Are you a high achiever with Premenstrual Dysphoric Disorder (PMDD)?
Oct 28, 2024
High achievers set big goals and have the discipline and determination to reach those goals. It’s a mix of ambition and grit. They keep going through challenges because they have a clear vision with an unwavering drive to make that vision a reality.
Does that sound like you (at least in your follicular phase)?
If you are a high achiever with PMDD, keep reading to explore why you don't have to wait for "perfect" or symptom-free cycles to be YOU and pursue your goals or vision.
Are you a high achiever with PMDD?
If you are a high achiever with PMDD, it might feel like a CLASH between your high achiever nature and the reality of your PMDD symptoms.
Perhaps it looks like this:
- You calculate how many days of productivity you lose to PMDD symptoms each month while internalizing the guilt and shame that you can't keep up.
- You see the first drop of blood of your period and quickly start planning all of the things you need to do before the next luteal "storm" hits.
- Then you go into TURBO mode trying to be the perfect student, parent, and/or employee to make up for lost time and productivity.
- You ignore or push past your limits, knowing that your "good days" are numbered and you better get things checked off the list.
All of those things are signs of what I call "Post-Menstrual Hustle Syndrome."
It's almost as if your high achiever nature make PMDD symptoms even more painful. One of my new clients just starting her journey described it like this:
I am confident, have good self-esteem and resilience but that fails during luteal due to despair, depression, and insecurities. I seem to move between being an incredibly driven and self-motivated over-achiever and barely able to function. [I've] been feeling that life would be easier if I weren't so competent/driven/intelligent because the extremes between two sides of the month wouldn't be so much.
Hits home, doesn't it?
This pain stems from another trait that often accompanies this personality type: High achievers have a deep need to be valuable. If a high achiever is achieving measurable success or receiving accolades, they often feel great. However, if self-worth is measured by achievement, the idea of not accomplishing enough can trigger intense feelings of worthlessness.
With that in mind, it's no wonder why the stark contrast between the cycle phases triggers the above signs of "Post-Menstrual Hustle Syndrome." This fear of not measuring up, especially during the luteal "bad days" phase, often leads to hustling, overworking, and perfectionism on the "good days."
Underneath all of that, there's another layer. You see, it's not just about checking things off of a list or getting things done. It's so much more than that. If any of this is resonating with you, you may have experienced this nagging thought:
"Who would I be and what would I be capable of if I had more days feeling like the 'real me'"? That nagging thought is sometimes connected to an intuitive knowing that you are indeed meant for something more... your calling or purpose.
That nagging thought represents an internal conflict, being caught between who you know you could be yet held back by your symptoms. It's like this invisible force that dims your internal light. The result? You feel disconnected from your purpose in a way that feels deeply unsettling yet hard to put your finger on.
Let's explore how you can pursue those goals, even with the menstrual cycle (and symptoms) you have now.
How can I pursue my goals and purpose if I have PMDD?
Here's the good news:
You don't have to wait for "perfect periods" to pursue your goals or vision. You might just need to do it differently, your own way, in rhythm with your current cycle and capacity.
In fact, I see that when people honor their current cyclical capacity while taking intentional steps towards their goals, it nourishes their soul and, in turn, can actually help with symptoms. Why? They feel less like a victim to their cycles and more empowered.
As we explore how to do that, let's remember this:
Your worthiness is not determined by your achievements. You are worthy, just as you are today.
Or as my mom liked to remind me growing up as a Type A, perfectionistic little kid, "You are not what you achieve." Thanks for that, mom.
When you realize you don't have to WORK to be WORTHY, the cyclical fluctuations in productivity become less triggering. Knowing (and practicing the belief) that you are inherently worthy, loosens the tight grip on the outcome or goal so that you can see the power in your cyclical nature.
As a fellow high achiever, below are some of the lessons I've learned the hard way. Keep reading for insights on how to lean into your strengths as a high achiever, without letting perfectionistic tendencies or feelings of unworthiness run the show. No "hustling for your worthiness" required. Thanks for that one, Brene Brown.
1. Pace yourself on the "good days."
What you do in one phase of your cycles, impacts all of the other cycle phases. Translation: Overworking and pushing past your limits on your "good days" can backfire and make the "bad days" even more challenging.
The antidote? Pacing yourself.
Start with a daily self-check-in. Do a mental check-in or written using our PMDD-specific cycle journal. This type of journaling is the first step to not only collecting data about your symptoms, but also looking beyond your symptoms for the other nuggets of wisdom that your cycle has to offer you.
- I'm feeling/thinking...
- In my body I notice...
- I wish I didn't have to...
- I'd really like to...
(Download the journal here for more specific prompts.)
