PMDD Awareness with Marybeth Bohn: Part 2

More with Mary Beth Bohn, co-founder of the Christina Bohn Foundation. Video slides are utilized so this one would be especially helpful to watch! Here's where it is on YouTube: https://youtu.be/taO0-OYAQf4

Take Aways

• 00 - About the Annual Christina Bohn Memorial 5K, establishing the first state recognized PMDD Awareness day (in Missouri), and about Mary Beth and her husband stepping into PMDD Awareness after Christina's death.
• Here is the 7 minute video... about high level overview about pmdd and Christina.
• 07:35 - Education about the menstrual cycle and pmdd including powerpoint slides by Mary Beth 
• Follicular phase: first half of the menstrual cycle. Starting on day 1.
• Luteal phase: second half of the menstrual cycle
• All women generally feel better in the follicular phase. This is a good time to make decisions.
• The luteal phase includes ovulation.
• In luteal phase your uterus is preparing for menstruation or preparing for pregnancy.
• We likely feel more tired, more sensitive, and more irritable in luteal phase than the follicular phase.
• PMDD happens in the luteal phase.
• Genetics influence the likelihood of experiencing pmdd.
• TONS of wonderful information shared in here!!!
• 47:38 Heidi shares a current practice that is helping her be more steady with pmdd

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• Heidi's website
• Heidi's YouTube

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Transcript

PMDD with Mary Beth Bohn: Part 2

[00:00:00] Hello, this is the Living Well with PMDD podcast. I'm your host, Heidi Bradford, certified life coach, mom of five and PMDD Survivor. Happy to have you here. This podcast is for informational and educational purposes only, and should not be considered health advice.

Let's shift to the PMDD awareness. You retired from work shortly after she passed away and have dedicated yourself to teaching people and sharing your experience, but also just that PMDD is a thing with people.

I'm wearing, so Mary Beth sent me Christina's shirt, her Memorial 5K. Tell us about this. What is this that you do? Okay, well, in 2023, we passed the nation's first pm DD Awareness [00:01:00] day, and it's on Christina's birthday and it's, Missouri is the first state to have A-P-M-D-D awareness . We hope to have more PMDD awareness days. We'd like them all to be on her birthday so that it just doesn't seem all scattered and messy on the calendar.

Mm-hmm. Um, we are reaching out to states where she's lived and where she's born and where she's lived and all that. And so went to school. Then we had a dinner for women with PMDD the night before the capitol, and then the evening of the event at the Capitol on her birthday. Those dinners with those women, with PMDD who had flown in from other states just to be part of it.

Women we'd never met. We also flew in the executive director of I-A-P-M-D, Sandy McDonald, and she spoke at the Capitol. And then we had, Jamie Hamilton speak. Who's now a dear friend. She had PMDV and then had surgery. A member of the house spoke and the member of the house who wrote the bill, he was our mc.

Then Steve and I spoke. Also the chief of staff for [00:02:00] the Office on Women's Health in Missouri spoke and gave us a proclamation from the governor. So that was a big special deal. But what was really neat was to see these women come together. And at first we were the hub of that little wheel, but as they met each other at our home, now they've all become friends. They're friends on Facebook. I see it and I think it's great.

The next year, we had our first 5K in 2024, and many of them came back. Now they know each other. So then when we had the dinner at our home and the fireside chat, we've done that each time, a fireside chat afterwards. Um, I see them sitting together and having that kind of fellowship, even though they're states away from each other, but now they come together, it's so great.

Then in October we had the 2025, um, annual 5K. It's grown a little bit, and then we added the virtual option. We were sending t-shirts off to Australia and to Poland [00:03:00] and to Sweden and Denmark and England and Canada. That's really special. And then around the US of course. And so we got pictures from people who participated.

You and your daughter have your shirts now, and I'm excited about that. Then we had the dinner again in the evening, and we also invite a few healthcare professionals and we have special facilitators. This time it was someone who's very, um, active in social media has thousands and thousands of followers.

She likes the evidence-based science and evidence-based research. It was a productive conversation. One woman wrote back, and I wish I could quote her word for word, but since I'm doing it off the top of my head, it really touched my heart. 'Cause she said she told her husband when they got in the car, that she felt prepared to be at our house at that moment, that night. The last 25 years. That was preparation to be there at that time. Wow. I know. That's how I felt when I read this. I thought, I can't believe I'm reading this. It [00:04:00] means so much to us to have them at our home and then to see the friendships grow and the connections and for them to be validated.

We always have a couple who will share their stories. It's just a really a special evening. We're excited about the next one coming up on October 17th, 2026 here in Columbia, Missouri. It's already out on run signup.com. The Christina Bone Memorial 5K for PDD awareness. Okay. We should put the link to, do you have a website?

