This episode is dedicated to Christina Bohn Rudd, a BYU nursing alumna who died due to premenstrual dysphoric disorder (PMDD). If you or a loved one are struggling with suicidal ideation or contemplating suicide, help is always available. A lifesaving resource is the National Suicide Prevention Lifeline, a service available 24/7 in the United States. If interested, please call 1-800-273-8255.
The fifty-third episode of The College Handoff is “No, It’s Not Normal: Speaking Up for Premenstrual Disorders.” This episode features Laura Murphy, an education director for the International Association for Premenstrual Disorders (IAPMD).
Just like any condition, it’s essential to be aware of the biology behind PMDD when seeking treatment for it. While most people expect PMDD to be caused by a hormonal imbalance, it’s actually caused by hormonal sensitivity. “So the brain has a genetic malfunction where it has an abnormal negative reaction to the normal hormone fluctuations. So PMDD isn’t a hormone imbalance,” Laura explains. “There’s nothing wrong unless someone has an imbalance as well, but that’s not the cause. There’s nothing wrong with the hormones or hormone levels or how they function. It’s during ovulation and around the time of someone’s period when those large fluctuations are happening in the sex hormones that cause the brain has a negative response to those, causing abnormal negative emotional symptoms.”
Laura’s passion for spreading awareness about PMDD began with her own experience with the disorder. “I started having symptoms of premenstrual dysphoric disorder when I was seventeen, and it wasn’t until seventeen years later that I got my answer via Dr. Google, where I found out that PMDD is a thing. So for years, I had suffered from bouts of depression, anxiety, and panic attacks. I’d gone back and forth to the doctor, you know, saying I think I have bipolar disorder and something’s not right. I was saying I have evil PMS. I’d get hypersomnia, so I’d have to sleep for sort of seventeen hours a day and just still feel exhausted in the week running up to my period,” Laura describes. “But as I said, it wasn’t for many years when I finally found out about PMDD that the penny kind of dropped for me. We call it the lightbulb moment–when you realize that all these experiences that you’ve gone through have a meaning, and they’re down to a biological cause. I think so many people put it down to a personality fault, like not being able to cope like other people, not being strong enough like other people, not being able to cope with a bit of PMS like other people. That’s what the doctors were saying: everyone has PMS, and you just have to learn to live with it.”
“So it wasn’t until many years later that I had my answer, and I joined some support groups for PMDD,” she continues. “It was a very jaw-dropping moment of scrolling down this sea of stories, and they were just very similar to mine: walking out of jobs, having panic attacks, not being able to hold down relationships or careers, struggling every month, having bad reactions to birth control. (Looking back, I’ve become suicidal on some forms of birth control and aggressive on others.) So for me, that lightbulb moment was such a change in my life that I kind of became a bit addicted to giving other people hopefully their lightbulb moment.”
“PMDD is so little known about and so little talked about generally among medical professionals as well as the public. So people suffer for years on their own,” Laura says. To emphasize this reality, she shares some jarring statistics that represent the prevalence of PMDD in menstruators. “This is a condition that affects one in twenty women and those assigned females at birth, so it’s not a small or rare condition, although it is a spectrum disorder, so people suffer to different degrees for different lengths of time each month. But 30% of those we surveyed had attempted to take their life while in a PMDD crisis. Parts of the symptoms can be severe depression, anxiety, suicidal thoughts, intrusive thoughts, issues sleeping, changes in diet, and other physical symptoms,” she explains. “I think so many people don’t put the link together between that aspect of suicidality and being so desperate each month during a period. I think PMS for many years has been a punch line and a butt of jokes about female hysteria, but knowing that this disorder can lead to that is kind of scary that not enough people know about it.”
One of the goals of IAPMD is to spread awareness and provide education about premenstrual disorders, including PMDD. However, Laura says one of the keys to achieving this lies in shifting our focus away from society at large. “The focus has to be on healthcare professionals. There is still such a lack of understanding and awareness that we see every day across the groups, and that’s international. There’s not one particular country where people are constantly going to doctors and being told it’s just PMS, or you have bipolar, or you just have to learn to live with it. So I think the focus needs to be on the medical profession,” she states. “We’ve just started at IAPMD a professional community for healthcare professionals and cycle scientists to sort of network, collaborate, and educate because one thing that we’re seeing is we’re creating thousands of patient experts, but when they’re going to see the providers, there’s no one there to help them. So the focus has to be on healthcare professionals looking at patients, seeing if they have any cyclical symptoms, and reacting badly to contraceptives. I think that PMDD is so easy to spot because I see it all the time. I see people talking on television. I see stories in the papers. It’s just obvious. As nurses, you’re in a frontline position and can see if someone’s reporting bad PMS. If someone reports mental health issues, that kind of come and go reports rapid cycling bipolar; it’s an excellent opportunity. All that has to be done is screening, and then get them in front of a provider that understands how to translate that information.”
Also featured in this episode are Marybeth and Steve Bohn, Christina’s parents, who share more about their daughter’s life and legacy and how healthcare workers can be more aware of premenstrual disorders. If you are interested in listening to their interview along with gaining more insights into screening for premenstrual disorders and premenstrual disorder support groups from Laura, visit https://thecollegehandoff.podbean.com/e/no-it-s-not-normal-speaking-up-for-premenstrual-disorders/ or anywhere you listen to podcasts. Additionally, if you want to learn more about Christina, you can read her obituary at https://www.columbiatribune.com/obituaries/pclm0093521