A Discussion on PMDD with Charlotte Atkinson
This week I'm SO excited to introduce Charlotte Atkinson! A badass film/radio producer, blogger, and consultant from London. Check out her website HERE or find her on Instagram at cat_atkinson_ We talked about her experience with Premenstrual Dysphoric Disorder (PMDD), seeking treatment, and self-care.
Q. You’ve suffered from PMDD since you were 16. Can you explain what that is and how it affected you?
A. I like to think of PMDD as PMS but with mental symptoms rather than physical. PMS is extremely common, so many women will be familiar with cramps or headaches. PMDD symptoms include severe depression, fatigue and in some cases, suicidal feelings. Much like PMS, these symptoms last for around a week leading up to your period and go within two days of starting your cycle. This part is crucial as it’s how PMDD is distinguishable from other illnesses like depression. Although it sounds pretty rare, it’s actually fairly common. I read that 1/20 women suffer from PMDD (although I’m not sure if that statistic is for the UK, US or both). It was medically recognised around 20 years ago, but a lot of doctors still haven’t heard about it.
I didn’t realise I had anything abnormal to do with my periods, but I would be stuck in bed feeling miserable for around a week before my period. I was so exhausted during my period that I often needed to stay in bed for another week. But after it was over I almost forgot about it! It was so strange, and it wasn’t until my mum pointed out that I couldn’t be this miserable and exhausted for two weeks every month that I went to the doctors. It started in earnest during my first set of school exams when I was 16. I was so stressed and anxious about my exams my brain went into overdrive and then just shut down. I had severe depression that didn’t fully lift until months later when I got my results. My periods became a lot worse after those exams and a lot harder to manage.
Q. How did you figure out you had PMDD and what was your experience like seeking medical help?
A. The first time I went to the doctors about my periods I was turned away with no medication or help of any kind. My periods had gone mental during my second set of school exams when I was 18. I’d been so stressed again that I had two periods in a month, then three and then four. They went back to normal after my exams were over, but the doctor said that as my periods had only just settled down she didn’t want to interfere with that. It must have been six months later that I was Googling my symptoms, which I’d really started to notice since finishing school, and PMDD came up. I had every single symptom, and I got every symptom every time I had a period. I went back to the doctors, and luckily got a great doctor. He said that under the NHS this would probably be classed as ‘severe PMS’ (even though PMDD is listed in full on the NHS website). He put me on the combined pill (which contains bothestrogen and progestin) as he guessed that regulating my hormones might help.
Q. How did birth control and 5htp help you?
A. My first month on the pill was amazing! I’d never felt so good in my life. I had more energy, my PMDD depression had gotten better and I woke up every day and felt the same as the day before. No dips, no mood swings, no sudden fatigue, it was incredible. But on Rigevidon you have to take a seven day break with no pill at all, and my first day of the break was horrible. I remember looking at a wall and just bursting into tears. I felt like I’d never beat PMDD. The second day of the break was easier, but I found that by day 5 of the break, I was depressed and exhausted again. A couple of months later I went back to the doctors to review the medication and they said I could have a four day break, instead of the full 7 days. This was a huge help, as it meant that I kept the exhaustion and depression at bay.
After around 8 months on the pill, however, the PMDD symptoms came back. I felt depressed and suicidal for about a week (occasionally two weeks) every month. I gave up and stopped taking the pill and my symptoms gradually got worse. I tried talking to my friends about how suicidal I felt, but they didn’t really understand and just freaked out. I lost a lot of friends during that time, but I’m glad they didn’t understand it because I never want them to feel the way I felt. PMDD is not an easily understood thing unless you’ve experienced it. Even though feeling suicidal is horrible, I knew it was only hormonal because it would only last for a few days at a time, and it was really obscure things that stopped me from killing myself. I remember walking by the river and thinking ‘I should really just drown myself now’, but then thinking ‘oh no, actually, I can’t, because I only bought this coat last week and I really like it’.
It was so bizarre and totally uncontrollable. It felt like I was lost at sea a lot of the time, at the mercy of the ocean. I was given 5HTP by a friend as I was having trouble sleeping. It worked for about three days, and then the sleeplessness returned so I stopped taking it. My next period was a new level of awful and it wasn’t until I found out that 5HTP is often used by PMDD sufferers to manage their symptoms that I realised what had happened. Taking away the 5HTP had made the PMDD so much worse, so I began taking it three days or so before my symptoms would usually start. It helped a lot, but what helped more was stepping back from what was a very stressful, emotionally-charged life and taking time out for myself.
