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PMS, PMDD, and Self-Esteem
by Dr. Daniel J. Heller
Self-esteem is a big part of the foundation of a healthy, happy life. Self-confidence flows from the image you create of your whole self: your talents, smarts, dreams, ambitions, relationships, looks, and emotions. Even the knowledge of your own personal limitations and shortcomings can help you know when you’re in your comfort zone.
For nearly everyone, self-esteem is deeply influenced by the way we see ourselves through the eyes of others. As much as we might try to rely on our own inner strength, most of us still care, sometimes deeply, what others think of us. Often, we base important decisions and aspects of our lives on others’ opinions. This can make us susceptible to all sorts of pressures from friends, foes, family, the media, and our culture as a whole.
It’s even harder to feel good about yourself when you feel bad. PMS and PMDD symptoms including depression, anxiety, bloating and weight gain can undermine self-esteem. They might also make you feel like you must be doing something terribly wrong, or even make you feel crazy, especially when others, who don’t have premenstrual symptoms, are unable to sympathize with what you’re going through.
As children, we first begin to learn about the world and ourselves. We learn how to form that vital self-image from important people in our lives during those tender years: parents, siblings, family, teachers, and religious figures, to name some of the most important. Family issues and early encouragement and discouragement: these have a crucial effect on our self-esteem. While this is often true throughout life, it is never more fundamentally essential than during childhood.
Of all these influences, it is often the lessons we learn—often unspoken—from parents, siblings, and family members—play the largest role in our self-confidence and self-esteem. It is natural for any child to see parents and older family members as role models to emulate and respect. Children are uniquely attuned to those around them, so that when we are treated poorly, it’s easy to pick up on the implicit lack of respect. Most of us, as children, will tend to think "I’m being treated this way because I deserve to be treated this way." And a parent or authority figure who demonstrates low self-esteem may lead a child to think, "If this important person isn’t worth much, I guess I’m not worth much either."
Of course, these are generalizations. Some of us emerge from difficult childhoods with our confidence intact, while others with wonderfully supportive and happy childhoods stumble as we enter adulthood and navigate adult responsibilities. These early lessons aren’t the only influence on building our self-confidence and our adult selves. Building self-esteem is a life-long process. But awareness of those early experiences can help you identify and understand negative patterns, thoughts, and behaviors. And understanding them is the crucial first step that can allow you to change them for the better.
Popular media like TV and advertising target children at an ever younger and tenderer age. The portrayals of girls and women’s bodies; the culturally accepted standards of beauty; and the unrealistic depictions of the appearance of models and celebrities create a massive potential for girls and women to feel they don’t "measure up." The media’s near-constant presence in most children’s lives means unrealistic standards for physical appearance are often absorbed whole and uncritically. Then, comparing oneself to that idealized image is bound to result in unrealistic expectations and a constant struggle to measure up.
TV and Advertising
Let’s take a brief tour of the depiction of women and women’s bodies in TV and advertising. Models are chosen from among thousands of hopeful young applicants, most of them much thinner than the average girl or woman. Then, these already atypical women are photographed in carefully controlled lights, after professional makeup artists apply their craft. Still images are then made even more unreal using airbrushing and image manipulation software that remove any remaining “imperfections.” These image editing tools can make a model look thinner, erase a premenstrual acne eruption, or just make her look more typically attractive. These unrealistic images are then promoted as an attainable goal for girls and women, which helps to sell all manner of cosmetics, clothing, diets—and, very probably, antidepressant and anti-anxiety medication too.
This problem is amplified during adolescence. At this is a time of incredible change, young girls suddenly feel like strangers in their own skin. The transition to adulthood, physically and emotionally, gets mixed up with our skewed, media-driven ideas of how girls and women ought to look. Our culture doesn’t offer many avenues to help smooth this transition, leaving girls and young women who are developing their self-image and self-esteem little way to make sense of it at all.
It is difficult to feel good about your body, and yourself, when there is so much pressure to conform to unrealistic ideals. Even if you somehow manage to ignore the TV, the advertisements, the women’s magazines, you will still have to contend with family, friends, boyfriends, and spouses who don’t ignore them at all, but instead are chasing that illusory vision, and think you should too.
Physical or emotional abuse is emotionally devastating at any time, but during childhood and adolescence it’s particularly damaging. Growing up with a deep-seated sense of physical and emotional insecurity makes it extremely difficult to properly nurture a confident adult self. Hundreds of research studies have now proven that early trauma has a profound effect on a person’s social, emotional, and cognitive health, including self-esteem and self-confidence.
A history of childhood abuse, sexual abuse, or domestic violence doesn’t write anyone’s fate in stone: plenty of women recover from these painful episodes, even if they lasted for decades, to put together fulfilling and meaningful lives. The process of understanding what happened, and putting it in the past, and realizing that it happened because of very bad luck—not because you deserved it—can be a stepping stone to propelling yourself to greater heights, helping others in need, or simply coming to peace with the past.
In addition to the depression and anxiety mentioned above, many other premenstrual symptoms can hinder your ability to feel good about yourself. Among them:
Too many women blame themselves for their PMS and PMDD symptoms. Overeating, for instance, may make you feel out of control or weak, while the thought that it puts more distance between you and the uber-skinny unrealistic artificially-enhanced supermodels can make you feel even worse. Being bloated and swollen doesn’t make any woman feel good about herself. Irritability, anger, and wild mood swings strain relationships and create guilt, potentially adding layer upon layer of feeling bad about yourself, and depriving you of intimacy that would otherwise make you feel good about yourself.
Self-esteem is healthy, and it doesn’t mean that you’re selfish. In fact, true self-esteem means you’ll have a greater ability to care for others, because you’ll spend less energy trying to build yourself up and fighting off those self-criticizing demons. Having a positive self-image makes you more resilient and more able to face the challenges of your daily life. And it makes you happier so that you can enjoy yourself, build healthy relationships, and feel strong and comfortable in your skin.