Lying in a hospital bed with a drip attached to my arm, I looked down at the fresh cuts all over my limbs. I was 21, a final year law student with a bright future ahead of me, and yet here I was at the lowest point of my life having taken an overdose.

The year leading up this point had been a mishmash of extreme emotional  lows to the point I was convinced I was suffering from a serious mental illness. An attempt on my life felt like the only way out of being continuously sucked in to a blackhole of hopelessness.

Years later I discovered that I wasn’t suffering with bipolar disorder or something even more serious such as schizophrenia, both illnesses that are apparently often miss-diagnosed. I had been suffering from premenstrual dysphoric disorder, or PMDD.

But what caused it and how sure are we that a lack of acceptance over hormonal imbalances in the medical profession can actually be linked to mental illnesses among women? And why had it suddenly taken such hold of me?

And would it reemerge with my pregnancy or could exercise be the key to my mental wellbeing?

pms

Progesterone

Let’s go back to 10 months previously. I had just started a new relationship, had been on the pill for a few years, and doctors at my university were pushing other more enduring methods of contraception. The contraceptive implant was suggested and I felt it was time to give it a go. Any concerns I had over possible side effects were dismissed. There apparently weren’t any.

The implant, for those who don’t know, works by continuously releasing the hormone progesterone to stop the release of an egg. Often your periods completely stop.

What ensued were months of acute mood swings of which I felt no control over. My relationship was disastrously detrimental  already without my bouts of intense rage and anxiety, and this coupled with a history of depression led me to believe that I was simply ‘going crazy’. Two weeks without breaking down started to feel like an accomplishment and as I was made to feel worthless and pathetic by my manipulative boyfriend, I stood in my room after another dressing down from him and thought; “I need a break from this. I need a break from me.”

It wasn’t that I wanted to die. I just wanted to escape myself as that appeared to be the problem.

During this period I felt anger, depression and hopelessness like I had never known it. I was put on antidepressants and, while these helped repress some of the negative emotions, they also capped how happy I felt when times were good.

One day about a year later, I came across an article about PMDD, a severe form of PMS. It spoke about how women who had suffered had been driven to extremes of self-harming and suicide. Never once had I considered hormones as a possible culprit to my sudden change in personality! Not only did the time line fit exactly as to when I had the implant inserted, I also started to realise that the ups and downs were happening monthly around the time I would have had a period!

I immediately booked an appointment and had it removed. I wasn’t cured of my anxiety and depression, and the damage done emotionally over those months left a significant mark, but the severity of the symptoms on a monthly basis completely died down. It felt manageable.

Since then, no doctor has believed that progesterone could have caused such a severe reaction and they continued to push this method on me every time I got a repeat for the pill. But having spoken to many women since, there have been numerous cases where the implant made women who are more sensitive to hormone changes, such as myself, fell the same way. A simple google search shows just how many women are affected with these types of mood swings, yet no one is listening!

A sexual health clinic nurse once routinely asked me if I would consider the implant. When I said I had a history of depression, she immediately said ‘Oh no you don’t want any progesterone based contraceptives’. It was a relief to be finally validated in my experience with it. Yet still no warnings are given and no doctors I have come across want to accept that some women are severely sensitive to hormones in this manner.

Filling out prescriptions of antidepressants is easier apparently.

Pregnancy Hormones

When I became pregnant, I instantly felt fear of what this could mean to my mental health. The way it felt like something had taken over control of my body when I had the implant, was not something I was sure I could go through again.

Just so you can appreciate what kind of hormone levels we are talking about: during early pregnancy you are getting the progesterone equivalent of 400 birth control pills a day! Apparently by the end of the pregnancy it is more like 1000.

So you can understand my hesitation!

So far I have broken down over pizza, an argument with my husband that happened years ago and driving. I have at times wanted nothing more than to crawl inside my bed and never emerge from it.

I would say there have been days like this around once a month, like severe PMS. Crying down the phone to my husband saying ‘I don’t knoooowww’ when asking me concerned what is wrong, has happened twice. Luckily he doesn’t get frustrated; knows me well enough to know when it’s hormones, and thinks these mood swings are ‘adorable’. In fact at times he’s laughed because really it is ridiculous to cry about pizza. Then he gets to work at looking after me and making sure I feel cared for. He’s a good ‘un.

Another time my brother-in-law and his girlfriend heard me wailing at my husband that I was crazy. Because that is how it can feel. Super embarrassing!

So Why Didn’t I Relapse?

Don’t get me wrong, it’s not been easy or funny during those times. But never have I felt a relapse into the truly ‘crazy’ and uncontrollable depth of despair like I did 9 years ago.

And what made the difference?

After a day of hormonal crying yesterday about feeling pathetic and not good enough, and consequently being convinced my husband will realise this and leave me (another thing he thought was funny and ‘cute’), I couldn’t face the day.

But I had to get up because he’d made me breakfast, and so I went for my morning swim. 45 mins in the pool, just time to myself in my little weightless cocoon and I emerged as the ‘real’ me, feeling powerful and ready to tackle the day.

There is a lot of research into how exercise helps combat mental health issues, the benefit of which are now being recognised by the nhs. There are also many articles suggesting that, “doing cardiovascular exercises are equivalent to pressing a button to launch the hormones that help you feel good.” Thereby balancing out the less helpful ones.

What started out as a way of keeping physically fit and prepared for labour and birth, has quite possibly now become by very own personal mental wellbeing formula. I cannot think of how bad things may have been without this one thing.

My body may well have become better at balancing out my hormones as I’ve aged, but with increasing evidence to suggest exercise has a significant impact on mental health, I am not willing to risk it so easily again.