[et_pb_section admin_label=”Section” fullwidth=”off” specialty=”off” transparent_background=”off” allow_player_pause=”off” inner_shadow=”on” parallax=”off” parallax_method=”off” make_fullwidth=”off” use_custom_width=”off” width_unit=”on” make_equal=”off” use_custom_gutter=”off” background_image=”http:\/\/cusjc.ca\/catalyst\/wp-content\/uploads\/2017\/04\/blood2.jpg” custom_css_main_element=”height: 100vh;”][et_pb_row admin_label=”Row”][et_pb_column type=”4_4″][et_pb_text admin_label=”Text” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n
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By Caroline O’Neill, Catrina Smyth and Christine Vezarov<\/strong><\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=”Section” fullwidth=”off” specialty=”off”][et_pb_row admin_label=”Row”][et_pb_column type=”2_3″][et_pb_text admin_label=”intro – frustrated tears” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n All Eryn Speers wanted was an answer.<\/p>\n \u201cI got sent to a psychiatrist who basically laughed at me,\u201d says the 27-year-old.<\/p>\n In the two decades since the Toronto native started her menstrual cycle, Speers says she\u2019s been riding an emotional rollercoaster lurching from a spectrum of feelings, like anger to depression. \u00a0From 2015 to a few weeks ago, she exhausted Google\u2019s search engine looking for scientists and studies to explain what was wrong.<\/p>\n The trek to a diagnosis was filled with awkward encounters and frustrated tears.<\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=”Row”][et_pb_column type=”1_3″][et_pb_image admin_label=”Image” src=”http:\/\/cusjc.ca\/catalyst\/wp-content\/uploads\/2017\/04\/IMG_8899-1.jpg” show_in_lightbox=”off” url_new_window=”off” use_overlay=”off” animation=”left” sticky=”off” align=”left” max_width=”300px” force_fullwidth=”off” always_center_on_mobile=”on” use_border_color=”off” border_color=”#ffffff” border_style=”solid”] [Photo \u00a9 Eryn Speers]<\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”2_3″][et_pb_testimonial admin_label=”eryn” author=”\u2013 Eryn Speers” url_new_window=”off” quote_icon=”off” use_background_color=”on” background_color=”#f2f2f2″ background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n [\/et_pb_testimonial][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=”Row”][et_pb_column type=”2_3″][et_pb_text admin_label=”emotionally debilitating form of PMS” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n She is one of the estimated two to eight per cent of women who experience Premenstrual Dysphoric Disorder (PMDD), \u00a0according to the Mood Disorders Association of Ontario<\/a>. Dysphoric, or dysphoria, is defined as a state of feeling unwell or unhappy in the Merriam-Webster dictionary. \u00a0This disorder is most easily understood as an aggressive and emotionally debilitating form of Premenstrual Syndrome (PMS), according to the Diagnostic and Statistical Manual of Mental Disorders\u2019 fifth version.<\/p>\n \u201c[The psychiatrist] wasn\u2019t sure what to make of it, he hadn\u2019t really heard of it and basically threw me on a bunch of medications,\u201d says Speers, matter-of-factly. \u201cIt ended up making me a lot worse.\u201d<\/p>\n Officially classified four years ago, PMDD is new terrain to not only the millions of women around the world who suffer from the illness, but physicians as well.<\/p>\n [\/et_pb_text][et_pb_counters admin_label=”Bar Counters” background_layout=”light” background_color=”#000000″ bar_bg_color=”#fc0000″ use_percentages=”on” border_radius=”0″ use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n [et_pb_counter percent=”50″] Women in the world [\/et_pb_counter][et_pb_counter percent=”85″] Women with PMS symptoms [\/et_pb_counter][et_pb_counter percent=”5″] Women with PMDD symptoms [\/et_pb_counter]<\/p>\n [\/et_pb_counters][\/et_pb_column][et_pb_column type=”1_3″][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=”Row”][et_pb_column type=”2_3″][et_pb_text admin_label=”spears was – what is my problem?” