Have you ever felt like you’re losing your mind for half the month only to wake up a few days later wondering what just happened?
You’re not alone.
Have you ever sobbed from the depths of your soul, snapped at someone you love, or fantasized about disappearing, only to feel totally fine a week later?
You might be dealing with Premenstrual Dysphoric Disorder (PMDD).
PMDD is more than PMS. It’s a severe, hormone-based mood disorder that impacts around 5–10% of menstruating people, though many go undiagnosed or misdiagnosed for years. And if you're also navigating motherhood, postpartum changes, or societal expectations of being a "good mom," PMDD can feel like an absolute tidal wave that keeps dragging you under.
What Is PMDD?
PMDD is a cyclical disorder, meaning symptoms return predictably during the luteal phase (the 1–2 weeks before menstruation). It affects mood, thoughts, and physical well-being in ways that can be destabilizing, especially when misunderstood or minimized.
Common PMDD symptoms:
- Sudden mood shifts or rage
- Suicidal thoughts or feelings of hopelessness
- Extreme sensitivity to rejection
- Panic attacks or anxiety spikes
- Fatigue, brain fog, insomnia
- Difficulty parenting or managing day-to-day tasks
The contrast between who you feel like during your follicular phase (after your period) and your luteal phase can be mind blowing. You may feel like you're two different people, which is terrifying for anyone, but especially for moms already juggling so much.
PMDD, Motherhood, and the Mental Load
For moms, PMDD doesn't exist in a vacuum. You're not just managing your cycle; you're also::
- Taking care of a baby or child
- Often sleep-deprived
- Expected to be emotionally available 24/7
- Navigating feeding, school, or sensory issues
- Shouldering the invisible mental load of family life
This is where PMDD intersects painfully with maternal mental health. It can mimic or worsen postpartum depression, anxiety, and even OCD. Many moms describe “rage,” uncontrollable sobbing, or deep shame that lands like clockwork before their period…and then disappears just as fast, leaving guilt in its place.
And society? It rarely gives you permission to rest, rage, or fall apart. You're expected to smile, meal-plan, and be grateful. But PMDD can make that feel impossible, and you are not weak because of that.
Suicide and PMDD: What Needs to Be Said
It’s critical to name this: suicidal ideation is a common symptom of PMDD. Not because you don’t love your life or your children, but because your brain, during this phase, is impacted by hormonal sensitivity that can distort your thinking and shut down your hope.
If you’ve ever felt like ending your life during this phase, you are not alone, and there is help. The thoughts may feel real, but they are not permanent. Treatments work. Connection helps. Naming it out loud changes everything.
If you or someone you love is having thoughts of self-harm or suicide, please reach out to the 988 Lifeline or a trusted mental health provider.
How a Psychotherapist Can Help – Especially with ACT
As a psychotherapist specializing in maternal mental health, I’ve seen how life-changing therapy can be for PMDD, especially when paired with a compassionate, values-based approach like Acceptance and Commitment Therapy (ACT).
Here’s how ACT can help:
1. Defusion:
Defusion is a technique used in Acceptance and Commitment Therapy (ACT), it teaches you how to separate yourself from your thoughts. Instead of “I’m a terrible mom,” we shift to, “I’m having the thought that I’m a terrible mom.” That tiny shift creates space between you and your PMDD brain, making room for self-compassion and grounded choices.
2. Values Clarification:
When everything feels chaotic, ACT brings you back to your core values, the mom, partner, human you want to be. Even when you're not feeling like yourself, you can still act from your values. It’s not about fixing yourself. It’s about anchoring to what matters.
3. Willingness & Self-Compassion:
PMDD hurts. ACT invites us to make room for that pain without judging ourselves for having it. You learn to say, “This is really hard, and I’m still here.” You stop fighting the wave and start surfing it with skill.
4. Committed Action:
We can’t make PMDD disappear overnight, but you can take small, meaningful steps like tracking your cycle, asking for help, setting boundaries, and carving out rest during hard weeks. Action rooted in compassion, not perfection.
What You Can Do Today
- Track Your Cycle: Apps like Me v PMDD or simple journaling can help you connect the dots.
- Build a Luteal Plan: Schedule lighter tasks, ask for help, and prep easy meals when you’re feeling good.
- Talk to a Provider: Psychotherapy, birth control, antidepressants, and lifestyle changes are all on the table.