We do have a website. It's not on a, we need to update it. Steve and I, um, need to update our website, but we are also in the process of having another one built. We'll get the word out somehow. Yeah. But we will be putting it on the website for sure.

I'll send you the link. Mm-hmm. Okay. You are wearing A pin. Yes. Uhhuh. I'm wearing this shirt. Yeah. And then you even made these cute little, uh, bracelets. Is it more than PMS learn about PMDD in memory of Christina Elizabeth Bone. [00:05:00] These, and there's, what are these called? Mail files. Isn't that the biggest mail file you've ever seen in your life?

Yeah. It's so big. It's so thick. But at first we were thinking, oh, we didn't realize how big it was gonna be, and so we thought, do we dare, do we dare give those away? And it ended up that they're really popular. I've had friends say, I can find it in my purse. I can grab it. I, they have better control.

An Emory board. Are they called Emory? It's an Emory board. Uhhuh. And then you've got the pin. And then this is the card mm-hmm. That you give out. And I have given out at least five Oh good. In the last two weeks. Okay. I have been surprised by the response. Everyone has been so genuine. I gave it to my doctor last week. Mm-hmm. She then said, I'm the medical director here, and we have a conference coming up or maybe just a, within the medical group, but mm-hmm. She said, I wanna talk about this at it. [00:06:00] Wow.

Wow. I will gladly send you more cards so you can take her, uh, some cards for her office. I did give her, I gave her a few. Okay.

Another woman that I gave at least two to is, um, from church. She and her husband are going to serve a mission in Peru. Oh, good. But she's medical. She will be the nurse over all of the missionaries. Mm-hmm. And their age, 18 to 27 or so. She said to me, we just had a Zoom meeting about, mental health, and she had been informed that one of their sister missionaries, one of the girls only had, uh, symptoms around her period. There we go. And she, yeah, she said, I don't know much about this, but I'm gonna look into it.

It's making a difference, you know? That's, thank [00:07:00] you. If you'll go out to the Christina Bone Channel on YouTube. Then there's that seven minute video. It's a high level overview about PMDD and Christina. We originally made it for our Chamber of Commerce last fall, and then we edited out the reference to the chamber so we could share it anywhere. Mm-hmm. You might wanna share that link with your friend who's going to Peru and with your medical director.

Okay. Because it kind of sums it up. I have the gift of being long winded, but I can contain myself if I absolutely have to, to keep a presentation 20 minutes or whatever minutes I can do it. But it has it all condensed into a seven minute video and then at least it gives somebody the idea, this is real and you need to take your loved one very seriously and their care seriously.

We all need to share. 'cause we want this ripple effect, like what you're doing right now and what you [00:08:00] have been doing to share about PMPD. It's so important. Yeah.

You've learned so much that we can benefit from. I wonder if you can share what we've talked about, previous conversations about a review of the menstrual cycle.

Menstrual cycle being the fifth vital sign and Christina's questions, how those came to be Sure. And what they are. Okay. May I share my screen? Yes. Do I have permission to do that? Okay. I believe so. Oh, I do. Okay. Oh, wait, one moment. I need to, I realize what I need to do. Okay. Now I need to reduce this and reduce, now share.

Sorry. It probably seems silly that I'm talking through my, it's helping my brain. No, we all do it. Okay. Oh, good. Okay. Now I need to figure out where that word. There we go. [00:09:00] Okay. This is our beloved, sweet, precious daughter, Christina. I'll go quickly through her pictures because I think everybody has grasped that she was a lovely person.

And I always say to others with PDD, and you are lovely too. And if I'm the only one saying it right now, when your brain is saying something different, please believe me. Um, because everybody's beautiful. Everybody should be loved and appreciated for their gifts and just for who they are. So Christina had an abundant life and was such a joy to raise.

Our home was filled with sung because of her. Now this. Is the menstrual cycle. And you might remember from biology class that we have a follicular phase, an all luteal phase, and in the follicular phase that includes this red section right here that indicates bleeding. This is when you have your period.

But the follicular phase overall, what we probably didn't learn in high [00:10:00] school biology was the fact that we feel better overall in the follicular phase. This is the phase where we're more likely to make better decisions. And let's take PMS and PMDD off the table. That's just true for all women.

Then we have the luteal phase. This middle line, this would be the day or timeframe where you're ovulating and then you have the luteal phase and your uterus is either preparing for menstruation or preparing for a pregnancy. In the luteal phase, again, take off PMS and PMDD, take it off the table and just consider all women in general.

We all might feel a little more tired during this time and we all might feel a little more sensitive. Lal phase we'd say is not the time to be making major life decisions. It's better to make that in the follicular phase. You're a little more clear minded. So this luteal phase is when PMDD is happening.

