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Originally Posted by tradika
The difference is if it always hits before your period (may be a little more diagnostically complex if hypomanic symptoms are present though because it's generally depression/anxiety/irritability). Otherwise, I believe it's considered exacerbation of your per-existing condition . However, if antidepressants don't work (or your bipolar and can't take them), that doesn't mean that it isn't PMDD. Some people do not respond to Sarafem/Zoloft. I think they try a specific type of birth control, and there is another treatment which I can't think of off the top of my head. Plus, a bunch of other non-prescription treatments.
My diagnosed PMDD is so very predictable. If I experience any hormonal fluctuations I begin to have rapid mood swings similar to what you are describing. There isn't so much of a euphoria but agitated irritability (depression isn't always present in these states in the traditional sense) to the level I could send tables flying. I feel severe depression, agitation, and I pace, disassociate, sleep less, feel rejection sensitive paranoia, anxiety, etc. These comes in cycles, and in between I am happy and chatty. If they do not resolve, I know that I've just hit a really bad case of it. My functioning hits bottom, and I just wait for it to go away.
Oh, and I'm experiencing it now! How exciting!
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SSRIs never did anything for me except make me realize that my problem wasn't just PMDD. That's actually how I started my "journey" (s into therapy and medication. I went to my gyno about PMDD. She gave me Prozac. I took it. It worked a little. I realized I needed it more, not just for PMDD. And then it quickly stopped working. SNRIs work better, though mine kinda failed me last month (not for PMDD) but that's partially why I started Topamax.
You sound just like me, though! I become a ragey mess. The agitated irritability where you could send tables flying -- and I have destructive fantasies constantly when I get like that. I just want to put my fist through everything and tear off my skin. I get just about evety symptom you named - even the dissassociative symptom. I experience derealization, most likely due to my anxiety.
I hate birth control. It makes me gain weight and it makes me cry easily. I don't cry easily. It takes a lot for me to cry, or certain buttons have to be pushed. And while there are times I wish I could cry, because I could desperately use the catharsis, the last time I was on birth control I felt like I was PMSing all the time, I was crying every week, and I just can't go back on it. It was terrible. I've tried it several times. Hated it every time. I know, you're going to say, "Fine Mary, suffer!" But hopefully the Topamax helps alleviate some of the symptoms . . . We'll see.