Wednesday, April 24, 2019

"Such a Man!"

Fighting Back Harder: A PMDD Case Study from A Husband's Point of View

Updated: Mar 29


INTRO: A friend of mine sent this very personal narrative to me almost 5 months ago (on my birthday I might add). A few years earlier he had read an older post of mine about my own experience trying to make sense of my PMDD and promptly messaged me "SUSIE WE HAVE TO TALK!". We did. It was the first time I realized that sharing my experience could actually help another feel "NOT ALONE". It was so obvious that this guy loved and adored his wife. He had wooed and married her and had felt he'd gotten the far better end of the deal. He was ecstatic to be getting closer to the true character of his wife's mood disorder and saw the light at the end of the tunnel. Thankfully he is very expressive, and could barely contain himself to ask me if I could publish this for him, with the agreement that he remain anonymous to protect his wife's privacy. THIS IS NOT EVERY WOMAN OR PARTNER's EXPERIENCE WITH PMDD OR WITH GETTING A PROPER DIAGNOSIS & TREATMENT PLAN. I hesitated to go forward because light is still being shed on this disorder and every case is different in what can agitate it to the point of dysfunction and dispruption in one's life. There is definitely something going on with the woman's personal sensitivity to even NORMAL hormonal changes let alone when you add synthetic birth control or any hormone supplement or replacement. It could be the metaphorical difference between blowing gently on a flame and throwing kerosine on it. In any case, it is extremely rare to get the partner's point of view and experience. Most partners of women desperately trying to hold onto some semblance of normal, are being tossed in a sea of confusion alongside their partner. I admire how this friend "went to bat" for his wife, demanding that she and he be heard. To that I say: "What a man." Here are his words.
"Let me begin with the conclusion. PMDD(pre-menstrual dysphoric disorder) is a significantly underdiagnosed, misdiagnosed, and misunderstood medical condition that impacts far more women in the world than reported and it can be SEVERE. Here is the story.
My wife suffered from painful and long periods. They were just awful. On top of it she would have bouts of depression. As our marriage continued her depression only increased. Her gynecologist put her on birth control pills and told her to see a psychiatrist. The psychiatrist told her she had major depression and gave her lots of pills. Her depression went from mild to severe. During the severe cases she was hospitalized. She never tried to kill herself but she absolutely couldn’t handle her state of being and sometimes she would hurt herself just to feel something- ANYTHING. Some mental health programs were outpatient and some were inpatient. I absolutely did not accept the diagnosis of major depression. I explained that this is not who my wife is. I was looked upon as someone who simply didn’t want his wife this way; like I was trying to change her into something she is not. I explained that I know who she is and this is not her- something is causing it. Multiple doctors explained that the issue was psychological. None of the doctors could point to a reason or cause. Their diagnosis was based on symptoms. I was determined to find the cause. It was a broad search at first.
Her depression started to come on in her teenage years and it just grew from there. By the time we were married it started to get bad. A year or so into our marriage it increased to severe: inability to go out, to see people, to even shower. (This went on for years- and I refer to this part of our lives as "the dark ages"). I remember bringing her to the store one night and she had a breakdown in the ice cream isle because she couldn’t figure out which ice cream to get. That started off a very bad episode of “depression”. Depression is like a dark storm where you can’t see anything clearly and you are pelted with winds of self-hate, your future seems bleak and hopeless, and your past takes on the beauty of a mud puddle. I realized this was getting severe. She had many many many therapists; therapist in person, therapists over the phone, so many ways we tried to work with her but there was something inside of her fighting back harder.
Her periods were rough from the start but they also grew in severity. When her period started surpassing 30 days more than once a year I realized this was getting really bad. By the time she had her 3rd D&C I realized this was a severe problem.


The third time she was in the mental health hospital I was on my way to visit her and she called me and told me to pick up tampons. I didn’t even have to ask what flavor- purple, max, overnight with wings. I also got a small bag of gummy worms and started taking some of the tampons out of the box and filling them up with gummy worms- since she loves gummy worms and can’t have candy in the hospital- they literally check everything- so I thought it was fun to sneak contraband in there. As I am stuffing the gummy worms in the tampon box I realize I have been to this pharmacy 3 times now. Each time she was hospitalized I had to go buy her tampons. This is a pattern.

I started my research with 2 truths: 1. her depression is not who she is, it is caused by something. And 2: her lady plumbing is messed up. I spent years researching this. Many nights were spent with Doctor Google. I found a website that let me buy time to communicate with a doctor overseas. We chatted back and forth for a while one night, discussing hormones. Finally, after my wife had had her second dilation and curettage (D&C) and started bleeding again her doctor suggested a drug called Lupron. Lupron is administered through an injection and it puts a woman’s body into menopause for 6 months. You stop ovulating- no periods for 6 months. It is usually administered back-to-back with a compliment dose giving you a total of 12 months of no periods. Sounds like paradise, right? …lets see…

