Premenstrual: darkness, anxiety and PMDD
Hi there! I’m Lisa. I am a women’s health coach specialising in the menstrual cycle, chronic pain, trauma and burnout. I specialise in helping people who have been around the block already with courses, doctors and therapists. My clients are often stuck, frustrated and in an endless cycle of looking for answers for their healing and recovery. I help you to get unstuck and clear the invisible blocks along the way. I am also the founder of a professional training at the Menstrual Coach Academy.
Since working as a Women’s Health and Menstrual Cycle Coach, I have had many women share in workshops, or with me privately, that they experience a very intense sort of PMS. Not the usual and more accepted “PMS symptoms,” such as irritability, tender breasts, cravings or perhaps feeling a bit teary. Rather, what I hear is that these women experience quite an intense darkness of the psyche and heightened anxiety up to ten days prior to menstruation.
This shows up as feeling hugely depressed, very anxious to the point they can’t be looked at, or, can’t look at their loved ones. There can be grief and anxiety about life in general is strong. There is a huge visceral charge in the body and it can be very difficult to cope. It shows up differently for each woman but the common theme I have heard is that there is ‘darkness’ and a ‘charge’ to the experience. Menstruation brings a sense of relief as it passes.
In the medical world, this experience could be diagnosed for some people as a condition known as premenstrual dysphoric disorder (PMDD), which is, in essence, a mental health condition linked to the menstrual cycle. There are several ways to address it, including psychiatric medication, therapy, self-care practice and so on. From my perspective as a Menstruality coach interested in the holistic experience of the cycle, I have learned a few things and would like to shine a bit of light onto the experience:
Hormonal contraception
If a woman is on hormonal contraception, which suppresses ovulation (e.g. the combi pill), then because ovulation is not happening, the body does not produce its own natural progesterone. Progesterone, the predominant hormone during the premenstrual phase of the menstrual cycle, has a role of soothing the nervous system and allows us to build emotional resilience as we move towards menstruation. If you’re not getting your body’s own progesterone then you’re not receiving the calming, soothing benefits of natural progesterone and are more vulnerable to mental health challenges. Do speak to your doctor about the option to move onto the mini pill, which does not suppress ovulation. Look into other ways to calm and soothe the nervous system through diet, meditation, healthy relationships, etc.
Hormonal imbalance
Similar to the point above, if you’re not on the pill, there could still be a possibility that your body is not producing enough progesterone which is needed to calm and soothe the nervous system. Look into ways to boost progesterone and ways to bring down oestrogen dominance. E.g. taking magnesium, zinc, vitamin b6. Have a look at Lara Briden’s blogs and book to find out what exactly would be right for you. You could also speak to your doctor or functional medicine doctor about using a bioidentical progesterone cream.
Burnout
Anxiety and depression in the premenstrual phase can also be a result of physical and emotional burnout from pushing ourselves through the menstrual cycle. Think of the physical body as a container for our mental, emotional and spiritual experiences. They are all linked. If we are physically drained, we then have a less robust container for our emotional lives and are left more vulnerable to ‘life’ and ‘the world.’
A good way to prevent this is to rest at menstruation as much as you can. Rather than resting reactively during the ‘inner summer’ ovulation phase. Rest at menstruation is proactive and is hugely restorative for the body when hormones are low. Small changes to include a more restful approach to the day can work wonders! Learning to ask for help and support during this time will also serve everyone!
In the world of mental health and conversations about burnout, I firmly believe that we need to incorporate the menstrual cycle and hormones as part of the conversation. Women are not linear so learning to rest at the right times can prevent unnecessary burnout.
Welcome the darkness
Sometimes, our mental health can suffer when we resist feelings, thoughts and when we fear the fear itself. Create a soothing and safe environment for yourself to explore what is under the uncomfortable feelings. Set an intention to stay present with the body and welcome the feelings. I suggest doing this in the bath, light some candles, play some soft music and make sure you have privacy. Laying out a comfortable space on a yoga mat with blankets on the floor is also a good alternative to the bath. Keep a journal next to you. Give yourself a container of time so that you can close the ‘healing session’ after a certain amount of time and get on with the day. This may need to be done several times as there are layers to the emotional experience and it’s important to go gently. Feelings of grief, disappointment and fear can arise. Let the body move or shake if the impulse is there. Allow tears to flow.
