PMS is a Bitch

275mg

I feel this hole in myself. I feel a sense of emptiness, somewhere inside of me that I cannot place. In my heart, in the pit of my stomach, in me there is a cavity, and it needs to be filled. I feel a sense of confusion. I feel I have lost my way. I know what I want in life, and why I want it, but all of a sudden I just feel so insignificant. I feel so small.

– My Journal: 31 January 2012

I’ve been depressed.

I hate to say it, because I feel ashamed and embarrassed. I always blame myself for it, I always have. Logically, I know my depressions cannot be blamed on some flaw within me. Emotionally, I feel I am responsible. Defective even.

I have not done this. I did not choose this. Yet continuously, depression after depression, I point the finger of blame, and I always point it at myself. Everytime, I feel that I have failed.

I know that’s the depression talking – I know that after the fact. But when I’m down, I don’t see any other possibility.

In a way, it actually is my fault this time. At the start of December 2011, I came off my contraceptive pill. My reasoning for this was that it was giving me acne (and some unsightly facial hair too if you really must know). So, I thought, I’ll come off my pill and see what happens. Maybe the acne will clear up, I thought. Maybe the facial hair will cease to grow.

In actual fact, the acne – which is actually a facial infection that I am apparently prone to – and the facial hair became worse. So did my mood.

I had been on that pill for about four years. It’s a mini-pill, a progesterone only pill and it blocked my hormonal cycle. I had a period about once every six months, and PMS was minimal. This lulled me into an absolutely deluded sense of security. I guess I forgot, or cleverly rationalised away, how bad my PMS was when I wasn’t on the pill. And it was really bad.

When I say really bad, I actually mean diabolical; out of my 28 day cycle, I have PMS symptoms for 14 days. Yes. Two entire weeks out of every month, I become a living, breathing demon.

It’s not just sore boobs, swollen abdomen and grumpiness. It’s more like completely unreasonable, completely irrational and entirely emotional she-devil. I rise from hell. I get angry. I swear. I scream. I cry for hours on end. I moan. I even get paranoid – yes, actually paranoid – that everyone hates me and is out to get me.

Within a few days of stopping the pill I became more lethargic than usual. I put that down to the changing hormones and the impending period that didn’t make an appearance until one month later. When it did, I received my usual 14 day warning, but I figured, “oh you know, it’s just because it’s been so long. It will get better”.

It actually got worse. Slowly, my mood deteriorated. I noticed, but I kept coming up with alternative explanations that explained away my symptoms and kept the finger of blame away from me.

When I became afraid to leave the house, I decided something was up. Two days later I started my pill again and two days after that my mood improved dramatically. I am back to my normal, stable, and angelic self (that’s an exaggeration, I’m a bit cheeky really).

From this exercise I have learnt two things:

1)    Never come off my contraceptive pill again.

2)    Follow the rule of parsimony: whatever is the simplest explanation is probably the right one (i.e., if your mood is down and you have bipolar, you are probably depressed!)

Interestingly though, that the little white pill that stabilises my hormones stabilises my mood more effectively than the Quetiapine. Or at least, that’s what I think.

Quetiapine withdrawal will begin again. Probably this Saturday. Stay tuned!

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7 thoughts on “PMS is a Bitch

  1. Oh, what misery! I truly empathize/sympathize/etc.

    I tried the pill back in college when estrogen-based birth control was the only option. I have no idea what progesterone-based would do to me, but the estrogen one? OMG. 30 lbs weight gain in no time flat. But the real reason to quit it ASAP: I became a raving lunatic. Mood swings like mad, and it seriously exacerbated bipolar symptoms that I didn’t know were bipolar symptoms at the time.

    I’m not surprised that a good hormonal treatment is helpful. Women’s hormonal shifts have a massive effect on body chemistry and research practically never studies the interactions of hormones with medications. Most medical studies are based on men anyway. But estrogen is one of the most powerful drugs out there! Imbalanced progesterone in particular can have nasty mood effects.

