MAFS shed light on PMDD and relationships. Bridie knows the struggle well

Bridie describes herself as happy, cheerful and positive. Except for two days of the month.

“I’ve been in an unbearable situation these two days and I wouldn’t wish this on anyone,” says the 38-year-old actor from Queensland.

Bridie, who asked that we not use her last name, has premenstrual dysphoric disorder (PMDD); A condition that causes serious emotional and psychological distress before menstruation.

Warning: This story mentions suicidal ideation.

He was diagnosed eight years ago after talking to his doctor about relationship breakdowns.

“I found the cycle of breaking up with my partners every month.

“I admit I’m not in the right relationships, but about two days a month I feel okay; I don’t value myself at all, I don’t want to be intimate anymore.”

PMDD can have a negative impact on romantic relationships, says Melanie Hemsley, MD, Women’s Health Practitioner at Jean Hailes for Women’s Health.

This is something we saw on the last Married at First Sight (MAFS) UK season.

Participant Kristina Goodsell openly shared her struggle with PMDD on the reality show, which was at the center of relationship hurdles between her and her “husband” Kieran Chapman.

PMDD and its symptoms

Jayashri Kulkarni, director of the Health Education Research Center at Monash University, explains that PMDD is caused by increased sensitivity to hormonal fluctuations before menstruation.

Professor Kulkarni explains that unlike PMS, which refers to a wide range of physical and emotional symptoms in the days before a person’s period, PMDD is a significant and severe depression that comes on suddenly.

In addition to depression and low mood, symptoms can include tearfulness, anger, confusion and extreme fatigue, he says.

Dr Hemsley says anxiety, feelings of helplessness and sensitivity to rejection may also occur.

“It’s something that has knock-on effects on interpersonal relationships.”

Although the exact causes of hormonal sensitivity are unknown, Dr Hemsley says it may be genetic and rates are higher in those with a history of depression or early childhood trauma.

“We also see that (symptoms) worsen during perimenopause.”

Professor Kulkarni says statistics on the prevalence of PMDD vary widely, with the rate for women of reproductive age ranging from 5 to 15 per cent.

And even those figures are likely an underestimate, he says, given that many people assigned female at birth don’t realize they have PMDD.

There is no test for PMDD, so diagnosis is determined by the pattern of symptoms.

The main difference between PMDD and depression is that PMDD symptoms improve after menstruation begins.

Before she was diagnosed, Bridie thought she might have bipolar disorder; Professor Kulkarni says women with PMDD can be misdiagnosed.

Management of the condition depends on the individual’s symptoms and may include certain types of oral contraception, therapy and hormonal treatments including antidepressants, but Professor Kulkarni warns that the latter may not be as effective as some women hope.

“That’s what most general doctors and psychiatrists recommend (but) it doesn’t necessarily mean getting the best results.”

How to play in relationships?

Having PMDD is like “being overwhelmed by your hormones,” says Bridie.

“My friends describe me as a true Gemini; cheerful, social, fun. Someone who can light up a room.

“I feel worthless, I feel like a burden, I feel suicidal sometimes.”

Bridie, who is currently single, says her PMDD symptoms are more intense when she’s in a romantic relationship. And during this time, he was not with anyone who made him feel supported.

“I actually got to know my body so well. As soon as the crying started I would say, ‘Okay, it’s about to start, can you please be gentle with me? I know this is hard for you, but this is so hard.’ ‘Can you bring it?’

“And they couldn’t.”

Bridie’s experiences caused her to question entering into relationships.

“I don’t want to put this burden on anyone else.

“You ask… are all the other days wonderful and wonderful, is that enough for someone to stay for two days when you are at your worst?”

Bridie has three sons and says she was able to protect them from PMDD symptoms, even though they were aware Bridie was experiencing them.

“They are the kindest people I’ve ever met. My oldest cooks dinner when I’m feeling that way.”

“My middle child mowed the lawn the other day. My youngest gave me a massage.”

Professor Jayashri says the anger women may experience can be particularly difficult for partners.

“Of course he may have a legitimate reason and a real reason why he feels the way he does, but it’s like his perspective goes out the window.

“Women will also describe feeling disconnected from love or not having the capacity to feel positive emotions.”

Managing PMDD as a couple

Bridie says she’s gotten better at knowing what she needs from a partner when she’s experiencing symptoms.

“For me personally, I don’t need to have big conversations. There are no big conversations to get heated.

Dr Hemsley says women need to have compassion for themselves during this period and communicate what they need to their loved ones.

“I have some patients who lightly schedule the week before their period.

“This isn’t the time when they say yes to extra duty at work… or they may need to schedule extra relaxation or gym sessions, so develop coping strategies.”

Professor Kulkarni says it’s understandable that partners may feel hurt, as if they’re “getting pretty beat up” when experiencing PMDD symptoms.

Educating themselves about PMDD can help them be more understanding and seek their own support, she says.

“It is difficult to move forward between the couple if there are problems that are magnified during this period.

“Or there may be no problem at all and this is all just really disproportionate anger about his mental health.”

Dr Hemsley says individual therapy and couples counseling can be helpful.

Bridie says seeing Kristina share her story on MAFS has helped her feel less alone, and she hopes sharing her story can do the same for others.

“It’s a terrible thing to experience.”