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Monique Gonzalez, Psy.D.


It can feel lonely with PMDD

Aug 22, 2023

“It feels so isolating and lonely.”
I feel too angry to talk to my family but at the same time, I am sad and lonely.”
"I know I’m not alone, but it just feels so lonely.”
“I feel like I’m going to be trapped in this lonely bubble forever.”
“It’s such a lonely place to be, but I’m so grateful for all of you who understand.”

If you live with PMDD, it’s likely that while reading these statements, at least one - if not all - of them tugged at your own heart because you have experienced it yourself. These are all expressed by people managing PMDD, time and time again. As someone personally navigating the complexity of PMDD, those could have been statements drawn from my own journal history.

There are days when living with this health condition can feel like you’re on a foggy, moody, desolate island separate from others. Sometimes, it’s feeling alien in your own body or your own home. Other moments it can feel like there is a transparent barrier between you and the rest of your world. It’s as though everyone and everything else is living, moving, or progressing right in front of you. Meanwhile, you are stuck in place.

Premenstrual Dysphoric Disorder can feel isolating due to a number of interwoven factors:

〰️ Challenges explaining invisible chronic illness to others

〰️ Spending more days in bed

〰️ Higher rejection sensitivity

〰️ Deep sense of feeling ‘extra needy’ in luteal phase

〰️ Thoughts of being ‘stuck' or 'behind' while others are living their life

〰️ Cyclical depression related thoughts and feelings

Losing touch with friends due to multiple social cancellations, needing to focus on your own health, or not having energy to nurture relationships

〰️ Difficulty connecting meaningfully with your loved ones like you used to

〰️ Biological sensitivity to hormones tricking us into thinking we're all alone

〰️ Unsettling anxiety, panic, or dissociative episodes 

〰️ Needing to self-isolate to regulate pain, emotional instability, energy level, rage, or sensory sensitivity

〰️ Navigating the ongoing, unpredictable, and complex range of symptoms that others (who don't have PMDD) likely cannot fully understand

〰️ Holding the burden of stigma at the intersection of menstrual health and mental health

If any of this resonates, it makes sense that you’re feeling the way you are and you’re truly not alone in this lived experience. These components are listed here, not to make us feel worse, rather to acknowledge the reality of so many living with PMDD. Oftentimes, the very first step in addressing loneliness is recognizing that it exists, that it's a normal human emotion, and that we are in fact not the only ones moving through the thick of it. We can allow space to witness it.

The PMDD version of lonely is complicated

As a clinical psychologist who flows with PMDD too, I will be the first to say it’s a unique type of 'lonely' with PMDD. The multifaceted components interacting, as mentioned before, make it less than straightforward. Also, it’s an uncomfortable feeling that arrives cyclically like clockwork, yet can also remain quietly in the background always. There are the real hard PMDD days, and then the ‘normal’ days. On the ‘normal’ days, the lonely might still emerge in any of the following: needing to plan things in advance that others do not, remembering that you need to take medication and supplements, having to ‘catch up’ on tasks, not being able to apply for a desired job due to the demands/schedule, declining an invite for next month, explaining to a doctor ‘I’ve already tried that.’ Not a lot of folks understand these quieter lonely parts.

PMDD is a chronic illness that is associated with reproductive health. Those with chronic health issues are at higher risk of social isolation. This is then complicated further by the fact that the science community and larger public do not feel comfortable talking about periods. When we do not feel understood or are often dismissed, it makes complete sense that a part of us feels detached from the rest of the world. 

It is also very common during a PMDD phase to feel both a sad loneliness and the urge or need to be alone at the same time. This contradictory experience can feel unsettling, confusing, and exhausting.  

Let’s look at a few scenarios…

Imagine the scenario when you’re deeply wanting affection from your partner, yet you’re unable to be around them for long periods of time due to spiky irritation. You ask for their hugs but the way they communicate something (completely benign) sends your irritability thermometer soaring. You yearn to be in close affection but you also absolutely do not. Immediately this prompts disconnection, feeling misunderstood, and a profound sense of loneliness.  

Imagine this other scenario. You see your best friend is calling on your phone and you deeply want connection. You stare at the number ringing, thinking you could really use a cozy conversation with a familiar voice right about now. However, the thought of communicating words and socializing weighs you down. You slump into your couch with the crushing fatigue.

How about the scenario where you are telling your kind and empathic co-worker about your PMDD condition, and you desperately want them to understand. It would be so lovely to have someone who ‘gets it’ at work. You even think about how nice it would be if they experienced something similar so that you didn’t have to explain yourself. You immediately are hit with guilt in response to wishing them an illness. Then you soak in that familiar, disappointing realization that this is another person who will likely just not be able to fully understand. 

