PMDD and Acculturation

I was looking through academic journals for articles about PMDD and I ran across one out of the Journal of Affective Disorders out of SciVerse on Science Direct.  The article spoke to me specifically because it was about PMDD and acculturation.  Now, the article was specific to ethnic women of minority status being acculturated in American culture.  While I am not of a minority ethnic background, being a TCK makes me feel like a minority or like an immigrant in my passport culture.  The summary of the abstract explained that “the stressors that are associated with the ethnic minority life in America – discrimination, poverty, pressures to assimilate, etc. – may contribute to ethnic minority women’s vulnerability to PMDD” (Corey et al., 2011).

I have not dealt with poverty, except the lifestyle that a poor college student deals with, but discrimination and pressure to assimilate are issues that I’ve been dealing with since I moved back to the U.S.  I’m discriminated and pressured against to assimilate because I’m an American and I should know current pop culture and should dress appropriately for whatever subsection of the U.S. I’m in.  American culture, specifically for women, is latent with sexual images.  Women are taught from a young age, usually subconsciously, that we are sex idols.  We are to dress sexy, act sexy, be sexy.  Don’t get me wrong, I’m a partial feminist deep down inside, but I believe there is more to a woman than her body.  Women have been suppressed for decades upon decades.  We’ve made great strides, but take a look in a magazine sometime.  How are women in the ads depicted?  Sexy?  Being chased by something mysterious?  A young/younger girl-type picture?  This is another issue for another time.  My point is, I did not fit into the American culture in many ways when I moved back.

I grew up in Bahrain and the Azores.  Bahrain is a country that is very different from the United States and women do not have the same rights or freedoms they do here.  Many of my friends wore abayahs and when I turned 12, I could no longer where short-sleeve shirts.  That was the culture I was surrounded by.  I was convinced that wearing spaghetti strapped shirts was wrong because it showed off my bra straps.  So, ultimately, I was showing off my underwear!  This may sound absolutely ludicrous to some, but this was my reality.

When we moved to the Azores, I was not permitted to go and socialize in the clubs or discos.  If I had, maybe I would have been introduced to a more liberal way of life.  I understand why my parents wanted to keep me from that lifestyle.  A lot of it had to do with their Christian values.

So, I thought it appropriate to go to a Christian school when I graduated high school.  The problem is, just because we had faith in common….it wasn’t enough.  I still did not fit in with my peers.  For all intense purposes, I was a nerd and I didn’t think I would have to conform.  I was accepted in the other places that I lived even though I was different in many aspects from my friends.   

I’ve heard so often that your true friends will appreciate you and accept for who you are and if they don’t, then they’re not your friends.  That’s great when you’ve had several years to acclimate to a location or the time to develop relationships over an extended period of time.  However, moving away to college is a time in your life that you make new friends.  I made friends, but then I lost them because of PMDD.  So, in many ways I am like the ethnic minorities. 

The article also discussed that "foreign-born ethnic minorities have a mental health advantage over  US-born ethnic minorities that is attributable to certain protective factors engendered by immigrants' attachment to their country and culture of origin.  Research links these culturally-specific protective factors, namely strong social support networks, family cohesion, and religiosity, to positive mental health outcomes among minority populations".

So, I did fine when I was an "immigrant" or "expat" living overseas because I did have what the researchers were discussing.  I had a close support network with my parents, as well as other school teachers and their kids, and I had a strong religious background.  The article does not discuss anything related to immigrants moving back to their homelands but discusses that the US born minorities have a more difficult time because they are expected to assimilate.  I relate to this because I'm expected to be an all-American girl and in a lot of ways I've lost touch with my upbringing due to wanting to fit in.  It's not even remotely fair to say be yourself....there is a need for all people to fit into the bigger picture, to feel a sense of cultural or societal acceptance.  My lifestyle and the aspect of acculturation probably have played a big role in my PMDD. Stress plays a HUGE role in PMDD and can you image the stress that I've dealt with not being able to relate and integrate into the society that is supposed to be my own? 

So, where to go from here?  I’m still figuring that out, but a good start is to find others with whom I have things in common.  It was just an interesting observation.  It makes me feel better to discover these sorts of things.

