Ruby Irons

When PMDD returned to my life, it brought an unwelcome companion: rumination. What I didn’t understand at first was how these two forces would feed into each other, creating a cycle that felt impossible to break.

The Dance of PMDD and Rumination

Think of PMDD and rumination like two dancers in a dark waltz. PMDD leads with heightened emotional sensitivity, making you more vulnerable to negative thoughts. Rumination follows, grabbing those thoughts and playing them on repeat, which in turn intensifies the emotional response of PMDD. Round and round they go, each making the other more powerful.

During my worst periods, this dance would start with PMDD making me more sensitive to everyday situations. A normal family interaction or casual comment would catch my attention. Then rumination would take over, turning that moment into an endless loop of dark thoughts and interpretations. The more I dwelled on these thoughts, the more intense my emotional response became, and the harder it was to break free.

More Than Just Worry

What makes rumination different from normal worry is its persistent, cyclical nature. While worry might make you think “what if?” about a future situation, rumination gets stuck on “what is,” replaying past events or current situations over and over, adding new layers of meaning with each pass. Sometimes, rumination can even latch onto healthy situations that simply feel unfamiliar to us. Our past experiences create a lens through which we view the world, and when we encounter relationships or dynamics that don’t fit our established patterns – even positive ones – our minds might flag them as “wrong” simply because they’re different from what we’ve known. This can trigger thought spirals that try to make sense of these differences, often leading us to dark interpretations of perfectly innocent situations.

For me, these thought spirals weren’t just background noise – they consumed mental energy that should have been available for other things. Work, relationships, and daily tasks all suffered when my mind was caught in this loop. It felt like my brain was running a negative narrative in the background at all times, making everything else harder to focus on.

The Physical Toll

The mental exhaustion of constant rumination takes a physical toll too. Sleep becomes elusive when your mind won’t quiet down. Lack of sleep then makes both PMDD symptoms and rumination worse, creating yet another cycle of escalation.

I found myself needing more alone time, more quiet time, just to manage the noise in my head. But isolation, while sometimes necessary, can also make rumination worse. It’s a delicate balance between getting the space you need and not feeding the thought spirals with too much solitude.

Finding the Breaks

Breaking these cycles requires understanding how they work together. Some strategies I’ve found helpful:

• Recognizing triggers: Certain situations or environments make both PMDD and rumination more likely
• Sleep hygiene: Protecting sleep becomes crucial when both conditions feed off fatigue
• Movement: Physical activity can help interrupt thought patterns
• Meditation: Honing in on purposeful positive (and realistic) thoughts
• Communication: Having someone who understands and can reality-check your thoughts
• Professional support: Working with healthcare providers and/or therapists who understand how these conditions interact

The Role of Treatment

Managing this dual dance often requires a multi-pronged approach. Medication helps create space between the thought and the spiral – enough room to implement other coping strategies. But it’s not just about the medication. Therapy has helped me develop tools for catching thought spirals before they spin out of control.

A New Understanding

Learning about how PMDD and rumination feed into each other has helped me be more compassionate with myself. These aren’t character flaws or signs of weakness – they’re recognized medical phenomena that interact in complex ways. Understanding this has made it easier to reach out for help when I need it.

Moving Forward

This journey isn’t a straight line toward improvement – it’s more like a winding road with its share of bumps and detours. While the Sertraline helped make things manageable, my current transition to Bupropion has brought new challenges. The familiar pattern has returned: watching myself say hurtful things to my husband, aware of my behavior but feeling powerless to stop it. It’s like being trapped behind a glass wall, able to see and hear myself but unable to intervene.

I’m actively working with my healthcare provider to adjust my medication dosage, trying to find that sweet spot where both the PMDD and rumination become manageable again. It’s frustrating and sometimes frightening to feel like I’m sliding backward, but I keep reminding myself that this is part of the process – finding the right treatment takes time and patience.

The goal isn’t perfection – it’s progress. Sometimes that progress means taking two steps forward and one step back. Sometimes it means recognizing when you need help and reaching out for it. And sometimes it means being grateful for understanding partners who weather these storms with you while you work to find your balance again.

Coming next in “My PMDD Journey” – Finding Balance: Navigating medication changes and building sustainable management strategies.