Episode 362: PMDD Treatment & Dealing with Scary Ex

Hello, everyone! I hope you are doing super well. As always, I really appreciate your attention. A special thank you to everyone that has left feedback for me about the show. Very helpful. In this weeks episode, I tackle the following questions:

  • Could my symptoms be PMDD and if so, how do I get help?
  • What can I do about my ex that is spreading harmful lies about me?

As always, you can send me questions to duffthepsych@gmail.com and find the show notes for this episode at http://duffthepsych.com/episode362


This episode is sponsored by BetterHelp. If you could use the support of a therapist to help you navigate life’s challenge. Check out BetterHelp and get connected to a licensed therapist quickly, entirely online. Visit http://betterhelp.com/duff for 10% off your first month.

This episode is also sponsored by OneSkin. If you’re like me and would like a simple skincare routine that is backed by clinical research, then OneSkin is for you. Visit http://oneskin.co and use the code “duff” for 15% off.

Question 1:

Hello Dr. Duff,

I recently found your podcast and it has been very helpful, especially the episodes on anxiety and stress. Thank you ahead of time for the awesome work you have done already and look forward to listening to more episodes in the future.

Here is my question:

As with many, I have struggled with pandemic-induced anxiety and depression and have been trying to address it through therapy. My anxiety has greatly improved however, depression continues to be a cyclical problem for me. It comes as a crashing wave of sadness, low self-esteem, and irritability a few days before my period when my body’s hormones are gearing up. I’ve recently heard about PMDD (Premenstrual Dysphoric Disorder) and I’m wondering if this is to blame. Basically, 2-3 days before my period I get an overwhelming sense of despair, helplessness, numbness, and sometimes anger which dominates my thoughts for a few days and goes away shortly after, almost like it never happened. I was unable to find any conclusive information as to who I should talk about this with, GP, Therapist, Psychiatrist, OBGYN, etc. especially since it seems not all doctors believe it is real. Any advice on the topic is much appreciated.

I appreciate even just the space you provide in allowing anyone to send in an email. I’m sure I am not the only one who feels seen by the hand you extend through your platform. Looking forward to listening to the upcoming episodes.

Thank you for sharing your experience and reaching out with this important question. I’m truly grateful that my podcast has been of assistance, especially during times of heightened anxiety and stress. Your kind words mean a lot, and I’m excited for you to explore more of the upcoming episodes.

I can’t commend you enough for taking steps to address your mental health struggles through therapy, especially given the challenging context of the pandemic. It’s quite common that the added stressors brought about by the pandemic have intensified existing mental health issues, making it more challenging to cope. Many individuals have found that their usual methods of managing anxiety and depression are no longer sufficient in the face of these extraordinary circumstances.

It’s fantastic that you’ve experienced progress in managing your anxiety. However, it’s clear that the cyclical nature of your depressive episodes remains a concern, particularly the waves of sadness, irritability, and low self-esteem that coincide with your premenstrual phase. This pattern strongly resonates with the concept of PMDD (Premenstrual Dysphoric Disorder), which has been gaining increasing recognition in recent times.

I want to assure you that you’re not alone in this experience. PMDD-related discussions have been cropping up more frequently, not only among patients I work with but also within broader conversations in my personal and professional circles. Your situation sheds light on the interplay between hormonal fluctuations and mental health, a topic that’s garnering well-deserved attention.

Your dedication to therapy amid the pandemic’s challenges is commendable, as is your commitment to managing anxiety. The pandemic has indeed acted as a stress amplifier, often pushing individuals beyond their normal coping thresholds and making it difficult for them to manage anxiety or depression effectively. It’s crucial to acknowledge that these are extraordinary circumstances, and it’s entirely valid to seek assistance tailored to this unique context.

Your descriptions of the emotional upheaval you experience in the days leading up to your period strongly align with the symptoms associated with PMDD. I don’t personally experience this, but I’ve had the privilege of observing it closely through my girlfriend’s journey. She, too, grapples with severe PMDD, allowing me to better understand the profound impact it can have. The way you describe feeling like a different person during these episodes resonates deeply with her experiences and those of other patients who have shared similar accounts.

