Navigating PMDD in the Workplace
Introduction
In this article, we're sharing a heartfelt story from one of our community members. They’ve opened up about their journey with PMDD (Premenstrual Dysphoric Disorder) in the workplace, and it’s something many of us can relate to. By sharing our experiences, challenges, and tips for managing PMDD at work, we hope to create a space where everyone with PMDD feels understood and supported. Feel free to share this article with others who might benefit from it.
Discovering PMDD
As someone who was only diagnosed with PMDD (Premenstrual Dysphoric Disorder) in my late 30s (unsurprising given that it takes an average of 12 years for women in the UK to get a PMDD diagnosis), I had been in the dark for much of my adult working life as to why I went from one week feeling confident in my professional abilities, teaching large groups of students, speaking out in meetings and liaising freely with colleagues, to the next week, feeling overwhelmed, anxious, shy and self-conscious, even crying in the toilets when things got too much.
The Impact of PMDD on My Professional Life
On the few occasions that I plucked up the courage to confide in line managers about the stress I was experiencing, I was told that this was simply ‘the nature of the beast', leading me to overwork and self-berate for not being able to cope with stressors that other people seemingly could. I felt backed into a corner and ended up taking time off sick before leaving these jobs. I felt ashamed to go back after these periods of sick leave, feeling that I had somehow ‘lost face’ and would forever appear overemotional and unprofessional if I stayed. As a millennial, ‘hustle culture’, purporting that the worst thing a woman can do in the workplace is cry, was engrained in my psyche.
Seeking Help and the Struggles of Misdiagnosis
As this cycle took its toll on my mental health, I eventually sought help from a GP. I was mistreated with antidepressants (fluoxetine) and left to languish on these for three years without regular check-ups. The antidepressants dulled all my emotions, positive as well as negative. I simply felt flat. Most upsetting was that they robbed me of the precious part of the month where I felt like myself.
The Turning Point: Recognising the Cyclical Nature of My Symptoms
When my sister recommended a period tracking app, I had the ‘lightbulb’ moment that so many women with PMDD talk of, when it finally clicked that the symptoms, I had been experiencing were cyclical. Having an explanation was enlightening. It took away some of my self-blame, making me realise that the common dominator in my previous jobs hadn’t been me but rather the absence of managerial training and support systems that would have made the work sustainable. I recognised that I was burnt out by years of having to mask my symptoms, perform and navigate office politics on my bad days.
Navigating Education and Work with PMDD
Pursuing postgraduate studies allowed me some much-needed respite from my stressful and rigid administrative role. I was able to organise my work schedule so that I tackled difficult pieces of writing or theoretical concepts during the first half of my cycle. However, during the luteal phase, I would still spend hours agonising over the wording of one sentence due to brain fog. It made and continues to make me sad that I only have full brain capacity for half the month, but I am also trying to be kinder to myself and feel proud of what I manage to achieve in half the time.Returning to education also allowed me to work from home. This meant that for the first time in my life, I didn’t have to perform after a sleepless night of anxiety and palpitations. I still struggled when it came to presenting at conferences or even meeting my supervisors during my bad phases. The effect of PMDD anxiety on the gut is often underreported so I feel it is important to bare all, and highlight the stomach pains, diarrhoea and constipation that I experience when I force myself to do presentations or have to meet with my intimidating manager while experiencing such anxiety. I have upcoming surgery for a prolapsed pile that stemmed from one of these incidents.
The Reality of Working with PMDD
When I returned to the workplace full-time after completing my studies, I made a conscious effort to choose what I thought were inclusive working environments. I also believed that while I had been out of employment, awareness of menstrual and mental health issues in the workplace had increased through greater social media and mainstream cultural coverage (particularly following the COVID-19 pandemic). A support role at a mental health organisation appeared to offer an opportunity to help others struggling with conditions like mine. What is more, I believed that I would finally be able to be disclose my PMDD episodes without the risk of being negatively judged. Disappointingly, the company and its managers proved patronising, tokenistic and worryingly negligent. In training sessions, colleagues with past trauma were told to ‘get over’ the triggering stories that they heard from the people they were supporting and obliged to learn breathing techniques to use with clients, that gave them panic attacks. The last straw for me was when my concerns about meeting a client alone, who had a history of violent threats against her own family, were dismissed.