As you're doing those daily check-ins, notice if the "Hustle Syndrome" is showing up. You might experience it as a sensation of being rushed or plowing forward, restlessness, or shallow breathing. If you notice that, PAUSE and observe. Then mindfully slow down what you're doing (plus schedule breaks) and see your productivity actually increase.
When we tune into our emotions and nervous system response, we have more clarity on how to tend to those needs so we can keep going all cycle long, rather than crashing and burning by the time we hit luteal.
The takeaway:
You don’t have to make up for lost time. In fact, it may worsen PMDD symptoms for the next cycle. Instead, notice your needs and honor your capacity every day of the cycle, not just during the luteal phase.
2. Identify your cyclical superpowers.
These daily self-check-ins are the first step to increasing your cyclical awareness and the challenges and limitations but also strengths and super powers that come with each cycle phase.
As you journal, you may notice themes emerge for each phase of your cycle. Perhaps there are things you resist during certain cycle phases that feel easy and effortless in others. Or you might notice you naturally gravitate to certain types of tasks during particular phases.
Keep in mind that everyone has a different experience of their cycle, but here's an example of what it looks like for me:
- Menstrual Phase: As I surrender and retreat into rest, somehow the act of letting go brings clarity. When I slow down, I feel more connected to myself and my purpose. I often receive a gentle nudge in the right direction for next step's in my goals, relationships, and work.
- Follicular Phase: Post-bleed my energy levels start to increase and I experience increased focus and productivity. Taking direction from the menstrual phase, I pace my energy as I get to work. My goals and vision all of the sudden feel more possible.
- Ovulatory Phase: For me, this phase brings increased energy and desire for social connection but also increased anxiety. I plan for active social time to release restless energy. I continue taking paced action while also sharing my ideas with colleagues and asking for constructive feedback.
- Luteal Phase: I experience the first week of this phase as an intense need to get things done. If I pace myself, I relish in the dopamine hit from checking things off the list. I also intentionally give a set amount of airtime to my Inner Critic so she can voice her concerns and help me identify where I need to shift my boundaries.
Explore on your own:
Here's a graphic from inside the PMDD Revealed program to save to your phone and reflect later. Using your new PMDD-specific cycle journal, notice the trends and themes that emerge with each cycle phase (beyond your symptoms).
Challenge yourself to see and embrace each cycle phase for what it is, rather than placing more value on cycle phases that feel easier (or more productive or socially acceptable). As you continue to explore with curiosity, your own cyclical limits, preferences, and strengths will become clear.
One other caveat: As you get to know your cycle phases, remember that each individual menstrual cycle will be different. Sometimes on the path to honoring our cyclical nature, we can unintentionally become rigid in our expectations of those cycle phases to help us feel safe and secure. Instead, check in with your self daily and embrace each cycle day and each cycle phase as it comes. There are no rules. Let it be messy. Let it evolve.
The takeaway:
Menstrual cycle awareness helps you understand and honor your limits while also maximizing your cyclical strengths and superpowers, even if you experience PMDD symptoms.
.png)
3. Rebuild trust in your menstrual cycle (and yourself).
If you're struggling with severe PMDD symptoms, it's almost like your menstrual cycle becomes the enemy to your goals and erodes the trust you have in yourself and your capabilities. It can feel like you are taking one step towards your goals and two steps back… every single month. I
If that's you, begin here: The daily self-check-ins we covered above are the launching point to learning how to befriend your cycle.
With time and support, you'll learn how to live cyclically, even in a society that doesn't yet notice or honor your cyclical nature. That's an integral part of what we explore inside the PMDD Revealed program.
As you do that little by little, you can rebuild trust in your menstrual cycle again. You learn how to work with your cycle, instead of against it. More importantly, you'll build trust in yourself again.
The takeaway:
Meet yourself where you're at. Embrace the cycle phase that you're in, even if it feels messy. Take small steps that honor your current daily and cyclical capacity.
A Functional Medicine Root-cause Approach to PMDD
The above steps can help you take meaningful steps towards your goals and purpose, without ignoring your needs or white-knuckling it through symptoms.
Yet, we also understand how hard it can feel to even identify what your purpose is when those symptoms feel like they overshadow every facet of your life.
That's why our company mission is this:
To help thousands (hey, why not millions!) of people free themselves from debilitating mood and menstrual symptoms so that they can reclaim their life and live out their purpose.
Why? We know that helping our clients achieve tangible and measurable relief from PMDD symptoms leads to an intangible impact on the world. We call that the "Ripple Effect." It's our term for when someone can now live more fully and give back to their community while fulfilling their purpose.
