PMDD & Emotional Overwhelm

PMDD: Understanding the Irritability, Anxiety & Emotions

If the days before your period bring a version of you that feels more irritable, overwhelmed, anxious, emotional or simply not quite yourself, you are NOT imagining it.

For some women, these changes are more than typical PMS. Premenstrual Dysphoric Disorder (PMDD) is a genuine, cyclical condition in which emotional and physical symptoms can become intense enough to interfere with relationships, work and everyday life.

And importantly, PMDD isn’t simply a case of having 'unbalanced hormones'.

So, why does PMDD happen?

Throughout the menstrual cycle, oestrogen and progesterone naturally rise and fall. After ovulation, progesterone increases and is metabolised into a neurosteroid called allopregnanolone, which interacts with the brain’s GABA-A receptors- part of the system involved in calming and regulating the nervous system.

In women with PMDD, research suggests that the issue may be heightened sensitivity to these normal hormonal changes, particularly changes involving allopregnanolone and the GABA system. Serotonin, stress-response systems and other neurobiological pathways also appear to play a role (PubMed).

In other words, the hormones themselves aren’t necessarily abnormal.

The brain and nervous system may be responding differently to their normal fluctuations.

And this can help explain why irritability can feel so enormous.

When the volume gets turned up

One way we can think about PMDD is that one's 'internal volume control' becomes far more sensitive.

Things one might ordinarily tolerate- a messy kitchen, a demanding partner, a difficult colleague, noise, pressure, someone’s tone of voice- can suddenly feel far more irritating.

Sometimes there may also be genuine frustration, resentment, exhaustion or unmet needs lying beneath the surface.

That doesn’t mean PMDD is 'all in your head'.

Far from it. But it does mean there can be an opportunity to explore what your mind and body are trying to communicate, while also helping your nervous system respond with greater flexibility.

Where hypnotherapy can help

Hypnotherapy works by creating a deeply focused, relaxed state in which we can work with the subconscious patterns that influence thoughts, emotions, physiological arousal and behaviour.

Rather than trying to suppress anger or frustration, therapy can create space to ask:

What is this irritation trying to tell me?

Is there a boundary that needs strengthening?

Is there something you’ve been tolerating for too long?

Are you constantly putting everyone else’s needs before your own?

Is there emotion that hasn’t had the opportunity to be processed?

Through hypnotherapy, we can work on changing the relationship you have with those internal experiences- reducing automatic reactions, strengthening emotional regulation and developing a greater sense of calm and choice.

There is emerging evidence that hypnotherapy and cognitive-behavioural hypnotherapy can reduce premenstrual symptoms and improve emotional regulation (PubMed).

And what about the vagus nerve?

Your vagus nerve forms a major part of the parasympathetic nervous system – the system involved in rest, recovery and regulation.

Research has identified differences in autonomic and vagal regulation in women with PMDD, and studies suggest that stress processing and autonomic regulation may be involved in the condition. (PubMed)

This is one reason I incorporate nervous-system regulation into therapy.

Breathing, relaxation, visualisation, hypnotic suggestion and other regulation strategies can help shift the body away from a heightened stress response and towards a calmer physiological state.

The goal isn’t to 'switch off' your emotions. It’s to allow your nervous system more room to respond, rather than react.

Where EMDR and NLP can help

For some women, PMDD seems to amplify emotional material that is already sitting close to the surface.

EMDR can be used to process distressing experiences, memories and emotional triggers that may continue to activate the nervous system. When appropriate, this can help reduce the emotional charge attached to particular experiences.

NLP techniques can also be used to explore the relationship between thoughts, language, beliefs, internal imagery and emotional responses- helping us to recognise automatic patterns and create new, more resourceful responses.

And sometimes the most powerful work is surprisingly simple:

“What am I actually feeling?”
“What do I need?”
“What have I been holding in?”
“What would change if I listened to myself?”

You don’t have to fight your body

PMDD isn’t a failure of emotional control, and you don’t have to simply accept that “this is how I am before my period”.

Your hormones are communicating with your brain. Your brain is communicating with your nervous system. And your experiences, thoughts, emotions and environment can all interact with that system.

Therapy cannot stop the natural hormonal fluctuations of your menstrual cycle, nor can it replace appropriate medical treatment for PMDD. But it can help you develop a calmer, more regulated and more empowered relationship with what happens when those fluctuations occur.

Sometimes the goal isn’t to silence the noise.

It’s to understand what the noise is saying- and learn that you don’t have to be controlled by it.

If you experience severe premenstrual mood changes, particularly depression, hopelessness or thoughts of self-harm, please speak with your GP or mental-health professional. PMDD is treatable, and psychological support can be one part of a broader treatment plan.

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