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I had a melt down last week.  Luckily for me, I was on MSN with a dear friend when it happened; she had the patience and took the time to talk me down, such as it was.  After she had calmed me down, she started asking questions: what happens? when? for how long?  She then gently suggested that I ask my doctor about Premenstrual Dysphoric Disorder (PMDD).

As I read and read and read, the more it made sense.  The more first-hand accounts I encountered, the harder I cried because bits and pieces of each one was me.  When I got to the screener, I was able to definitively answer "yes" to seven of the eleven symptoms, and could say "sometimes" to three of the remaining four.  And then the questions: Do these symptoms disappear during or after your period?  Yes.  Do these symptoms occur with most every cycle?  YES.  Are the symptoms severe enough to really interfere with your life?  YES!  My GOD does it interfere with my life.

Every month, about a week before my period starts, Teh Cray-zee sets in.  I feel irrational, paranoid, angry, weepy, and I plummet to the depths of despair.  I am mortified at the crap that spews from my mouth: as it's pouring forth, it's like I'm watching from outside my body SCREAMING at myself to calm the fuck down -- at the height of my neuroticism, I know I'm over-reacting and blowing things out of proportion, but it's like I am absolutely powerless to stop myself.

My biggest concern (after wondering if I truly am losing my mind) is Chebbar.  Every time this happens, that wonderful man gently, calmly, rationally tells me that it's okay; it's not that big of a deal; it doesn't happen that often (read: only once a month *eye roll*).  But every time, regardless of what he says, my mind starts spinning a million miles a minute: what if some day it's NOT okay?  What if it DOES become a big deal?  What if it picks up in frequency?  What if he just. can't. handle. it anymore and he leaves me?

And every time I voice these irrational fears (and trust me: I can't NOT voice them, dammit), I see the frustration in his eyes as he has to reassure me yet again, and I feel terrible.  He shouldn't have to reassure me every. damned. month.  He shouldn't have to hold my hand.  He shouldn't have to exercise such patience.  Yet he does (and god I love him for that).

So, yeah.  This DOES interfere with my life, thank you very much.  It interferes with MY life.  It interferes with HIS life.  It interferes with OUR life.  And that's not acceptable anymore.

"Your answers suggest that you may have PMDD, but evaluation by a professional would be necessary to know for sure."

In that moment, I was relieved at the prospect of a diagnosis, an explanation, answers.  I knew *something* was... off for awhile.  I actually started to track these melt downs back in April, which means they happened a handful of times before that if it was bad enough for me to think "Hmm.  I should track this."  Before I met Chebbar and went back on the pill, I would have a day one week before my period started where I would have all-over-the-map mood swings, but never anything like this.  Unfortunately, being on the pill did not solve this, as it does for some women.  I can't say that the pill made it worse, because this could be a recent change; however, it certainly didn't help.

During the course of that reading and through talking with Cat, I realized that antidepressants were a very real possibility.  Unfortunately, I seem to have issues with that idea.  I have for a long time.  I would never question someone's need for antidepressants; in fact, I would wholeheartedly support anyone that felt he or she needed medication.  As many people have equated, it's no different than a diabetic using insulin: it's necessary.  As I have mentioned in previous posts, I have no problem supporting others; however, I cannot cut myself the same slack.  I am harder on myself than I am on anyone else.  I expect more from myself than I do from anyone else.  Some how, some way, for some reason I equate my needing help -- in any way, shape, or form -- as a sign of weakness.  Essentially, for me, having to take antidepressants is akin to failure because I can't fix myself.  However, the last episode was bad enough that I was okay with the idea of antidepressants.  Unfortunately, once my period arrived and my hormones levelled out and I went back to "normal," I started convincing myself that I was okay and it wasn't that bad and I didn't really need pills.

Oy.

My doctor's first suggestion was to switch to a different pill; evidently, sometimes just a change in hormones can help.  Because the PMDD episodes occur towards the end of my active pills, she said that I would be able to tell before my period starts if the switch in brand was successful; if not, she has instructed me to take nine weeks of active pills and then take a week off, reducing my cycles from twelve down to four a year (approximately).  She had suggested St. John's Wort as the third step if need be.  I had read numerous times that St. John's Wort is contraindicated with oral contraceptives because it can lessen the efficacy of the pill.  When I asked about this, she was very quick in emphatically denying that...  Barring all of these options, she said that we may need to look at antidepressants.  However, she did mention that it's possible that I may only need to take them for a week or two before the PMDD generally occurs (as opposed to every day).

I came home feeling rather optimistic.  Except I hadn't discussed this with Chebbar yet.  I felt... silly? ridiculous? like a hypochondriac? discussing it before getting a definitive answer.  I was also a little worried about what his reaction to the possibility of antidepressants would be because he hasn't seemed... overly fond of them in past discussions (I'm also still worried about my mother's opinion based on her pill-hating philosophy, but I'm going to have to get over what other people think, too: this is MY life and I get to do whatever is necessary to make it the best I can).  As usual, Chebbar was open to what I had to say, honest about his opinion, and completely supportive.  As he pointed out, I am aware of my body and what works (or doesn't), and will be proactive in seeking out other alternatives if something isn't working for me, so he's not concerned that I will fall prey to the wrong medication.

I feel like a HUGE weight has been lifted from my shoulders.  Again, I would like to thank you all for the support, and if you made it alllllll the way to the end of this epic post, you get a gold star AND a cookie.  ;)

(In talking to the pharmacist when picking up my new pills, he actually pulled out his, uh, Big Book o'Drugs to show me where it is stated that St. John's Wort can result in increased metabolism of certain drugs, which in return can ultimately result in an unplanned pregnancy.  Needless to say, I wouldn't be ON the pill if I was up for an unplanned pregnancy, so again, needless to say, I won't be taking St. John's Wort.)