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PMS & PMDD Anger: Women Get Mad Too
by Dr. Daniel J. Heller
Anger is one of the most difficult emotions for women: it's often considered unladylike or inappropriate for women to express or even feel anger. Many women have internalized this cultural judgment to some degree, and so the feeling of being angry can be disturbing and threatening. For this reason, women tend to find indirect ways of dealing with anger, or even just bottle it up altogether, and suppressing anger can contribute to depression and anxiety. Unhealthy ways of dealing with anger lead to continued feelings of powerlessness, which only create more anger, and also contribute to a lack of self-confidence.
Feeling and expressing anger can feel scary and out of control. Anger issues, anger management, and learning how to control anger are common concerns for both men and women. But PMS anger creates special problems, because your usual coping strategies may be overwhelmed by the hormonal and mood chemistry imbalances that often accompany the menstrual cycle.
It's important to remember that if you experience difficulty controlling your anger before your period, you aren't alone: millions of women struggle with this concern. PMS and PMDD anger and angry outbursts are extremely common, and one of the main reasons women with PMS and PMDD seek help for their symptoms. Unpredictable and inappropriate angry episodes—or even just the chronic, repetitive nature of these "attacks"—can impact relationships on all levels of your life: friends, family, children, spouses, partners, co-workers, and customers.
Essentials of Healthy Anger for Women
Remember that there's difference between being assertive and aggressive: You have every right to stand up for yourself, say "no," and express what you think and feel, even if upsets others. Of course, it's best done with tact and grace, and don't expect others to be happy that you're standing up for yourself.
Venting anger doesn't help: It used to be thought that it was important to "get anger out," but it turns out this isn't the case. Angry outbursts beget more anger , and increases tension and resentment in relationships.
Learn your anger triggers: Most women become angry when they feel powerless, disrespected, ignored in their intimate relationships, and when their core values are violated . Understanding what triggers your anger can help you prevent unproductive angry outbursts.
"Acting in" is no better than "acting out": Bottling up anger is no better than venting, because the feelings underneath the anger: the hurt and feelings of powerlessness and being disrespected don't go away. It's important to find constructive ways to deal with angry feelings.
Of course, it doesn't make sense to expect that women shouldn't experience a whole segment of normal human emotion. It's normal to feel anger when you feel offended or violated or disrespected. Of course, it's also healthy to be able to express an emotion like anger moderately and appropriately, and to be able to keep anger from completely taking over. But when a reasonable emotion gets bottled up over and over, it is unhealthy, so our cultural attitudes about women's emotions actually have the potential to cause real harm to women's lives and women's health. This makes it so important to find that delicate balance between allowing yourself to feel anger as a natural and normal human emotion, and learning how to control and manage anger for the sake of your health, relationships, and work.
PMS anger can be a real hardship for women and the people in their lives. But we feel it's important to stop for a moment to acknowledge another way anger has affected the lives of so many women: as the victims of abuse, in which the perpetrator's out of control anger was a cause, or perhaps used as an excuse, for the violation. Many women have, at some point in their life, been subject to emotional, physical, or sexual abuse or violence from parents, children, siblings, spouses, partners, or even coworkers. This kind of trauma can leave lasting scars that persist as post-traumatic stress disorder (PTSD), and that actually increases the chances of having PMS and PMDD. Living as a victim of anger, and the feeling of powerlessness that goes with it, may eventually give rise to PMS anger, though it may just as easily result in PMS depression, anxiety, or even physical premenstrual symptoms. Feelings of powerlessness often give rise to anger, but people who tend to vent anger usually choose people less powerful than themselves as the recipients of their out of control emotions. This suggests that there probably is some degree of self-control available to manage anger, because otherwise, a "rage-oholic" boss who emotionally abuses an employee would be just as likely to dish out the same kind of treatment his own boss, or to an important customer.
If you've been on the receiving end of anger that felt abusive, having that out of control PMS angry feeling yourself can bring up some very scary feelings. It is peculiar that either feeling or receiving anger or angry behavior elicits similar emotions of powerlessness and feeling out of control and overwhelmed. It doesn't appear to matter that the roles are completely reversed: to your brain, both situations feel similar, upsetting, and stressful.
Of course, PMS anger only rarely reaches such a violent and abusive level. For most women, anger is more often like a passing storm, and an uncharacteristic departure from a more balanced emotional life. One of the amazing things about PMS is that women who are ordinarily mild-mannered, even-tempered, and patient will often feel they don't recognize the woman in the mirror who, for those few days or weeks each month has a hair-trigger temper, yells at the kids for the same things she chuckled about a week before, and who can be mean and even vicious in pointing out a loved one's flaws and foibles.
Anger affects the angry person every bit as much as it does the people who absorb its effects. Chronic or recurrent PMS anger has a real and detrimental effect on your health. And this is true whether you suppress the anger or let it out.
Anger raises blood pressure, switches our nervous system into a state of stress and alarm, and causes the release of stress hormones like cortisol and adrenaline. When anger is appropriate, this state of alarm serves a purpose—for instance, if you had to protect yourself or a loved one from harm. In such a case, though, that angry feeling would pass when the threat passed. Typically, though, chronic or recurrent PMS and PMDD anger have negative physical effects and, as they ripple through your emotional life, they have other "rebound" health effects. You might feel badly afterwards, and eat a pint of ice cream or a bunch of cookies to try to feel better; the guilt that follows an angry outburst can make you tense and stressed for hours or even days; and then there is the long, drawn-out argument in your brain about who was right, who was wrong, why it happened, and so forth—all of which detracting from being present and available to whatever is going on now.
Whether you are a woman concerned about PMS or PMDD anger, or chronic anger, or you're concerned about a loved one who appears to have problems controlling and managing anger, it's important to recognize that in the vast majority of cases, the anger and the outbursts aren't intentional, and most people with anger issues really do want to learn how to control and manage anger. Meeting anger with compassion—especially your own anger—is often the first, and most important, step.