Trauma
From my experience, I believe that many women struggling with PMDD symptoms carry trauma in the body that might never have been addressed or taken care of enough. Trauma comes in all shapes and sizes and is relative. It could have been a shock trauma once-off event, birth trauma, childhood developmental trauma or any other experience that left a mark on the nervous system. It’s important to get professional support with this from a therapeutic practitioner who you feel safe with and who is trauma trained in some modality. I recommend somatic practices that incorporate the body and bodily sensations as a way to release trauma.
I also believe that many women unconsciously tap into what I describe as collective trauma. The fact that the menstrual cycle and menstruation itself has been shamed and silenced generationally is something that impacts many of us on a physical level. Taking a look at working with boundaries can help with this so we don’t take on the world’s pain in our bodies.
Generational trauma is also a thing. That is where trauma experienced by our ancestors is passed on generationally. For example, if a grandmother was in a warzone then that impacts how she relates to her children and the wounds get passed down. Take some time to consider what traumas were experienced by your ancestors. Then there are many things you can do to soothe that, such as practice a ritual to release the trauma, bring it to an energy worker, a shamanic healer, bodyworker, etc. At this level, doing what you feel called to do is usually the most appropriate way to shift things.
Practice menstrual cycle awareness
Come into relationship with your menstrual cycle on a daily and weekly basis. Coming out of menstruation, take extra care to cherish yourself as you approach ovulation. Download my guide here on more details of how to embody this practice.
Self-care
Speak to yourself tenderly and kindly as though speaking to your inner child. Hold space for difficult feelings and give yourself anything that feels soothing. It’s ok to not be ok during this time and taking care to address the emotions, over time, and with the right support, it will get easier. Emotional processing through the body takes time. A gentle approach is needed but it can be very powerful.
Seek support
It’s important to seek support. In fact, it’s not possible to heal yourself. Polyvagal theory explains that ‘co-regulation’ is required to come into a place of healing within the nervous system. We can practice meditation until the cows come home but really what’s needed is a safe and empathetic witness to our experiences. Seek out a good therapist, a coach or even a listening partner to share with. I encourage listening partnerships in my online courses and offer coaching support privately for anyone looking for 1:1 support.
Hope
What can you do to create hope for yourself? As someone who has experienced a lot of darkness at other phases in my own cycle, I can assure you that there is hope and that this too shall pass. When you are in the midst of it, it can feel scary but do take responsibility for your wellbeing. Reach out to a friend, a coach and don’t stay alone in that space. We humans are incredibly resilient. It’s important to understand our needs and take actions to take good care of ourselves. There are gems of wisdom in that darkness, so make sure to take them with you when you come out the other side!
Spirituality & Creativity
I encourage you to explore your spirituality and creativity during the premenstrual ‘inner autumn’ phase of the menstrual cycle. This time is a potent time that can be very charged. I describe it as the shamanic time of the cycle. If you are in any way sensitive, creative and curious about spirituality, allow those feelings, thoughts and curiosities to come up through the body. Allow yourself to explore the arts and practice things that help you feel connected to yourself and the world. From that place of feeling connected, you may get clarity, through the body, on what needs to be released. Bring what needs to be released to prayer.
If you would like support with mental health around your menstrual cycle or with PMDD symptoms, I can help you with that.
I run a small group programme a couple of times a year. You can read more about that below to be part of a group of other women doing this healing work together.
Are you interested in the world of Menstrual Cycle Coaching as a professional? Learn more about our work at the Menstrual Coach Academy.
I have lots of free resources and courses all about Menstrual Cycle Awareness, Cycle Tracking, Healing Trauma and Chronic Pain, Support for PMDD. Grab your free course below!