Update 2016: this post was written in 2007. I now know that all systems can be impacted by trauma. Trauma is an agent of general destabilization and dysregulation in our bodies, minds and spirits. As holistic beings everything is impacted. This article doesn’t surprise me at all anymore.
I got turned on to this article (reprinted below) via Stef at Life with PMDD. This is really shocking in my mind. I know that other mental distress has a close link to childhood and adolescent trauma, but I wouldn’t have guessed that severe PMS would have that same link. Unfortunately after this study in 1998 there seems to have been no more interest in this finding. Dropping the ball on studying trauma and mental distress seems to be the way it goes with that which gets labeled mental illness. (since 2007 when this was written the tide has been turning. Trauma is being recognized as significant to everyone. We live in a traumatic world)
The article does not postulate why this might be. Does trauma dis-regulate our endocrine systems as we are growing and changing? The women in the study are found to have more incidences of major depression as well, separate from their pre-menstrual distress. As you know I was diagnosed with bipolar due to menstrual related distresses and I know of several other people (two of whom I’ve sat down to a cup of tea with) who have been diagnosed with bipolar disorder while only having symptoms during their premenstrual phase.
Okay now the article I start this post with:
Severe PMS linked with physical, sexual abuse in childhood
By LESLIE H. LANG
UNC-CH School of Medicine
CHAPEL HILL — More than half of women with a severe form of premenstrual syndrome are likely to have histories of physical or sexual abuse during childhood or adolescence, according to researchers at the University of North Carolina at Chapel Hill.
The findings of their study apply to women diagnosed with premenstrual dysphoric disorder (PMDD). This psychiatric condition affects 5 to 10 percent of women in their childbearing years, and is characterized by bouts of major depression and/or anxiety during the second half of the menstrual cycle and severe irritability before subsiding with the onset of each menstrual period.
“About 50 to 60 percent of the PMDD women may have sexual or physical abuse histories. That is much greater than you would expect in the general population of about 20 to 25 percent,” said the study’s lead author, Dr. Susan S. Girdler, assistant professor of psychiatry at the UNC-CH School of Medicine.
“The severity of PMDD symptoms are as great — or can be as great — as those of women with full-blown major depression or major anxiety disorder,” she said. “But what makes them different is that the symptoms are very time-limited and linked strongly with the women’s menstrual cycle.”
Girdler emphasized that to qualify for PMDD, symptoms must be severe enough to interfere with everyday functioning — to disrupt relationships, result in social withdrawal, even prompt thoughts of suicide.
“We are talking about women who meet very stringent diagnostic criteria for PMDD,” she said. “This is not the garden variety PMS.”
In a report published Nov. 16 in Psychiatry Research, Girdler and her colleagues from the UNC-CH departments of psychiatry and psychology and the School of Public Health note evidence showing that women diagnosed with PMDD also tend to have chronic stress in their lives on a daily basis. This finding, they say, confirms that of other studies and further supports an important role for stress, either as a cause of PMDD or in making its symptoms worse.
The study of 12 PMDD women and 12 healthy women without the disorder looked at responses to life-stress questionnaires, tests of anxiety and depression and to several stressful experimental situations.
These included a “speech stressor” test in which each study subject gave two three-minute talks on what her actions and emotional responses would be to hypothetical interpersonal “hassles.” Scenarios included dealings with an inconsiderate houseguest and a used-car dealer. Cardiovascular measures were recorded, as were blood levels of the major stress hormones norepinephrine and cortisol.
Besides finding evidence of greater chronic life stress and severe traumatic life stress, physiological abnormalities in the stress response system of women with PMDD were documented for the first time.
“We saw evidence that their stress response systems are dysregulated,” Girdler said. “Measures of norepinephrine were abnormally elevated in PMDD women, while their cortisol levels were abnormally low. And we saw this regardless what day of the cycle we looked at. This abnormal elevation in norepinephrine was found all month long.”
As Girdler pointed out, norepinephrine, a neurotransmitter, is a brain chemical that plays an important role in regulating mood.
“And it has been strongly implicated in depression,” she said. “So we think that abnormal norepinephrine levels may play a role in premenstrual dysphoria — depression — that many of these women experience.”
As the UNC-CH team adds more women to the study, differences between the groups persist as stated in the journal report. So far, results confirm other studies that show about 40 percent of women with PMDD have histories of major depressive episodes.
“This is separate from PMDD. This is full-blown, long-lasting major depressive episodes,” Girdler explained.
To date, Girdler and her colleagues have studied and compared more than 20 PMDD women and their healthy counterparts and hope to enroll more.
