Why is it that some medical conditions persist for centuries without very much being said about them?
An answer, I think, is that medical conditions affecting women, in particular, have always run the danger of being marginalised.
Look at how much we are now hearing about endometriosis. It has caused so much pain to so many women over time, yet little enough was said about it in the media until the 21st century.
What started me on this train of thought was reading that a condition called premenstrual dysphoric disorder (PMDD) was added to the Diagnostic and Statistical Manual of Mental Disorders only in 2013.
PMDD is like an extreme version of premenstrual tension. It can cause intense symptoms such as anger, mood swings, depression, anxiety and conflict in the weeks before bleeding begins, according to the American Psychological Association in its Monitor on Psychology.
In some cases, symptoms are so bad that women with the condition have had hysterectomies or taken their own lives.
It can be argued – and indeed is argued – that classifying PMDD as a mental disorder is inaccurate and stigmatises an extreme version of a normal condition. Still, its inclusion in the DSM means it is officially recognised in psychiatry.
This painful, emotionally shattering condition can lead to conflict that harms relationships – so ‘werewolf week’ as some sufferers call it can have consequences that go on long after it is over.
We all know that anger or irritation in a female colleague can be dismissed – usually not out loud – as ‘it’s the time of month’ but this is of a different order.
Researchers say that what is behind it is an ‘abnormal sensitivity to the normal rise and fall of hormones during the menstrual cycle’.
During that time, it can exacerbate other conditions such as post-traumatic stress, ADHD and borderline personality disorder.
Some men also have an abnormal sensitivity to the rise and fall of hormones, and suffer mood swings, but the effect is under-studied.
A Swedish study found that women not only with PMDD but with PMS are at a higher risk of falls, car accidents and suicidal behaviour
About 6 per cent of women have this condition and for those who have it it’s a huge issue and also presumably for those around them, which multiplies the effect.
Some of these symptoms occur at other points in the cycles of some of the women concerned and not only in the two weeks before their periods so it can be very disruptive.
Researchers wonder if hormonal fluctuation around puberty is linked to a big increase in depression and suicidal thoughts or behaviour in girls that isn’t seen in boys.
In one study of almost 600 females, aged 13 to 62 with a diagnosis of PMDD, 72 per cent reported suicidal thoughts throughout their lifetime. Half had planned suicide, a third had made an attempt and more than half had injured themselves.
A Swedish study found that women not only with PMDD but with PMS are at a higher risk of falls, car accidents and suicidal behaviour. How many lives are lost or wrecked?
According to the American Psychological Association article, oral contraceptives and Prozac or similar medicines can help. Cognitive behavioural therapy and mindfulness can also help by enabling the affected women to make good choices arising from their knowledge of where they are in the cycle. Techniques such as tracking one’s emotions can also help – possibly by enabling the person to take a step back from the emotional experience.
One woman interviewed for the APA article said therapy, an antidepressant and good self care habits have helped her to minimise her symptoms.
All of this I think should make us, especially men, less inclined to dismiss distressed behaviour by women as solely a ‘time of month’ thing. There’s a lot more to it than that.
And it makes me wonder what else is out there that women have been suffering from for thousands of years but that has not been brought to light in the same way that endometriosis and PMDD are being.
- Padraig O’Morain (Instagram, Twitter: @padraigomorain) is accredited by the Irish Association for Counselling and Psychotherapy. His books include Acceptance – Create Change and Move Forward; his daily mindfulness reminder is available free by email (email@example.com).