Now, there are some who have days of PMDD [00:11:00] symptoms even into their period time, even into bleeding days. For Christina, it was more that she would go back to normal as soon as she started bleeding. And there are those who can tell that they're bleeding even before they go to the bathroom because it's already lifted.

Now, PMDD happens in this luteal face, generally just in that two week time so the way to learn if you have PMDD versus another mood disorder would be to track every single day of your cycle from day one of bleeding all the way through. Now, this is showing a 28 day cycle, and we know that our cycles can vary and some people have longer cycles or shorter cycles, but hopefully you're getting the idea track every single day and note your behaviors, note your moods, and then c, are you feeling fine in this phase, but not fine in the luteal phase? Are you having symptoms spiking? It can go beyond depression and anxiety. There's so much more to it, and we'll get to [00:12:00] that.

Premenstrual dysphoric disorder is thought to be a brain disorder. It's thought that the brain is having a negative reaction to what your hormones are supposed to be doing.

Your estrogen and progesterone are doing their dips and their shifts in the luteal phase and the brain doesn't like it. Now that sensitivity can develop any time during a menstruating women's life from the very first period on up through perimenopause and different things could bring it on.

Pregnancy, birth, um, miscarriages, anything, uh, that could kind of jostle your hormones. I definitely sound like a lay person and I don't apologize for that. 'cause I think most of us listening are lay people. For Christina, I wonder if trialing birth control in high school tipped that balance toward PMDD.

We definitely see a strong genetic connection in the family. She is not the only cousin with PMDD. We learned that [00:13:00] after she passed away. It's thought that perhaps past trauma and extra sensitivities could play a role. Definitely trauma, stressors, things like that could play a negative role in any kind of illness, whether it's a mental illness or physical illness.

So maybe it could push that genetic button and get the PMDD going. We don't know for sure. That still needs research. But we have all probably experienced times when we've skipped our period because we are under a time of stress. Can you relate to that, Heidi? I can relate to that. So maybe that would jostle hormones enough.

I don't know. That'll be interesting to find out over the years and as more research has done. I will back up and say what I can guarantee you just from being a witness to suffering is that PMDD makes a perception of stress and trauma far worse. It magnifies. [00:14:00] Premenstrual exacerbation is different, but it also needs care.

Premenstrual exacerbation is when you have a disorder all month long, but it gets worse before your period. Now it does not have a diagnostic code, but I will tell you right now that probably your great, great grandmother even knew this existed, but they never called it premenstrual exacerbation. It's when, say for instance, I'll speak about myself, I have a migraine disorder and it always got worse before my period.

Somebody could have an eating disorder or anything else, major depressive disorder, whatever it is, they have it all the time, but it's worse before their period. Yes. I definitely think that's a thing. And I do think our grandparents and others recognized a difference. Some women would go for like menstrual help.

Yes. I can't remember what it was called, but I do remember looking that up sometime. Mm-hmm. Well, and the sad tales of women in the 18 hundreds being put in mental institutions, things [00:15:00] like that, could PMDD have played a role in that? I don't know. It's something that we could only guess about right now and speculate, so I don't know.

I like to compare PMS and PMBD, and while I don't wanna diminish anybody's experience with PMS, I definitely had it myself. PMS is kind of like these waves that are safely at the shoreline. You know, you're gonna be feeling better. You know that you can get over the counter meds. It is not, in the diagnostic and statistical manual version five, it is not in the DSM five because it is not considered a mental health disorder.

So the waves, while you have to write them of being sensitive, tender, tenderhearted, maybe a little tearful or, maybe a little more irritable. You can mask those symptoms more easily than you could ever mask PMDD symptoms. I would say that those who have PMDD have developed great inner strength that they might not even realize they have because of all the years that they've had to mask in [00:16:00] different situations. When they have felt like they have been thrown out into the open ocean in a storm.

Now, the thought of an open ocean terrifies me and the thought of being cast out on the waves, like I can't even watch the news when they do those open ocean rescues with helicopters and boats are going up on their, ends and all of this. It makes me sick. I can't watch it. I can't watch it in a movie.

It just makes me sick. But that to me is like PMDD. It is dark and it is frightening, absolutely terrifying. And somehow that person with PMDD has to try to tread water for a week or two every single month. Out in that open ocean. That to me is the analogy. That's how I felt as a mom witnessing what Christina was going through. Just a tempest that we didn't know how to stop.

It's thought that 5.5% and you'll see different studies and we don't have to ever apologize for results of different studies. Sometimes they'll say between three and 8% could have [00:17:00] PNDD, roughly 5.5% or one in 20.

