Three years ago, my W (hrdhddwoman) was diagnosed with Pre-Menstrual Dysphoric Disorder (PMDD), a condition that affects 8% of menstruating women (according to the Mayo Clinc), which was the same time that she was diagnosed with (and started treatment for) depression. For those that are not familiar with PMDD, here is a general description of the symptoms for the disorder:

Signs and symptoms of PMDD:
Unlike PMS, PMDD symptoms are very severe, completely disrupting the lives of the women affected by it. Women diagnosed with PMDD usually present 5 or more of the following symptoms:

• Very depressed mood, feelings of hopelessness
• anxiety, tension, feelings of being "on edge"
• Mood shifts (e.g., suddenly feeling tearful or extremely sensitive)
• irritability or increased interpersonal conflicts
  
• Decreased interest in usual activities (e.g., work, school, friends, hobbies)
  
• Difficulty concentrating
  
• Fatigue, tiredness, loss of energy
  
• Change in appetite, overeating, food cravings
  
• Insomnia (difficulty sleeping) or sleeping too much
  
• Feeling out of control or overwhelmed
  
• Physical symptoms such as breast tenderness or swelling, headaches, joint or muscle pain, "bloating," weight gain.

These symptoms do not necessarily occur every month, but they are present in the majority of months. Some months may be worse than others.

The symptoms of PMDD manifest themselves after ovulation and end a couple of days after the start of menses. Living with a W with PMDD, and me not dealing properly with the episondes has basically creates chaos in our home for one-half of our lives together, and in the past, this has been when we have had our major fights (of the blowout magnitude).

My problem dealing with a PMDD W for so long, is that my learned reaction to the onset of symptons is first to withdraw for a short period of time, and to become defensive with the irrational attacks come from my W. The reason that I initially withdraw is that during the other days of the month, our time together can be absolutely wonderful. Then all of a sudden, PMDD sets in, every month. It is always a shock to the system, even though I should know that it is coming. This happened this past Sunday night, in the space of a few hours.

Hrdhddwoman and I had just experienced one of the best weeks ever together last week. We had finally come to an agreement together using POJA on two issues that have plagued us for a long time (many thanks to Larry178). Then all of a sudden - BAM - HHW is very upset with me over something, not even a normal level of 'upsetness'. This proceeds to HHW being upset about several things from our past.

My learned reaction to these PMDD attacks is to become defensive, and try and reason with HHW as to why I don't think whatever issue she is mad about doesn't fly. This usually worsenes the problem, when I become defensive.

Sometimes I think that dealing with HHW during PMDD symptoms, is similar to dealing with a WS right in the thick of the fog. The major mood swings, the irritability and increased personal attacks, and much more.

I guess I need to learn to 'recognize' the shift each month, but I have not been very good at this in the past. But I really need help in learning NOT to respond with defensiveness, as it really makes the problem worse.

Thanks for any help or suggestions you can provide,

LoBoy


PS - HHW has been on AD's for her depression and PMDD for years. Unfortunately, there isn't many treatments for PMDD out there right now, although HHW found out a new birth control pill that is supposed to help with the effects of PMDD. She will work on her side from the medical end, and I need to work on my stuff and how I respond.

lostboy...

With great respect....It is my opinion that while the sypmtoms listed are many...

they are not absolute nor are they a reason to accept behaviors from your spouse...

meaning that while I think there are good ways to cope with this....

the ONUS of responsibility lays with your wife....

a lot of the symptoms you site...once reconized are cyclic reactions that can and do respond to...

medication
and
more importantly biofeedback and knowledge of what is happening....

it's not enough to the person to have a diagnosis...
one also must seek and USE what is out there for control...

hypnosis...biofeedback....exercise....anti anxiety meds...are all tools to deal with anxiety...

behavior modification self awareness deal with the food issues....

tylenol warm/cold compresses deal with the breast tenderness...headaches...etc...

in other words...

the first real step is your spouse identifying what specifice symptoms she experiences..
and to have a concrete game plan for each one...

