unfiltered therapists podcast Episode transcripts

Allegra Taylor (00:22)

I am here joined by Danielle Hilt. Danielle is so gracefully sharing with us her journey with PMDD. Danielle has dedicated a lot of her time in the last couple of years to researching the shit out of PMDD and working on developing some amazing education programs and information for other women who are facing PMDD diagnoses as well as being a registered massage therapist. So a lot of understanding body and a deep appreciation for mental health. And I'm so honored that you are taking the time to share a lot of what your journey has been like and the information that you've been collecting because this has been an incredibly hot topic in the mental health space. I'd say specifically in the last year, I've seen a huge jump. So thank you so much for making the time to do this with

Danielle (01:15)

my gosh, thank you so much for the opportunity to come and have this conversation. I think it's a really important conversation to have, not only for my own experience, but because there is a lot of menstruators out there who are struggling with this and there's not a lot of places to go to. There are some really great resources out there for sure, but widely misunderstood and there's still tons of research coming out like monthly about what PMDD could even possibly be.

Allegra Taylor (01:52)

Yes, I think that you are actually one of the first people who ever introduced PMDD to me. And I remember initially trying to understand it enough as a clinician to know how I could support people that are going through a PMDD diagnosis or just living with PMDD. So guess let's start with that. What is PMDD? What does that stand for? What is it? I think it's so important that you share this from your perspectiv

Danielle (02:21)

Okay, yeah, so PMDD stands for premenstrual dysphoric disorder. And the idea is that it is a cyclical mood disorder. It is not a hormonal imbalance, but it is the way, the idea is that it is the way that our brains are reacting or overreacting to the natural fluctuations of estrogen and progesterone that happen throughout the menstrual cycle.

There is so much really great information out there. And before I even start, just want to share one of the main resources that I found when I was first diagnosed with PMDD in 2023 is IAPMD .org. This is a group of volunteers who have gathered all of the resources that they can find. They're continually putting out the new research. It's just a really great hub for not only people who are experiencing PMDD, but for health professionals like therapists, doctors, anyone who is going to potentially come across someone who is struggling with this diagnosis. definitely if you are looking for information, that is one of the first places that I would start is the iapmd .org.

Allegra Taylor (03:50)

Amazing. I'm going to link that in the bio of this episode for anyone who is listening to make sure that you can just click the link right in the description. So thank you for sharing that. The more resources the better. And maybe Danielle, if you have other resources or anything specifically that you recommend that people check out after this, if they are still interested in learning more, please share with me and I will totally link it into the episode as well. Yes. I love it.

Danielle (04:12)

you know I do. You know I do. Yeah. We'll get into those. Some of those are tools that have really helped me figure out kind of what it is that I'm experiencing and how to like track what it is that I'm experiencing. But before we get into that, I do kind of just want to touch on some of the details of PMDD. I'm just going to start listing off some facts about it. So PMDD affects about 5 .5 % of women and AFAB individuals of reproductive age. So you don't experience PMDD if you do not currently have a menstrual cycle. It is, as I mentioned before, is not a hormone imbalance, which is really challenging when you're trying to first get that diagnosis because for me personally, in my experience, when

It took me about four years, if I'm being generous, to get the PMTD diagnosis. And when you come to a lot of healthcare professionals and you say, hey, I think something might be going on with my menstrual cycle. The first thing that they're gonna do is check your hormones and your hormones are gonna come back normal and they're gonna tell you that there's nothing going on. And that is a really big challenge within the healthcare.

field and menstruators coming into that who are having menstrual distress and don't really know anything about it or what's going on. I think we already mentioned that it's just a severe reaction of the brain to the natural fluctuations that occur with estrogen and progesterone within the menstrual cycle. And the people are experiencing PMDD are at an increased risk of they're at an increased risk of experiencing just severe mental distress. And along with that, we'll pull the disclaimer in here right now that we will be talking about suicide and suicidal ideation, because there is also a severe increase of that type of behavior as well within the PMDD community. I also want to mention that PMDD is commonly misdiagnosed. Because there are so many symptoms happening and a lot of those symptoms can mimic other major disorders. So the five that they list are major depressive disorder, panic disorders, generalized anxiety disorder, bipolar disorder, and borderline personality disorder.

If you are experiencing any of these major distressors and you think that it is aligning with your menstrual cycle, I highly recommend to look into the PMDD side of the experience.

Allegra Taylor (07:36)

wondering when you share about it being kind of like a cyclical mood disorder that is attached to the natural fluctuations of hormones and you brought up suicide ideation which we will absolutely talk more about but can you share a bit about some common symptoms and maybe some uncommon symptoms that people might be experiencing that they could take note

Danielle (07:56)

Yeah.