Befriending loneliness with self-compassion

When you read those situations, was there a part of you that wondered, “Wait, I’m not the only one who has thought that?” Dear one, you are not alone. So so many of us have been there. It's not easy to say out loud these thoughts and experiences. Shame can arise. But you know what? You are not a bad friend, parent, family member, partner, co-worker, person for feeling these things. You are worthy of connection, love, relationships, space to yourself, support, healing, rest, and any nourishment that aligns with your particular cycle. For some of us, it's a matter of saying, "You know what, I'm just cuddling my dog, because she's the only one I feel comforted by and can be around at the same time." 🐾 (Let's hear it for our furry babes who just always accept us in all of our messy).

SELF-COMPASSION PRACTICE: When you are managing PMDD loneliness, your being is trying to hold conflictual emotional states ("I want to be alone. I want connection."), all the while still managing all of the other PMDD symptoms. It's a lot. One supportive tool is to pause and notice these feelings when they occur. Take a deep breath. A slow, steady inhale, and long release of an exhale. You can do this however many times you may need. Then, take a moment to name the feelings. Validate that it’s normal to have multiple, mixed emotions and desires at the same time. Gently remind yourself that this is a temporary state. Place your hand on your heartspace and say, “It’s hard right now. You are doing the best you can in holding all of this.” Then ask yourself, “What do I really need right now? What would bring me a little bit more ease?” Write down what comes to your mind and heart. Circle any ideas that are accessible or seem to bring a sense of lightness to your being. Practice one of those things with non-judgment.  

When we are feeling lonely and also requiring some mental or physical space, it can be hard to explain this complicated situation to ourselves and to others. It’s important to be extra kind to our own being. It is nearly impossible to strike the most perfect balance of craving connection and needing our space. One suggestion is to notice when you are harsh on yourself amidst this back and forth experience. The self-criticism or judgment creates an additional layer that exacerbates suffering. Therefore, extending some self-compassion, including patience and grace, during this push and pull is key. (I speak on how to do this in the mindful PMDD program).


Some ideas on how to hold tender space for the parts of you that feel lonely:

🌙 Schedule times of affection, play, intimacy, joy, connection with loved ones during times of your cycle that feel more conducive to that. Actively savour these moments. Write about them. Take photos of them. Paint them. Name them. Allow these memories to soak into your being. 

🌙 During luteal moments where you’re needing a simple loving reminder that it's going to be okay - reach out to a partner, family member, or trusted friend who has shown sincere interest in supporting you and who isn't the 'advice giver' type.

🌙 Go out in nature. Take a walk and talk with the birds. Journal under the sun. Befriend the trees. Create connection with plants. Commiserate with the moon.

🌙 Give yourself active permission to take care of yourself. Whatever that looks like.

Consider a PMDD support group or forum, such as the IAPMD PMDD & PME Support FB group. You can post to gain supportive feedback from others or view what others have done to navigate this experience. Sometimes simply seeing the messages of “I get it. I’ve been there. PMDD is so hard. We’re here for you” can help us feel a bit less alone and bring a relieving validation to get us through a tougher PMDD wave.

Create a self-soothing kit that can include:

  • A journal for self-reflection
  • A handwritten note with a gentle reminder, such as “It’s hard right now, I know. We’ve been here before. We know it's temporary and this will pass. We will give ourselves so much love as we move through this.”
  • A textured or tactile element
  • A calming scent
  • A list of books, TV shows, meditations, music playlists that help you feel less alone
  • A list of go-to people or animals who you can turn to for nourishing connection
  • A list of physical activities that have supported you in the past in these moments
  • A list of ‘It’s a No Go’ – the things that you know are not helpful during this time and should be avoided

🌙 Connect one-on-one with a professional processor, such as a therapist, to reflect on the experience of living with a chronic illness and to learn self-care tools.

🌙 Sign up for the Mindfulness for your PMDD Journey self-paced program to learn self-compassion practices that can support you in holding space for and addressing feelings of loneliness, anxiety, and depression.

🌙 Join the next PMDD Grounding Circle, a beautiful virtual community gathering where we co-create nurturing space to feel seen and heard as folks figuring out how to navigate PMDD. Previous participants have repeatedly shared how impactful it has been to connect meaningfully with others who truly understand. Sign up for Dr. Mo’s newsletter to stay informed of future Circle events.

You are seen. Your lived experience matters. You are worthy of meaningful connection. You are not alone, dearest PMDD friend.

Please feel free to share this post with other PMDD folks to continue to build community 💛

With much love,

Dr. Mo

✨Was this post supportive? Share your thoughts with me! Would love to hear from you. Looking forward to staying connected.



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