I have Bipolar and PMDD. I will share my story incase you can get something out of it.

My bipolar had been stable for 2 years... but then the PMDD turned up. For exactly 9 days of the month, every month, I was depressed, sometimes experiencing something similar to a mixed state, basically batshit crazy, but as soon as the bleeding started I was totally fine again. I recorded my symptoms, and charted my mood carefully, my pdoc then confirmed PMDD. As it the moods were directly hormone related, all we could do was manage them. Upping the antidepressant did nothing so my antipsychotics were upped at that time of the month, which did help but did not completely take away symptoms.

Eventually I got an appointment with a gyno, who suggested the mirena to try to control the hormone shifts (other forms of hormonal birth control were out due to blood clotting disorder). I've had the mirena for a few weeks now. Getting it was painful. I had tried to get it for years before the PMDD but no doctors would approve it since I havent had children. Now they had a good reason to. So far I havent had any depression despite having a period. I am a little more emotional than usual but it is not a mood shift, just run of the mill emotions. I am SO thankful I havent had any depression as it has been a stressful week and Im not sure I could handle a mood shift on top of it. Dont have time to fall into a depressive hole at this time of the year!

PMDD is a very severe form of PMS, my symptoms included depression, severe agitation, sleep disturbance, very high sex drive, massive carbohydrate and sugar cravings, increase in intrusive pure O OCD thoughts, self harm, uncontrollable crying, suicidal idealation and specific suicide plans to name a few. (I have had some of these symptoms in the past when I was younger unrelated to my menstrual cycle, but had not been suicidal or self injuring for a number of years.)

It took me a little while to make the connection but for me the fact that it completely stopped as soon as the bleeding started cemented that this was not purely mental and I started to investigate further.

Im just hoping the mirena is the answer to my prayers, it has quite a few upsides already!