Posted by Paulette on March 27, 2001, at 19:49:29
In reply to Re: PMDD - Premenstrual Dysphoric Disorder, posted by Lori RN, psychiatry on March 27, 2001, at 8:09:40
> The best advice I've read so far on this disorder comes from the Sarafem website and includes keeping a journal of daily moods/emotions/and behavioural responses for a 3 month period (number of days in the month is based on the length of your cycle). You can then discuss mental status changes with your doctor or psychiatrist to confirm or negate the diagnosis of PMS or PMDD. It is interesting to note that only a small percentage of women suffer from PMDD, and that many have an underlying depressive disorder that is signifigantly impacted during the pre-menstrual period. Or, others may have undergone many recent life changes as in one of the letters I have read above, which will most certainly have an effect on mood and coping. The thing is, treatment is very much individual and may require many modalities (maybe just medication, or combinations of medication, counselling, and lifestyle changes). It is important, as with any illness, not to diagnose yourself, but to seek medical advice. I realize that this may be difficult as the disorder is somewhat stigmatized and not widely accepted as a real medical condition. Persevere. Recent FDA approval of Fluoxetine in treatment is encouraging and Lilly is working hard to market their brand (Serafem) and in doing so, PMDD is becoming well known. Psychiatrists have been treating PMS with SSRIs for years and it has been recognized as a dysphoric/dysthymic disorder in the psychiatric community for quite a long time. If your family doctor does not recognize PMDD, ask for a referral to a psychiatrist and go armed with your 3 month journal. Be sure to include a thorough history of your pre-morbid personality, any lifestyle changes or recent stressors, a synopis of your normal coping ability, and describe your behaviour on a normal continuum and during mood swings. Suggestions I have picked up in the area of lifestyle changes include:
>
> Additions of Calcium supplements
> Vitamin B6 - 10 mg daily
> Exercise 3-5 times per week
> Balanced diet with increases in whole grains and fruit and vegetables, decreased in salt, sugar, alcohol, and caffeine
> adequate rest
> Relaxation exercises, music, visual imagery, whatever works for you.
>
> I am not just a spokesperson for the PMDD club for women, I am also a member. I take 10mg of Prozac daily, and I'm working on the above lifestyle changes. Of signifigance, the reduction in caffeine alone has made a huge difference in my concentration and response to stress, particularly at work. Avoiding alcohol also makes a difference, as alcohol in itself is a depressant and is also contraindicated with the use of SSRIs. Jan, if your medication is not working, you need to visit your doctor again and be assessed. Obviously, you need more effective treatment.
>
> Lastly, remember it is your responsibility to be actively involved in your treatment. If changes need to be made, you are the only one who can make them, medication alone is not always effective. You also need to be open and honest with your health care professional, help them to help you.
>
> Hope this was helpful.
>
> LoriYou are very right Lori...all the diagnosis in the world will not help you unless you are willing to put as much effort into getting better as you expect your doctors to do for you....I did the journalling for 2 months, put them side by side and rated day by day of cycle and am able to pin point my really bad times and I am learning to find something to aim back at it to help disarm those times. Dont get me wrong...I still have had 2 days each month where some poor person was the brunt of my undeserved rath...but I have been able to avoid more than those days by actually seeing that those days are coming and making a very very concious effort to be 'good' during those times...it may mean I am extra quiet for a couple of days...but it saves my sons heart being broken if I yell at him....
I really do recommend the journalling through this if not to help the doctor..surely to help yourself realize what you are going through...I wish I could share mine with you but 2 months is a lot of stuff...I am sure that a lot of you would be surprised that you really are not the only ones going through it...
poster:Paulette
thread:3315
URL: http://www.dr-bob.org/babble/20010327/msgs/57715.html