Editor's Note: This article discusses themes of negative mental health including suicide.
Reader discretion is advised. Please see some useful helplines below this article and do not hesitate to reach out if you feel you could benefit from support in any way.
It’s the week before your period and you’re in a low mood, hormones out of whack and without your wits to keep you together – it feels like another hell of a school week.
Pre-menstrual syndrome or PMS is the name for symptoms women can experience in the weeks before their period. Most women will have PMS at some point.
PMS is a generalised term to rationalise all those feelings of anxiety, depression, sickness and pains that flood away with the hit of your period. So, part of the problem of experiencing whatever the hell PMS is, is that we haven't fully understood why we do so, and some women may be affected by these changes more than others. Premenstrual dysphoric disorder (PMDD) is another name, another general term applied, but this time the term rationalises even more severe symptoms of PMS.
One of the difficulties of having a menstrual cycle is that you can’t tell whether you just have really bad mental health, or if it’s the ‘hormones’ again; it’s just that time of the month.
Something that concerns me when I think about PMS is that there’s a very disturbing difference in how we consider mental health in regard to environmental causes and supposed biological ones.
If you’re feeling anxious and depressed about something you can actually explain, it’s much easier to get help for it. But if you’re depressed and anxious, or perhaps even bordering on suicidal tendencies about something that you can't do the same with – especially as a young girl or woman uneducated on PMS – it isn't always possible to receive the help you feel you need.
So, many of you may be thinking, ‘What the hell am I supposed to do?’
Short answer – I have no idea.
But looking at what may exacerbate these symptoms, and what incentivises us to repress and stay silent about them, can give us some kind of insight into how to minimise them.
A common question behind the studied (understudied but nonetheless studied) symptoms of PMS and PMDD is whether they are cultural or biological. If part of it is cultural, which has been largely suggested from studies finding that women who endorsed stereotypical gender roles experienced worse PMS than those who didn't, then we have a lot of work to do. A sudden drop in mood that maintains throughout an entire week or two can make you feel out of control. Around 75% of women experience PMS, with 2-5% experiencing PMDD.
The majority of women wouldn’t even acknowledge their symptoms as anything more, let alone pathologize them under a label of PMS or PMDD. I get stressed by these thoughts because I doubt so many women experience it to the point that they want to die – but then again, I don't know how exactly to place my experiences, in part because the condition isn't talked about often enough at all. This can really damage your self-esteem because then thoughts may bubble up that perhaps ‘I shouldn’t pathologize my symptoms’ and that ‘maybe it’s me, maybe I am the problem.’
There’s something correct yet still inaccurate about thinking this way; pathologizing helps rationalise an experience through legitimising pain, but it also helps to rationalise a pain that perhaps shouldn’t exist. And we’re back to the main question: to what extent is PMS or PMDD a cultural phenomenon?
To get there, let me explain a bit more about what severe PMS or PMDD can look like, addressed here as severe PMS (because addressing it as anything else gives me a headache, it is quite difficult to define in reality). You might spend an entire week hating yourself for being a woman. Then a week later you’re in the most jovial mood ever, creating Pinterest albums about girlhood and drawing all these pretty women and obsessing over these strong female characters to which you then reflect on your radically different behaviours and almost go insane. No, I don’t hate being a woman, but I certainly did in that moment.
I’m troubled by my reflections. I think, does this mean that my anger and anxiety at the time is now illegitimate? Were my outbreaks of low self-esteem just a consequence of hormones? Did I not have a legitimate reason to be angry at that time? Do I not have a legitimate reason to be happy right now? Why should I legitimise my happiness and not my pain?
This can be rounded up into one question – are my feelings just neurochemical processes and the workings of a bloody reproductive system, or is there something more?
Let me tell you about the American 1950s housewife phenomenon. The majority of housewives were prescribed with a large range of anti-depressants to deal with their anxiety and depression. The great development of psychiatry is that now we can prescribe drugs that will cure everything. It wasn’t endorsing stereotypical gender roles that caused the anxiety and depression of the housewives – it was hormones, it was the biology of the woman.
The biological essentialist view of the housewife phenomenon can be applied to modern day conceptions of PMS and PMDD. It’s just ‘biology’. But it’s not just biology. Anti-depressants aren’t going to stop the housewife from being a housewife. Anti-depressants aren’t going to cure internalised misogyny either.
So before falling down the slippery slope of attributing everything to hormonal imbalances and figuring out how to develop hormonal therapies to cure them, we need to consider the reality of the world we live in; cultural misogyny still thrives.
And, as with everything – education comes first.
Helpful Resources:
0800 689 5652 - National Suicide Prevention Helpline UK
kooth.com - Free, personalised professional mental health assistance for 18-25 year olds
0800 1111 - Childline
116 123 - Samaritans UK