Originally published in The Ottawa Citizen August 21, 2001

Every month it came. The anticipation of its coming slowly turned light into dark. A shroud of darkness gradually enveloping her. Each month she lost a part of herself. It was a demoralizing and humiliating experience. But she was told that this was just the way life is; you can’t change who you are. Live with it. Other do why can’t you?

There are many women who sufer with this condition. It does not matter whether you are a man or woman, suffering is a universal condition. How or what leads to it is irrelevant. The end result is the same; depression, mental anguish, marital strife, family breakdown and physical pain.

Yet with all this despair, the stigma remains a potent force restraining the sufferer from seeking help.

Premenstrual syndrome (PMS) has been derided by some who are unwilling or unable to understand it and ignored by others who choose not to believe it exists. Let us be clear. It is a real disorder that can be a minor irritant for some women, a major handicap and impediment for others.

PMS is a chemically induced disorder. With each menstrual cycle the effect of changing hormone levels affects neurotransmitter levels in the brain responsible for mood. You cannot control your cycle.

These mood changes are identical to Major Depression. The difference is that while the depressed person remains so everyday, the PMS sufferer experiences it seven to 10 days per month. Some report feeling suicidal, aggressive, irritable or emotionally labile. The have difficulty concentrating and functioning at work. They pretend to others that they are happy but inside they feel rotten. Their husbands and children suffer along with her.

Many treatments have been proposed. Different vitamin concoctions, B6, B12, primose oil to name a few. Lets be frank; it is a chemical disorder. It is a variant of depression that is no one’s fault.

A patient of mine quipped when finally relieved of her PMS symptoms, “Better health through brain chemistry.”Many patients have been successfully treated by regarding this disorder as a physical illness like any other. The mainstay of treatment is antidepressant therapy. A medication is required to revers the effects of this chemical disorder.

If PMS interferes with your day to day activities and cause undue hardship, it becomes a quality of life issue. Avoid the stigma and get treatment. Do not deny yourself improved quality of life. Indeed the prerequisite to treat is based upon whether quality of life improves.

Would you deny yourself or others from treatment of Crohn’s disease, asthma or arthritis? These diseases can spontaneously enter remission and relapse. Medications are available to help prevent relapses so that people do not suffer and deteriorate. The brain is no different. It functions under the same physiologic principles like any other organ.

But we think we can control how it functions. Tell that to someone under the influence of a mind altering substance. Chemicals do influence behaviour. In this cae, it is the chemical effect of a woman’s menstrual cycle that alters mood and behaviour. The logic is consistent. The visceral reaction is not.

Do not be afraid to confront PMS if you suspect it. Do not needlessly suffer. Please talk to your doctor about it. Regain those three to four months of life lost for each and every year.

© Dr. Barry Dworkin 2001