For two weeks every month, Carrickfergus woman Melanie Galbraith, 31, used to be engulfed in a depression so deep she often felt “suicidal”.
The A&E nurse said the symptoms of premenstrual dyshoric disorder, a severe form of premenstrual syndrome, turned her life upside down, causing severe fatigue, mood swings, irritability and depression.
“Whenever you are in the moment, all you can think about is how am I going to keep on living my life this way - every two weeks feeling OK, then not OK.”
So severe has the impact been, that Melanie literally has to work around her symptoms, giving up her full-time job to join a nursing agency which allows her the flexibility to work when she is feeling well.
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She said: “I was in a full-time post as an A&E nurse and obviously you are on a rota with different shifts. You just have to really try and get on with it as much as it’s affecting you, but whenever you are doing that job and feeling fatigued, maybe not sleeping, having low self-esteem, you’re getting hot flushes, whenever you are in that environment and you are running around, going through that, it’s difficult, but you have to override it because obviously your patients come first. I obviously have a duty of care to my patients and myself, so I would never have considered going into work when I was so low, this resulted in multiple periods of sick leave.
“But I did leave my full-time post and joined with an agency, so it means I work as much as I can when I feel well and then when I know I’m at that point where I can’t, I take time off.”
Melanie said the symptoms of premenstrual dysphoric disorder, or PMDD – have dogged her for years, although she was only diagnosed two and a half years ago.
“From the age of 14 or 15 I remember starting to get suicidal thoughts. I didn’t know at that time that it was linked to my menstrual cycle. I would take these moods for about two weeks and I would just be so angry and agitated.
“I know as a teenager you are hormonal, but I remember having these really big fights with my mum. I would lash out and then I would lock myself away.”
She said family holidays were also blighted by her symptoms.
“I remember for the two weeks of the holiday being in completely terrible form, crying, angry, my whole mood just completely changed and then the day I got home, I got my period and all that went away. I do also have polycystic ovaries and endometriosis, which doesn’t help.”
It is thought PMDD affects one in 20 women of reproductive age. It’s caused by fluctuations in hormone levels which affect brain chemistry and result in severe mood disturbances.
Unlike PMS, which hits two to four days out from menstruation with various physical and emotional symptoms, the onset of PMDD is one to two weeks before a woman gets her period, known as the luteal phase. It results in a sudden and significant depression and lifts just as abruptly when the woman’s period begins.
Over the years Melanie has tried “every treatment” to ease her symptoms, including having a contraceptive, progesterone-only implant to stop her periods, which had catastrophic results.
“Within five weeks my mum had me back at the GP demanding it be removed because the hormones were driving me crazy. I was crying, feeling suicidal, not sleeping.”
She added: “I’ve tried everything. I’ve tried the progesterone-only pill, the combined pill, the coil and the implant, nothing worked to help the PMDD. The only thing I would say that has helped is CBT and antidepressants. Exercise and healthy eating help, but it (PMDD) never goes away.”
She said medics ‘‘only started listening to her’’ recently, when she was older.
“I’ve been tracking this for a few years. Eventually two and a half years ago. I saw a doctor who did help me. He put me through a six-month menopause to see if that helped. Unfortunately it didn’t help, but I feel he was the first person to really listen to me.
“Then I was referred on to mental health services. PMDD is sensitivity to hormones, but it creates mental health problems. So I then was under the care of a psychiatrist and he did help and I felt he did listen and he was able to help me with medication to try and get it under control. Now I take an anti-depressant every day.”
Melanie said she “really had to fight” to get CBT (Cognitive Behavioural Therapy), a type of talking therapy.
“They said at the start they didn’t think it would be beneficial, but I kept on fighting for it and eventually got it. I feel that is something that has, really helped because it’s about acceptance of what your life is and what you are going to have to deal with. It has given me better coping mechanisms and when you are having really bad days, they give you techniques and tools to help you deal with it better.”
But she said the condition is “always going to be there” unless she has her ovaries removed.
“It is definitely something that I am considering, possibly not right now. I’m going to give myself three or four years depending on how bad it gets. It’s a big decision, because I never thought I wanted children until the last couple of years.”
PMDD, according to Melanie, also has an impact on relationships.
“This condition makes it extremely difficult to have what you would call a normal relationship. It can make you unreliable, where you have to cancel plans and you can have very low self-esteem. I think a partner watching you going through that, crying uncontrollably, doesn’t know what to do.
“They can try to support you as best they can, but can often feel helpess themselves.”
But Melanie said she has found support through online groups.
“When I discovered women speaking out, I didn’t feel as alone because for such a long time I felt so, so isolated. I could talk to my mum and my friends about it, but they don’t go through it.”
And she believes there is a reticence to talk about women’s health, particularly anything to do with the menstrual cycle.
“I didn’t realise that it’s such a high percentage of one in 20 women who suffer from PMDD.
“I’d say it’s more than that because it’s not talked about.
“Talking about suicide, I just think it’s something people are scared to speak out about, especially if it is linked to women’s health.
“I decided to speak up about it, because I thought if I don’t, who else is going to?”
“CBT has really helped me fight through the barrier and I have become a lot more resilient, however I still experience some of the symptoms, but they do not impact on my life so much anymore.
“I do feel like I have got my life back and am moving forward and I would like to start up a support group to help other women.
“I would like women to know there is light at the end of a very dark tunnel.”
*If you, or someone you know is crisis, Lifeline can be contacted on 0808 808 8000
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