    Now you’ve got me thinking whether it’s worth experimenting with the progesterone pill. I could try it over the summer, and if it works for the symptomatic stuff, that would be awesome. I get a little bit of mood swings with PMS, but since getting up to dose on Lamictal it was actually much worse last month and Lamictal does interfere with estrogen-based birth control, so it may also be interfering with natural estrogen levels. We’ll see what happens this month…

    I get a little bit of acne that’s like, come on, I’m in my mid-30’s for crying out loud, is this stuff ever going away? Proactiv helps but is expensive and requires constant diligence. And facial hair. Big, big sigh. Getting worse over time, and mine is heavy, prickly, and black. I’m going to make a call for laser hair removal because even if all it does is reduce the density and rate of growth, that would be worth it. I did a round of it before and the upper lip hair is much, much lighter, to the point that I rarely need to intervene much. My skin is too sensitive for waxing or bleaching, plucking leads to infected follicles, and shaving requires daily or every-other-day upkeep. And I really hate the stubble. I did calculations and plucking-based facial hair managements costs enough in time to totally offset the cost of laser hair removal in relatively short order. (yes, I know that’s very geeky, but it’s how I make some of these decisions…) 🙂

    • You should definitely get some laser hair removal – sounds like it is the best option for you. I have light fluffy hairs, and a few coarser darker ones and they are bad enough! I do have friends with full on beards. I feel so self-conscious about mine if I don’t wax it off.

      Very interesting about hormones – it could be worth a shot trying progesterone only. I’m not sure if it works for me because I am naturally low in progesterone (which my GP did suggest), or what. But I do know that I have felt much better while on it, even though there is a bit of cycling going on it’s probably just because things need to even out again.

      Thanks for your comment!

  2. Something similar happened to me when I had to have one of my quarterlies in September. I only had to go off for a week, but it sent me in a tailspin. I’m so sorry you are in this hormonal hell.

    You can’t fault yourself for something you didn’t know. You couldn’t have predicted this. And if you could, then it’s not as if you would have done it. No one can predict how their mood is going to be affected when chemicals change.

    The good thing is that you have a solution and a foreseeable end. (And I know what you mean about the facial hair. My husband teases me about it. It doesn’t make matters better.) Focus on knowing that this has a solution; it will be resolved because it’s tied closely with your female hormones.

    You are not defective. You are human, inherently, but masterfully flawed. Because those flaws are what makes you, you.

    I don’t feel like I’m sounding like I’m helping. All you need to know is that you never have to apologize for the way you feel or the fact that you exist to anyone, especially yourself.

    • Your words are always helpful Luna! Things are looking up now, definitely much better being back on the pill. And you are right, there is not a lot I could have done about the situation. It’s just that depression turns me on myself. Now I feel good again, I can see that it wasn’t really my fault, but at the time I just feel this overwhelming sense of responsibility and guilt. It is so interesting how my thought processes and perspectives change with my moods.

      • I know what you mean. Depression has a tendency to turn the loaded weaponry at me, too. You know, in BP, there is this spectrum of mania. Why isn’t there a spectrum of depression? Basically, all they have is dysthymic and depressive. But, it’s so much more complicated than that.

        I’m trying to keep myself as disarmed as I can manage, still pointing the emotional bullets away from my person. But for how long? Is it inevitable?

        I’ve reported to doctors that I get paranoid with delusions during depressive episodes that cause panic attacks. “Delusion is not part of depression.” Then tell me this, doc. Tell me why I am an otherwise rational person until I get overwhelmed by my emotions, depressive or hypomanic. I get delusional in an episode, any episode. Euphoric hypomania; i am awesome. Dysphoric hypomania; I hate everyone because they have either wronged me or planned to wrong me. And then there’s depression. Delusions are just as fierce then. Suddenly, my self-worth melts and I am determined in my thinking that everyone secretly hates me. I find faults that aren’t exactly real. I’m not selfish, intentionally mean, or particularly dramatic for effect. But, I will think these things, and even worse.

  3. I too suffered from PMS, long before I experienced ‘depression’. Out of 28 days, the only good days were the ones during my period. It got worse and worse. Finally had a hysterectomy, unusual treatment for PMS but it worked for me. (That was way back in 1992.) My life improved 100% as a result of that surgery. Depression didn’t enter into play until a few years after that. Don’t give up, keep doing what you can to deal with this old depression.

    • Thanks for your comment Wendy. I have to say, your PMS experience sounds like absolute hell. 14 days was more than enough for me! Happy to hear though that your surgery improved your quality of life. I am pleased to report that I am feeling a lot better already, still a bit all over the place, but evening out all the same. What a relief!

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