References

Corey E. Pilver, Stanislav Kasl, Rani Desai, Becca R. Levy, Exposure to American culture is associated with premenstrual dysphoric disorder among ethnic minority women. Journal of Affective Disorders, Volume 130, Issues 1–2, April 2011, Pages 334-341,

Finding Happiness With a Chemical Imbalance

Sometimes, when people have chemical imbalances such as depression and PMDD, it can be difficult to find and maintain happiness.  Step into the shoes of women that deal with PMDD for a moment.  What do we look forward to?  We know that every single month, without doubt, anger, sadness, depression, irritability, among additional physical pains will be popping up to wreck their havoc on us.  Don’t you think that gets tiring?  Absolutely.  The disorder already conjures up depression on a monthly basis, but the cyclic pattern and knowing that it’s coming back around again also contributes to depression and not feeling very happy.  So, what happens is that many women with this disorder develop long-term depression (this is not a scientific fact just knowledge I’m going off of talking and discussing the issue with other women that also deal with PMDD) and feelings of hopelessness and a lot of unhappiness.

So, how can we curb this?  Being that it is a chemical imbalance, some medication may be required.  However, there are other things that an individual can do to help their well-being and mind set.

I had the opportunity to take a class called Happy Talk and two things I’ve learned about finding happiness involves finding “flow” and being “mindful”. 

A lot of research has been done about obtaining happiness.  It is said that happiness is subjective and relative.  Many people think that if they made more money, they would be happier.  That’s not always the case.  Brickman et al. (1978) explains that lottery-winners and people who have recently become quadriplegic don’t see much of a change in their happiness level as one might expect. 

Another bit of research states that people who are more extroverted have a greater chance at happiness (Lucas, 2008).  Also, those who have personality traits such as conscientiousness, agreeableness, self-esteem, and optimism warrants the ability to basically be happier than those that are introverted or without the traits just mentioned (Lucas and Diener, 2008).

Ok, so what happens if you’re introverted and you may not be optimistic or have the best self-esteem.  Introversion is a personality trait, yes, but there are things that a person can do within their comfort zone to present themselves to a more social atmosphere that an extrovert may encounter.  Find a support group.  Allow yourself the opportunity to tell your story.  Talk with people you trust and if you don’t have any, find some.  If you feel you’re not good with people, there are things you can learn to help you out.  There are social skills that can be learned.  Make sure you start small.  And keep in mind that everyone has a story and many times people just want to be heard and want someone to be interested in them.  You’d be surprised to find out that not everyone is bad or not trustworthy!

So, back to finding “flow” and being “mindful”.  What is flow?

Flow is the state you're in when you are fully engaged in a task that is interesting, challenging, and intrinsically rewarding to you. This is the experience of "losing yourself in the moment" or, as sports players say, "being in the zone." (Csikszentmihalyi, 1990; 1998).  Flow can also be stated as finding your purpose and living out that purpose fully.  The first step to finding flow is to find out what your skills are.  Don’t compare yourself to others, this is about you and what you may be good at not what society, your parents, your teachers, or anyone else expects of you.

With that being said, I’m going to jump back for a moment and make sure that you understand that happiness is often based on expectations, as well (Gilbert, 2008).  By allowing yourself to lower your expectations about certain things, you’ll be allowing yourself the opportunity to experience happiness.

So, how do you obtain flow? 

After you figure out what your skill set is, challenge yourself.  Do something you’re good at but push it to the limit.  Don’t push it too far because you might become discouraged and give up altogether.  If you’re in a job that is boring or that you don’t like – consider getting another job.  If that is not feasible, challenge yourself in your job.  Make your own goals.  Make up games.  Make the job interesting.  Only you will truly know how to do that.

What is mindfulness?

 Mindfulness is paying attention to your situation, your actions, and your feelings.  This can take practice, too.  It means to slow down in the business that we can often get caught up in.  It means not allowing consumerism to take over our lives because now you know, these things ultimately won’t bring you happiness.

It’s about finding others, interacting with others, finding something you can get lost in the moment with and being mindful of yourself and your situation.  I’m going to give these things a try.  If you’ve had experience with any of this, I would love to hear your feedback!

References

Brickman, Coates, & Janoff-Bulman (1978). Lottery winners and accident victims: Is happiness relative? Journal of Personality and Social Psychology, 36: 917-927.

Csikszentmihalyi (1990). Flow: The Psychology of Optimal Experience. New York: Harper and Row.

Csikszentmihalyi (1998). Finding Flow: The Psychology of Engagement With Everyday Life. Basic Books.

