If you are the partner or family member of someone with PMDD, you have our sympathies. We know how challenging, disruptive, and scary that can be. Why does the ordinarily reliable, loving, generous, nurturing, capable woman in your life become decidedly unreasonable, overemotional, paranoid, seemingly selfish, and full of rage once a month? She seemed to like you so much only yesterday. Now she's demanding some space and acts like never seeing you again would be a gift. Is it something you did or said? It can be all too easy to take the PMDD behaviors personally and worse, lash out in return. So here are some helpful things to remember:

1) It's not your fault.

You didn't do anything to cause her PMDD. You didn't say or do anything that brought on her symptoms. Okay, maybe something you did or said triggered a reaction due to emotions she was already carrying, but in the end, each one is responsible only for his or her own behavior. Do your best. Expect her to do hers. The rest is out of anyone's hands. Be sure to help your kids, if you have any, understand this also. No one is to blame.

2) No, it isn't easy.

That doesn't mean that living with her symptoms will become a piece of cake, but it will take away some of the guilt or blame you might feel. You'll still have to find the inner strength to deal with whatever symptoms she's presenting which could range from sleeping all day, not wanting to be anywhere near you, yelling or screaming, or even self-harm. When the person you love or rely on is going off the deep end, all kinds of fearful emotions and thoughts can arise. You're going to have to find ways to constructively cope with what it brings up and out in you.

3) No, it isn't fair.

When someone is yelling at you or accusing you of something you didn't even think, let alone do, it's natural to feel anger arising. Remember, you are not your anger. Neither is she. But right now, she's having trouble managing hers because of something she can't control... her hormones. Unless you have mental and/or emotional problems of your own, it's time to be the bigger person. No one said life was fair. If you do have some issues of your own, it's your responsibility to get the help you need.

4) She's doing the best she can.

Because her body is having a sort of allergic reaction to her hormones, the most important thing for anyone to understand is that she's not necessarily in control. Even if normally, she's a very stable woman who doesn't allow little things to get under her skin, during PMDD, every minute irritation can become inflamed. It's just that her perception at this time is out of whack. There's little she can do as her thoughts turn nasty and her usual ability to dismiss them evaporates. The even worse part is, women with PMDD are completely aware of their downward spiral. That sense of helplessness as one falls through a bottomless pit of despair and dysphoria can lead to self-blame, self-hatred, and self-sabotage. Please don't add fuel to those feelings by telling her to try harder.

5) So are you!

Guess what? The same goes for you. You're doing your best too. So if you yell back, feel like swatting her (no, it's never acceptable to actually do it!), or enter into a dramatic game of who can hurt who most, call a time out, take some space, breathe, and calm down. But don't hate yourself for getting sucked in. If you're too tired to help, to over her neediness, or just plain fed up, it's okay to to take care of yourself... guilt-free.

6) While she's in extreme self-care, so should you be.

In fact, just as it is crucial for her at this time to take extra-special care of herself, it is time for you to do the same. Maybe you can't do everything you'd like... like sleep in as long as she does because someone has to get the kids ready for school... but you can still take time for yourself. You can still schedule that massage next week. You can still make sure you are eating healthy food and drinking plenty of water. You can still get in that workout at the gym or practice meditation. And you can still say "no" when asked to do something that you simply don't have the energy or desire to do. When we're empty, we're empty. Do what you need to refuel.

7) Celebrate and communicate when it has passed.

When it is all over and you can both breathe again, celebrate it. When she lets you know she's starting to feel normal, mark it in some way. Welcome her back, buy her a single flower, plan a date night, open a bottle of bubbly. Most importantly, talk about what you both felt went well and what didn't. Use this time to communicate, ask questions, and solve all those problems that it wasn't safe to approach before. Learn from mistakes and remember to do things a little differently next month... because, yes, there will be a next month!

Here are three more relevant articles that you might find incredibly helpful...

Living with PMDD: A Husband's Battle and Lessons

What We Need to Hear: A Friends and Family Guide to PMDD

Things Never to Say: A Friend and Family Guide to PMDD

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