PMDD is ruining my life. What can I do? | Health & wellbeing

II am 32 years oldAnd was recently diagnosed with premenstrual dysphoric disorder (PMDD), although I suspect I’ve had it for about five years. He seriously affects all areas of my life.

For 10 days per month I become irritable and impatient, and I have debilitating brain fog. At worst, I am depressed, with uncontrollable crying and suicidal thoughts. I go to weekly therapy sessions, take a variety of supplements, and lead a healthy lifestyle – exercise, consume little alcohol, eat well, etc.but all that habits become almost impossible during my luteal phase after ovulation and I feel like I’m completely stuck.

When I’m not in my luteal phase, I love life. And then everything falls apart: I want to quit my job, break up with my partner, ignore my friends. I have a hard time sharing this experience with someone or seek help because the condition is chronically below-recognized and little studied. Sometimes I I even make myself believe that maybe it’s not real. I I feel more and more like I’m burdening my partner because he’s almost the only person with whom I can be completely myself.

When I’m at my best, I forget I even have this disease. When my period comes, it’s like I’ve had a brain transplant: I’m a whole new woman. And then the countdown begins until the next luteal phase. How can I live the next 20 years like that?

That’s a lot to deal with. You’re right, PMDD is chronically under-researched (like so many women’s health issues). It has been around for a long time but has only recently been classified as a disorder.

I have taken your concern to Dr Sophie Behrman, a psychiatrist who recently opened an NHS menopause and menstrual health clinic in Oxford. Her book Menopause, Menstrual Cycles and Mental Health will be published later this year. She told me that an estimated 1-3% of women have PMDD and it can happen at any time during their menstrual life. It is a mental disorder that causes serious psychological (and sometimes physical) symptoms during the luteal phase of the menstrual cycle.

Your thought that after your period it’s like you’ve had a brain transplant is actually very astute. With PMDD, it’s not that you have an abnormal hormonal balance in your body, but how your brain responds to them, and specifically to the drop in progesterone levels before your period. The result is that sufferers end up feeling irritable, anxious, depressed and impulsive.

Behrman said you’re already doing a lot of things that can help. There is evidence that a good, whole-food diet and exercise can be very beneficial (although I know it’s not always easy to maintain), and supplements can help. It would be irresponsible to recommend anything specific or suggest further surgical or pharmaceutical steps, but if symptoms don’t improve, go back to the person who diagnosed you and ask what might happen next. Cognitive behavioral therapy may be helpful. Behrman also mentioned the importance of peer support. You can visit the iapmd.org website for more information.

The “good” news is that you already have a diagnosis. Because it is a relatively new named disorder, many women should do their homework before seeing a doctor with information.

I’m very happy that you have a supportive partner, but I would like to gently urge you to share your condition (because it is real) with people you trust. It’s tiring having to educate people, but sometimes it’s up to us to do it. Then they can support you – because you deserve to be supported.

In the United Kingdom and Ireland, Samaritans can be contacted on the free number 116 123 or by email jo@samaritans.org Or jo@samaritans.ie. In the United States, you can call or text 988 Suicide and Crisis Lifebuoy to 988 or chat on 988lifeline.org. In Australia, the crisis support service life line is 13 11 14. Other international helplines are available at friends.org

Each week, Annalisa Barbieri tackles a personal issue sent in by a reader. If you would like advice from Annalisa, please send your problem to Ask.annalisa@theguardian.com. Annalisa regrets not being able to enter into personal correspondence. Submissions are subject to our terms and conditions. The latest series of Annalisa’s podcast is available here.