PMDD diagnosis can be a revelation to women who don't know they have it – Laura Waddell

My book of the week is The Red Zone by Chloe Caldwell, a memoir about living with pre-menstrual dysphoric disorder, or PMDD, a worse form of PMS.

The symptoms of PMDD, a severe form of PMS, include headaches, joint and muscle pain, mental and emotional problems (Picture: Anna Gowthorpe/PA)

Caldwell’s description of discovering she has PMDD chimes with my own experience. About ten years ago I too started piecing together my symptoms, contextualising what I was feeling with snippets of other people’s testimonies, things I’d read in magazines, and a suspicion my monthly mood swings weren’t ‘just’ PMS.

I mapped out good days and bad days – and the very worst days of extreme highs and lows – with a large wall chart and coloured stickers.

Having suffered from depression since my early teenage years, I’d chalked up the monthly agonies to that, as did doctors. But a few months into charting the symptoms, a pattern emerged.

In the week before my period, I had instinctually adopted a policy of battening down the hatches to ride out these days, retreating indoors with my insomnia, irritability, and angst.

When I learned I had PMDD, it was a relief – finally I understood what was happening, and why. What I’ve taken to calling the ‘PMDD Zone’ when giving a heads up to those closest to me, Caldwell calls ‘the Red Zone’. A Facebook group of sufferers she frequents refers to their premenstrual hormonal swings as ‘Werewolf Week’.

It’s not a surprise to me we have all found our own words to describe the pain we experience, or that knowledge of this condition passes by word of mouth.

Although I’ve over two decades under my belt of managing the undulating waves of mental health, and have seen doctors in that time ranging from completely unhelpful and patronising about menstrual pain to empathetic and insightful, I have come to first expect a moment of confusion when I bring PMDD up in the GP’s surgery, just as time and time again I’ve witnessed clarity on the faces of friends who, hearing about it for the first time, start to join the dots of how their lives have been impacted.

Caldwell’s insightful interviews with family and friends show how common the slow realisation is.

“The one thing I wish someone would have told me when I was young was the immense impact that my period would have on my general well-being. That my PMS/PMDD symptoms sometimes become so severe that it’ll affect my mood, my thought process, my behaviour, and my energy levels so much to the point that I become a different person.”

Or “I treated the physical symptoms of PMS with ibuprofen and a hot water bottle. But I did nothing to treat the emotional and psychological symptoms of PMS”. And there’s this admission, which sums things up: “I wish someone had told me I didn’t have to suffer so much!” PMDD meets at the intersection of historically minimised conditions: women’s pain, and the nuances of mental health.

Some of my bookish friends are tiring of literary memoirs about pain: it’s true there have been a lot in recent years. But there is so little writing on PMDD that Caldwell’s cathartic The Red Zone will be a comfort and a revelation to those suffering, especially those yet to discover it.