Yeah, definitely. So with PMDD, most of the symptoms that you will be experiencing happen within the luteal phase, which occurs immediately after ovulation. You'll hear a lot of people who talk about their experience at PMDD as if it's like a half life or that you're two different people because for the first half of your menstrual cycle, you're just plugging a long life and then ovulation happens andthere's like a steep decline of wellness just overall. And that can be body symptoms, mental symptoms, spiritual symptoms. And those symptoms are mood and emotional changes. So you have mood swings, you could be feeling suddenly sad or tearful, have increased sensitivity to rejection, things like that. There is a massive increase in irritability and an anger, and there can be an increase in interpersonal conflicts in your life. There are depressed moods, feeling hopeless, feeling worthless and guilty. There's an increase in anxiety and intention and a feeling of just like being on edge. There's a decreased interest in your usual activities.

So things that you usually engage in like work or school or friends or hobbies, you just like don't really want to have anything to do with those at the time. You can have difficulty concentrating or focusing, thinking, brain fog is a really big symptom. You can experience tiredness and low energy. You can experience changes in appetite, food cravings and overeating, hypersomnia or insomnia, feelings of being overwhelmed or out of control, and then your usual physical symptoms of PMS. So we're thinking things like breast tenderness or swelling, joint and muscle pain, bloating, weight gain, that type of thing. Now with PMDD, in order to get a diagnosis of PMDD, you have to have at least five of those symptoms and one of them has to be for emotional symptoms.

Allegra Taylor (10:26)

Okay, I'm curious like, you know, this is a common misconception I think that comes up around PMDD and I'd love to hear your personal response to it is usually when we're talking about some of these symptoms people say well doesn't that just sound like regular like PMS like isn't that just what women do when they are just PMS saying like you're just grumpy and irritable and you're crying a lot like that's always been kind of the MO of what everyone expects. How would you classify that this is different?

Danielle (11:02)

It affects the way that I am able to engage in my life, in all aspects of my life, for my entire luteal phase. So while, yes, there is PMS and there's also PME, is premenstrual exacerbation, which they're doing a lot more research into as well.

Allegra Taylor (11:09)

Yes.

Danielle (11:28)

when you have PMDD, it's more than PMS when you can no longer engage in your life in the way that you desire to.

Allegra Taylor (11:37)

Yes. How comfortable would you be sharing a little bit about in your own life how this has impacted your ability to function in day -to -day settings?

Danielle (11:48)

Yeah, I'm super happy to share that because I think it's a really important conversation to have. Before I was diagnosed with PMDD, I was unaware that it was A, even a thing, or B, I really didn't know anything about my menstrual cycle. I didn't know the different phases. I didn't know how the hormones were changing. So I was kind of just along for the ride.

Allegra Taylor (12:04)

Yes.

Danielle (12:19)

It brought a lot of interpersonal conflict in my life. There were times where it's greatly affected my ability to work and it still does. I've just adapted my lifestyle to be able to accommodate it instead of trying to fight against it. Yeah, is, there are days where it's such a challenge to just get the motivation to get out of bed or take care of myself, like shower or feed myself, just like things like that. And if you can't meet the basics, then you're really unable to engage in life.

Allegra Taylor (13:05)

Yes, 100%. I know that menstrual tracking is a really big part of this. I'm wondering if you can teach me a little bit about what that looks like, what you are tracking, and in your own experience, what maybe like a average month could look like for you as you are tracking your hormonal changes and then your cyclical mood as a result.

Danielle (13:28)

Yes, yeah. my first of all, if you have a menstrual cycle, I'm a huge advocate of menstrual cycle tracking, whether you have a menstrual disorder or not. You will learn so much about yourself and how your body works and how you're feeling and how that is all intertwined by tracking your menstrual cycle. And when I started tracking my menstrual cycle, I was not aware of apps for that or

I didn't know that there were tools that could help me do this and I'm going to share some of those tools for sure because they are amazing. But in order, it's important to note too that in order to get a PMDD diagnosis, you have to have two months of a tracked menstrual cycle. And when I first started tracking, it was literally just on a piece of graph paper.

Allegra Taylor (14:04)

completely.

What the heck?