That is approximately similar number to the number of women who have diabetes. And we see how well known diabetes is, and PMDD needs to be as well known. We could have more than 4 million just in the United States. It is a global issue. Like I mentioned earlier, it's commonly misdiagnosed. Bipolar disorder is the most common misdiagnosis, and you can appreciate why. If someone is at their doctor and they're happy, then the next time they're sad, then they might go back the next time and they're happy or mad and back and forth. It goes. It might seem very obvious and like an easy diagnosis to make. Other misdiagnoses could be schizophrenia because someone is presenting with psychosis.

There could be other mood disorders and depression disorders that they're also misdiagnosed with. But actually depression is part of this. The numbers for those who attempt suicide is quite high. [00:18:00] It's 34%, so one in three will attempt, 72% will suffer from suicidal thoughts and 49% will plan.

Now these are statistics from the researchers on the clinical advisory board for the International Association for Prial Disorders. Mary Beth, I wanna add here, because I remember using that statistic about 34% will attempt suicide. Mm-hmm. Those are the ones that weren't successful.

Oh, and we don't know how many have died. This is a sad story to tell, but after Christina died, I did join some Facebook groups for parents who had children who died by suicide. And there was a specific group for mothers who lost children to suicide. I was reading too many descriptions of daughters like Christina and they couldn't understand why their daughters were gone.

Among the rules are, one, you weren't allowed to share your faith. And two, you couldn't diagnose anybody else's kids. If I [00:19:00] could have taken my scepter and said, and I think she had PMDD and I think she had PMDD, it would've been very easy for me to do. And it was so distressing to see these parents wondering, why did my daughter go off to college and die by suicide A couple years later?

She was doing great in school. Well, Christina graduated valedictorian at BYU. She had PMDD that whole time. Her roommates didn't even know 'cause she was that good at masking it. So there you go. It can be so hidden by the person who's suffering. I had to back out of that group because it was just breaking my heart too much.

So we don't really know what the true statistics are for those who have died because they suffered from PDD because they may not have even been diagnosed with it. I've seen that with a couple young women who were major athletes at their universities in the last four years since Christina died.

And I can't help but wonder if they had PMBD because I'm thinking you would not be a top tier athlete if you had depression all the time. Mm-hmm. [00:20:00] Also somebody else who was very well known in the media, um, died by suicide a few years ago. I don't wanna give too many identifiers, but she told her best friend, she didn't feel like she had accomplished anything in her life.

And I thought, what is she talking about? Her resume is amazing. How is that even possible? To me, that's luteal talk. That's PMDD talk, not normal talk to feel that way. Yes.

Speaking from experience, when you feel good, you just wanna go with it. You just wanna like, revel in that. And you just wanna feel good. You don't even wanna think about what's coming. I think that's also why it's hidden. It's because you just don't even wanna talk about it. You just wanna enjoy feeling good. Yes. And when you are in the throes of it, in the luteal phase, self-isolation can feel so powerful. That need to self isolate. And the thought of talking to someone can feel extremely difficult. [00:21:00] So that's when your friend, or your daughter or your partner is not returning texts, phone calls, listening even to the voicemails. They're isolating. So can you imagine, uh, I would try to ask Christina a question and she would just cut it off.

Like we said, it could strike at any age, and it is a spectrum, and that's why we feel like Christina could do so well in the last year or two of high school and do well in college, do well as a nurse. Um, she was popular preceptor. She was very well loved. Her goal was to help other nurses every day. I think among her coworkers, she was beloved. And, you know, their beautiful card from the hospital indicated that too, with the messages that they wrote. But as she had her children and as time went on, she developed more severe symptoms.

The serious symptoms though, can occur at any age. So there are [00:22:00] already young girls in behavioral health units from time to time because of psychosis, self-harm, suicidal thoughts, or suicide attempts. A nurse practitioner followed us out of a conference one day where we spoke and she called our name as we were walking down the hall and caught up with us.

She said that she was a nurse at a behavioral health unit and she was eager to get back because they had the same girls coming every single month. Now of course, they're coming according to their cycles, you know, their different times. They weren't coming as a group. She said they called them their frequent flyers and she felt that she finally had their answer.

She couldn't wait to get back to talk about P and DD. So that conference was in 2022, October of 2022. So you see how recent that was? Yes. You think how many other behavioral health unit staff and doctors and nurses don't know about PMDD yet? Happens all the time. It can be very challenging to treat.

There [00:23:00] are those for whom something works right away and they don't feel the need to be on private message boards seeking support. They're just carrying on with their lives. Then there are others who desperately try one thing after another. They may be on private message boards. They might be like Christina, who she would never get on a private message board. I wish she had, I wish she had spoken up. I so appreciate those who do write about what their thoughts are, and especially when they're having dangerous thoughts. I'm grateful that they will go to a private message board and express that so other people can shore them up in whatever ways they possibly can to try to lift that person and help them get through it.