Our mission is to help you find relief with a data-driven root-cause approach. With reduced symptoms, your vision for your life and purpose naturally become clearer and clearer (even if you have no idea what that is right now).
Here's what our client Anna had to say about that:
The symptoms got in the way of feeling capable of doing the work I like to do. Learning ways to relieve symptoms UNLOCKED my ability to participate in meaningful work again.
Keep reading to hear Anna's story and the profound "Ripple Effect" she's now having on the menstrual health and PMDD community.
A PMDD Story: How Anna when from Debilitating PMDD to Femtech Founder
Meet Anna. She came to us struggling with PMDD symptoms like mood changes and exhaustion. As a self-identified high achiever, she felt like she would fall apart for two weeks each month and then spend the rest of the month picking up the pieces. She wanted stability for her family.
When I asked her what was standing in the way of finding relief, she shared that she believed it was "TIME and SELF-DISCIPLINE." Classic high achiever response.
Spoiler alert: Neither of those things were true. Her barrier to finding relief from PMDD symptoms was neither time nor discipline. It wasn't her fault. She simply needed a more precise strategy and lots of support.
Here's her story.
The Before
I was diagnosed with PMDD and I just had my second child. I was wondering if this was postpartum depression. But what it felt like was I would have a week where I enjoyed being a new mother. I felt satisfaction out of life for one week. The next week, everything would kind of darken. I was very tired. It was harder to focus. And then the week after that, I needed help. I couldn't do my normal work or job. And then the next week, I felt okay, but I was exhausted trying to pick up the pieces from the two weeks before. This wasn't sustainable for my family. It's not how I wanted to live.
She had tried so much already...
She worked with a psychiatrist, therapist, gynecologist, and even a different dietitian. She had tried two different medications, one of which INCREASED symptoms and the other helped with energy but NOT PMDD symptoms.
Her new diagnosis brought her the understanding she needed, but not relief. Since birth control and antidepressants didn't work for her, she started asking, "Now what?"
Can you relate?
I got this diagnosis I had never heard of before. And it was honestly a relief to put a name to what I was experiencing. But it kind of stopped there. I spoke with my psychiatrist, my gynecologist, my general practitioner, and they all were aware of PMDD but didn't quite have the toolbox for me, or what should I do now beyond here's some birth control, which I knew didn't work for me.
The Process
Her goal in working with us was simple:
"I have a good life. I want to enjoy it."
Anna knew she needed a different toolbox to get there. Antidepressants increased her symptoms and she didn't feel "right" on birth control.
"I found Mandy in a desperate Google search one night, trying to figure out who could help me with PMDD. And I was thrilled to see somebody who was practicing functional nutrition, who also had PMDD. I immediately connected with her story."
She joined the PMDD RevealedTM program and followed the Reveal MethodTM.
Our 4-phase Reveal Method combines what we know from PMDD research with the data we gather on YOU. We translate that data into actionable steps so you know WHY you're feeling like this, WHAT to do, and HOW to do it. Then we measure and assess progress along the way so we're always tweaking and refining your plan to achieve as deep of relief as possible.
Here's a recap of what that looked like for Anna:
Phase 1: Reset
During the first month of the program, we covered foundational changes for quick relief.
She began cycle tracking using the Reveal Method. She set doable nutrition goals to support blood sugar regulation based on her cyclical needs using our meal prep tools designed for PMDDers. We explored both the physiological and emotional triggers to her cravings: how to work with her body. We also outlined a streamlined supplement to support taking the edge off of the symptoms while we prepared for testing to do the deeper root-cause work. Just from these foundational changes, in the FIRST month she cut the number of severe days IN HALF from 10 to 5 days and reduced the severity of symptoms by 30%.
Phase 2: Reveal
For each client, we customize which tests will be most helpful to fuel our data-driven approach. For her, we did both extensive blood work and Neuro-Adrenal-Hormone testing. With her testing, we uncovered that she had extremely low nutrient levels along with hormonal imbalances (which is not always the case with PMDD).
She also had low levels of cortisol and catecholamines (dopamine, norepinephrine, and epinephrine), experiencing symptoms like:
- Fatigue with minimal "get up and go" energy
- Feeling flat and depressed
- Low motivation or desire to do anything ("high achiever trigger")
- Difficulty focusing and concentrating
- Needing caffeine, sugar, or chocolate as a "pick-me-up"
If you've ever been told your labs are "normal," rest assured that we dig deep to find the imbalances that may be contributing to symptoms. Then we take strategic action in the next phase: Rebalance.