Danielle (14:25)

with how like my mood was like one out of ten and then like my body symptoms one out of ten and I like created a graph and I brought it to my psychiatrist and he was like you have PMDD and that was the first I ever heard of it. So now there are some really great tools. One of them is a tracking app called PMDDVME. It was created by a mother and daughter duo the daughter has PMDD. So it's a bit more PMDD specific. And basically what you do is you just go into the app and you just are adding in your symptoms for the day of however you feel. And being honest with yourself is definitely the best way to track. You don't have to share your data with anybody, but other than your like healthcare team, if you're seeking a diagnosis, but

Yeah, tracking is huge. I've shifted from that app. I now use the StarGust app, which I am a huge fan of. It's super cute. And it just makes tracking so much more fun because there's like cute little pictures and they add in some really cool resources as well. So they might cite just like menstrual research that you can look further into. They've also connected and Ayurveda into that. Just better ways to keep you aware of what is happening within your menstrual cycle. Yeah, so for me, my menstrual cycle looks probably different than anyone else's menstrual cycle, as you would expect for all different people. So day one is your first day of blood.

So whenever you're tracking, just remembering that your first day of bleeding is day number one. And then from there, follicular will happen after you're done bleeding. Within the follicular phase is when I experience my highest energy. I feel unstoppable. I can do all of the multitasking and keep track of all of the and I just I feel like I am at my absolute best. And then ovulation occurs which I think there's a bit of a misconception with ovulation in that some apps will track it as like a phase like a chunk of time but ovulation is actually only one day. depending how long your menstrual cycle is will depend when ovulation occurs. So before ovulation is follicular and then after ovulation is luteal. During ovulation or like that little window of like the day before and the day after, I'll be feeling definitely a decrease in my energy overall, but I'm still feeling really good. I feel like naturally I wanna start slowing down.

I feel really good in my body at this point. And then once we move into luteal is where we really start seeing the body symptoms and the mental and spiritual symptoms that I listed off at beginning of this cycle. And I really do, I experience most if not all of those. It's just been a matter of how I have made space for that within my own experience.

Allegra Taylor (18:10)

Yes, speaking of that exact thing, it's making space for this. So I was reflecting back on when you were saying that if people go into a healthcare professional and they say like, I'm struggling around my cycle and you do some hormone testing and it says everything's clear, like nothing to see here. And you find that this is actually just your own body's response to a totally normal hormonal change and that the mood is cyclical, but totally different throughout the month. There's not a lot of quote unquote treatment for PMDD at this point and it's much more symptom management and cycle management. Is that fair to say?

Danielle (18:52)

Yes, yeah, absolutely. I was told that the first line of defense for PMDD is SSRIs. So of course that was the route that I took and I'm definitely not saying that those things don't help with PMDD, but they didn't help me. There is a group of people of which I include myself of where we are saying that we have treatment resistant PMDD. So I found that the SSRIs were helpful and I really noticed a difference during the follicular phase, but then as soon as luteal hit, they just didn't really seem to make much of a difference for me. And that was when I really decided that I had to essentially rearrange my lifestyle to accommodate for PMDD. Yeah, there's

When I say lifestyle too, I'm not necessarily only talking about diet and exercise and those types of things. The things that made the biggest difference for me were mental health related.

Allegra Taylor (20:06)

Yeah, if you're comfortable, can we talk a bit about that? How have you managed it or continuing to manage it? How do you look at your mental health and how do you try and keep on top of it? Also, when you talk about kind of like accommodating your life and changing your life in response to PMDD, like how are you doing that and what advice would you give other people?

Danielle (20:31)

Okay, that's a big, that's a big inspection. Okay, so let's start off with how I've made space for PMDD in my life after recognizing that I was treatment resistant. I am unable to work in the same way that I was brought up and wanted to work. So I am unable to work during the last week of luteal right before I bleed. And that is simply because social interactions are really challenging for me. I have really low energy and my body is not feeling at its strongest.

And as a massage therapist, that is a really challenging aspect to deal with. I have social interactions. I need to be feeling strong and capable. And when I am massaging, I really want to make sure that I'm in the right head space for it. I don't want to be worrying about whatever narratives are playing in my brain, I want to be focused on the body on the table. So that might be different for other people who experience PMDD who maybe have jobs where they don't need to be as focused or maybe they are already working from home or just other ways that they can manage their work lifestyle. One of the main...

Things that I have done for creating space for myself and my experience with PMDD is through cycle tracking. I was able to recognize what my worst symptoms are and how to integrate that into my life. I take my and I actually also plug them into my calendar app on my phone so that when I'm scheduling myself, I am making informed and aware decisions of how I'm going to be feeling. And that has really allowed me to become aware of where I can stretch myself and where I need firm boundaries to support my wellness.

Allegra Taylor (23:09)

Yes, I think this is so important and I think it's actually something that should be translated across the board for anyone who struggles with any sort of mental health disorder that knows that there are high periods and low periods even seasonally is if you already know that it is cyclical in some nature and you have something that can be predicted to some extent in that cycle is not overstretching yourself by making commitments that you know your body is not going to want to help you function in completing in those periods. It's like setting yourself up for success so that when you know you're going to be in a low, you know that your life is going to be able to accommodate you being in that low. And I can imagine that like relief of that pressure to still perform, air quotes, as a air quotes, typical normal functioning person.

