Written by Nirajana Sinha
Dealing with PMDD in a heteropatriarchal society obsessed with menstrual normativity is much of a task. There are layers that one has to break before one is diagnosed with it. First is the lack of awareness on this topic.
PMDD or Premenstrual dysphoric disorder is a chronic condition similar to PMS or premenstrual syndrome but much more serious and severe. The symptoms of PMDD show up 7 to 10 days before the start of the menstrual cycle. A study showed that out of 20% of women with PMS in India, almost 8 per cent have PMDD.
The symptoms of PMDD involve physical and psychological symptoms which include mood swings, emotional sensitivity, depression, tension, anxiety and other mental health issues, fatigue, appetite change, headache, muscle ache, breast tenderness, sleeplessness or changes in sleeping pattern, joint or muscle pain, hot flashes, respiratory issues, decreased libido, acne etc. It also includes trouble concentrating which further disrupts the daily activities of menstruators.
The symptoms usually persist till the first 2-3 days of the period. Researchers have not been able to determine exact factors contributing to this menstrual condition. Lately, serotonin, a neurotransmitter that plays a huge part in one’s mood, has been linked to PMDD. It is also extremely crucial to focus on the mental health aspect of this menstrual complication. Menstruators with PMDD experience a wide array of complications ranging from severe anxiety to even suicidal tendencies.
The mockery and trivialization of PMS also fuel this lack of awareness. “Are you PMS-ing?” is a common question thrown at menstruators, especially women who decide to put their foot down, challenge casual sexism or do as little as not laugh at a joke. Though at first glance it may seem harmless, such jokes mainly stem out from deep-seated misogyny.
PMS has just been reduced to a joke as portrayed by popular media. Scenes of women behaving erratically (like screaming, crying loudly, having mood swings) are used to depict PMS and, needless to say, that is the punchline in most cases. This normalization of offensive PMS jokes leads to menstruators not reaching out for help and suffering in silence. There is immense pressure on us to behave in a way that can be aligned with menstrual normativity; otherwise, we are made to feel there is something wrong with us and our bodies.
The second layer is the lack of government funding in sectors of mental and menstrual health awareness. In 2019 Lok Sabha, the Ministry of State for Health and Family Welfare, reported that India had only 3,827 registered psychiatrists and needed at least 13,500. Deteriorating mental health is a symptom of PMDD, and patients have also reported feeling suicidal. With two taboo subjects overlapping, it gets even more difficult for menstruators with PMDD to reach mental health experts. The third layer is medical gaslighting.
Medical gaslighting is a term used to define doctors and medical practitioners who blame a patient’s illness or symptoms of psychological factors or completely deny a patient’s illness. Patients are made to question their own issues, pain and discomfort. PMDD diagnosis requires noting and tracking the re-emergence of at least some 5 of its symptoms a few days before periods, among others.
More often than not, menstruators have a hard time getting their condition diagnosed by medical professionals without getting medically gaslit. Many menstruators have to go through different doctors to finally get diagnosed, resulting in a lot of financial and emotional exhaustion. At least two medical experts have told me that this is “nothing” or “normal” when I have spoken about my symptoms to find out much later that I do have this condition.
Only when one is finally diagnosed with it by a professional can one start to deal with it. However, due to the lack of awareness and other socio-economic-cultural factors, many people find it extremely hard to break through even one of these layers, and they end up suffering in silence. The symptoms make it exceedingly hard to sail through even normal basic daily activities. The sooner we understand and acknowledge that there is no normal way to bleed, the better and safer it will be for several menstruators to bleed freely.