Phase 3: Rebalance
Fueled by her lab data, we worked together to bring those systems back into balance. Step by step, we made targeted nutrition and lifestyle changes, with a continued focus on meal solutions and prep strategies that would work well for her entire family as a mom with young children. We explored Menstrual Cycle Awareness strategies to help her work with her cycle. (You'll read in a bit how that inspired her big project.)
We also brought in strategic supplements to address the root-cause factors we had identified. Beyond foundational supplements like a multivitamin, magnesium, and fatty acids, we brought in more targeted mood-focused supplements to support dopamine. This was a game-changer for her.
With each step she took, she saw deeper and deeper relief... all while navigating life as a busy working mom and household manager.
Phase 4: Reclaim
After doing the deep work during Phase 3 to address the underlying imbalances, she was ready to graduate from the program with a streamlined protocol to sustain her progress. We outlined exactly which nutrition and lifestyle changes were most important to sustain her progress and created a simplified maintenance supplement plan. She graduated with clarity on how her needs change throughout the cycle, how to specifically support each phase.
The Result
As a result of working us through each phase of the Reveal Method, she experienced over 65% symptom reduction in just 3 months. But we weren't done yet. After three months, I (Mandy) went on maternity leave to have twins. She maintained her progress during that time from June to October, sustaining what she had learned. You can see it all in the graph below.
Based on how much her symptoms had improved, she decided she felt ready to go off meds and made a plan with her doctor to taper off. As you can see in the graph below, she maintained her symptoms med-free for the first time in YEARS.
Her life is forever changed. In her own words:
"Honestly, it was the best care I've received from any type of practitioner. I hadn't received care like that before or since. I've never worked with somebody in this way and it's really, I think, gold standard for care. I'm still using what she has taught me and my life has totally changed because of it."
What FINALLY made the difference?
She didn't need more TIME and SELF-DISCIPLINE as she once thought.
You see, for Anna and most of our clients, not finding relief is almost never due to lack of effort and trying. She was TRYING everything she could on her own without seeing any results.
When that happens, we often blame ourselves. (Do you do that, too?)
What she needed was data-driven strategy and personalized action steps. Once she knew the right steps to take, she took those steps consistently and (intentionally) imperfectly so that it felt sustainable in the context of her busy life.
Hear it straight from Anna in the video below:
The Ripple Effect: From PMDD to Femtech Founder
With her newfound capacity, Anna is now giving back.
Giving back started by sharing her story more openly. She felt less shame and more empowered to speak up. That voice grew into a new menstrual tracking app called Embody that's now helping thousands upon thousands of people.
Embody is a private-by-default cycle wellness app to help you unlock your cycle superpowers. Honestly, it's the app I would have created myself and it now lives on the homescreen of my phone and that I recommend to clients. We have also officially come full circle: Anna asked me to contribute nutrition and menstrual cycle awareness content right inside the app. You can download the app for free here.
"Fast forward to today, I now have a menstrual health startup company and really it's all thanks to what Mandy has taught me. This is important information we need to know that really affects our wellbeing. And that's something I am lucky enough to get to work with her on carrying forward into the future." Anna Hall, Founder of Embody
Ripple effect in action.
Next Steps
Everything changed for Anna when she combined the art of menstrual cycle awareness with data-driven strategy to create her personalized plan.
If you feel like you've tried it all like Anna, we got you. Take the first step to experience our special sauce of a systematic root-cause approach combined with community & cyclical awareness by scheduling a no-cost 1-on-1 Strategy Session.
During this Strategy Session we will:
1. Evaluate your symptoms and cycle patterns to suss out the underlying root factors.
2. Explore WHY what you've tried hasn't worked and identify the missing links.
3. Map out your personalized strategy for more peaceful periods.
Click here to snag a spot on my calendar.
You have a whole life to live. It's time to live it.
DISCLAIMER: All information is meant for education only and is not intended for the diagnosis or treatment of disease, nor does it serve as a substitute for medical treatment or advice. You should seek the advice of a physician with any questions or concerns regarding personal medical conditions.
Author
Mandy Rother
Functional Dietitian
Moody & Menstrual blends the science of a root-cause approach to PMDD with the art of menstrual cycle awareness so that you can learn to go from the PMDD tsunami to peaceful periods.
Subscribe to Moody & Menstrual for weekly coaching and PMDD real talk, every week.
Peaceful Periods Guide
Symptom tracking is essential. HOWEVER, there are 3 tracking mistakes that stand in the way of it actually helping you get relief.
Download + watch to learn a different way to track your cyclical patterns as the first step to reclaiming your life from PMDD.
Is PMDD stealing half your life every month?
It's time to work with your body, not against it. Unlike conventional band-aid solutions, we'll take a root-cause approach so you can stop guessing and finally get relief.
Recent Posts