Danielle (23:52)

Yeah.

Allegra Taylor (24:02)

and instead be realistic about what you can achieve would relieve just a huge amount of personal pressure.

Danielle (24:09)

Yes, absolutely. And the flip side of that is when I'm in follicular and leading up to ovulation, I feel like I can do everything. I feel like I can say yes to everything. I want to do all of the things. I don't want to feel like I can't do the things that I want to do. But at the same time, I've learned through trial and error that it really is best to be aware

Allegra Taylor (24:32)

Yes.

Danielle (24:39)

where I'm scheduling myself. So yeah, I wanna go for coffee with my friends, but I'm not gonna schedule all that during Luteal. I'm going to schedule that when I'm feeling my best. I'm gonna schedule that during Follicular before ovulation. Yeah.

Allegra Taylor (24:53)

Yes, it's funny, I actually kind of equate this to some degree with managing ADHD where I think that we all have like a really unhealthy in some ways narrative that the thing that we are supposed to be aiming for is consistency. Like the highest form of management and stability is consistency. And humans aren't actually really that consistent. We're just not that way.

And if you're adding any level of a mental health disorder into that, the idea of consistency becomes like a carrot that's dangling that you can never seem to reach. And so it feels like you're personally failing. And where I equate this to like ADHD management is when you're in like a hyper -focus phase, you can do everything all the time so perfectly.

and the world will look at that like you're overdoing it, you need to relax, slow down, conserve your energy. Maybe if you conserve your energy when you're feeling like that, then when you go into a low period, it won't be so bad. And so you start to guilt trip yourself for getting everything done. And then when you go into a lower period or like I will call it a, I call them lows for myself in my own ADHD where I am just completely done with executive functioning.

I don't actually have any of that said, quote unquote, conserved energy left. It's not doing anything. And I'm still just beating myself up. And so what I've learned in ADHD management is to absolutely maximize the amount of stuff I can get done when I'm feeling hyper -focused and make space, as you say, so that when I go into a lower executive functioning period,

I'm still on top of what I needed to get done. I just did it in what would be perceived as inconsistent from an average lifestyle. And so what I'm hearing you say is something very similar where it's like, I'm going to do all of the things that I know I need to get done and maximize the time that I feel really, really good so that when I go into what I inevitably know is going to be a low functioning period, I have space to actually just be in that low functioning period.

Danielle (27:04)

Yeah, yes, and I will say that it is a continual journey and I'm always trying to figure out how I could have prepared better for my needs when I'm in luteal. Prepared better in follicular for when I'm in luteal. One of the things that I'm working on right now is meal prepping.

Allegra Taylor (27:09)

Yes.

Yes.

Danielle (27:31)

So I mentioned earlier that during luteal, one of the things that I struggle with is feeding myself and feeding myself with healthy things that are going to make me feel good and not exacerbate my symptoms. So when I have all of that extra energy and I'm really excited and jazzed about making lifestyle changes, I can meal prep, throw stuff in the freezer so that it's really manageable during luteal to still kind of stay on track.

Because one of the things that I've noticed with my own experience with PMDD is that narrative of like, you're not doing enough, you're not good enough. There's a massive piece of self -worth that is missing during that time. And so when not only are you unable to care for yourself, you're also beating yourself up when you can't care for yourself. So it's just this really...it can feel like a really dark spiral. And you know it's gonna end, but it feels like it's never gonna end at the same time. So trying to prepare for that in the best ways that you can is really important. And it comes with time. Like these are things that I'm just starting to do for myself now. Now that I've been able to make space for that mental piece, the lifestyle pieces are kind of falling into place a little easier.

Allegra Taylor (28:57)

Yes, 100%. I think I want to go back to the topic of suicide ideation. And I'm curious about your experience in how severe suicide ideation has been over time from like initial diagnosis or even pre diagnosis to now where you can predict kind of where your mood's going to be at a certain period of time and know full well that it's not going to last forever. But in that moment, it feels like it will. And how has that shown up in your patterns of suicide ideation.

Danielle (29:31)

I love that we came back to this. So thank you so much for that. I do want to throw out some stats first before we get into it. So I believe that PMDD awareness is suicide awareness because 30 % of people with PMDD will attempt suicide, which is a massive number. And then I figured that out.

Allegra Taylor (29:39)

Yes.