ALSO
diagnosis while they may "explain" don't excuse....
and both of you must work very hard to control this rather than be controlled by it....

ARK

Since you and your wife are working on your POJA skills, can you POJA this? That is, can you two work together to come up with a plan or agreement on the best way for you to behave during that time of the month? Something like: When it's that time of the month, and W's emotions start to become erratic, H will ____ [remove himself from the situation, give her a hug, dance a jig, whatever]. W will do her best to _____ [practice breathing exercises, go for a walk, journal, whatever]. H&W will meet once a month in the calm period to review and critique their performance during the rough week in the effort to refine and reinforce the POJA.

ARK:

Yes, my W is looking at alternative treatments for PMDD AND she is trying to be more cognizant of me when the episodes hit, so she has accepted the onus of responsibility. I am also taking an interest in learning about and implementing alternative treatments. In the past, I just sat back and let the doctor's prescribe their AD's that were supposed to treat the depression and the PMDD. While the AD's have helped with the depression, the PMDD symptoms remain strong, even though the particular AD's she is on are supposed to be proven treatments for both.

While my W is handling the medical side (with me helping her), I wanted to work on changing things that I have control over to lessen the impact PMDD has on our lives. After thinking this through, and discussing it with my wife, the best thing that I could do is to learn new coping behaviors when the episodes present themselves, instead of me either withdrawing emotionally, or becoming very defensive. Which is the purpose of this thread, to find out if other people had defensiveness tendencies, and what they did to overcome these tendencies.

I think it is important that we both do our parts to deal with this.

LoBoy

Lost,

The problem that I see is this seems to be a cause and effect relationship.

So The cause of your withdraw/defensiveness is her lashing out at this time.

How do you fix this? In most cases most would say that the cause needs to be removed. However you are saying this isn't possible based on the PMDD.

So you want to figure out a way to be attacked but not become withdrawn and defensive.

Well I personally don't know if you can condition yourself to do that but essensially that is what you need to do.

I have a way of dealing with things like this where I overcompensate for a while purposely. So instead of being withdrawn I am right up in it. Hey how are you, can I get you something, lets take a walk. I think you get what I mean. After doing this for a while it becomes more natural. I of course don't stay that way forever but it helps me break the behavior I want.

With the defensiveness count backwards from 10 before you speak in a defensive manner.

You can also have a code word when you feel like you are being attacked and are becoming defensive. I like to make them somewhat funny. Like blue baboon. When you feel attacked say Blue Baboon.

With that you are asking the W for a break.

She also needs to try some behavior modification. If she treats you badly at this time she needs to realize that and try to change as well.

She can't use that as a reason to treat you poorly.

Good luck.

LoBoy:

Uh, keep her barefoot and pregnant? <img src="/ubbt/images/graemlins/wink.gif" alt="" /> <img src="/ubbt/images/graemlins/grin.gif" alt="" /> <img src="/ubbt/images/graemlins/grin.gif" alt="" /> But I don't think it would be a good idea to tell her that <img src="/ubbt/images/graemlins/eek.gif" alt="" /> <img src="/ubbt/images/graemlins/eek.gif" alt="" /> <img src="/ubbt/images/graemlins/eek.gif" alt="" />

Seriously, POJA for this is great. But that just helps mitigate the worst of the conflicts, it doesn't stop the very real stuff that is going on in her head.

The person in charge of owning it is HDDW not you. Male that you are, you can't solve her problem, only deal with your own, but you know that.

How does HDDW want you to deal with it? Does she know?

Larry

C53 - I think we are trying to POJA a remedy for this situation as I stated what we are trying to do in my post above. We have talked about a "get out of jail free" card for one of us to exit the discussion before things progress to the nasty stage.

FNM - Those are great ideas, I love the overcompensate, and the counting backwards.