Q. You mentioned that your symptoms always worsened when you were under a great deal of stress. How have you learned to manage your stress? What have you done?
A. Going to therapy has been a big help for me. I realised that I couldn’t rely on friends to talk about how I was feeling because I was having severe, scary feelings. I let go of every main source of stress in my life. From the outside, it probably looked like I was being cold-hearted and selfish but it had to be done. Nothing is worth suffering with the symptoms I had, so I made a list of everything that kept me up at night and stepped away from it. The PMDD really affected my physical health and I had begun feeling really unwell. I couldn’t walk longer than 20 minutes before I felt completely exhausted and had sharp, stabbing pains in my hips and legs. I went to the doctors and found I had an under-active thyroid. Unfortunately for me, that meant months of struggling with physical symptoms while doing tests over and over again and not seeing any progress. My physical health declining was the biggest wake up call, and whenever I felt guilty for letting go of stress-inducing projects I remembered how bad my health was.
Letting myself sleep as much as possible and making the effort to eat proper meals instead of grabbing something while running between meetings made a huge difference. It’s really basic stuff, but it’s so easy to put it at the bottom of the list and prioritise everything else. Breathing exercises and taking the time to stop and truly enjoy things have also helped me a lot. During my first week after getting rid of a lot of sources of stress, I went for a walk to test out how I was doing physically. I breathed deeply and realised there was a beautiful little cherry blossom tree in one of my neighbours’ garden that I had never noticed before that day. I’d always been so wrapped up in my work and my never-ending to do list that I’d stopped noticing things around me. Now I know when my subconscious stress levels are getting worse because I’ll stop being able to take in the details of whatever is around me.
When we are stressed, it’s like we can only exist inside our own heads because we have to hold on to everything in our brains. And of course, you can’t do that, there’s too much! But I see it all the time in the people I coach and work with - they’re trying to stay in control of everything and don’t have the head space to notice the things around them. Letting go of stress really means letting go of trying to hold on to everything.
Q. We also talked about how periods are not normalized, and often make others (especially men) uncomfortable. How do you think we can work to normalize menstruation? A. I think talking about it is a great way to start. Social media is amazing for that because you can literally talk about whatever you want. For me, I find that just talking about it freely without trying to tread carefully around men in particular has actually saved so much energy and time. It’s a little bit like when you’re a teenager and you waste so much time and energy worrying about whether people like you or not, or if they’ll still like you if you wear this dress or that top. And then you grow out of it and start wearing whatever the hell you like, and you realise how freeing it is. I think talking about periods in whichever way you like is always going to be the best thing. I’ve met so many brilliant women who suffer from difficult periods and it’s been so, so lovely being able to talk to them openly. So talk about it, find great people to talk to or just commiserate with, and don’t worry about other people. If others don’t want to talk about periods then they don’t have to listen to you, but it’s not up to us to censor ourselves just in case it makes other people uncomfortable.
Q. Finally, what advice do you have for other women suffering from PMDD?
A. Start by researching it and assessing what symptoms you have. Keep track of your symptoms so you can really get to know how bad it is and you might be able to find what makes them better or worse. When I first found out about PMDD I made monthly trackers (forever over-organised) and ticked any days when I’d felt depressed, suicidal, anxious, tired, had a migraine, couldn’t sleep or had physical pains. After three months or so I knew when the symptoms were going to hit me so I could plan accordingly which made things a lot easier. There’s nothing worse than scheduling a meeting and then cancelling on the day because you’ve woken up depressed and unable to move. After a few months of tracking, I remember feeling so confused because the depression felt like it was eating me alive, but I was only depressed for two to four days every month. Time moves like treacle when you’re depressed so it was actually very uplifting to know that however bad I felt, it would be over within a few days.
Experiment with remedies. I saw that Yaz (a combined pill) has been FDA approved for treating PMDD. It’s currently the only thing you can really use to treat PMDD. Some doctors may prescribe antidepressants, but the problem is that you’re not really depressed, it’s a cyclical hormonal imbalance. That said, I am not a doctor and if you want to try antidepressants then go for it. It’ll take a lot of time to find what works for you, and you’ll probably find that it may work for a few months and then need adjusting. Don’t be disheartened and don’t go to a doctor that doesn’t take you seriously. Find PMDD groups online - there are some great ones on Twitter - and don’t be afraid of reaching out.
Bio: Charlotte Atkinson is a London-based film and radio producer, blogger and consultant. She helps creatives (everyone from composers to dialect coaches!) to create their dream careers. She trained in theatre but began working in film aged 19 and has since worked on over 25 films. Her favourite things are Bird & Blend Teas, ballet, and books.