The reality of PMDD is not up for debate; it’s a legitimate and recognized condition. However, I empathize with your frustration regarding medical professionals who may not fully acknowledge its significance. In the case of my girlfriend, she struggled to find healthcare providers who took her concerns seriously until she found a program at UCLA’s Women’s Life Center that specializes in conditions like PMDD and postpartum mental health. This underscores the importance of seeking out professionals who truly listen and understand the impact of these symptoms on your life.

Determining the right professional to consult can be challenging, especially when skepticism exists. While OB-GYNs, therapists, and psychiatrists could all play roles in managing PMDD, the key is finding someone who recognizes the validity of your experience. Involving your therapist is also valuable; they can help you develop coping strategies, interpret behavioral changes, and explore the emotional depth that emerges during this phase.

Sharing your experiences with loved ones can foster understanding and support, although the choice to do so ultimately rests with you. It’s heartening to hear that my podcast provides a space for questions like yours, and I’m truly humbled that my words resonate with you. I encourage you to approach this journey with patience and self-compassion. Healing is a gradual process, and the pursuit of understanding and effective treatment is entirely valid. You’re not overreacting; you’re seeking the support you deserve. Remember, your well-being is a priority, and I hope you find empathetic providers who can help you navigate this challenging yet manageable path toward a more comfortable life.

Question 2:

I recently left a relationship of 7 years. While we shared a powerful love for one another, we were not compatible with what we wanted in life. It was a very difficult time, however we were on the same page about remaining amicable and friends. Immediately after I left, that changed. He began creating false stories and accusations about me, saying that I was living a double life and have been an online porn star for 10 years, and threatening to ruin my life. Photo shopping pictures, etc. In my opinion, he completely snapped. While I am hurt and angry, I am concerned for his well being. I cannot help but wonder if he went into some sort of psychotic meltdown. I’m terrified of him, yet don’t know what I can do to help him. I am wondering if this type of situation sounds like a mental health breakdown, and if I should try to help or walk away for my own well being. I hope to hear from you. Thank you so much for all you do.

I’m truly sorry to hear about the distressing situation you’ve been going through, and I appreciate your courage in reaching out for advice. Leaving a long-term relationship is never easy, and it’s especially disheartening when efforts to maintain amicable terms take such a hurtful turn. The sudden change in your ex-partner’s behavior, from initially agreeing to be friends to creating false stories and making threats, is indeed alarming and deeply hurtful. Such behavior is abusive and uncalled for, and it’s completely understandable that you’re concerned about his mental well-being in light of these actions.

It’s unfortunate that your ex-partner’s behavior shifted dramatically after the breakup, leading to unfounded accusations and threats. This type of behavior does not seem to align with the person you knew, and it’s understandable that you are grappling with the possibility that he may be going through a mental health breakdown. The false narratives, photo manipulations, and threats are indicative of a malicious intent rather than delusional beliefs associated with psychosis. It’s essential to recognize that most individuals with mental health struggles, even those dealing with psychosis, do not engage in such manipulative and harmful actions.

Your concern for his well-being, even amidst the turmoil he’s causing, speaks to your empathy and caring nature. However, it’s crucial to prioritize your own safety and well-being. If you’re worried about your safety, it’s wise to consider practical steps to protect yourself. Depending on the situation, seeking an emergency protective order could be a viable option. This legal measure can help prevent him from making further contact and provide you with a sense of security.

Considering the circumstances, it might also be helpful to reach out to your local law enforcement and consult with a lawyer if necessary. If you were married, navigating this situation might involve additional legal considerations, making legal advice particularly valuable.

Maintaining no contact with your ex-partner is an important step to ensure your safety and reduce the potential for escalating the situation. Blocking all communication channels and limiting his access to you can help mitigate the impact of his hurtful actions on your well-being.

Sharing your experience with friends and family, if you’re comfortable, can offer you a support system and increase awareness about the situation. Your decision to speak up is not an act of “tattling,” but rather a way to safeguard yourself and ensure that those around you are aware of the challenges you’re facing.

It’s unfortunate that your ex-partner’s behavior has escalated to such a harmful extent. Remember that you made a valid decision for your own well-being by choosing a path that aligns with your goals and values. Prioritizing your safety, maintaining no contact, and seeking legal assistance if necessary are essential actions for you at this time. While your empathetic nature is admirable, it’s important to recognize that saving him is not your responsibility, especially when his actions are causing harm to you. Your safety and well-being are of the utmost importance.

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