One minute, I’m myself—happy, chatty, and free spirited. The next, I’m unrecognisable—a shell of a person, lost, numb, and completely isolated.
Premenstrual Dysphoric Disorder (PMDD) affects 5-8% of women (AFAB) in the UK. It is not the same as PMS (Premenstrual Syndrome). It is much more severe. While PMS can cause discomfort and mild emotional symptoms, PMDD triggers extreme mood swings, depression, and anxiety, severely impacting daily life. These debilitating symptoms occur during the luteal phase—between ovulation and menstruation. Unlike a hormone imbalance, PMDD is caused by an abnormal sensitivity to natural hormonal fluctuations throughout the menstrual cycle.
One of the hardest things about PMDD is how drastically it changes your mood—to the point where you might feel like a completely different person compared to the rest of the month. Every. Single. Month.
Despite its severity, PMDD remains widely misunderstood, even among medical professionals. Diagnosis can take years, often leading to misdiagnoses with other mental health conditions. Many women are left feeling alone, confused, and disregarded. PMDD should be considered in medical discussions. More awareness could save countless women from years of traumatic suffering. A common coexisting condition is ADHD (Attention-Deficit/Hyperactivity Disorder)—a neurodevelopmental disorder that affects attention, hyperactivity, and impulsivity. In the UK, 3-4% of people are diagnosed with ADHD. Research shows that 46% of women with ADHD also experience PMDD. Now, imagine juggling both conditions, each amplifying the struggles of the other.
ADHD already impacts daily life – regulating emotions and motivating myself is challenging and PMDD enhances those challenges. When you may feel out of control and impulsive – add the difficulty of also feeling physically drained, depressed and helpless. Creating a safe routine to cope with this overlap is completely unmanageable.
For me, they consume my life—and I know I’m not alone. This is my story.
Growing up, I had a regular cycle. Like most women, I tried different contraceptives over the years, and the Depo-Provera injection worked well for me. It stopped my periods—but who complains about that?
As I got older, I wanted to be more connected to my cycle, to understand and embrace it. The fact that I wasn’t getting periods began to unnerve me. PMDD hit me in 2023 at the age of 28, when I came off Depo-Provera. As my period recalibrated and became regular again, the symptoms crept in, and I started to notice a pattern—a soul-wrenching, mind-altering pattern. I would wake up—on my ovulation date—feeling trapped in a pit of depression. I was unable to speak to anyone, be near anyone, yet I felt totally isolated and alone. I feared my own presence but had no energy to be social. I pushed everyone in my life away, including my loving boyfriend, who, alongside me, had no idea what was going on. We both assumed it was an unhappiness in our relationship. He had just moved from New Zealand to London to be with me, and the daunting thought that it had been a mistake hung over us.
It wasn’t just my relationship that suffered. Friends noticed I withdrew, cancelled plans last minute, or lashed out over small things. My binge drinking and substance abuse made me passive and apathetic. At work, my inability to focus, constant exhaustion and bursts of tears made me unreliable and made me feel even more incapable with a lack of self worth.
I had no idea what was happening to me. Was this normal? Naturally, I did the one thing you should never do—but everyone does. I Googled it. PMS? Depression? I’d experienced both before, and I knew this wasn’t it. All the advice pointed to exercise, healthy eating, meditation, therapy. But I could barely move—how was I supposed to do any of that? When my period arrived, I was myself again. The happy, bubbly Alice returned. Then, teasingly—as soon as I ovulated—the pattern repeated. I would lie in bed all day, tears in my eyes, feeling numb and foggy. Anxiety crippled me. I would barely eat—even if I was starving—because that pain was easier than the pain of getting up. I was short-fused and angry, allergic to being touched or held, and tired—so, so tired.
It wasn’t until I broke down to my dear friend, flustered and confused about what was happening but now aware that it must be linked to my cycle, that she mentioned Premenstrual Dysphoric Disorder. She is a journalist and had read about PMDD, recognising the undeniable resemblance to my symptoms.
I began researching in depth and was almost reassured to know I wasn’t going crazy. In an attempt to find a solution, I spoke to many people and doctors—only to have my “self-diagnosis” dismissed. I tried everything to take control. I’d drink excessively and take cocaine to force myself to be social at weekend events. I’d hide away for hours, ignoring my boyfriend, who became increasingly anxious around me, afraid of saying or doing the wrong thing. Naturally, this wasn’t the solution.
I tried countless natural remedies, every supplement I could get my hands on—but nothing helped. Then I started therapy, which did help. It felt great to have someone listen to me and let me cry without judgment. However, the cost became too high to manage because I couldn’t work as much as I used to, so I had to give it up. After months of struggling, I finally cracked. On New Year’s Eve, I broke down to my dad, saying I didn’t want to be here anymore.