Danielle (29:56)

there are as many as 4 million women and AFAB individuals in the USA that may have PMDD. 30 % of that number is 1 ,200 ,000 people who will attempt suicide at some point during their menstruating years. So it is definitely something that we need to talk about. Going back to like when I was a teenager and woman was not taught and did not seek out information about my menstrual cycle. It was just something that happened. The narrative was, know, you're a girl, you just deal with it. And, you know, it was an inconvenience for most of my life. But when I was a teenager, I struggled with self -harm. And there's a lot of shame that comes with that and that I had carried through past those experiences as well. I think that people are, just people in general from my experience, are really kind of squeamish about talking about suicide and so that makes it a very lonely experience because you don't want to, you don't want to bring people down around you even though you are literally just seeking connection and help and support. When I started taking birth control, it was about the age of 16, 17, that suicidal ideation did diminish. It was also at a point in time where I was experiencing massive life changes. I was just like really caught up the excitement of like graduating high school and deciding what you're going to do with the rest of your life and relationships and like all that kind of stuff. But it's never something that has gone away. It has become a... I want to say that it's become a part of my self -identity in that I'm really comfortable with death and I'm really comfortable with those feelings that I feel within myself. And I also try to remain aware of the fact that when I'm in follicular before ovulation, I love life. And I excel in all the things that I want to do as we talked about. I have really been focused on my mental health in the last probably two years, but specifically after I got my PMDD diagnosis. Once I figured out kind of what I was experiencing and I read through all the symptoms and I felt like I was literally looking in a mirror of my experience, I realized that the things that I was feeling were not a self -failing. It was not something that...

Allegra Taylor (33:07)

Yeah.

Danielle (33:22)

It wasn't a part of me that I couldn't move, not move past because it happens regularly, but a part that I could get to know and get to be comfortable with. So even just this week, like I'm on day 26 right now, so I'm like right in the thick of luteal.

Allegra Taylor (33:48)

No.

Danielle (33:49)

which is pretty nuts that we're talking right now and that I like feel kind of human at this point. But the mental health aspect of PMDD is massive and really challenging. And I don't think that it's focused on enough. I think a lot of the information that's out there is very lifestyle directed. It's very medication directed. And we're not talking about the mental health aspect that occurs.

Allegra Taylor (33:56)

Yeah, honestly.

Danielle (34:19)

One of the most challenging aspects of PMDD are the narratives that run consistently. And even though I'm aware of them, and even though I know that it's PMDD that is allowing this cycle to kind of run its course, it feels like there's not a lot that I can do about it. Unless I make the space actually work through those thoughts and that narrative, it will just keep, it just keeps playing. And so it's really easy to fall into feeling like things would be so much easier if you just weren't here anymore, right? Having PMDD can feel like a burden to not only on yourself, but on the people around for two weeks out of the month, every month, I don't function well. It's definitely getting better. The more space I make, the more changes that I allow for PMDD in my life and in my experience. yeah, suicidal ideation is a really heavy aspect of PMDD and we don't talk about it because we're already feeling so burdened by the fact that we can't feed ourselves, we can't shower, we don't want to do things, maybe we can't work full -time, things like that, that it's just that extra little piece on top that just can make you feel really alone.

Allegra Taylor (36:02)

Yeah. How do you work through the narratives that are coming up and the moments where you think it would just be easier to not be here? When you genuinely in those moments feel like there is nothing you can do, what keeps you going and what do you wish other people knew in those moments that would help them keep going too?

Danielle (36:26)

You need to find support. And if that support is not in your family or friend group, you can find that support with a wellness team, with a really great therapist. You need to have someone that you can touch base with. Even just to say like, hey, today is a really challenging day. I don't need any advice. I don't need any, you know,

That's a big one. Don't need any advice. They don't need any like extras from me. I just need you to know that like today's a really challenging day for me. Some of the things that I have incorporated into my regular life. These are regular things that I do, whether I'm in Luteal or not, that have really helped me work through some of those narratives are creating a nervous system safe environment for me to explore the narratives that are happening. think a lot of times I feel like I just want the narratives to stop and I just wish that I could just turn them off. And that often can lead me into disassociating or trying to distract myself. But I realized that even when I'm dissociating for super long periods of time, or I'm trying to distract myself with social media or Netflix or video games or whatever, those narratives, they're still happening. When I really slow down and I pay attention, my brain is still spinning those narratives. So I realized that I had to interrupt that pattern. And in order for me to do that, I had to disconnect myself from those things.

