This is what it can be like to live with pre-menstrual dysphoric disorder – Laura Waddell

When the veil of PMDD descends, Laura Waddell feels so depressed and distressed that she struggles to see life as anything but irrevocably ruined

I’m writing this week’s column from a dimly lit chain restaurant across from the chain hotel I’m staying at in London, fantasies about venturing further for more imaginative food dissipated after a day on the train and work yet to do. Around me, heads down over bowls of noodles and katsu curry, are other business travellers, maximising their per diem allowance on solo dinners.

I haven’t been to the English capital since before the pandemic, and I don’t miss my old working schedule where a few fatiguing back and forths a month were typical, so the novelty of this trip is heightened. I contemplate a rum cocktail not eligible for reimbursement.

I’m not sure who I am when I’m travelling for work these days. I have been the traveller keen to utilise all downtime around a work trip, heading to the theatre of an evening or taking the opportunity to seek out dinner spots recommended by southern foodie friends. Equally, I have been the one gritting my teeth from an AM alarm before an uncomfortably early flight, wishing with all my being it was already over; knowing that, at the end of the same very long day, I’d have the return journey north to complete before I could get into bed.

Travelling has always been an exercise in managing the anxiety that accompanies being away from home, and balancing that with the enjoyable adrenaline of doing something out of the ordinary working week, even if it’s just another meeting, in another city, seeing faces in the flesh rather than on Zoom. Although where I am staying is surrounded by the identikit retail premises familiar to any major UK city, the warm burble of commuters heading to and from the underground at home time gives it the busier, buzzier feel of a bigger city than the one I live in.

I went to Berlin last month on holiday, not for work, but I struggled terribly to relax. I had overestimated my appetite for a city break; a few months into adjusting to working in a new industry, what I really could have done with was a lounger by a pool and zero demands on my time, a kind of holiday I never understood the appeal of before I turned 30 and the fatigue of life began to cling.

But the real issue was that it was pre-menstrual dysphoric disorder week, and when the veil of PMDD descends in the days before my period begins, I feel so depressed and distressed that I struggle to see life as anything but irrevocably ruined. In the grip of PMDD, I am desperate to return to a more manageable emotional equilibrium, but from inside the prospect feels impossible.

In the swirl of fear and anxiety, I feel lost; off course and uncertain as to where I should be on life’s map. At these times, I don’t assess my day by how much work I’ve gotten through and what I had for lunch. My perspective zooms out to life’s whole trajectory. I become stuck in horror, fear, and dread; at my own failings, at the workings of this world, at how vulnerable it feels to be human in it.

In these panicked moments, I consider the drastic measure of a complete life change, of withdrawing from the world I know and trying another. What if, to find peace, I just need to live a simpler life? To move to an island? To Finland. To Texas. Feeling fine one day and plunged into such despair the next lends itself to the desperate idea that luck can turn on a dime; I just need to land on the right square.

I am searching for a cure for this feeling, a depressive gnawing I can neither intellectualise away nor switch off. The rest of the time, I live with regular old depression. PMDD feels more like an alarm going off, bad feelings dialled up to their bleakest. It is difficult to simply sit with. Crawling the walls of my own head, thoughts of running away offer the mirage of escape. I am trying to get away from the PMDD, but I can’t. It is like a bad trip I get stuck inside.

But it doesn’t last forever. Some months are better, some months are worse. I have accepted it is inside me, emerging for four or five days out of every 30. When it lifts, I take great comfort in feeling OK instead of inconsolable, once again appreciating mild, pleasant sensations like the breeze on my cheek, and understanding the day ahead will be bearable.

As I’ve written before, where I can, I rest and ride it out, trying to remind myself it will pass. When I can’t, and must engage with the world, I mask it as best I can. I forge on at work. I plan around it, where possible scheduling the most stressful tasks on either side of its estimated arrival in my calendar. As whenever I speak to a GP about PMDD, it’s a toss-up whether they’ve heard of it or not, the chances, then, of an employer already knowing what it is are slim.

But as I re-enter the working world, I am determined not to let my health fall by the wayside. There are simple adjustments: working from home helps after a night of insomnia, and I’m strongly in favour of a four-day working week for how it lets workers catch their breath and balance their lives.

Perhaps it is the adjusted perspective of age; perhaps it is returning to work in a post-pandemic world, but I am no longer willing to push myself beyond my limits and run myself ragged, saying nothing while I grow more exhausted. Just as workplaces are becoming familiar with making adjustments for neurodiversity, increasingly I see long-term management of mental health as a holistic endeavour. If it is always to be with me, why pretend otherwise?