So that supportive care is vital from their healthcare providers, from their families, from people you don't even know. And private message boards. Wherever you are, you need that support.

Did you want me to talk about the core emotional symptoms and then the other, these are the official symptoms from the DSM five.

Would you like that? Sure. Okay, [00:24:00] so you need to have five SY symptoms overall, and at least one needs to come from this core list. In case somebody's driving, I'll read them mood and emotional changes such as mood swings, feeling suddenly sad or tearful or increased sensitivity to rejection.

Now that increased sensitivity to rejection is where you're highly sensitive if you feel criticized or not approved of or rejected. For instance, I as a well-meaning mom might call Christina Wendy and say, Hey, I learned a new way to cook hard boiled eggs. If she's in her luteal face and suffering in the depths of PMDD, she might be thinking, do you think I'm an idiot?

You really don't think I know how to run a household and you're telling me how to boil hard, boil eggs. When excited mom is just wanting to have a conversation with my daughter. And I learned a new hack on Good Morning America. So the conversations can go sideways when that rejection sensitivity dysphoria is at play.

That can [00:25:00] be very difficult because I see RSD as a real problem for family relationships and friendships during the luteal phase. What is RSD? Is that, oh, rejection sensitive dysphoria. Pardon me. Okay. Yeah. Yeah.

The next symptom group would be irritability, anger, or increased interpersonal conflict.

So that irritability could be something as simple as Christina taking a picture of the kitchen sink in her apartment with her roommates because she was mad that the dishcloth was getting stinky at the bottom of the sink underneath a bunch of dirty dishes. That was not like Christina, that only ever happened in that last semester at college.

And that was when it just seemed like PMDD started to bloom. Like come out. That's when her roommates noticed that she just seemed more on edge. That would be Christina's level of irritability. But for somebody else, they could have extreme anger. They could have outbursts, they could have domestic violence, they could have loud fights, saying hateful [00:26:00] things.

They could have a depressed mood. They could feel hopeless. They could feel worthless or guilty. I would add shame to that list. They could have anxiety, tension, feelings of being keyed up or on edge. So you have to have at least one of those symptoms. And we recognize that Christina had all of those in that last year, maybe the last few years of her life.

Then additional symptoms decrease interest in usual activities. Difficulty concentrating or focusing thinking. It's often called brain fog, tiredness or low energy changes in appetite. You could have food cravings, you could overeat or binge eat. Christina had some notes in her journals. We noticed that her journals were luteal phase journals. She wrote about how guilty she felt hiding in the pantry eating.

Hmm. You could have hypersomnia where you're very, very sleepy. You could just feel flattened, like you can't get out of bed. So now you're calling in sick or you're not going to your class in college or at high school [00:27:00] 'cause you can't peel yourself off your mattress or get yourself off the couch. Or you could have insomnia where you're having trouble falling asleep or staying asleep. You could feel overwhelmed or out of control.

One day, that beautiful, wonderful woman who you knew in Lincoln who was so sad that Christina died. So she was the president of the women's organization, I believe she was the one who called Christina and wanted to add one more person for Christina to do visits with.

Now Christina loved doing that. She loved all her church assignments, but Christina told me she started to cry. She felt overwhelmed. That wonderful president brought over dinner. And when Christina told me that my heart was so touched. Now we look back and we see, oh, it was luteal FaceTime. It was PMDD that was causing her to feel so overwhelmed.

You could have the physical symptoms that are also common with PMS as far as breast tenderness or swelling. But then I would go further to say joint or muscle pain [00:28:00] can be much more extreme with PMDD. Bloating and weight gain can happen also with PMBD. And then while suicidality is not yet an official symptom in the DSM five, it certainly ought to be because the research has borne this out. Those with PMDD are at that increased risk for suicidal behavior.

What is important to understand is if you are using hormonal contraceptives, tracking is not gonna be accurate. You can do your best, but also I would say to some you might already have the evidence because unintentionally you may have been tracking for years. You can look if you have a really good period tracker where you've been tracking things or you have your journals.

I used to keep the little Hallmark calendar books and I would track when I would start my periods and when I had my migraine headaches and I could see the spike in migraines before my periods every month. Having the benefit of that paper tracker, [00:29:00] actually I could see more clearly. And now that we've moved to our phones, I kind of feel like that was our disadvantage with Christina at our home, was that I wasn't looking at a paper tracker. Maybe if I'd been tracking things, I would've seen the cyclical nature of things.

These are ways PMDD can manifest what it could look like in somebody's life. And you might have other ones that you would add to this list. They might be absent from worker school in a cyclical fashion. They might be really good at wearing a mask as far as being able to hide their symptoms.

But once they get in the car, they might be crying all the way home in their commute. Or once they get home, they might be taking out their day stresses on their kids or their partners, spouses, any other loved ones, their moms, dads, whoever because they've been wearing a mask all day and it's just too much now once they're in their safe zone.

