Over the course of the next few months I have moments of peace and clarity, and then depression, and then rage and irritability, and depression again and then peace and clarity. I have matched it to the fluctuations in my hormones. Sometimes I was very scared that I was wrong, that I was truly bipolar, but whenever my period hits and flood of relief comes the day after I knew I was not. After awhile I am convinced it is PMDD. I have discussed it with some my doctors before and they agreed that I had PMDD but that it was only treatable with the psych meds I was already on and birth control. I read and read and read some more. I didn’t know PMDD could be this extreme. My symptoms lasted for upwards of three weeks at times. I wasn’t just depressed and full of rage or irritability, I was actually psychotic at times. How could hormones be this bad? I didn’t know until after all my reading that PMDD is commonly mistaken for bipolar. I didn’t know that there were other treatments for PMDD if everything else had failed. Including the sought after total hysterectomy I had previously asked my psychiatrist for. I had hope again. If other women had gone through this exact thing and found help, so could I.
My family backed me up 100%. They even did their own research. Anything to save me, to keep me going. I called numerous doctor offices, I even saw a reproductive endocrinologist, to no avail. After that for a couple weeks I was depressed. But I gathered my strength and charged forward. I knew I wanted a hysterectomy. In the meanwhile I had heard of Lupron. A drug that causes chemical castration (menopause). It had been used to prove that a total hysterectomy would “cure” pmdd. Of course I would be dealing with surgical menopause but anything, anything(!) was better than this monster in my head (or ovaries). I looked back at all my history and found that yes I was intolerant to progesterone. I found after taking the phytoestrogen, that while during my ovulation phase, taking additional estrogen caused depression (estrogen dominance) so I would have to back off my supplement during this time. I was super sensitive to hormone fluctuations!
My husband was still in Washington state for his contract work. I wasn’t having luck finding doctors near me who treated PMDD so exasperated I called a doctor that was near where my husband was living at the time. He knew what PMDD was and he had treated PMDD before. I didn’t bother to ask how he had treated it, I just booked an appointment. It meant me leaving my kids with my parents for an indefinite period of time. I could be back in a week, it could be a month. I didn’t know. They were very encouraging, both my kids and my parents. I needed to get better, I needed to take care of me before I could truly take care of them. I needed to be whole again. Putting myself first was mandatory at this point. So off to Washington I went.
On April 5th, 2016 I saw my doctor for the first time. The nurse who did the intake didn’t know what PMDD was until I broke apart the acronym, which made me nervous. She didn’t know why I would want to try Lupron, Lupron is only for cancer patients. This made me even more nervous. We waited, I kept staring at my husband, and he at me. We are putting so much faith in this and hoping and praying we are not wrong.
It wasn’t a long wait, maybe five minutes. The doctor came in, I felt immediately that he had a very strong personality, very cocky and sure of himself, someone who was very intelligent. I also noticed a warmth and humor radiated from him. I was still nervous as hell. I have been around many charismatic doctors.
I went into this visit armed to the teeth. I went in with lists of all the medications I had been subjected to in the last five years. All the antidepressants, antianxiety, antipsychotics, anticonvulsants, birth control, sleep meds. I wrote my entire history of my menstrual cycles, their changes, my history of PCOS and its symptoms, my experiences after both births. I talked about my reaction to a simple estrogen supplement, the changes it wrought in me in just days.
So after the pleasantries and the doctor asked me what he could do for me, something like this came out of my mouth.
“I have pmdd, premenstrual dysphoric disorder. I was misdiagnosed bipolar II with rapid cycling and treatment resistant for a long time. I recently tried an estrogen herbal supplement that changed my life and came off all my psych meds. It worked but I still have very serious issues. So this is what I want, I want to go on Lupron, induce chemical menopause, for three months, so YOU will feel comfortable in authorizing me to have a full hysterectomy and oophorectomy.”
I was not prepared for his response. He didn’t disagree with me. I don’t remember his exact words (my short term memory is not good) but it blew me away. The rest of the time I was in there talking to him with my husband we talked about how hormones work, about hormone replacement therapy, and how Lupron would actually work on my ovaries. He looked at my medication lists, asked me how I reacted to birth control, and said that I was very educated. I knew what I actually wanted and I understood what the risks were and he would be happy to start the treatment I was requesting. He made some off colored jokes about my husband staying with me through my insanity and all but I didn’t care. He took me seriously! So we discussed timing for the injection, what to expect, and how to start the process. This would be the first of several wonderful conversations with this doctor. I do remember him saying something about this being his first time treating PMDD like this and it would be a cool little experiment. I didn’t care. I was delirious with relief. Most of my information was taken directly from a Dr. John Studd of worldly renown in treatment and therapy of PMDD, so while I was anxious and worried I had some hope.
Getting the Lupron proved to be more difficult but the doctors office staff were miracle workers. That is all I can say on that.
I got through the rest of April with my current normal of depression, weepiness, emotionality, rage and irritability, and more despair and panic. The doctor said it was best to do the Lupron injection day 3-5 of your period. I had hope. It got me through. I struggled with being away from my kids. I struggled with what to do right after the injection. I had heard plenty of horror stories of how hard menopause can be and I didn’t know what my reaction to the Lupron itself would be. A couple days before the shot I confessed to my mom that my anxiety levels would be better if I just stayed for the duration of the first injection. Another month. Now I was going to be gone from my kids for two whole months. This is especially hard because I homeschool my kids, I was around my kids 24/7 and I loved being around my kids. Yes they were difficult at times and sometimes I really needed a break from being with them and I got those breaks. But I never went any amount of time like this away from them. It was hard on me, it was hard on them, it was hard on my parents.
April 26th arrived, the day of my injection. It was just a nurse visit. I fidgeted a lot in the waiting room. All the doubts and fears had surfaced, even though I was supposed to be calm since my period had started. Those doubts and fears are normal in every person regardless of what they suffer from. I was terrified I would be proven wrong, that I was psychotic and that I was untreatable.
I was called back by the nurse. They weighed me and took my blood pressure. She was talking to me about PMDD and kids. She was very sweet and kind. The Lupron is a powder that they mix into liquid to be injected. It is always injected at the hip. It didn’t hurt. It didn’t even sting. I didn’t bleed at all, she couldn’t even find where to put the band aid. She wished me well, I went up to the front and made my next appointment for thirty days. May 24th. Here we go!