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n \u201cUntil I found out about PMDD, I thought, \u2018everyone else is coping,\u2019\u201d says Liana Laverentz, a writer and editor in Pennsylvania, U.S.A. \u201cAll women get their period, what is my problem?\u201d<\/p>\n [\/et_pb_text][et_pb_testimonial admin_label=”liana” author=”\u2013 Liana Laverentz” url_new_window=”off” quote_icon=”off” use_background_color=”on” background_color=”#f2f2f2″ background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n [\/et_pb_testimonial][et_pb_text admin_label=”wrote alot of posts – experience each month” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n Now entering menopause, Laverentz didn\u2019t receive an official diagnosis until a few years ago.<\/p>\n \u201cI wrote a lot of posts when I was under the influence of PMDD,\u201d says Laverentz, who runs a popular blog<\/a> with over half a million hits that focuses on her personal experiences with the disorder.<\/p>\n PMDD manifests itself in the form of severe emotional reactions ranging from blowout arguments with a partner to some mothers reporting their children are scared of them once a month.<\/p>\n \u201c[There is] a list of stuff in DSM-5 that you have to have to, very specifically, meet the criteria for PMDD,\u201d says Dr. Robert Reid, a professor at Queen\u2019s University\u2019s department of Obstetrics and Gynaecology. \u201cThe reason for that is when we talk about it in medical circles, we are all talking about the same patient.\u201d<\/p>\n For some women, a week every month can be likened to a punch to the gut. Women experience a myriad of symptoms from bloating and spurts of snarkiness to food cravings. These universal symptoms have opened up conversations about menstruation around the world.<\/p>\n But until 2013, up to 160 million women were excluded from at least part of that dialogue, and diagnosed incorrectly.<\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″][et_pb_image admin_label=”dsm” src=”http:\/\/cusjc.ca\/catalyst\/wp-content\/uploads\/2017\/04\/17668617_10211961159571981_1135745846_o.jpg” show_in_lightbox=”off” url_new_window=”off” use_overlay=”off” animation=”left” sticky=”off” align=”left” max_width=”600px” force_fullwidth=”off” always_center_on_mobile=”on” use_border_color=”off” border_color=”#ffffff” border_style=”solid”] [Photo\u00a0\u00a9 <\/b>Catrina Smyth]<\/p>\n [\/et_pb_text][et_pb_image admin_label=”blog pic” src=”http:\/\/cusjc.ca\/catalyst\/wp-content\/uploads\/2017\/04\/Screen-Shot-2017-04-05-at-1.38.48-PM.png” show_in_lightbox=”off” url_new_window=”off” use_overlay=”off” animation=”left” sticky=”off” align=”left” max_width=”500px” force_fullwidth=”off” always_center_on_mobile=”on” use_border_color=”off” border_color=”#ffffff” border_style=”solid”] LivingonaprayerwithPMDD.ca<\/a><\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=”Row”][et_pb_column type=”2_3″][et_pb_text admin_label=”but until 2013 – im pmsing” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n It took over a decade for Laverentz to put a title to her condition.<\/p>\n Her hormones were tested and she was misdiagnosed with Polycystic Ovary Syndrome (PCOS). In 2009, she finally learned she has PMDD. While PCOS does have a mood component, it is predominately known for its physical symptoms, like ovary cysts, facial hair and weight gain.<\/p>\n \u201cPolycystic ovary syndrome is totally different than PMDD,\u201d Reid says. \u201cIf you got diagnosed that way, it was very wrong.\u201d<\/p>\n Awareness about PMDD is increasing among gynaecologists and general practitioners but there remains a disconnect between medical professionals and the public.<\/p>\n \u201cNot very many [doctors] say, \u2018do you have mood symptoms? Is it affecting your function?\u2019\u201d Reid says, \u201cI\u2019m not sure why that is, but it\u2019s the way things have been happening.\u201d<\/p>\n It\u2019s not just the regular host of reproductive health illnesses PMDD can mimic, as a mood disorder it also shares symptoms with other mental illnesses.