And one of the first things I started doing was really trying to calm down my nervous system. So I don't know if this example is the best choice for everybody, but for me, it really started with once a week, making sure that I took the time, intentional time to allow those narratives to run, but not silently in my head out loud. So I would run a really hot bath, which again, you need to make sure that that's a safe thing for you to do with whatever medical diagnoses you may have. For me, I love coming out looking like a lobster. So I would run a really hot bath, turn off all the lights, and get to a point where I am feeling calm and safe. And I would voice note, I would have a conversation and talk out those narratives. And then I have that, I can come back to it at any point in time. I still have all of those voice notes. But a really great time to come back to those is when you're in follicular. When you have that self -awareness piece, when you have more self -compassion and more self -love that you can kind of coach yourself into recognizing

You don't need to be afraid of those narratives. If you never confront them, they are just going to keep going and going. And like one of my favorite Carl Jung quotes is until you make the subconscious conscious, it will continue to run your life and you will call it fate. You have to confront it.

Allegra Taylor (40:07)

one of my favorites too. Yes. I wonder when you are in follicular and you go back and you listen, will you record yourself coaching yourself through those narratives so that when you go back into a luteal phase you can actually hear yourself in a follicular phase like being more of a coach or having a different perspective?

Danielle (40:29)

I have not, but recently I haven't been able to incorporate as many baths into my life in the last few months just from some other lifestyle changes that I've made. So one of the things that I have been doing is journaling instead. And I have a lot of blocks to journaling and I realized that it was a lot easier to just notepad it on my phone.

And this last cycle and a little bit of the cycle before what I would do is go back to those journal entries and in a different color, I would put in the self -awareness pieces, the self -care pieces, the self -compassion pieces that may have been missing during the first draft. And I'm recognizing that doing that has really helped me shift some of those narratives and I'm more capable of doing that in the moment. Even when I'm in, you know, on day 25 and in the depths of luteal, I have the narrative but then I also have cultivated that self -compassion, self -awareness, and self -love piece.

Allegra Taylor (41:49)

I love that so much. In so many ways, I almost hear it like, you know, earlier you shared that it can feel sometimes like you have two completely different people in you and you are just living in whatever version of you is existing based on your cycle at that time. And in some ways, when I like imagine this journal and what it must look like, even for you to like go back and review, it's almost like an integration of those two into being like your whole self. It's seeing something that is a whole self. And I think

It doesn't matter what we are dealing with. If you feel like you as a person are fragmented or your parts are not whole and integrated, it's going to feel incredibly disorganized to just function on a daily basis. There's so much dissonance in our living if we feel like we can't fully see our whole self in anything. And I don't think that that means that you know, totally easy and natural to imagine that all of us feel fully integrated with all of our parts of ourself all the time. Maybe an idealized version of life, that's reality, but I think that we have to create spaces where you can put all of your pieces together and see that you are actually like, okay, you are able to function. It's just going to look a little different every day, and if one part can counteract the other, at least there is a balance there. You are the balance, your true self is that balance. And I just think that that's such a powerful exercise that even, you know, I'm imagining so many other examples outside of PMDD where that sort of exercise would be incredibly helpful to just allow yourself to, yeah, brain dump everything that's coming up and then actually go back to it when you're in a different head space and challenge it or add to it or learn from it and not be ashamed to go back to a place that felt really, really dark and lonely and hard.

Danielle (43:47)

Yeah, yeah, I love that. I think that we probably could all use a little bit of integrating of ourselves. I do think that it has been just a really, a really positive way to bring clarity. Because when those narratives are going, and one of the things that I recognized at the very beginning of PMDD journey would have been maybe like 2018, 2019, is that the same narratives will play. So depending on where you are in your cycle when you experience PMDD and other forms of menstrual distress, those same stories will just keep coming back up. And I've noticed that if you make space for them and are able to confront those spaces, that story gets a little less strong every time. And you are much more able to add in that self -worth in a more like timely manner. You're not just like living to get through PMDD so that you can live for a week, 10 days at the beginning of your cycle. You're actually able to live through your whole cycle and you get much less afraid of yourself as you practice.

Allegra Taylor (45:18)

Yes. I love the idea of being less afraid of yourself. I think, you know, as a trauma therapist, I hear so many parts of what you're sharing and I think to, you know, types of therapy like EMDR, for instance, where a lot of it is challenging negative core beliefs or like patterns of negative core beliefs. And that's what I'm hearing when you talk about narratives and, you know,my brain as a clinician goes to if you are having cycles where the narratives are repetitive for years, it's the same narratives that are coming up that there actually is a lot to benefit from in therapy to challenging those narratives whether you are in a follicular state or a luteal state because in that there is still something deeper that can be worked on so that you don't have to be so afraid of how hard those narratives are. If we can challenge those narratives least when they pop up, you don't believe them as heavily. You're able to discern them to a different degree. And that when you talk about why managing mental health is such a neglected part of the conversation around managing PMDD, I think that it comes down to the fact that like, why there's such complications in a diagnosis with other diagnoses that meet the same criteria is

I don't actually think that it's like we might be missing the mark on this, that, or the other. It's like, what if we just assumed that the acronym, the word, the diagnosis itself wasn't the main focus? What if we looked at the symptoms as the main focus and what we have to do to try and minimize or work through those symptoms? There's a lot that can be touched on that you are managing every two weeks that can make a huge difference if you have trust that

Danielle (47:00)

Yeah.