Larry - LOL! I am sure it took every ounce of self-control for HHW not come crawling thru the monitor after that comment given the way she is feeling right now. BTW, at this point it would be a miracle if I got her pregnant since I had the pesky operation that every guy hates to think about, five years ago.

HHW wants me to be more supportive of her mood swings and when she if feeling down. For me to recognize the situation, to be supportive and validate her feelings, instead of becoming defensive.

BTW, it is not as though HHW is constantly attacking me, there are many times that she gets severely depressed, tries to share her feelings, and I end up getting defensive. Then things escalate, she's doesn't get validation, I start feeling attacked and get even more defensive, and so on. We need to break that dynamic, and I appreciate everyone's input.

I am working on MY STUFF, and will try to implement the suggestions made.

Thanks,

LoBoy

When she gets severely depressed...

What BEHAVIORS do you notice yourself reacting defensively to?

Can you give examples?

See...you may feel defensive because you are assuming ownership of her feelings [if she is unhappy it is because I have failed] or you may be growing defensive because you ARE being attacked with DJ's etc.

Which makes it sort of hard to advise you because the correct response for appropriately defending yourself in an attack is different from offering emotional support when someone shares that they are feeling badly.

A-HA! <img src="/ubbt/images/graemlins/rolleyes.gif" alt="" />

I am a chick--may I suggest something?

When you perceive that she has "attacked" you and figure out that it's probably PMDD related, could you just try to practice one thing? Why don't you ask her, "What would you like from me right now?"

Here's the way I see it. Her moods are shifting. She is probably aware that her moods are all over the place. So she says something fairly ... um ... aggressively, and then realizes, "Oops that's probably hormones." And right about then she's probably thinking, "If he'd only _____, I wouldn't feel so bad!" Now, I'm not saying that it's your responsibility to make her feel anything (she chooses that), but you CAN say, "What would you like from me right now?"

Here's an example,

LoBo: "So we enthusiastically agree that you will XYZ and I will ABC?? Cool!" <img src="/ubbt/images/graemlins/smile.gif" alt="" />

HDD: "How can you SMILE at a time like this? It almost cost us our M and just because we've reached an agreement, you're SMILING?" <img src="/ubbt/images/graemlins/mad.gif" alt="" />

(HDD inside herself: "Uhhhhh...that was a little harsh. I bet I'm hormonal.")

(LoBo inside himself: "Hey! That was uncalled for! I didn't deserve that! I bet she's gone hormonal for the month again. Now, nothing I say will be right")

IN THE PAST, LOBO MIGHT HAVE SAID SOMETHING LIKE: "Well, yeah I'm smiling. I thought it was a good thing that we finally reached an agreement. What? Are you MAD about it? You're PI$$ED that you finally agree with me on something?"

(fighting is about to ensue!!!)

INSTEAD LoBo says: "What would you like from me right now?"

* * * * *

Now, HDD can say, "I don't know. I just feel so angry that we almost lost our M because of something we could have agreed to years ago! Do you feel the same way?"

or

"I don't know. It just seemed so snarky to me that it took us all this time to finally agree on something and your smile was like you beat me! Could you reassure me that I'm safe?"

or

"I don't know. It just struck me wrong and we've fought about this for so many years that it feels funky to agree. Can you just let me feel funky but keep me safe?"

or

"I just feel grousy! Could you just give me some room to feel grousy and I will make sure that I don't aim it at you."


Does that make sense? At first she may not be able to verbal what she needs/wants without going around and around a bit, so let her have a little time to figure out what it is that she wants from you--and ask for it respectfully not demandingly. But keep on just mirroring back what she said. Don't defend or agree or disagree...just let her say it and then YOU say, "So...what you're saying is...."

Your faithful friend,



CJ

Noodle:

It happens both ways.