<\/p>\n \u201cI see women coming in with a diagnosis of bipolar disorder because a psychiatrist had never taken a menstrual history,\u201d says Dr. Reid.<\/p>\n Women are three times more likely than men to be diagnosed with rapid cycling bipolar disorder, according to the American Journal of Psychiatry<\/a>. Individuals with bipolar disorder often experience bouts of depression. Likewise, the DSM lists depression as one of the top four symptoms a woman must experience to be diagnosed with PMDD.<\/p>\n \u201cIt\u2019s so, so critical to distinguish between the two because one is a very severe mental disorder, and the other is a disorder but it\u2019s a disorder that is hormone related,\u201d says Ann Marie MacDonald, the executive director of Mood Disorders Associations of Ontario.<\/p>\n [\/et_pb_text][et_pb_text admin_label=”getting the diagnosis – six weeks” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n Getting the diagnosis right is so important because different disorders require different treatments, Dr. Reid stresses.<\/p>\n Women with PMDD often respond to their medication within 48 hours. In contrast, most individuals with major depression won\u2019t see results from their anti-depressants until about six weeks.<\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″][et_pb_accordion admin_label=”symptoms” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n [et_pb_accordion_item]<\/p>\n [\/et_pb_accordion_item]<\/p>\n [\/et_pb_accordion][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=”Row”][et_pb_column type=”2_3″][et_pb_text admin_label=”A vicious cycle 1\/2″ background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n Other than emotional behaviour one may associate with a menstrual cycle, PMDD has no visible symptoms, making it challenging to properly diagnose.<\/p>\n To complicate matters, the miscategorization of PMS has compounded a lack of understanding surrounding healthy periods among the public, Reid says.<\/p>\n Menstrual molimina is a set of mild symptoms women experience during ovulation and until the onset of menstruation, Reid explains. Food cravings, breast tenderness and fatigue are all considered normal.<\/p>\n [\/et_pb_text][et_pb_testimonial admin_label=”%22PMSing%22″ url_new_window=”off” quote_icon=”off” use_background_color=”on” background_color=”#f2f2f2″ background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid” author=”\u2013 Dr. Robert Reid”]<\/p>\n [\/et_pb_testimonial][et_pb_text admin_label=”vicious cycle 2\/2″ background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n Overusing the term PMS has created a culture of women thinking they have Premenstrual Syndrome when they are really experiencing moliminal symptoms.<\/p>\n While 85 per cent of menstruating women do suffer from PMS, the two are separate. PMS is a possible side effect, not an obligatory symptom of a period.<\/p>\n A specific distinction means the difference between a diagnosis and misdiagnosis when women go to their gynaecologists looking for answers.<\/p>\n \u201cIt\u2019s only when the woman brings it up, brings it forward herself,\u201d says Dr. Reid, \u201cthat suddenly it tweaks to them [doctors] saying, \u2018oh maybe this is PMS or PMDD.\u2019\u201d<\/p>\n [\/et_pb_text][et_pb_text admin_label=”spotting the stigma 1″ background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n The mood disorder\u2019s obscurity is also owed to the general stigma associated with mental health disorders.<\/p>\n In a 2016 survey of Ontario, the Centre for Addiction and Mental Health (CAMH)<\/a> found 40 per cent of participants have experienced depression but never sought out help.<\/p>\n [\/et_pb_text][et_pb_testimonial admin_label=”%22silently suffer%22″ url_new_window=”off” quote_icon=”off” use_background_color=”on” background_color=”#f2f2f2″ background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid” author=”\u2013 Ann Marie MacDonald”]<\/p>\n [\/et_pb_testimonial][et_pb_text admin_label=”Text” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n \u201cWhen we are not well and we keep it to ourselves and we silently suffer,\u201d says MacDonald, \u201cwe don’t get the help that we need.