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I know many people here have taken Abilify longterm as an adjunct, but I am honestly worried about longterm side effects (weight gain, akasthia). I trialed it twice and it made me constantly hungry, wanting to eat everything (I tried both 2mg, 5mg), made me tap my feet a lot. I wonder if taking it only on the week that I am very symptomatic (week before menstruation) it would be effective? Is Abilify something that kicks in within a few days of taking it? My other thought was biting the bullet and using Risperdone for this week (which I really hated when I was on it daily, it made me a zombie, and my Prolactin shot through the roof) The symptoms I want to treat (happen @ 4-7 days per month) are: dysphoria, hypersensitivity, severe depression, anger, uncontrollable crying to exhaustion, suicidal ideations, ruminations, stress and some heart palpitations.

I’m currently on a waiting list to see an endocrinologist. I’m wondering if anyone has had success with a PRN med for PMDD? Something other than SSRI’s? I've had bad side effects with SSRI’s & antipsychotics. I'm so desperate I'm worried I might have to go on Prozac or Celexa due to no other options....Celexa was an OK med, however, it increased my lethargy and kills my sex drive/ability to O (as all other SSRI's). I also don't know if SSRI's are actually effective if you only take them 1 week per month? Lamictal has been a great mood stabilizer, however, it doesn't work at all the week before menstruation, I become SEVERELY depressed, uncontrollable crying spells, irritable, angry, anxious with suicidal ideation to the point of practically checking myself inpatient. Once my period arrives, I'm fine/normal. It’s unbearable. Previous hormone tests come out normal (I will test again). My thyroid is in normal check also. I’m wondering if anyone has tried something different that has helped? Perhaps I could increase my Lamictal that week? I have read that Lamictal can reduce effectiveness of birth control- but I have not heard about vice-versa (whether your hormones can reduce the amount of Lamictal)?

Hi I have just joined here out of desperation. It's a long story but feeling as if I can't carry on at the moment. I had severe post natal anxiety, insomnia and depression 10 days after giving birth 4 years ago. was put on mirtazapine 45mg which got me back to myself for a year. I tried to go on contraceptive pills microgynon and loestrin both of which sent me spiralling back into the worst depression. Stopped these and couldn't really get over the hormone problems so added venlafaxine 37.5mg to mirtazapine which worked great for a year. Since December 2015 I have had to increase my venlafaxine 5 times so now I'm on the top dosage of both venlafaxine and mirtazapine. My relapses always happen 10 days before my period and I get so bad I can't even function and have suicidal thoughts so I have to increase my tablets. I am 4 days in to my last increase and 5 days before my period and I just can't cope. My doctor has given me a prescription for a progesterone only mini pill, he has said to take this after my period so middle of next month when I'm feeling better but I am PETRIFIED that it will make me even worse and I can't increase my anti depressants. I honestly feel if this gets any worse I will have to hospitalise myself as I am so tired of fighting this awful thing and it never gets better. I have cervical erosion since the birth of my daughter and had this frozen two months ago and since this my last two periods have been hell and I feel as if I'm having a breakdown. My GP says this procedure wouldn't have affected my hormone levels. I also take supplements Agnus castus, vitamin B6, magnesium, calcium, vitamin d, evening primrose oil, vitamin b complex food supplement and exercise when I am feeling well. I just don't know what to do anymore should I take this contraceptive pill? If anyone has any experience or advice please please contact me I am desperate. Thank you