Allegra Taylor (47:11)

It might be something that you'll cycle through for the rest of your, you know, menstruating life, but it doesn't have to be to the same degree if you're willing to let yourself sit and how scary it is to just confront

Danielle (47:23)

Yeah, that's so true. And I think it's also really important to note that this is not something that I have done completely alone. I definitely have navigated a lot of this on my own, but I do have supports in my life. Even if they are only a few, they are extremely valuable.

I am such a huge advocate for therapy. I grew up in the 90s where mental health was not discussed and if it was discussed it was a very shameful discussion to have. was something just like really horribly wrong with you if you couldn't function in the same way as the rest of society.

It has been so, so valuable for me to have the right therapist, a compassionate and well -integrated person who is also removed from my situation. So it's one thing to like have friends or family that you can talk to about, but some of these things you

Allegra Taylor (48:44)

Yes.

Danielle (48:52)

you don't want to or you feel like you can't or they're ongoing traumas that you just, you need space from that. And having someone who is not a part of that story can really help give perspective and clarity to that. I really, really truly believe not only just through my own experience, but having talked to many other people who experienced PMDD that the most debilitating symptoms are mental health symptoms. They're the ones that make us feel most alone. They're the ones that are the hardest to navigate alone. And we're kind of taught to like not bring your problems to people, right? Or to not dump on people or whatever the case may be. So having someone who it's their job to do that takes away a lot of that guilt and they're not judging you, which is fantastic. Because you're judging yourself.

Allegra Taylor (49:57)

Yeah, no, I... yeah. And I mean, like, I'm a therapist who has a therapist and, like, as I think every therapist probably does or should, I believe, I mean, I'm so biased, I believe everyone should have a therapist because it's that exact reason that you can just go and be unapologetic and just saying the things that are coming up in your head without fear of how that's going to impact people who are emotionally tied to your real life stories. And sometimes I think that, like, even when you talk about sitting in the super hot bath and just, like, getting yourself calm and starting to like actually vocalize the thoughts that are coming up in your head, there's something incredibly powerful about not masking anymore what's going on internally. And sometimes when you're just saying the thing, even if it sounds in your head so clear, it's like the minute it comes out of your mouth, you're like, that sounds ridiculous. Like, but you don't hear it until you like actually get it out.

And sometimes you need just another person to give you a flip of perspective to show you that it's not as clean cut as your brain wants you to believe that it is. And we need that challenge sometimes. And I think actually one of the questions that I was going to ask you earlier, and this is good timing for it, is around your partner. So I know obviously that, you know, we're talking about how your life is so now needing to be integrated around how your cycle is happening and effects on your life with that cycle. How do you think that people who are either new to PMDD or maybe have had a diagnosis for a while and are still struggling in this, what do you think is important for them to know in terms of communication with their partners or what do you think is important for partners to know in terms of supporting the people who have PMDD?

Danielle (51:38)

This, I love this question. Thank you so much for bringing it up. I have a lot to share. So I think one of the most important, I want to say lessons, I guess, that I've learned through PMDD is that my luteal brain is not always based in reality.

Allegra Taylor (51:45)

Yes!

What is that?

Danielle (52:05)

So there's a large portion of PMDD that is interpersonal conflicts. And a lot of that happens during the luteal phase. So those narratives that are happening, it's important to be aware of them and be aware of the ways in which you are feeling within your interpersonal relationships, but I would highly recommend against talking about them during luteal. You are already in a state where just existing can be really challenging. And on top of that, if you are coming forward in a combative way, which is very common, with PMDD because irritability and anger are major symptoms, mood symptoms of PMDD. It can just really make things that much more challenging. one of the things that I have done, one of the changes that I've made is to keep track of those things because they're obviously important. They're making me feel all some type of way and that needs to be resolved. But I come back to those things during Follicular and I look through them again and then I'll bring them up with my partner if I felt like this is something that we really need to work on either together or I noticed that I could use more support with these things during this time. But because I'm in such an emotional state, I find that it's really important for me to take a step back from having those types of conversations at that time. Not to say that they're not important to have. Definitely have them, just maybe not during Luteal. Yeah.