\u201d<\/p>\n While the CAMH has found mental health disorders are becoming less stigmatized in conversation, MacDonald and Reid say PMDD faces the additional burden of being associated with menstruation – a topic riddled with myths, taboos and even disgust.<\/p>\n [\/et_pb_text][et_pb_image admin_label=”infographic” src=”http:\/\/cusjc.ca\/catalyst\/wp-content\/uploads\/2017\/04\/PMDDInfographic.png” show_in_lightbox=”off” url_new_window=”off” use_overlay=”off” animation=”left” sticky=”off” align=”left” force_fullwidth=”off” always_center_on_mobile=”on” use_border_color=”off” border_color=”#ffffff” border_style=”solid”] \u201cIf you say three to five per cent of women go crazy every month we will never have a female president, we\u2019ll never have a female astronaut,\u201d says Dr. Reid.<\/p>\n In attempts to raise awareness to the medical requirements women with PMDD need while trying to avoid stigmatization has created a double standard: efforts have shrouded the disorder in uncertainty.<\/p>\n Until PMDD was recognized as a mental disorder in 2013, gynaecologists couldn\u2019t apply for grants to begin learning more about PMDD and how to determine the right treatments.<\/p>\n \u201cWe could say there\u2019s no diabetes too if you want, but when you say the disease doesn’t exist then you don’t get funding to do research for it,\u201d says Dr. Reid.<\/p>\n There is currently no specific course of action for individuals with PMDD. Since women with PMDD experience the disorder through its different manifestations, treatments vary to reflect these needs.<\/p>\n A few go-to medications doctors and experts prescribe are oral contraceptives, the estrogen patch, estrogen pellets and some anti-depressants (SSRI\u2019s), according to Dr. Reid. Discrepancies in how PMDD is researched globally factors in. For example, estrogen pellets, which are implanted under the skin, are not available in Canada.<\/p>\n Some treatment can work against its intended purpose, as female sex hormones, like estrogen and progesterone, can exacerbate PMDD symptoms in many women, according to a study released this year in the Molecular Psychiatry Journal<\/a>.<\/p>\n [\/et_pb_text][et_pb_testimonial admin_label=”%22self compassion%22″ url_new_window=”off” quote_icon=”off” use_background_color=”on” background_color=”#f2f2f2″ background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid” author=”\u2013 Eryn Speers “]<\/p>\n [\/et_pb_testimonial][et_pb_text admin_label=”You definitely – 30″ background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n
\n[\/et_pb_image][et_pb_text admin_label=”Text” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n\u201c[The psychiatrist] wasn\u2019t sure what to make of it, he hadn\u2019t really heard of it and basically threw me on a bunch of medications.\u201d<\/h3>\n
Suck it up, buttercup<\/h3>\n
\u201cAll women get their period, what is my problem?\u201d<\/h3>\n
\n[\/et_pb_image][et_pb_text admin_label=”\u00a9” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n
\n[\/et_pb_image][et_pb_text admin_label=”blog link” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\nA gendered diagnosis<\/h3>\n
\u00a0Top 4 PMDD Symptoms<\/h3>\n
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Additional Symptoms<\/h4>\n
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A vicious cycle<\/h3>\n
“There’s no such thing as ‘I’m PMS-ing.'”<\/h3>\n
Spotting the stigma<\/h3>\n
\u201cWhen we are not well and we keep it to ourselves and we silently suffer, we don’t get the help that we need.\u201d<\/h3>\n
\n[\/et_pb_image][\/et_pb_column][et_pb_column type=”1_3″][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=”Row”][et_pb_column type=”2_3″][et_pb_text admin_label=”when we are not well – psychiatry journal” background_layout=”light” text_orientation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\nThe confusing world of treatment<\/h3>\n
\u201cYou definitely have to learn some self-compassion.”<\/h3>\n