The med tinkering is driving me nuts. Anyone with me here? Sigh. I have had depression and major depressive episodes for the past 20 years, but I have only been doing the med thing for the past three years. I feel like I get so close to finding a combo that works, albeit with some intolerable side effect... and then I try to get the combo better and wind up making it worse. My latest foray brought back my PMDD crying/depression/irritability for the past week and I'm just at a loss of what to do next. My psychiatric nurse is pretty much up for whatever I want to try, but I don't know what to do anymore. Maybe you all have some ideas? Here's what I'm on right now: Lamictal 200mg (for MDD; *supposed* to be my main antidepressant), Wellbutrin XL 150mg (for giving me more energy and helping with my sex drive), and Lexapro 2.5mg (I had been up to 15mg, but completely lost my ability to orgasm and decided to go off it; hence going on Lamictal). Dx: MDD, PMDD, Primary Insomnia (which may or may not be related to my depression) Antidepressants I've been on: 1) Prozac: numbed me to the point of apathy, caused periodic limb movement disorder at night, sedated me 2) Zoloft 75mg: improvement over Prozac! actually helped me sleep through the night! Yay! Killed my ability to orgasm. Boooo! ... until I added Wellbutrin, then WOW! Sedated me so badly that I only survived on caffeine pills that I had to carefully time through the day, at 100mg every four hours. I hated the sedation (as in I would fall asleep wherever I was multiple times a day if I ran low or out of caffeine), so decided to try something else... 3) Wellbutrin 150mg: Added to help give me my sex drive back. Worked wonderfully! Love this one! Wish it still worked with Lexapro... 4) Lexapro 15mg: Swapped out the side effects. Caused periodic limb movement disorder like Prozac, but NO SEDATION! :-). Sadly, killed my ability to orgasm so completely that not even 300mg Wellbutrin could touch it. I could say that I could live with this, but the endless frustration in my relationship has made me want to pursue another option. 5) Lamictal 200mg: I started this in January of this year, for the purpose of getting off Lexapro, and have been titrating up ever since! Holy crap; it's been forever. Within that seven months, I tried to go off the Lexapro three times. The first two times, my Lamictal was at 100mg and I got down to 7.5mg of Lexapro before having a return of depressive symptoms. This past attempt at going off Lexapro, Lamictal was brought up to 200mg for two weeks before attempting to titrate down on the Lexapro. I titrated by 2.5mg every 5 days and I got down to 2.5mg before having discontinuation symptoms, including depressive symptoms along with headache, irritability, and nausea. So now I'm at 2.5mg of Lexapro and have been holding there, afraid to go off it completely and afraid to go back up. Clearly the 200mg of Lamictal, plus 150mg Wellbutrin are not enough to deal with my depression, particularly the menstrual/hormonal version of it. I was at 200mg of Lamictal for 7 weeks before this last period hit, so I know that there was plenty of time for it to work. If I increase the Lexapro, it defeats the purpose of why I went on the Lamictal. I've never had good anti-depressant results from Wellbutrin, only increased energy, so no reason to go up on that. I am disappointed at the possibility that I've given Lamictal this entire year to work and I don't know if it is marginally working, or not really at all. I'd like to think that the reason I was able to get down to 2.5mg of Lexapro without return of symptoms this time means that the Lamictal is doing *something.* Do I ask to increase the Lamictal? Go up to 300mg? Do I add a different SSRI and go off Lexapro completely? Pdoc thinks I should try Zoloft again. Aaack! Must I live in a sedated state for the rest of my life?! I don't know if there is even the possibility that another SSRI would be better than Lexapro with the side effect profile. But maybe try Celexa and hope for the best? Do I add an antidepressant that is not an SSRI, like Strattera, Abilify, etc.... Since I know y'all are going to ask, I have tried Mirena and Nuva Ring to control the hormone influenced depression and it has been a crap shoot. Mirena turned me into a raging bitch for months and I bled and bled for weeks at a time. So I had that taken out, needless to say. Nuva Ring caused weight gain, pimples, break through bleeding, and did not seem to make any difference with the hormonal depression. So I went off that too. Talk to me, people. Lend me your ideas.