Allegra Taylor (54:04)

Yes.

Yeah, valid. Do find that your partner is also better at, like if they have something that they want to share to know that that's not the right time to bring it to you either and to wait until you are in a better head space to have those conversations or is that an ongoing thing? Is it not even a thing? How does that work on the other side?

Danielle (54:28)

I think intuitively he has just gauged where I'm at. So one of my symptoms of PMDD is irritability. I work really hard to not project that out into the world, specifically at my partner. We exist within the same space. So a lot of that irritability would naturally come out at the people that are closest to you. So he'll notice the change of tone in my voice or how I'm holding my body. And I think that he is just aware that maybe now is not a great time, but I am absolutely blessed with a partner who is very intuitive to me and my experience. I think that partnerships with PMDD are really challenging not only because of the interpersonal conflicts that can arise, but because you are relying on this person for support, for not only like emotional support, but physical support when you're unable to engage in the same activities that you were before. Also, rejection sensitivity is huge for me anyway, during Luteal. And so from my partner, even like the smallest things can really make me feel rejected. And so the journaling has been really important for me with that aspect. I need to get those things out because if I don't, that narrative will just like keep going and going as we've talked. But I definitely make a point to address those things at a time where I am calm, where I'm emotionally stable, and where I know that I'm showing up with kindness and compassion for not only myself, but for my partner as

Allegra Taylor (56:39)

Yeah, my gosh, I feel like such an important lesson across the board even, you know? Like maybe if we are not feeling like we are very emotionally regulated and we know that we are lacking compassion for ourselves and for our partners, it might not be a great time to have a difficult conversation about something that we are feeling or noticing and you just have an extra difficult battle of knowing that you are going to be in that headspace half of the month all the time. And so having to be more strategic about it. And again, I think that this is the lifestyle component of like making sure that you have set yourself up for success to the highest degree, knowing that we're also human and we're not perfect, but you try to recognize that it's okay if you lack compassion for yourself or your partner in those moments, but that's probably just like not the time to be confronting any other things. And you're right, it is. I think it's hard for any partners of people who are struggling with a mental health disorder because there is a different level of patience and compassion and care. And, you know, I think

Danielle (57:48)

Yeah.

Allegra Taylor (58:02)

it's learning as a couple what it is that works best for both of you and sets you up for the highest level of success that you can and knowing when you are basically, you know, lighting yourself on fire and then getting like angry when you realize it burnt, you know, like don't do

Danielle (58:12)

Yes.

Yeah, it's really easy to be emotionally reactive, especially when you're feeling all of your emotions at level 11. So it's so easy to just want to get it out. And you're not even necessarily getting out the truth of the matter. You're just

Allegra Taylor (58:32)

off

Danielle (58:45)

trying to alleviate some of the discomfort and it never comes out in the way that you want it to or in a conducive, constructive way.

Allegra Taylor (58:52)

No.

You can try your hardest, it's just probably not gonna land right now. It's just not the time. But man, I think you have really opened a lot of really important conversations today. I know that there are going to be people who probably have an obscene amount of other questions. I know I do and I could probably talk about this with you for another like three hours.

Allegra Taylor (59:20)

I know that we spoke earlier about having some resources shared, but if anyone is interested in connecting with you or asking questions or learning more about maybe what you recommend, are you open to that? And if so, can we share some of your contact information as

Danielle (59:36)

Yeah, for sure. So I'm definitely open for people to contact me if they have questions or they're needing help navigating some of the aspects of PMDD that seem to align with some of the things that we talked about today. I don't have any specific content up right now, but you can definitely reach me on Instagram at Danielle .ash .hilt.

You can also find me with the same handle on TikTok. So I will be putting out more PMDD information and educational resources for people to help them navigate this. This has been eye -opening and life -changing experience. And we definitely need all of the support and awareness that we can get at this point.

Allegra Taylor (1:00:34)

Yeah, no, I so appreciate it and I think it's an incredibly important conversation. And like I said, as a therapist, it's certainly been a much more prominent conversation in this space and something that the more I learn about it, the more I'm attuned to noticing it in other people.

Cycle tracking as a whole, think like has just been such an eye opening experience for anyone who is menstruating. I think it can be really, really helpful across the board. So I am so appreciative of, you know, the information that you've shared being open about your own experiences. I know that it will help a lot of people. And yeah, we will take everything, including your Instagram and TikTok in the description of this so that if anyone wants to find Danielle, you know where to go. Thank you.

Danielle (1:01:19)

Fantastic. Thank you so much for this opportunity.

Allegra Taylor (1:01:23)

No, thank you so much for making the time. I so appreciate you.