Finding Support in a New Workplace
Going back to the drawing board, I applied for and secured my current role, in health and social care research. Given the subject matter, I once again felt confident that I had found the inclusive environment that I had been seeking for so long. Not long after starting the job, I decided to declare my disability for only the second time in my life, so that reasonable adjustments could be put in place. I was disappointed and immediately regretful about disclosing my condition when, rather than the understanding reaction I had anticipated given her line of work, my line manager seemed uncomfortable, irritated and defensive. The next time we met, she told me she had sought advice from a senior manager as she hadn’t known how to handle me and my condition, which made me feel like a problem. I try to think that she had good intentions, but even so, I feel upset that she disclosed my PMDD without my consent to someone I barely knew, who is in a senior position. This staff member no longer greets me when we pass in the corridor or have meetings together. Perhaps she too, doesn’t know how to react to me, but it makes me want to cry each time this happens.
Disclosing PMDD
My line manager asked if I wanted to involve occupational health in implementing reasonable adjustments. My heart sank at this suggestion, as I had already been referred to occupational health via the company chiropractor, who had been helping me manage the ongoing physical symptoms of a viral condition, which I suspect I had also developed due to unmanaged stress. The chiropractor had been warm and intelligent, with a comprehensive understanding of PMDD. I hoped the occupational health advisor would be the same, but it turned out she hadn’t heard of PMDD, and I had to explain the condition to her and how it impacted me at work. Incredulously, she advised that I improve my time management. I had never mentioned this as an issue, and in fact, consider time management to be one of my greatest strengths. She offered to send a report back to my line manager with details of our conversation and her recommendation. She could also act as a go-between if I wished. I declined the offer and told my line manager I had decided not to pursue the occupational health route. It all felt futile.
Practical Tips for Managing PMDD in the Workplace
I wanted to share the following list of small tips that have helped me cope in the absence of formal support:
For me, one of the hardest things during my luteal phase is being ‘on show’, having to perform and ‘put myself out there’, and feeling exposed and observed by others. Booking important meeting or events during ovulation when I feel more confident and like myself, can help. Likewise, reserving individual or admin tasks to work on quietly during the luteal phase is helpful.
Where possible, working from home during the luteal phase, seeking out private workspaces or booking meeting rooms can be beneficial.
PMDD often gives me major brain fog, so preparing a script for presentations or meetings and reading from it directly, if necessary, helps me to stay on track. Although doing this lacks the spontaneity of talking from notes only, at least it ensures that I transmit the required information.
Peer support – I have a trusted colleague who I can email, call or WhatsApp if I am having a bad day, and I do the same for them. It helps having someone who understands the particularities of our team’s working dynamics and personalities.
I have spiralling anxiety before my weekly meeting with my boss, which is exacerbated during PMDD episodes. I have some go-to tunes to help me relax beforehand and wind down after. PMDD also makes me feel like I lose myself so listening to songs that remind me of happy times or my interests, for example, in travel and languages, makes me feel I am more than this job. Treating myself to a coffee or a walk around the park afterwards also helps me to decompress.
Outdoor exercise – although it can be the last thing I feel like doing when drained by PMDD, making myself get out for run or walk come wind, rain or snow, invariably helps take the edge of my symptoms and helps me to wind down before or after a challenging day.
Yin yoga – I have recently discovered Yin yoga. I have found this restorative style of yoga beneficial for improving my breathing, which can be constricted due to PMDD anxiety, as well as my sleep.
If this story felt familiar…
You’re not alone. Our PMDD & Work Guide shares practical strategies and workplace language to help you feel more supported (especially during luteal days).