PMDD, ADHD, and the week before your period.

Have you ever felt like a completely different person the week before your period? Like you know you feel really off, but you can't figure out why, and then your period starts and the whole world makes sense again?

I was drawn to menstrual cycle awareness because of the challenges I faced with my own cycle, especially the roller coaster of emotions. And the truth is, we are a little bit different people throughout the month. Our energy is different, our brain chemistry is different, and the hormones at play are different. Part of that is completely normal. But for some of us, the shift into the premenstrual phase hits a lot harder.

Why the premenstrual phase can be so hard with ADHD

The change from the ovulatory phase to the premenstrual phase can be particularly challenging for me, because my ADHD symptoms are greatly heightened during the premenstrual phase. That's because of the drop in estrogen. Estrogen supports dopamine, and when it falls before your period, a lot of women with ADHD notice their focus, motivation, and emotional regulation get much harder.

Emotional dysregulation, among other things, is a real challenge. It's a frustrating experience knowing the feelings you have are valid, and the reasons you have for being upset are valid, yet despite your best efforts, sometimes your reaction is extreme.

What PMDD is

PMDD stands for premenstrual dysphoric disorder. To put it very simply, it's like PMS on steroids. It's an extreme reaction to the normal shift in hormones in the premenstrual phase, and it can bring intense mood changes, irritability, anxiety, depression, and feeling like you're losing control, usually easing once your period starts.

And it's much more common in women with ADHD. In one study of women with ADHD, nearly half reported symptoms of PMDD, roughly ten times the rate in the general population. It was an early study, and more research is needed, but if you have ADHD and the week before your period feels unbearable, you're not alone, and it's worth talking to your provider about.

Cycle amnesia

Before practicing menstrual cycle awareness, I would feel triggered, emotionally dysregulated, and not know what was going on. I felt like I was actually losing my mind, and I wanted to run away from everything during this time. As you can imagine, judging myself for how awful I felt just made everything worse.

Then my period would start, and the whole world would make sense again. Have you ever had that experience? Like, what is wrong with me, I'm losing it, and then boom, your period starts and it's like, oh, duh.

My mentor, Claire Baker, calls this cycle amnesia. We have the same experience every month, but we forget we felt the same way the month before. Charting your cycle is extremely helpful with this.

What changes when you know your cycle

Things are a lot different now that I work with my cycle. But you know what hasn't changed? The intense emotions, the emotional dysregulation, and the super challenging days. You know what has changed? The way I deal with them.

Through charting many cycles, I know what this phase looks like for me. I can usually tell in advance when the tide is changing. It's not a surprise, and I'm not left wondering what's wrong with me. I know exactly what's going on.

That knowledge helps with the people around you too. When you can share what's happening with the people close to you, they can be more compassionate and patient, and you can be more compassionate and patient with yourself. They aren't responsible for fixing your emotional discomfort, and you don't have to expect them to. Just knowing what's going on changes the whole dynamic.

Permission to drop the expectations

When I recognize that I'm having a challenging day, that's when I pivot and start to drop the expectations. The kids might have cereal for lunch or dinner, and you know what? I call that a win. They're fed with something they love, and I practiced self care by not overdoing it.

Easy meals, prepared foods I can put together quickly, or ordering out more than I'd like to admit all help. When I'm more on top of things, I prep ahead for this phase and have some of my favorite nourishing things ready to go. All of this helps me save my energy for managing my emotions, and it keeps me from putting pressure on myself, since that only makes things worse.

Cycle awareness won't fix everything, and that's okay

I'm not perfect, you're not perfect, and cycle awareness isn't going to magically fix all of your problems. But it is going to help a lot.

I get kind of tired of seeing coaches say do this and this to not have PMS, or follow this extensive protocol and seed cycle and it will fix it. We are so much more complicated than that. The reasons we may be suffering are varied, so the solution is going to be multifaceted, and for some women that includes medical treatment.

This practice, to me, is about coming to know yourself in a deeply satisfying way, supporting your hormones for fewer symptoms, and growing and changing month by month. You won't ever fully arrive at a place where you're done. Sometimes you'll be rocking it on your own, and other times you'll need someone to share what you don't know, help you stay accountable, or just listen and understand.

When to get more support

If the week before your period is affecting your work, your relationships, or your ability to function, bring it to your provider. Tracking your symptoms alongside your cycle for a few months is one of the most helpful things you can bring, and my article on how to talk to your doctor walks through how I do it.

PMDD can bring very dark thoughts for some women. If you ever have thoughts of harming yourself, please reach out right away. In the US, you can call or text 988 to reach the Suicide and Crisis Lifeline.

And if today is a day when you need permission to pivot and drop the expectations and anything extra, consider this your sign. Give yourself grace, focus on the next best thing, and cheers to breakfast for dinner.

I'm a coach, not a doctor. This article is education, not medical advice. If you think you might have PMDD, talk to your provider.