This pushed me to go back to the doctor, where I broke down in tears, begging for help.
It took reaching this point for a doctor to finally take me seriously. But not seriously enough to refer me to a gynaecologist or for a psychological assessment—just enough to medicate me and hope for the best. I was put back on contraception—the oral pill. However, at this point, I was too deep in depression to pull myself out, so I was also prescribed antidepressants (Sertraline). The sudden adjustments initially sent me into a spiral of erratic and impulsive behaviour. My substance abuse worsened as I convinced myself I was finally happy. The drugs must have fixed me, right? Many of my friends spoke up, saying they didn’t recognise me anymore and were worried. I was becoming too much to be around. I lost so much weight, and my lows and anger outbursts were still excessive. I couldn’t clearly express my emotions and I wasn’t my usual empathetic-self. I ended up impulsively breaking up with my boyfriend—a total act of self sabotage.
After a few months like this, my body adjusted, and I became more level headed. As the clouds cleared and my periods stopped again, I could finally see things clearly. Instant regret made me beg for forgiveness and ask my boyfriend to take me back. I knew I’d made the right decision because instead of being angry, he held me and said he could see how much pain I was in. He did so much research on how to best support me and has since been incredibly patient and understanding. I spent the following months rebuilding myself. With a new understanding of my mental health, we sat down and decided what changes needed to be made. It would be us against the world now—we weren’t going to let this break us again. As the dust settled on a chaotic year, I realised that even at what I thought was my best, I couldn’t thrive. My mind, despite being clearer, was still struggling with the daily chaos around me. I was becoming increasingly forgetful and clumsy, at risk of sabotaging my business (a family-focused batch cooking service) due to disorganisation and being easily overwhelmed. Then, the next battle arrived. I had suspected for most of my life that I had ADHD. I struggled as a child—especially in school. I lacked the ability to focus and retain information, and I impulsively overspoke, to name just a few issues. When I brought this up to my doctor, it became clear that my depression and PMDD had exacerbated my symptoms over the years. I was finally diagnosed with combination ADHD, meaning I struggled with both inattentiveness and hyperactivity. It was recommended that I try stimulant medication, Elvanse, to help with focus and impulsivity.
Though relieved to have another tool to help me manage my struggles, the thought of taking yet another medication to “fix me” upset me. All I’ve ever wanted is to be a mother. I wanted to be my best self—naturally—before that happened. And the time to start a family was approaching for us. How would the pregnancy hormones affect me? Will I be more likely to experience postpartum? Will it make be a bad mother? After speaking with close family, friends, and my doctor, I came up with a plan. I wanted to start Elvanse for my ADHD but was anxious about taking it alongside everything else. So, I decided to come off the contraceptive pill and see how I managed with just the antidepressants and Elvanse. Then, if all went well when my periods returned, I would begin weaning off Sertraline. I make it sound straightforward, but this idea terrified me.
I got my first period this month, and it drained me. I know that once they are regular again, I’ll be waiting—each month—for the dreaded PMDD symptoms to take over once more. But I have my coping mechanisms in place. I have solid communication with those close to me. And now, coming off antidepressants is the next big step. I now go to the gym regularly, as well as yoga classes, and I cycle daily. Exercise—though it’s said over and over again—truly is the best resource for mental health. I listen to my body. If I’m not up for a gym session, even a light walk to clear my head helps. I’ve got my alcohol consumption under control. I avoid drinking during the week when I can, stay hydrated, and try not to overbook my social calendar. I’ve stopped taking recreational drugs and haven’t touched cocaine in almost a year, and I feel really positive about that. I don’t miss them at all. It’s evidence that they were simply a crutch to numb my pain. And hey—I’m actually great fun without them! When I’m feeling off, drained, or overstimulated, my boyfriend recognises the signs immediately—even though I’m now more vocal about my needs. I often come home from work to find he has run me a candlelit bath with my favourite show and a non-alcoholic beer waiting. He brings me tea in bed and opens the curtains in the morning to help me get up. I feel really supported. I can’t emphasise enough how important the little things are—having people who love you check in and understand what you need is invaluable. I also listen to audiobooks to help with anxiety and sleep. I go to bed at a reasonable time and wake up earlier than ever. Despite all these positive changes, I know I still have a way to go. Elvanse definitely helps me focus and stay motivated—I thrive when I am. PMDD and ADHD are very real—not just for those who suffer from them,
but also for those closest to them.
The more we tell our stories, the more awareness we create. Hopefully, that awareness will one day be reflected in our healthcare system and in society. I won’t let PMDD or ADHD define me. Instead, I hope to redefine the way the world sees these conditions. By sharing our experiences, we can demand the understanding and support we deserve. Help us take our lives back—whatever shape they may be.