So she got the shot of Lupron. Within a few days she went nuts. As the days went on she went CRAZY. Crazy doesn’t even begin to describe her as the days continued. See if you can figure out what I am saying if I give you the words Batman, poop, and crazy (editor's note: I still haven't figured this out. Someone please enlighten me!) That’s the kind of crazy I am talking about and just a few weeks after the dose she had to be admitted to the mental health facility again. And she had art therapy and group discussion and psychology appointments and psychiatry appointments and she was getting “better” and then BETTER and then BETTER! And this time the facility really helped her! And she was doing GREAT! And she came home feeling great! And she just needed to get in touch with her feelings. And she was far more capable now. She was happier and brighter and more down-to-earth. And she got her second shot of Lupron and she was still fine and then a few months later she started to bleed. And it wasn’t just a little blood. It was a monsoon of blood that didn’t let up for over a month. Her body declared war on her for going so long without bleeding. Those friggin' ovaries, those “mean girls,” decided they were going to teach my wife a lesson once and for all. I really hate those bitches, I really do! And so this opened up a tidal wave of blood and pain that just wouldn’t end.
About this time my research came up with a very RARE diagnosis called PMDD (premenstrual dysphoric disorder). As I researched PMDD I came to a blog written by a very brave woman who explained her bouts with depression and her decision to have her ovaries removed to help her mental condition (https://msjekyllhyde.wordpress.com) And it worked. This was intriguing. And so now I had evidence of a patient who got rid of their ovaries and it greatly reduced their depression. This is something counter to what doctors had explained! My wife fit ALL of the symptoms for PMDD. And so I started running with the theory that my wife had PMDD. I started doing more research.
The research into estrogen was the big eye-opener. Estrogen is talked about a lot but understands a little. The FDA would never allow a doctor to prescribe the amount or estrogen a woman can get in a day. It's also so hard to measure hormone levels because they change so much over the course of a day. But estrogen is an interesting little hormone. You see it DIRECTLY impacts the serotonin in your head. Now serotonin is something I had read a lot about. Many of my wife’s pills for her depression were aimed at impacting her serotonin levels. When people take drugs and self medicate they are usually trying to alter the serotonin levels in their head. This is what changes how we feel. Let that sink in. And so I discover that serotonin is directly impacted by estrogen. So now lets run with the theory that my wife does not get a steady flow of estrogen. A more traditional cycle sends estrogen into the serotonin river like a hose pouring water. My wife’s estrogen is released like a firehose and then trickle and then a firehose and a trickle or anything but a consistent flow. This makes her feel awful. And then came the Lupron. It made her crazy…and then she was fine.
I discussed this with her gynecologist- he is a wonderful man who was fellowship trained but he had no idea what PMDD was. He dismissed it and suggested she try more birth control pills- "let's go ahead and double it- I dare your uterus to bleed through that!" (by the way- don’t taunt your uterus…ever) Birth control pills are frequently prescribed when not needed or prescribed for convenience and frequently they are OVERPRESCRIBED because they are very misunderstood. I finally begged my wife to see a professional who specialized in PMDD and she reluctantly agreed. I called UCLA in an attempt to get someone top-notch in the field. I screened them all to find a gynecologist who had a lot of experience with PMDD and bonus- the doctor was a woman! So we met with her and she was so kind and sympathetic and she prescribed my wife 3 birth control pills a day and insisted that would teach your cycle who is boss! And about 2 months later my wife's bleeding was so bad and her pain was so severe we returned to see that doctor and the doctor said my wife should not be bleeding. I volunteered that my wife had a hormone problem and it needs to be fixed. I stated the estrogen was making her bleed. The doctor lost it and she yelled out something like this- “Such a man! SUCH A MAN TO SAY IT'S ALL HORMONES! SHE ISN’T GETTING ESTROGEN SO IT'S NOT CAUSING HER TO BLEED!” I calmly explained that it was all hormones and that the only way a woman can bleed is through hormones and the mere fact that she was bleeding was proof that she was getting estrogen and that her body's ovaries are just on overdrive and they are spitting out hormones that are messing with her lady parts and her brain. I was now more convinced than ever that the ovaries were the main culprit for my wife’s gynecological issues and her mental issues. I begged my wife to get her ovaries removed. She would not. I respected her decision since they are her ovaries and I would not take kindly to someone telling me to lose my balls.
A few years went by and she started to have a lot of abdominal pain. Turns out she had a cyst on one of her ovaries. The pathology was a bit fuzzy and he recommended a hysterectomy. So she did it. A few days later, as she was recovering, she started to spiral out of control. It was horrible. Secretly I was so excited and happy about it! You see what was happening here? It was the same thing that happened with the Lupron. The Lupron shut her ovaries down- the hysterectomy takes her ovaries out! She was having the same reaction to the hysterectomy as she did to the Lupron. And then a few weeks later it was like the dark clouds of depression cleared and revealed a beautiful blue sky! My wife is completely different now. She is able. She drives places. She wrangles our kid LIKE A BOSS. She runs to Costco like a champ! She owns Target! She does the school drop off, pick up, handles appointments, and bathes daily! She still deals with depression but not a tenth of what she used to deal with. I have my wife back! And as for her ovaries….wherever her ovaries are, I hope they are rotting in hell.
The point of me writing this is to let you know that many women have this problem. There is a reason why so many more women deal with major depression than men. It’s because of the estrogen. Women who have painful periods and bleed heavily and have severe depression please take note. It’s not your fault. Your ovaries hate you. The way you test and see if you have PMDD is you ask for Lupron from your gynecologist. They will likely give it to you to see if it helps you stop bleeding. If you go crazy for the first month and then feel a LOT BETTER for 5 months then chances are your ovaries and you are not on good terms and it's either you or them in a cage match of death. Many women have committed suicide because of PMDD. It is a killer. Their ovaries drove them to do it. Their ovaries were pumping such massive and inconsistent quantities of estrogen into their serotonin stream that there was no recovery from the free-fall. There was no anti-depressant strong enough to counterbalance it.
Anyway, that’s my story. My wife has gotten so much better I now stick out as the crazy depressed one in our family and she helps me. A lot. I love her to pieces. I’ve always loved her, just not all of her. In truth, I never loved her ovaries. I’m glad she won that cage match. I wish the doctor could have given me her ovaries so I could throw them off the roof of the hospital, run over them with my car, stomp my foot on them, feed them to a colony of dung-beetles, and then burn everything with a blowtorch. That would have felt goooooood."



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