My advice to moms [00:30:00] who kind of feel like they could be a bit of a whipping post is, please remember the luteal phase is worse for your daughter and it's going to pass, it's gonna get better. But she needs your unconditional love and support right now more than ever.

They could be highly sensitive. They could become paranoid, like how Christina thought that we were against them for 10 years. That wasn't even true. But that was, you know, thanks to PMDs lies, they could become delusional. Now that's really called menstrual psychosis, but at the time we didn't have that vocabulary, which is with us for the first nine months.

So we were calling it delusions. Yeah. They could recall traumatic or cringeworthy memories where they just seem to come outta nowhere. You might be trying to calm them, comfort them, help them, and your words just feel like they're bouncing off some invisible shield.

But this is where PMDD is that liar and thief and that foreign hacker in the brain taking over. They could be writing [00:31:00] heart wrenching journals. The brain fog and ability to concentrate, can't get work done, can't meet deadlines, due dates, things like that. We have A Tale of Two families.

One family was continually harassed by the school district because their daughter missed a couple days of school every single month, but she was still an a student. She could compensate, but for a couple days outta the month, she just could not peel herself off her bed. They were harassed and got the letters from the district with all the threats.

Another school district contacted the parents of their daughter and it was a loving letter. They said, your daughter's teachers have gotten together and compared notes, and they realize something is happening cyclically to your daughter. It's always on a monthly cycle. And if we could ask you to please keep your daughter home for a couple days, every month, we feel that it's not helping her to be at school, that she is suffering.

Can you imagine that kind of [00:32:00] support? Because she was also an a student, two different school districts, two different approaches. Mm-hmm. And families really don't need to be dealing with the school district fight while they're caring for their loved one. What a beautiful thing that that school district did and her teachers to be so caring.

They might do self harm or have thoughts of harming others. Then they could have anxiety and that could go into panic attacks. And that's what we witnessed in the last year of Christina's life. She didn't always have delusions. She didn't always have suicide attempts. The panic attacks, the suicide attempts and the psychosis. Those, were in the last year of her life. But again, that could happen in a young person's life too.

They could try lots and lots of different medications. So as a family member, you need to understand it's not that they're being inconsistent. Maybe they are, but I doubt it. I bet that they're really trying hard, but it could be that the meds just aren't working well for them. They know that .They live in their body.

[00:33:00] For Christina, she did have genetic testing. Once her psychiatrist at the hospital where she was the most found out about that he requested those genetic tests and then so much made sense to him that there were certain prescriptions that would never work for her. So she had wasted time, months, and money on

prescriptions that were a bad idea for her. Like I said, they could be diagnosed, um, with bipolar disorder, but they could also receive many other misdiagnoses like Christina had. They could become emotionally or physically distant and not respond to texts, voice messages, or emails for long periods of time.

We saw that during COVID with Christina. Zoom calls with the family, playing games with family members around the country. Christina wasn't hopping on. We didn't know why. And it was this. They could be going to the ER pretty often and if the ER doesn't know to consider the menstrual cycle and ask about it, if they don't know about PMDD, it's a real disadvantage for them.[00:34:00] 

They could have the migraines and aches and pains. They could lack impulse control. Inhibitions go down. This is when you shouldn't be making big decisions. Don't decide to get a tattoo during luteal phase. Just don't do it. Don't, um, don't pick out your wedding registry during luteal phase. You might feel differently about breaking up or asking for a divorce if you wait because that could be PMDD lying to you.

Just know that you are on rough waters. You are in a sensitive time and you need support, but it can be really, really hard for some people to seek that support, especially if they suffer from mutism. I did not see mutism on the list when I read American Studies, it might be there somewhere and I just haven't found a study with it yet. But I did read it from a study in India,. But that was definitely one of Christina's symptoms. She would become ghostlike, just so quiet. She would become extremely fatigued and feel guilt and shame because she felt like cleaning the house and [00:35:00] doing lots of projects in follicular phase, but luteal phase, she didn't even remember that and she felt like everybody would be better off without her and that she wasn't a good enough mother, her children deserved a better mother and so on because she was judging herself and how well she was keeping up and she didn't feel like she was doing a good job of that.

They might sleep too much or too little. They could be suicidal or they could have homicidal thoughts. This is something where you really want to be watchful and have that open relationship as best you can. But also they need good doctors, good therapists who they can talk to.

Can you imagine how terrified a woman would be to admit that she's having homicidal thoughts because they're afraid that somebody's gonna throw 'em in jail and throw away the key. Know if they will say what they're thinking the doctor can say, there's help for this. There are prescriptions that we can help you with this. And there's therapy that we can give you. There's cognitive behavioral therapy that we can do, or dialectical behavioral therapy. There are good things we [00:36:00] can do. They could have depression, of course, um, crying spells.