“These women are often frustrated by their contacts with the medical community,” Girdler said. “They are very happy to help in any way they can to help validate what they feel is a real physiological disorder. These women feel very misunderstood. Their disease is very hard to live with, and yet few people understand how disruptive and devastating it can be.”
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I appreciate this thread too. I can’t even get started digging into what the hell happened to my endocrine system since I’m so pissed the medical diseases I’ve been living with since age 16 did not have to happen. Actual concrete reproductive and thyroid disease that correlate to sexual abuse in research, not to mention my um, LIFE. PMS off the charts, dysmenorrhea, endometriosis, and I take a thyroid pill everyday because while growing up my family nearly killed me? Yes.
Depakote can cause PCOS even when taken by women over the age of twenty. I know two young women who developed it shortly after taking it in their early twenties, twenty-three and twenty-four years old. They both became infertile because of it and gained a lot of weight. One even developed diabetes and she wasn’t even taking any anti-psychotics. It can be a very effective mood-stabilizer for some, but the endocrine risks for women need to be much more closely examined. I was on it for years and wouldn’t get my periods for three and four months at a time.
Two docs who work for the mental health center that I used to go to did an interesting study several years back that ended with the conclusion that psych patients are just naturally prone to endocrine disorders and that drugs like Zyprexa and the other atypicals actually PREVENT diabetes and other endocrine problems in psych patients. How’s that for a giant load of crap? I’m wondering which drug company funded their study. One of the docs involved put every damn patient he had on Prozac Weekly and Zyprexa. Maybe it wouldn’t be so hard to guess which drug company funded that study.
Depakote has a blackbox warning for women under age 20 for Polycystic Ovary Syndrome; and due to 6 years use of that drug it was confirmed by endocrinology/gynecology/psychiatrtry experts that my daughter in fact has it from the Depakote. It’s important to note that many of these medications cause irreversible body damage sometimes, and we are just learning what type of damage. By the time the blackbox warning came out for Depakote, it was too late for my daughter. Hopefully parents of young children on these medications [such as depakote] will note those warnings and not have their kids learn the hard way.
Wow Gianna, you are really opening the door to a lot of discussion that is so necessary re: women’s hormones, and psychiatry. Kudos to you, and the Mayo Clinic? Nice self-advocating! Good luck, you may just find the key to many women’s angst.
This is very interesting. I don’t have PMS of any kind that I’m aware of, but we only have two to four periods in a year, because we have PCOS – Poly-cystic ovarian syndrome.
“Our” psychiatrist, the one we’ve had off and on for a decade, who is the best one we’ve had in that time, says that definitely yes, sexual abuse and other trauma screws with the endocrine system. We have had problems with almost every major gland (nothing with the pituitary, as far as we know).
Hmm. We have a sibling who suffered horrible PMS, before they started calling it PMDD. She was impossible to live with, felt absolutely wretched, and had periods from hell – I’ll stop there before I get WAY too TMI. She also has / had PCOS, and she had the lining of her uterus burned away to deal with that and the danger of cancer it poses.
I don’t know, though, what her hormonal situation is like since that procedure. She doesn’t have periods, since then, but that doesn’t mean she doesn’t have the whole hormonal enchilada. I just don’t know, since she chooses not to be involved with us.
Uggg…when I gave up caffeine (coffee is my drug of choice, other than that I only drink water) I was sick for a month. Yes, I said a month! I actually went to the doctor numerous times in one week.
Of course this was one of the times I was diagnosed with bipolar, LOL. So, I have been in that same boat with you. I explained I was sick sick, not mentally sick this time when I came in and they said my ‘strange’ behavior was all about my ‘bipolar’. I left with all sorts of medications.
Needless to say, I didn’t fill the prescriptions. LOL, I even left with a muscle relaxer/pain medication.
Coming off of the caffeine put me through an exhaustion/pain like I had never felt before.
I stayed off for 3 months. I wish I could say it helped with my PMDD like most Women, it didn’t. I didn’t notice any changes unfortunately.
I decided coffee being one of my fave pasttimes, I took it back, just at a much lower dose, LOL.
It is definitely a big NO-NO for women with PMDD, I just didn’t notice a big enough diff for me personally and like I said, it’s my drug of choice. I don’t drink or anything else.
I love to read and have my coffee, laptop and coffee, visit w/ friends and coffee. 🙂
Hmmmm….did I say at a much lower dose?!? 🙂
Good luck to you, I hope you are like most and it will do wonders.