April 2009

Paula was suffering, but patience, and her determination to find help paid off.

I don't remember when my PMS started. I can remember however, realising that I had it though when I was probably about 29.

I had been married young and then divorced a few years later and I can remember feeling angry, so angry all of the time. On reflection, I realise that I did have PMS but had no idea and, of course, my terrible situation at the time only exacerbated the symptoms. It was like being in a thorny hedgerow and I had no clue how to escape.

When I did eventually discover that there was a link to my moods and my monthly cycle, I took myself off to my G.P. (Much to my disgust I must say that up until then I did not believe PMS existed except in the minds of females who used it as an excuse to throw a tantrum - Ha! - how naive I was!) I remember telling the doctor what I had discovered and expected to hear from him that there would be a 'cure'!! I do laugh at this now because all my G.P. did was to lean back in his chair, give a big sigh and tell me I would have to live with it until I hit the menopause!!

That, I am afraid to say, was not a good enough answer for me. I challenged him and asked him to refer me to a specialist. He said he didn't know of any in Liverpool. Great!

I went home and after this returned to the G.P. on several occasions almost begging for help because I thought I was losing my mind, literally going mad, until I saw a sign in the G.P.'s waiting room telling me of 'Mental Health Services in Liverpool'. I took the phone number and rang it. They then referred me to 'WHISC', which is the 'Women's Health Information & Support Centre'. I rang them not expecting anything and they gave me the number for NAPS. I rang NAPS immediately and spoke to a lovely nurse on the helpline called Barbara.

All I can say is, what a revelation to discover that I was not going mad, I was not losing my mind, and I certainly was not the only woman on earth to feel like I was feeling. I can remember how I cried and cried down the phone to Barbara because I felt utterly useless at the thought that I knew my kitchen cupboards needed cleaning out and yet all I wanted to do was to curl up in a ball, close my eyes and never wake up because of how low I felt. I felt useless, unworthy of anything or anyone and so guilty because of the thoughts of anger I had whirling around in my head. The anger caused me more pain than I can possibly express. I would be so, so angry at everything and then the guilt would overwhelm me and I would sob and sob for hours feeling exhausted, completely miserable and so utterly alone.

Needless to say, even with the wonderful support of NAPS, I was becoming seriously depressed because of the PMS. My symptoms would start to appear on or around, day 18 of my cycle and that would last until my period started. I would, by that time, be exhausted and worn out and would want to just sleep for days. Obviously a person can't do that because you do have to get on with life and go to work and I was always in trouble at work for taking time off.

Another very, very distressing part of PMS is that employers do not recognise it and so you are under pressure to perform at work, as well as just try and control the symptoms, which, when you fail to do, cause you to believe yourself to be an utter, utter failure because you are unable to 'get a grip' of yourself and 'sort yourself out'.

Every month I would promise myself it 'wouldn't happen again' and when it did, well, real depression set in and I became really frightened for my own mental health.

After much advice from NAPS, I had asked my doctor to try me on Prozac. Although it is licensed for PMS, it did not agree with me and so that attempt to try and control the PMS failed me. I then tried a similar product called Seroxat which I took for some months with a little success, then came off that because of the media scare at the time regarding the drug.

I continued on until the very supportive Christine Baker, who then worked for NAPS, told me of a specialist clinic in Leeds. I then had to go back to the G.P. for an NHS referral and after a couple of months, I went to Leeds General and saw an amazing doctor.

I had to go away and take charts of my symptoms for three months and in the meantime, the doctor gave me Cipramil, which, like the Prozac and Seroxat, is an SSRI (selective serotonin reuptake inhibitor) but is not related to that particular family of SSRI's. For the next three months, I was almost free of the symptoms. I could not believe it. Each month, I woke up on day 18 terrified my symptoms would come back and it took me a long time to realise and to trust in the medication, that they wouldn't. That was probably about 10 years ago and I haven't looked back.

I started out initially taking 20 mgs per day from day 15 then on day 1, I would alternate the dosage from 10 mgs one day and 20 mgs the next until back to day 15 and then 20mgs every day. However, I have to admit that after 10 or so years of taking this, the effect started to lessen last year. I went back to Leeds and we discussed about what options were open to me. I did also think of having a hysterectomy to have complete closure of PMS but elective hysterectomy on a 41 year old woman with no children is deemed far too drastic so rather than battle with my G.P., I decided, with the help of a new G.P. to my surgery, to increase the dosage of the Cipramil to 40 mgs per day and no alternating the medication, to just stick to that. I am happy to report that my symptoms have once again lessened. I have maybe a few hours when I could quite happily strangle the kid in the queue with its mother in the supermarket for banging into my trolley over and over with an evil glint in its eye but apart from that, I am relatively PMS free.

I would like to tell you though that, as well as the drugs, I did go to counselling. I went for about 12 months to see a wonderful lady called Yasmine who helped me understand that the guilt I was feeling about how useless I was in being unable to control my PMS was not abnormal. She helped me realise that I was normal, I wasn't a lunatic to be avoided, as many people hilariously think and do let you know in no uncertain terms, and that the fact I can't clean out the kitchen cupboards at a particular time of the month is absolutely no big deal whatsoever!!

Also, I know that your diet plays a massive part of managing your PMS. I am a coffee lover and if I do drink too much of it at any time of the month it's not good for me because it makes me agitated, so I do cut down a lot during my premenstrual time. I also eat something every 2-3 hours to keep my blood-sugar level up so that I don't have a massive drop in levels which then causes me to become exhausted and over tired. It doesn't have to be anything fattening, I eat crisp breads and fruit. It's the carbohydrates that are needed more than anything to slowly release sugar throughout the day, but keeping it topped up with small carb' snacks is important. Eat first thing in the morning and last thing at night so that you don't wake up with that lousy exhausted, 'hung over' feeling.

I urge you ladies to torment your G.P. and get the help and support you deserve. I suffered for a long, long time with PMS and it almost took over my life and ruined it but with the wonderful, never ending support of NAPS and the help of Julie Ayres and my new G.P., I have my life back. I do not have to worry any more about arranging days or nights out around my cycle nor about whether or not I can cope with certain situations. I just go about my life as normal. As long as I look after my diet when I need to, I am usually pretty O.K. nowadays.

The most important thing to me was that I never gave up on myself. I believed somewhere in me that I could fight this and it terrifies me and saddens me greatly to think that there are so many of you suffering as you read this. It makes me so angry at unsympathetic G.P.s who have no conception of the torture PMS sufferers endure not just once a month but throughout the month as the knowledge that you are going to have to suffer again in the upcoming weeks is extremely debilitating to a person’s psyche, which in itself, causes horrendous depression as it did to me.

Many years ago, women with postnatal depression were locked up in asylums. Nowadays, it is a recognised illness and although the attitude to PMS is not so archaic any more, it is still not a properly recognised medical condition. It is, I find, still very much a 'taboo' subject that many people do not believe in. I am completely unwilling to accept this and will continue to speak out about it whenever I can to help as many people as possible understand and recognise the seriousness of this illness.

Thank you for reading this and I hope I have given a little hope to at least some of you out there. Just please, please don't give up on yourselves. Each and every one of you deserves help and support and until we begin demanding this, we won't get it!

Good luck to you all.

NAPS comment

We are grateful to Paula for being such an inspiration to others and for demonstrating the importance of NAPS advice, information and support, to the successful management of PMS