August 2007

Managing PMS positively

7 Sep 2007

Susan Quilliam, relationship psychologist and agony aunt helps guide us through some of the ways in which we can try and help make our premenstrual period more manageable.

An estimated 90% of women suffer from some form of PMS
35% of women say PMS interferes with their lives.
The most common age for PMS to develop or worsen is mid-thirties.
Stress, genetics, age, number of children, diet and chronic disease can all affect PMS.

If you're a woman, you probably know the feeling. You ache... you feel nauseous... you're exhausted...everything jars and irritates... you feel fat... you hate your partner... you feel everything is your fault... . In short, you have premenstrual syndrome!

Personally I know about PMS only too well - I suffered from it for 35 years. Professionally, I know about it too: in my role as an agony aunt, I receive 25,000 letters each year and many are from women who suffer from PMS - or from their partners, children, or friends.

"They write to me things such as "I feel so guilty at being like this...", "The only way I survive the month is if a miracle happens." "Our love is ruined." "This is my life now, for always." "PMS dominates everything." These words break my heart.

Pessimistic thinking

Recently, however, I realised that they remind me of the work of Martin Seligman, a psychologist based at the University of Pennsylvania and who studies optimism and pessimism - thought patterns that make people feel constantly positive or negative. Seligman identified five pessimistic thought patterns: taking all the blame for bad things... thinking that progress is down to luck not your own success.. seeing the bad as affecting everything... thinking the bad will last for ever... feeling more strongly about the bad than the good.

Sound familiar? This is just what we PMS sufferers do. We take the blame for our illness - "I feel so guilty being like this". We think progress isn't down to our success. "The only way I survive the month is if a miracle happens." We see PMS as affecting everything. "Our love is ruined." We imagine PMS will last forever. "This is my life now, for always." And we feel more strongly about PMS than about the good in our lives. "PMS dominates everything".

Optimistic thinking

When we're in the middle of PMS, such thoughts are all too real. But they're just one kind of thinking. So what would happen if we thought a different way?

When Martin Seligman explored that different way of thinking - optimism - he identified the following five strategies: realising that we're often not to blame for problems... taking the credit for success... keeping the bad stuff separate and not letting it affect everything... remembering positive times... and feeling more strongly about the good than about the bad.

So how would we think about PMS if we thought optimistically rather than pessimistically? We might realise that PMS is a medical condition, not our fault...we might feel good that we've taken action to recover... we might see PMS as only one aspect of our lives ... we might realise that usually, PMS affects only a proportion of each month... we might focus on the good feelings in our life, not the bad feelings of our condition. In all these ways, it's possible to get PMS in perspective.

Why not...

1. stop taking the blame... realise problems come from the outside
2. stop thinking progress isn't down to personal success ... take the credit
3. stop seeing the bad affecting everything... keep the bad separate
4. stop thinking the bad will last for ever...remember the positive times
5. stop feeling more strongly about the bad... feel more strongly about the good

Getting support

I'm not saying that switching thought patterns like this is simple - if it were, we'd already have done it - but Seligman suggests that there are ways forward. Happily, PMS sufferers have four key resources here.

1. Unlike many other illnesses or conditions, PMS has a 'reprieve', a monthly break when you can step back and realise that PMS isn't the 'real you' and doesn't last for ever.
2. Family, friends, partners - who aren't suffering from PMS - can provide an external perspective on the situation.
3. Health professionals - your practice nurse or GP - can help medically and with information and advice.
4. The National Association for Premenstrual Syndrome - NAPS (www.pms.org.uk) - offers many resources, including an online medical panel and a user forum.
   

Action Plan

So how to think differently? You can begin to realise PMS is not your fault by really grasping that it is a medical condition. It'll help to actively find out the facts, do your research, discover all you can about the biological background to PMS, why it happens, what causes it - and what can alleviate the symptoms. Doing that not only makes you feel more in control; it also reminds you that PMS is something external, an outside enemy. Your medical professional and NAPS can give you information and diagnosis; your loved ones can keep reminding you that you are not to blame here.

How to start taking the credit? The key thing here is to rigorously note when you make progress - dwell on that, think it through, work out what you did to create that progress, and appreciate yourself for that. Here it'll help to diarise your PMS - not only so you can chart when it affects you badly, but perhaps more importantly chart when it doesn't bowl you over, when you're coping with it better than you did.

Helpfully, you can get a printable chart from the NAPS website or by telephoning them. It's designed to show your symptoms month on month; fill it in daily and get your partner to fill it in too - they will almost certainly see symptoms arising, or improvement showing, before you do. Crucially, celebrate progress not as sheer luck but as proof you've taking action that works.

How to keep the bad separate, and not generalise it through your whole life? First, get more resilient about when things go wrong; making mistakes, getting tearful or angry does not mean you're a terrible person or that the world is at an end. Also, become aware of your strengths, the ways in which you're bright, capable, loving - get your loved ones to tell you what they value about you and write the positives down as a reminder for when you're feeling particularly awful.

Your loved ones can support you by...
... gently pointing out when you're thinking pessimistically
... helping you to be interested in other aspects of life than PMS
... celebrating your personal strengths, spells when you don't have PMS, or your victories over the condition

How to remember the positive times? Once again use a diary. It'll help you mark when PMS starts, so you can expect pessimistic thought patterns and guard against them. It'll help you know how many days it will be until you feel well again - give you something to hang on for. Put in your diary active reminders of the good times - a theatre programme, restaurant bill or a photo of that day at the zoo - and get family and friends to remind you that "you felt good last Thursday - you'll feel good again."

Finally, how to feel more strongly about the good than the bad? Quite simply, put more emotional energy into the times you're not suffering. Yes, it's tempting to spend all your energy in 'solving the problem' of PMS, whether it's that time of the month; but if you do that, the condition will literally take over your whole life. Instead, during spells you feel better, concentrate on having fun, building relationships, celebrating your progress.

You can do it

Developing optimistic rather than pessimistic thought patterns isn't something PMS sufferers can achieve overnight. But it is something that our bodies and minds will naturally want to do - because it not only feels good short term to be positive, but because it's also better for us long term. So as with a car that needs a bump-start in order to get rolling, if we start thinking positively, that will build up energy and prime our whole system to respond enthusiastically.

Determination, self belief - and some help from friends and professionals - and it is possible to turn thinking patterns around.

Your health professional can support you by...
...giving you information about your condition
...developing a treatment plan which may include medication
...referring you for counselling if necessary
.... contacting The National Association for Premenstrual Syndrome on 0870 777 2178 or at www.pms.org.uk

The article was reproduced courtesy of Women’s Health magazine. If you would like further information or help from Susan you can visit her exciting new website on www.susanquilliam.com .