Gilbert (2006). Stumbling on happiness. New York: Knopf.

Who Knows Better?

Who knows better, you or the doctor?  You would hope your doctor....

Every time I've gone to see my doc, he doesn't give me very much information as to what he thinks I'm dealing with.  That implies to me that he isn't quite sure.  I know what it is!  It's called PMDD!  I've known it for the past 6 years!!!  And when I get stressed out, I have a tendency to get depressed (shown through my anger and irritability). 

Why can't medical professionals just acknowledge that this is a real thing?!?!

My doctor prescribed me abilify along with my antidepressant.  I wasn't sure what it was.  It's considered an atypical anti psychotic (which sounded kinda heavy duty to me!).  When I researched it, it's a medication that is typically used for patients with schizophrenia or bi-polar disorder.   It can also be used for patients who aren't responding that well to their antidepressant.  It's suppose to augment the affects.

I've been on it now for three weeks today.  Ok, that's a lie.  I didn't take it last night and I had very good reason for it.  I, in no way, condone ignoring what a doctor prescribes.  But I am an advocate for understanding your own body and how you react to medications.

I was on lithium for over a year several years ago.  That is a time in my life that I barely remember anything.  I started to feel like that again.

The first week was ok, the depression had subsided.  But my menstrual cycle hasn't begun, so now I'm freaking out about if I'm pregnant or not.  I've taken two pregnancy tests so far and both have come back negative.  Last night was rough!  And when I say rough, I mean - my brain was having a hard time functioning.

My hubby and I got into a fight over some finances.  The stress of the fight got me really worked up.  I started screaming and crying and when he wanted to leave, I freaked out even more.  I don't do well when my loved ones want to leave me alone.  Anywho, from that point on I could barely formulate sentences and was exhausted trying to carry a conversation.  That's ridiculous for someone who doesn't typically have a hard time talking, thinking, or feeling.  Last night was an extreme to how I've been feeling the past two weeks.  It's affecting my job and I need to be on the ball and need to be able to explain concisely what I'm doing and why.

Because of these factors and the fact that I've been on a mood stabilizer and had a negative experience with it in the past, I decided to just take my antidepressant and not the abilify.

I already feel tons better today.  My mind seems to be quicker and sharper.  I'm tired, but that's because of the emotional outburst that happened last night.  Other than that, I'm quite alert mentally.

So, who knows better?  Me....or my doctor?

I'll take some Prozac, with Abilify and sprinkle some Xanax on the side...

I just realized that I've been on 10 DIFFERENT medications for my PMDD in the time span of 7 years.  That's sad.  I'm not even 30 years old yet.  And honestly, I feel like that is a problem.  I went for 3 years medication free until I had a relapse, but I'm realizing how stress plays a huge, and I mean HUGE, part in this disorder.  For more info, go here (type in stress in her search box) and read this article.

Man, I get so aggravated at myself.  You think I would know this by now, but it's like a light bulb just went on.  TADAH!  Stress really triggers your moods, Megan.  Stress is really not a good additive when you're in PMDD phase.

My friend and I were talking about how our doctor's pretty much blow us off when we bring any sort of self-found material into their office.  God forbid a person try to understand themselves and what might be beneficial to their health.  Oh, no.  You're encroaching on their precious territory and it becomes almost like we're showing them up.  Have you ever experienced this?  So, instead of listening to you....you get a fast food pharmacy instead. 

So, what do you want for it?

The oh, so infamous question. 

What do I want for it??? 

Well, first, I would love for you to listen to me.  Second, I would like for you to look at me.  And third, I would like to know if you know any other alternatives to what I can do to help myself besides pumping umpteethbagillion different drugs through my body.  That's what I want!!!! 

This is EXACTLY why I went stopped seeing doctors and stopped all medication for three years.  Was it hard?  Oh, yes.  Was it miserable every. single. bleeping. month?!  Oh, yes.  But did I feel true to myself the other parts of the month?  YES!  And that's the difference.

I don't want a smorgasbord of drugs.  I get that they're there to help, but when your doctor realizes that one medication, two medications, three medications, etc aren't working.....wouldn't you think they would be smart enough to figure out that maybe - just maybe - that's not the fast fix they're looking for?!

I shouldn't be as surprised as I am at how easy it is to get whatever drug you want.  I just would hope that doctor's have some human-ness left to their souls and would think about their patients' health and not always about the money.  A girl can dream right?