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PMDD & Extreme Anger: When Hormones & Stress Boil Over
by Dr. Daniel J. Heller
PMDD can cause a variety of emotions. Depression, fatigue, anxiety, feeling overwhelmed, mood swings, irritability, difficulty concentrating—even this is just a partial list. So there are many ways PMDD can drag you down and make you feel downright awful. But we’ve been struck at just how often we hear from women who say that the worst PMDD symptom is extreme, impossible to control, scary anger. Lashing out at family and friends; yelling at co-workers and even becoming violent with significant others; and making bad decisions while driving or in public due to white-hot rage are sometimes consequences when PMDD anger boils over.
We get letters and phone calls all the time from women whose most troublesome PMDD symptom is extreme, out-of-control anger that makes home life and relationships a nightmare. For instance, P.R. told us:
"I have been suffering with really terrible PMDD. I get so angry and look for fights. I can’t control it, and literally can’t cope with life once a month. I’ve been to several doctors but none of them get me. I am going to lose my family if I don’t get help."
We really feel for her and her predicament. And she’s certainly not alone: V.S. also told us she experiences uncontrollable anger with PMDD:
"I have terrible PMDD. During the other weeks of the month I am kind, energetic and helpful. I do have problems with anxiety and depression, but I can use coping skills to quell them. When I have PMDD, I feel an anger inside of me that is like a hot fire, and I will yell at people. I have an overwhelming sense that nobody cares about me, so much so that I cannot stop thinking about it, and I want to medicate myself until my period comes. It is like a switch has been pulled and I cannot control myself for a few days. People cannot relate to this so I try to avoid company, but my own company is ALSO unbearable because my thoughts are so sad and angry! I felt this anger/impatience once before when a doctor put me on birth control. I couldn't even get through one week of the pill because I wanted to scream about the smallest things."
Any woman who has been through this understands that a lot of common advice about coping with the out-of-control anger and irritability doesn’t help, because everything—most of all your own emotions and behavior—feels completely out of your own control. Sure, you can try to do what well-meaning friends and family suggest: get a hold of yourself, take a deep breath, think things through, or take a candle-lit bath. But we understand that if these things worked, you probably wouldn’t be reading this article; it wouldn’t be PMDD; and it wouldn’t be called out-of-control anger. What we’ve heard from so many women is that sometimes they just have to wait for the storm to pass, and ride it out as best they can. This can mean cancelling plans; avoiding people in order to avoid conflict; or at least steering clear of people to the degree you can.
PMDD vs Bipolar
Our main PMDD article points out that for symptoms to be PMDD, they must not be explained by some other psychiatric condition such as bipolar disease, PTSD, or personality disorder. This can be a little tricky with extreme anger, since psychiatric conditions can be aggravated premenstrually. Bipolar disease certainly can lead to extreme anger as well as the depression that characterizes PMDD. It’s important to realize that simple tips for anger management and anger control, or remedies for PMS and PMDD, are simply not enough if the real problem is a deeper psychiatric condition like bipolar disease or PTSD. This is why it’s a good idea, especially when symptoms are having a big impact on your life, your family, or your work, to consult with a qualified physician who can help you understand the possible causes of your symptoms.
It is like V.S. said: "People cannot relate to this so I try to avoid company, but my own company is ALSO unbearable because my thoughts are so sad and angry!" Since people—even those who love and care for you most—may very well not understand what you’re going through, sometimes you really do have to manage through this terrible time.
A hot water bottle can help if you’re in pain, as can an aspirin or anti-inflammatory, and it just might help you to feel a little better too. You can listen to soothing music, or take a bath, or watch TV. But one word that describes how many women experience the extreme anger of PMDD is inconsolable, which means that nothing really helps, or at least not reliably. But sometimes these kind of simple suggestions can just seem like proof that no one understands how truly painful and out of control the extreme anger and other PMDD symptoms can be.
Are You the Angry Type?
