couldn ’ t . My binges escalated , lasting initially one day , then two , three , four and so on . By the end of my drinking , I was drinking for eight or nine days at a time and then stopping for a
few days .
I was frequently admitted to hospital and was eventually told that if I carried on drinking for another year I probably wouldn ’ t survive . I was going to fellowship meetings , but I was a serial relapser . I couldn ’ t get it – everybody else seemed to be doing well but every two or three weeks I kept relapsing .
When I did finally get into recovery , I wasn ’ t diagnosed with PMDD until a year later . Those first months of not picking up a drink for the anxiety were horrendous .
I saw a consultant and explained my symptoms – he stated that what I reported was too extreme to be PMS and he diagnosed me with PMDD . Finally I knew what was going on .
During those first few months into my recovery , I rode it out for a while but it became too much and I was put on a low dose of anti-anxiety medication which pretty much changed my life . I didn ’ t want to take medication but it really helped with the PMDD .
It ’ s important for women in active addiction to understand that the hormone cycle can have a big impact on their mood , their ability to resist cravings , cope with triggers and reach out to others . It ’ s not the case for everyone , but it was for me .
Sadly , I only came to understand what was going on in my body by the time I was abstinent from alcohol . Nobody
It ’ s important for women in active addiction to understand that the hormone cycle can have a big impact on their mood , their ability to resist cravings , cope with triggers and reach out to others .
had put a link to my addiction and my symptoms until I was in recovery . Looking back , my drinking episodes and relapses were all just before or during my period .
Things are changing up a bit now as I ’ m also perimenopausal , so that ’ s a whole new world … And today I celebrate seven years of recovery from alcohol .
Lisa Yambo is a criminal justice recovery worker at The Forward Trust https :// www . mind . org . uk / information-support / typesof-mental-health-problems / premenstrual-dysphoric-disorderpmdd / about-pmdd /
Denis Novikov / iStock