The Work You Can’t See

Content Warning: Suicidal Ideation, Medical issues, depression



In the past few years, I’ve been very open about my struggles with PMDD. I wrote *this essay* which circulated on several websites, about PMDD and what my experience with it has been like. In the past year, I finally got on medicaid and got proper medical treatment. I started on a progesterone-based birth control pill and a low dose of an SSRI. Together with some helpful supplements, and meditation, my symptoms have improved greatly. I’m thankful for no longer losing half of my month to the array of physical, mental, and emotional symptoms. 

While my condition has improved, it’s not gone altogether. This week, I had some PMDD symptoms again. They are in no way as devastating as they have been. Unfortunately, this disrupted my life off and on for the better part of a week, at a time when I need to be on top of things, while managing my stress and well-being. 

The onset was almost sudden, last weekend. It started with extreme, illogical loneliness. Sadness, anger, and anxiety soon followed. I was slammed with flashbacks of painful memories, some of which have been burried deep. When that happens, it takes hours for me to meditate, self-soothe, and redirect these thought patterns. It’s a lot of work. I started to lament my depression and lost time. 

I wanted to die. 

It sounds silly and melodramatic to say that I often want to die once a month, but it’s a fact of my existence. It’s hard to find a light at the end of the tunnel, to see where the cycle of loss and grief and failure will ever stop. It feels like the only way all of that exhaustion and pain will end is when I rest for good. 

Most of the times I have wanted to die, I was in a tremendous amount of physical or emotional pain – or both. It wasn’t so much that I couldn’t think of anything about life that was enjoyable. There are many things I love about being alive. 

I just wanted the pain to stop. 

I get sick and tired of being sick and tired. I wish I had a body and a brain that bounced back from trauma and illness faster than it does. I have to accept that I don’t, and be okay with my reality. Trying to make other people understand that reality is a difficult task. And to work extra hard to be functional while you can is a trap. You can’t get much in the way of assistance if you are partially functional. People ask you things like, “Why don’t you just try harder?” or “If you could do those things one day, why can’t you do the same things today?”

If I gave in to my physical and emotional symptoms and never enjoyed anything or made an effort on my good days, I wouldn’t be here. I would have given in to those thoughts of dying, at the worst, or ended up living on the street, at best. 

The trap of partial functionality is a tricky one. You can be viewed as not sick enough to be sick. At the same time, the hours/days/weeks you put into accomplishing the things you do manage are not good enough for most people. Someone will always be there to tell you that you didn’t try hard enough. Someone will always be there to tell you it took too long, not understanding how hard you have to work just to accomplish those things. 

Then you are gifted the hard-to-erase label of “flakey.” People give up on you – collaborators, bosses, friends, lovers, family. Even the people who do stick around get frustrated with your inconsistency. You’re great when you are well, but mostly useless and a burden when you’re not. 

I have spent a lifetime getting bad medical advice, prolonging my pain and suffering  because of idealologies surrounding reproductive health care. First, it was my mother who didn’t want me to go to Planned Parenthood when I was a teenager when my problems began. Then it was doctors refusing to give me certain tests, or telling me I couldn’t get an IUD, exaggerating the risks of these procedures. 

My ability to reproduce was put ahead of my physical and emotional pain. Now here I am, nearing middle age and exhausted. I am childless, and while for the most part, I am at peace with that, I live with the understanding that this is primarily due to how PMDD affected my jobs, income, and relationships. If I could do it all again, I would risk my fertility in a heartbeat to have all of those hours of my life back, to not have had so many things fall through the cracks. 

For this, and many other reasons, I will keep fighting for myself and for other women. I will shout loudly and proudly all of the things that I am, and everything that I have survived. I will never give up my fight for bodily autonomy and to be seen as the valuable, whole, complicated being that I am . 

Sometimes, I am very, very tired, and in a lot of pain. I choose to be proud of how many times I could have left this plane and didn’t. I will choose to be proud of the things I have managed to accomplish and the experiences I have had, despite my exhaustion and pain, and regardless of whether or not anyone else sees that or understands. 

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