Many of the times (particularly when the first onset of monthly symptoms occur), I will feel really bad when everything switches from great to bad. This is what happened Sun night. HHW and I had just had an outstanding week, and I was really looking forward to cuddling on the couch in front of the tv after a hard day's worth of yard work. But then the PMDD kicks in, and HHW gets severely depressed in the space of a couple of hours. It is like a shock to my system. And I REACT, and yes I do assume ownership of her feelings bc I feel that I have failed. When the big swing happened, I started to withdraw and I get a little upset that all the fantastic times we had just had have ended. Then my withdrawing makes HHW feel guilty, and then she gets angry.

At this point either one of two things happen, either 1) I will try and get HHW to talk about what may be bothering her and I respond in a defensive way, or 2) HHW will start verbally attacking me for whatever is bothering her and I respond defensively. Either way usually ends up with the heated discussion escalating.

We have gotten better recently at trying to walk away before it turns into an all-out blow-out, but it still is a disturbing pattern in our relationship.


Remember HHW's post a month ago "My H is Addicted to MB" which caused a big stir around here? I looked at the date that post was created...exactly 28 days before this past Sunday. In that case, we were getting along great. I was working in my office that Sunday, and doing a little MB review and one or two posts. Then BAM, HHW started feeling depressed, got jealous that I was spending time on MB instead of supporting her feelings (and I didn't even know that the swing had occurred on that day), then she started that thread without warning.


This dynamic has been going on for years in our M, and I realize that I need to do my part so that half our lives are not spent dealing with the consequences of these symptoms. HHW and I talked about it this evening again, and we think that, in addition to her seeking alternative treatments to help alleviate the symptoms, I need to learn new coping behaviors/responses when the symptoms hit.

I really appreciate any help you can provide. Your questions are spot on.

LoBoy

CJ:

Your examples are exactly what I was looking for. I will use your line "What would you like from me right now?". That is so much better than what I have been doing. I will study this post.

But my big problem is recognizing when the switch takes place...it always catches me off guard like Sun night, and HHW even mentioned to me on Fri that she thought it was almost halfway thru her cycle. When I was in Plan A, it was much easier to be prepared with responses like "What would you like from me right now?" because I was prepared to hear things from HHW that would normally start me going. But now when we are recovering, I let my guard down, spend time enjoying our interactions, and then the mid-month shock happens.

I guess I need to just set up reminders in a tickler file or something bc what I have been doing hasn't been working that well. If you have any suggestions, please let me know.

Thanks,

LoBoy

I'm going to watch this thread with interest. My issue is peri-menopause, but I have all those symptoms, too, and can change from happy to depressed in a split-second. My FWH is a bit bewildered as to what to do or how to react. He usually keeps quiet!

Has she seen a doctor? If she can get it treated with medication maybe her mood swings won't be an issue anymore.

If that's not an option, there's always chocolate.

Uh <img src="/ubbt/images/graemlins/blush.gif" alt="" />

I'll be brave here. Lostboy, there is a website www.mymonthlychycles.com that you can use to track the monthly cycle. It will email you "reminders" that you choose...such as "it's time for ovulation" "cycle day 1 is one week away" or whatever. You might want to set up an email reminder of "the swing is expected soon" (based on X number of days past ovulation). That way it won't blindside you so severely and you can respond with a little more likelihood of wisdom.

--CJ

Edited to add: LostBoy, my current DH actually dealt with PMDD for 20 years with his exW, and here's his advice. It's kind of funny. <img src="/ubbt/images/graemlins/laugh.gif" alt="" /> He says you keep putting your hand in the door and slamming the door and then saying, "That hurt this time!" To some degree, he says to expect it to hurt. In other words, when you get the email that the mood shift is expected this week, don't expect her to "be healed this time" or not have a mood swing. Expect the swing! Because it IS coming...it just IS! Rather that hoping she won't swing this month, accept that it's coming, be prepared, and deal with it in a way that is more healthy FOR YOU...and allow her to deal with it in a way that is healthy for her. I don't mean physical health here--I mean "lacking in mental and emotional abuse" <img src="/ubbt/images/graemlins/wink.gif" alt="" />