They could be comparing themselves to others and feel inadequate and incapable. They may have different pregnancies, they may feel terrific and the PMDD might be on a break during their pregnancy and possibly while they're seeing it. Not a guarantee for everybody. But then others will have, prenatal and or postpartum depression. There is a bidirectional link with, um, PMDD for postpartum depression. They might have hateful outbursts or, like they could be at a family Christmas party and all of a sudden have an outburst and then they're so embarrassed. Can you imagine? I mean, family members are shocked and not prepared for it, but imagine being them and knowing reentry into the family or the workplace or church, wherever they have their outburst, will be very difficult.

Yeah. So let's make it easier to help them reenter after that [00:37:00] happens. They might make hateful comments that they don't really mean, but it feels so real at the moment. They might wanna end relationships or quit a job abruptly. Mm-hmm. Do you have anything you would like to add to this list?

I think this is a really good. This is an amazing slide. Amazing information I did not know about the, I've never felt better in my life than when I was pregnant. Like, that could be a thing. My husband and I have both said when I was pregnant, it's the best for me, uh, mental health wise.

Uh, mm-hmm. And it wasn't, it wasn't until after my third, that later we realized, I think some of those struggles were postpartum depression. And it was like, why didn't I think of that?

And the, uh, ending relationships. I always wanted to quickly end relationships in college. Mm-hmm. Very like, abrupt. Quitting jobs, for me it's more like projects or I will really be into something and then this [00:38:00] doesn't matter. Mm-hmm. And I'm just done with it. It can be really surprising for those around you and even yourself. Mm-hmm.

So. There are treatment options from SSRIs, and then some people will try SNRIs.

Those are the antidepressants. Mm-hmm. Then there are the oral contraceptives. Some people will try patches or they'll try the marina IUD. There are different things that people can try. Some people do shots. It's gonna be different for every single person. So your best friend might have PMDD and they might be responding to something very well and it could work for them for years or maybe the whole time even. And yet for you, you tried it and it was disastrous. So everybody's gonna be different. For family members to understand that is critical because you can't compare your loved one to somebody else that you heard about. Right. Until your loved one just buck up and be stronger or [00:39:00] something. It, it doesn't work that way.

There's the option of trying chemical menopause, and that's where you're stopping the menstrual cycle at the brain level. And there are different prescriptions for that. They'll generally do add back HRT depending on your age, especially if you're in your twenties, thirties for sure they're gonna probably wanna do that. If you're closer to menopause, they might not. It just depends. But the thing is that I feel like, and this is just Mary Beth talking. I feel like it is not accurate and I hear it repeated a lot that chemical menopause will give you an idea of what it's like to live after surgical menopause, after you get your ovaries and out along with the total hysterectomy by later cell pinal ectomy.

And that means getting your uterus, cervix, ovaries, fallopian, tubes out, the whole enchilada. But I have found that for many people, anecdotally, chemical menopause was a disaster for them. They felt more [00:40:00] suicidal than ever on it, or more angry than ever. But then when they had their surgery, they felt fantastic and are so glad they had the surgery.

So I think they have to be very careful about saying that chemical menopause is like a testing ground to see how you'll do. 'Cause I have too many friends now for whom it was just get me through chemical menopause because my insurance company is insisting, I do it as they're hanging onto the edge of the table for dear life trying to get through it without harming themselves or others. And then they finally get their surgery and it's like, oh, thank goodness.

Now most people, according to one study, 96.4% of those who had surgery were glad they had it. Generally, you're going to hear from the people on the message boards, those who are still on private message boards and social media are reaching out for help because they're having a bumpy ride. Some will say the first year, especially after having surgery, could be bumpy, but it's not as hard as [00:41:00] PMDD, but just adjusting to the right hormones for them could be a bit of a bumpy ride.

Then there's cognitive behavioral therapy, there's dialectical behavioral therapy, and then there are other therapies also that could be tried. And Christina tried 'em all. Her surgery was canceled or denied the day before she died. Mm-hmm. The day before she died was like a combination of lots of sad things.

Oh, there is something that I would like to paraphrase a gynecologist who spoke at a conference I was attending. She said she wanted to dispel a myth that is perpetuated every day in gynecologist offices around the United States. And that myth is that certain forms of birth control stay local. Your body is a system, and nothing stays local. Now, Christina and I trusted the gynecologist who she saw before she died, and that gynecologist said, I wanna treat it hormonally because I wanna prove it [00:42:00] hormonally that she has PMDD.

