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‘I thought I was losing it, until I finally learnt why I was consumed by rage’

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Rebecca finally has answers (Picture: Supplied)

On holiday with her family in the idyllic French countryside, Rebecca Seal should have been content.

But rather than feeling a peace, the mum-of-two says she was consumed by inexplicable rage.

‘At one point, I found myself getting so furious, I threw a shoe across the room, denting the wall,’ Rebecca, 42, says.

‘I grabbed the bike from outside and cycled 7km, sobbing. I felt like the world was ending. I remember going to bed that night thinking I don’t know who I am anymore. I’ve just lost it.’

This wasn’t the first time this had happened. Rebecca, a journalist, from London, had been diagnosed with anxiety in her 20s, and struggled with feelings of overwhelm and sadness.

‘I remember sitting on a step in an ex-boyfriend’s kitchen, howling inconsolably at five o’clock in the afternoon. utterly convinced that everything was awful – our relationship, him, me, my personality, my job, everything just felt cataclysmically bad.

‘But then, just a day or two later, everything would feel OK again.’

Rebecca struggled to understanding her long list of symptoms (Picture: Suki Dhanda)

Rebecca experienced pockets of despair on and off in her twenties, but things started to get worse as she started to creep towards 40.

Rebecca says she ‘endlessly worried’ about flying off the handle in front of her two young daughters. She adds: ‘My husband, Steven, was confused and concerned. He wanted to support me, but neither of us knew what to do.

‘I would go to the doctor with a portfolio of weird symptoms: brain fog, word loss, (which was terrifying as a writer) memory lapses, extreme irritability, sadness, low mood, low energy, insomnia, night sweats, debilitating anxiety, joint pain and teeth grinding.

‘I had very high anxiety at times, which really hit a crescendo in 2020 and got to unlivable levels.

‘I also had extremely heavy periods. The bleeding was so heavy that I would have to get up a couple of times a night. I thought I was perimenopausal.’

But Rebecca didn’t spot the link between her period and how she was feeling. ‘I wish I had tracked my symptoms,’ she says. ‘I started having treatment for anxiety when I was in my teens. My insomnia started then too. But it would come and go. I hadn’t really noticed that the symptoms did too. I just knew that sometimes I felt awful. And sometimes I didn’t, but I hadn’t realised it was around my cycle.’

She employed new habits, like cold-water symptoms, which helped (Picture: Supplied)

Rebecca was actually experiencing PMDD (premenstrual dysphoric disorder), also known as severe premenstrual syndrome, which is caused by the brain over-reacting to normal cyclical hormones like oestrogen and progesterone. It means she may feel normal half to three-quarters of her monthly cycle, but then experiences insomnia, low mood and sometimes also intense anger for up to 10 days before her period arrives. She thinks she has probably experienced this since her teens but had been misdiagnosed.

PMDD is not a hormone imbalance but rather a neurobiological sensitivity to hormonal changes (so there is no blood test for it). PMDD affects 5-8% of people who menstruate, with more than 100 symptoms – both physical and mental – which kick in seven to 14 days leading up to each period. There are about 14.6 million women aged between 15 and 49 in the UK, so between 730,000 and 1.2m may have PMDD/severe PMS in the UK.

In her attempt to get help, Rebecca would make a doctor’s appointment – but would then have to wait a week for the appointment, by which time, she felt different. ‘I told one doctor I felt so anxious, I can’t function. I was trying to take care of myself in all of the ways that I’d been taught to – CBT, all the alternative and complementary medicines and lifestyle changes such as cold-water swimming and weightlifting but at times, I still felt insane.

‘The doctor said to me, “you don’t come across to me as anxious.” And right that second, maybe I wasn’t, because I was at a different stage of my cycle, so I didn’t have the jittery body language of somebody who was really frightened all the time.

‘But that’s because my symptoms ebbed and flowed with my cycle. The same would be true of work. Sometimes, things I usually find familiar and easy – like appearing on live TV, which I did a lot, going to work events, or even meeting deadlines – would feel or be terrifying, when just the week before I would have done it without thinking about it.

‘A massive chunk’ of her kids’ childhoods involved ‘lurching from being okay to despairing’ (Picture: Supplied)

‘I remember screaming out loud once just because I’d accidentally tipped water over myself – not because of the water itself, but because I already felt so physically and mentally uncomfortable that I couldn’t withstand another unpleasant sensation.

‘And when it came to worrying, I could really spiral. I only needed to have a brief thought about whether my kids were safe, say, before I’d have imagined all sorts of awful things happening to me or them. At the same, I felt quite ashamed of being so panicky and anxious, so I think I hid it pretty well for a very long time.’

Finally, in 2023, Rebecca finally got some clarity, when she got a diagnosis of PMDD.

‘I had a phone appointment with a menopause clinic and finally got some answers. After just a 20 minute consultation, they told me I had PMDD.

‘I had never heard of it before, so being a journalist, I immediately started to research it. And it instantaneously became clear to me that it’s a very under researched topic. It’s quite widespread but the actual information and data about how to best manage it pharmaceutically or otherwise, is pretty few and far between.’

She finally got a diagnosis after years of confusion (Picture: Supplied)

Rebecca is not bitter that her symptoms were missed for so long. ‘I don’t blame the GPs for not having the time or the resources to fill the gaps in their knowledge because they’re so over overworked and underappreciated.

‘There’s a structural issue, which has to do with medical misogyny that flows through society as a whole, rather than being the fault of any particular doctor.

‘But it is extraordinary to me that I saw so many doctors over such a long period of time, and nobody mentioned it. There are studies showing that it can take between 12 and 20 years to get a diagnosis. It’s horrifying.’

PMDD affects lives in terrible ways. One recent global study suggested that up to 34% of people with PMDD have attempted suicide, 51% experience self-harm and 87% experience passive suicidal ideation.

‘After the diagnosis, I felt a strong sense of grief,’ Rebecca says. ‘My eldest daughter is nine, and my youngest is six, so that’s a massive chunk of their childhoods where I’ve been lurching from being okay to feeling anxious and despairing. My husband says our marriage has been speckled by incidents where he says he doesn’t recognise me. If I had a melt down at certain times of the month, sometimes I would spend the rest of the month trying to repair the damage I felt I had done,’ she says.

Rebecca now tracks her cycle, using an app called Drip. ‘I know exactly where I am all the time, and it’s really easy for me to predict when I am going to find life challenging.

Sarah had a whole month recently where she felt ‘completely normal’ (Picture: Supplied)

‘I tell my husband and my daughters so they know that I may be more emotional on those days. Professionally, I don’t book a live speech or talk to 300 people in an auditorium in that last week of my cycle, or my level of anxiety will be too much to tolerate,’ she says.

Rebecca still goes cold water swimming and weight trains at the gym. ‘The cold-water swimming makes me feel calm and the weightlifting makes me feel strong. It helps,’ she says.

She has also just started working with Dr Louise Newson, who founded the Balance app and runs a menopause clinic who has prescribed her with a continual low dose of progesterone.  ‘I felt transformed so quickly that I thought it must be psychosomatic. This can’t be working this fast. And then I did a bit of Googling and realised that actually, there are people who have lifted their postnatal depression with progesterone in 24 hours.

‘I have only been on it a few weeks, but I had a whole month recently where I felt completely normal. And I genuinely can’t remember the last time that happened. It feels like miracle.’

Be Bad Better: How Not Trying So Hard Will Set You Free by Rebecca Seal is out now.


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