I am sorry this is so long. I know this is probably blog-land territory, but I also wanted some feedback on this issue. I know different fonts and sizes can be off-putting, but I wanted to differentiate between what I wrote yesterday and how I am currently feeling today (wrote a post but changed mind, saved as word document instead). I am also curious if anyone else has experienced PMDD to this extent, what has helped (beyond the traditional treatments-- SSRIs, BC pills, diet and exercise regulation, etc... which I've tried and which I do currently except the BC pills-- and even some less conventional treatments-- mood stabilizers, antipsychotics). I am also wondering if anyone has ever required hospitalization due to PMDD or even if they require regular repeated hospitalization during PMDD times. Has anyone done ECT for the PMDD mood-symptoms? This is a "snapshot" of a typical day in the life of my PMDD, at its worst (like the 3 days before my period, though I am progressively symptomatic in about the 10 days before my period). This is what I wrote yesterday: (assume trigger warnings everywhere... I cannot get the emoticons to come up) "I have had some recent life changes and triggers, and my PTSD symptoms are now through the roof. I am also having a lot of paranoid thoughts about my boyfriend not being interested in me anymore and people just hating me in general. I feel disgusting and ashamed. I am shaking and have accidentally knocked my beverage over 3x today at work due to my jittery-ness. I am having constant intrusive thoughts of self-harm, then dissociating a lot, and then engaging in some self-harm quite impulsively (in an attempt to "snap out of it" though I feel like some part of me thinks I deserve it). I am having thoughts/images of attempting suicide, but I don't actually want to die. It is a couple days before my period. I have PMDD, and the ONLY times in which I feel depressed to this caliber (or suicidal at all) is right before my period (i.e. the 10 days before my period, escalating into quasi-suicidality and self-harm in the couple days before my period. The onset of my period generally brings instant relief and complete cessation of my depression. Not to be too gross, but I can often tell I've gotten my period before even "checking myself in the bathroom," just based on how relieved I feel, my drastic improvement in mood, and the physical and psychological tension leaving my body. PTSD symptoms make my PMDD worse, and being premenstrual makes my PTSD worse. I don't believe I have depression separately from PMDD and from what's triggered by PTSD. I have a therapist, and I am on a slew of meds as noted in my signature. I have been on a slew of other meds and various combinations. Medications are minimally helpful to me anyway, it seems. I have tried BC pills, various SSRIs at various doses, various AAPs, and various ACs/mood stabilizers. I have not found anything that helps at all with the the PMDD (in fact, the Lamictal seems to make it worse). And I have only had minimal med response with regard to PTSD. I self-harmed at work today, rather impulsively (hit/punched self in face and head repeatedly, burned self with hot coffee on purpose). That is the only way in which I self-harm-- not planned but rather as a knee-jerk response to a trigger. I also really want to OD on on the PRN Vistaril I have in my purse. I am also having urges/images (have NEVER acted on this whatsoever) of hurting others in a non-lethal way when my symptoms are agitated by interpersonal interaction-- like wanting to throw things at people, hit people, dump hot beverages on people-- pretty much the stuff I do to myself but directed at others). I have had to be fairly up front about my issues at work... due to symptoms (like this) occurring at work in the past. (I work as a therapist in an addiction treatment facility so my boss is at least somewhat understanding of MI stuff). I told my supervisor about it (well, the self-harm shortly after it happened-- the pill impulses didn't come until a couple hours later). I was fairly certain he'd tell me to go to the ER but instead focused on ways I can be functional in other ways at work today (aside from seeing clients). I think that's because it looks bad (on him AND me) with how much time I've been out due to symptoms in the past and because I really don't have any more accrued time off to take. If I even step foot into an ER with my present symptoms, I believe they would admit me. However, the cycle of my past hospitalizations (3 in total) goes like this... I present in the couple days before my period with symptoms like above, they admit me, and then I get my period while IP and feel instantly better. However, the staff doesn't necessarily believe that I could be instantly better and think that I am pretending to be better so I can leave and kill myself or something. Then, after a couple days in, I actually get worse PTSD-wise (due other patients' behavior triggering me, due to the hospital reminding me of being trapped at work because its similar to the work I do, due to being invalidated/not believed by staff, due to confinement in and of itself.) And I don't know if I am ACTUALLY suicidal or if I just fear becoming suicidal. It's kind of hard to explain, and sometimes when I am like this, I can't tell the difference. It's like I am paranoid of becoming suicidal (though I haven't attempted suicide since age 15, which is half of my life span). I really wish I could just quarantine myself until I get my period so that I am not exposed to additional stressors (like just about any stress whatsoever, like having to file something in a chart that I can't find, or even mis-perceived stress-- like me reading into a slight grimace on someone's face and assuming they hate me and I'm the most annoying human being on the