I said, there's no need to prove it hormonally, and my poor little daughter is sitting there, a mere shell of herself, and so sad and withdrawn. I had permission to advocate for her at this appointment. And I said, you've received a preemptive email, did you not? You know about everything she's been through and that, um, birth control is not her friend and the psychiatrist wants you to do chemical menopause.

She said, I don't wanna do chemical menopause. I wanna do it hormonally and it'll be fine. It'll be the patch. Then she went on to explain that patch would stay local, and we sat there believing her. I mean, she's the doctor, right? And she's saying this, well, it was not true. It's never true. So you could have a marina, IUD, you could have a ring, a patch, or a cream. They will not stay local. And I still see it on message boards. Somebody will say, do the patch. It'll stay local. And I don't wanna embarrass that person by correcting them. [00:43:00] Mm-hmm. But at the same time, they're perpetuating that myth. And when that gynecologist said this in this conference, it's like the scales fell off my eyes.

And I thought, of course that would be true. Your body is a system. I mean, my goodness, when I follow my husband out in the yard putting poison on the honeysuckle, they just cut. I have to wear special gloves because if it got into my skin, it's gonna travel in my system. It could cause some organ damage, the special kind of poison for honeysuckle.

Mm-hmm. Well, that's true for anything. Whatever we put in or on our bodies, can travel around. So we need to be careful of that. Yeah. I love your list. And most of my listeners know I've tried various things. I've tried fluoxetine and it worked for me for time. I did it both like every day for a few months. Mm-hmm. And then I didn't like that there were some things missing in my life and to me, it felt like I was kind of this robot and [00:44:00] I didn't have emotions. Mm-hmm. Very, very productive. In that way I loved it. I was like, I could just mm-hmm. Go and do things. But the emotion and feeling was a lot less. And then a doctor told me that you can actually do it just the two weeks before your period. Yes. And, and he said some of my clients do it, um, on their period, and some don't.

His thing was seven to 10 days before your period. Mm-hmm. And then for some, during their period as well. And that worked really well. And then for me, it, it abruptly stopped working. Isn't that interesting how that can happen? Yes. With treats for PMDD. Mm-hmm. Yes.

All along through this time that isn't the only thing I've done. I've done lifestyle changes, exercise, um, wellness things. You mentioned cognitive behavioral therapy. I've done life coaching and the process that I was taught and certified in was a self coaching [00:45:00] method that you can use on other people.

It looks at your thoughts, feelings, actions, and what was the circumstance and what's the result? And you just look at all of it and is very helpful. It can be, but again, the phase you're in, right, the follicular, it's very helpful. During the luteal, that would just depress me.

For a time I thought life coaching was just the answer. And then I started having really bad experiences when I would get coached and I was like, what is going on? I got certified actually in 2021. I didn't know about PMDD until later that year. Mm-hmm.

And then you know, it just takes time for your brain to kind of catch up. Like, oh, so this tool is very helpful now and at this time it's not helpful, so don't use it. Right. Use mindfulness, use breath work, use meditation, journaling. For me, I kind of embrace all of it and some [00:46:00] vitamins.

Did you have to write it down so that you would remember when you got into your luteal phase to try those other things so that you would see it say on a phone calendar or somewhere? Yes. I definitely do it. Because I could imagine once you're into the throes of PMDD, that it would be easy to forget that you made that promise to yourself that you were going to switch it up and do some other things for self-care.

For me, I have always been pretty self-aware of feelings and behaviors. So when I recognize that, I'm feeling irritated. Mm-hmm. And especially if I say something to one of my kids or to my husband, I'm like, Ooh, what's going on? That's sounds too sharp. Yeah. Yep.

Mm-hmm. Let's look at what time of the month it is and I'll just look and I will see what day it is for my menstrual cycle. Right now I do, a five minute meditation that I listen to, and then five minutes of journaling. Not usually when I get up, 'cause I gotta get kids to school, make [00:47:00] lunches. Just anytime.

I like it better if it's closer to nine or 11. I put mc for menstrual cycle and the day, just write under the date. And then I just write. And I'm so much more positive. In the past, I've always been writing at night and in high school it was always you know, usually at midnight.

Mm-hmm. But I was a very event person in my journal, so I would write events and then sometimes my feelings would spill out. And that's why I can see, see things now that I didn't really notice at the time. I think journaling is such a great expression, but I feel that doing it earlier in the day, right after having done breath work or short meditation, it's really working well for me. It helps me just get into a better place with myself, I guess. Oh, that's wonderful. And I have a feeling somebody listening is going to try to implement what you're talking about. Oh, [00:48:00] I hope so. Mm-hmm. Yeah, try it. I think so. 

Thanks so much for listening to the Living Well with PMDD podcast. To learn more about life coaching with me, visit my website Heidi, H-E-I-D-I, bradford coaching.com. Until next time, keep hoping, keep loving, and remember that you are not alone.