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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.
I'm going through an extreme med switch, which I know has to be part of the problem, but my depression is so bad and it's been horrible for almost a year at this point that I'm ready to give up (and all that entails). About the med switch: Was on effexor for 4 years and it pooped out so abilify was added. abilify seemed to work at first, but then made me gain weight and turned out to be some sort of false positive. Ended up in the hospital because I couldn't stop thinking about suicide. Was only there for a couple of days because my suicidal thoughts stopped and I had a really good plan in place. When I left the hospital I saw my old pdoc (whom I had not been able to see because he had been sick for a few months). He decided to be aggressive and started taking me off the effexor right away and adding wellbutrin. now i'm also going off the abilify (thank goodness because the weight is starting to come off finally). The Wellbutrin has made me very restless (leg shaking and pacing). I have a good energy level, but that's almost worse because now I have enough energy to think about all the things wrong with my life! I hate my job and so I have decided to quit my career and go into one that makes half the money. Everyone I tell agrees that I am making the right decision, but how the fuck am I going to pay rent next fall? There is bullshit going on with my apartment which means i might have to move, but I don't have the money to move. Plus, how will I find a new roommate and a new apartment at the same time??? Then there is the fact that I still don't have enough people in my life. It takes a ridiculous amount of effort for me to have a social life. No one calls me. I have to call all my friends to make plans. And if I didn't I would spend all my time I'm not at work alone. And the new job I'm taking has almost no built in community. I couldn't build a community at jobs where I saw the same people every day; how will I build community in a job that is notorious for having no community? And this is not even mentioning my complete epic failure at dating right now. So right now i have this future ahead of me that I am completely dreading. I have to live through 21 more days at a job in which every day is torture. Then I don't know where I will be living. Then I go to a new job in which I won't be able to make more friends so my social life will continue to suck. I just think my life is going to continue to be this lonely, silent POS that it is right now. And yes, I'm talking to my therapist about all this. And I see my pdoc again on Thursday. My brain is just a complete fucking mess so I just needed to share.