Two types of women experience extreme PMDD anger: women who get angry easily, and women who don’t. In other words, any woman can have extreme anger with PMDD, whether it is characteristic of her personality or whether it is a complete departure from her usual style. If you are the type who gets angry easily anyway, PMS and PMDD can lower your inhibitions and make that anger come out more dramatically. If you’re the type who doesn’t often get angry, PMS and PMDD can lower your anger threshold so that abnormal anger—for you—takes over. Extreme, disruptive PMDD anger can happen to anyone.
As we discussed in our articles on anger control and anger management, most girls and young women are taught that anger isn’t ladylike and feminine. What’s more, in some households anger is wielded like a battering ram, so it becomes associated with something scary and dangerous. While you might think this personal history would make you less prone to anger—wouldn’t anyone avoid something scary and dangerous—that isn’t necessarily so. It’s just as likely to make you suppress your anger until you it becomes impossible to continue to do so, and then it boils over and you lash out.
The best way to develop a healthy relationship with anger, whether during PMDD time or throughout the month, is to practice expressing yourself, and how you feel—while respecting others—all month long. When you express yourself and how you feel, making "I" statements, without trying to injure or control anyone, you develop a healthy habit that can come to your rescue when PMDD is making you feel awful.
For instance, a non-productive expression of anger when a friend has let you down might sound something like this:
"Why didn’t you call me back? Don’t you care about me? Didn’t you know I put my plans on hold because you said you’d get back to me?"
You can put a positive spin on your expression of these feelings that will empower you without alienating the other by making "I" statements about how you feel without "pointing the finger":
"You know, I feel upset and hurt/angry that you didn’t return my call. I care about our friendship and would like to be able to continue to count on you in the future."
Again, you may have learned from your childhood models (family, friends, others) to use emotions and anger as a weapon. Instead, making "I" statement keeps things more balanced and rational, yet allows you to express exactly what you feel without threatening the other person.
To take a slightly different example, you might say to family member in a moment of anger and irritability:
"You left another mess in the house and I had to clean up after you—again! Why don’t you ever clean up after yourself? You treat me like I’m the maid around here, and you don’t give me any respect. I’m sick of your nonsense!"
Of course, under these circumstances you may have every right to feel angry, and that you, your needs, and your time are not being valued. However, by making "I" statements, you can express yourself without ending up in cycle of defensiveness, recriminations, and hurt feelings. For instance:
"When I have to clean up the house at the end of a long, busy day, it makes me feel unappreciated. I feel angry when I come home to a messy house and you are playing video games or watching TV. It would make me feel loved and respected if you would help clean up without being asked to do so."
Extreme PMDD anger is real, and it isn’t a result of being a bad person, or a lack of willpower. It’s a result of an explosive mixture of hormones and emotions, but with help and practice you can get through it and feel positive again, all month long.
How To Express Anger
- Make "I" statements.
- Say what you feel, without disparaging the other person.
- It’s OK if you tremble, cry, or get angry—but stick to the facts. And what you feel is a fact.
- Don’t lash out.
- Express yourself but don’t try to even the score.\
- If you want to talk about someone else’s behaviors or feelings, talk about them in "I" terms, such as: "When you do or say X, it makes me feel Y."
- Repeat. It may take months or years of practice to learn how to express your feelings in a way that feels good to you, and that works in your relationships.
Keep in mind, some people may prefer that you don’t express how you feel, even if you’re doing it in a mature, respectful, and responsible way. This is often a warning sign that this person may not be able to face their own feelings, or may be more interested in controlling you than in relating to you as a real person.
PMS and PMDD misery aren't always taken seriously enough by doctors, family, and friends. At PMS Comfort, our whole purpose is to empower and educate you about premenstrual symptoms, and to provide real, natural relief so that you can feel great all month long. Our all-natural doctor-designed programs are based on decades of experience helping thousands of women recover from what you've been going through. Our Herbal Relief formula, when combined with our diet and lifestyle guidance, addresses more than just your symptoms—it can help bring your body and mind back into balance, and help you get and stay healthy. Plus, we're here to support you, every step of the way.