planet. Also, this quarantine would help so that I don't risk damaging my interpersonal relationships due to my behavior or risk losing my job further. (Of course, I feel like my job is at risk due to my absences, but I feel it's less at risk than me losing control and accidentally self-harming in front of a client, like I have actually done in front of a co-worker and in front of a supervisor, on two separate occasions.) During this time, I would take my PRNs and distract myself with mindless activity (TV, internet, chores as I can handle it, gentle yoga as I can handle it). But what I really wish is that I could take something or do something to induce my period at will, so that the unmanageable/out-of-control aspect would go away and it would no longer severe interfere with my functioning." OK, so I wrote all of that yesterday. I went home from work at about 11:30 and cancelled my 3pm tdoc appointment for yesterday. I know that was really stupid considering my level of distress, but my level of distress was so high that I was having difficulty verbalizing it while in the midst of it without it escalating my distress to point of becoming unsafe., This was just our 3rd session, and I didn't want her to mis-read my symptoms or take action based on something that is transient and temporary (like admit me to IP when the symptoms are going to go away soon...and honestly my motivations in avoiding IP are also largely financial). (Plus, I presented in that state at a previous therapists' office, and that therapist was completely invalidating, saying I was using my PMDD symptoms as an "excuse" to not work on my PTSD that day. I stormed out rather than do something violent to myself or throw something. I also presented like that early in my relationship with pdoc and she was also somewhat un-empathetic, stating, "Is this the way the rest of our interactions are gonna go?" to which I said, "No, but it's possible we may have more interactions like this if I happen to see you the day before my period.") So, is being hospitalized and/or quarantining myself in the couple days before my period really a sustainable option? I do not have the funds for that (no sick time at work to be missing work, high hospital deductible, living paycheck to paycheck as I just moved out of my abusive parents' household). But I don't know what the lesser of the evils are, and I have yet to find treatment that works. I don't feel that way today as I did yesterday (I am still in a crappy mood but not hurting myself), but I also called out today because I feared having symptoms at work (we have a state audit today, and the last thing anyone needs is for me to self-harm or act out in front of the state mental health department). I have a pdoc appointment tomorrow and HOPEFULLY I will get my period before then so I can have a rational discussion with her. In any event, I am printing this out and showing her (and will show to tdoc next week at our session). It just really sucks to truly not be in control of my behavior/thoughts/moods for a few days and feel like an alien creature has hijacked my body. Thanks for reading.

it is day 33 of my cycle and i am waiting for my period to get on with it. i've been dealing with the usual lowered immune response that leaves me with cold or fever from days 21-40 -- as applicable; period arrives anywhere in that window. and the moodiness, irritability, exhaustion, mind fog, loss of coordination and balance, cramps. ten days of menstrual cramps, and only a tiny bit of blood spotting. some of this is no doubt attributable to cysts & fibroids. and maybe my age. i am 42. i will be getting another ultrasound soon (no no no do NOT want) to gauge status of cysts/fibroids. i am not taking any hormones atm. those i have taken in the past were ineffective. for mood, for cycle regulation, for alleviation of any of the complaints at all. and SSRIs/multiple reuptakes do not touch this. am having suicidal thoughts as usual; wondering how thorough i would need to be with evidence for my suicide in order for the authorities to rule out foul play. to say "yes, she killed herself, no question" and minimally hassle my friends and family when i do it. i would say my history as an utter loser, my hospitalizations, should speak for themselves? for those suffering pmdd as well: are your physical symptoms just as bad as mental symptoms? better? worse? do you get strong suicidal urges & make plans every month?

This may need a trigger warning. I struggle with anxiety and depression - my hormones escalate both and interfere with my basic daily functioning with work, professional relationships and personal relationship - barely even able to do my dishes or take a shower. Before my period and around ovulation i get super weepy, my anxiety is out of control (have to take ativan to even try to calm down) the first few days of my period and that typically turns in to depression along with suicidal thoughts and feelings of worthlessness and despair - i also become more prone to a bit of binge drinking and wanting to self harm around these times (especially when depressed). I was on oral contraceptives for 9yrs, so these issue caught me by surprise when i stopped the BC pills. stopped them a year ago and been getting my period semi-regularly for the past 7 months. On top of my regular meds (with the addition of Buspar starting next week), my pdoc suggested flaxseeds/omega 3 and a wholistic MD suggested vitex (chasteberry). Flaxseeds have yet to help after months and i have only been on the twice daily vitex for a month and a half. Any general thoughts or comments? Also, is vitex worth the money for helping regulate my period and symptoms? Thanks Current wholistic supplements: 2x/daily vitex (chasteberry), 2x/daily magnesium taurate, multivitamin (with CoQ10 and metholated B vitamins), probiotics