PMDD and the SSRI Tightrope: When Culture Says No and Your Body Says Help
I was at the tip of it.
Not metaphorically. Actually there. At the edge where intrusive thoughts become something more dangerous. Where you start asking questions you shouldn’t have to ask. Where your body feels like a stranger who’s actively working against you.
That’s PMDD.
Not bad PMS. Not “just hormones.” PMDD—Premenstrual Dysphoric Disorder—is when your brain chemistry shifts so dramatically in the two weeks before your period that you become someone you don’t recognize. Rage at your kids over nothing. Sobbing in the pantry. Intrusive thoughts that terrify you. And then your period starts and you’re… fine. Back to baseline. Like it never happened. Except it did. And it will again next month.
And when I was there, teetering at the edge, wondering if I could keep doing this; SSRIs felt like the answer. But culturally? Taking medication for mental health doesn’t exist in my world.
The Clash:
My culture taught me that mental health medication is weakness. That our ancestors survived without pills, so why can’t I? That strength means enduring. That faith means trusting without chemical intervention. That taking meds is Western indulgence, moral failing, evidence that you’re not strong enough. And then there’s Western medicine, holding out a prescription and saying: “This is a chemical imbalance. SSRIs regulate serotonin. Why suffer when there’s help?”
So, I stood between two worlds. Again.
Do I honor the ancestors who survived without medication? Or do I honor myself and my survival now? Do I take the pills and feel like I’ve betrayed my lineage? Or do I refuse them and risk what happens when the next cycle hits?
The Question I Couldn’t Stop Asking:
Why does Western culture push meds so hard? And the answer is: it’s complicated.
Yes, Western medicine over-prescribes. Yes, the pharmaceutical industry is profit-driven. Yes, there’s a tendency to medicate normal human emotion instead of addressing root causes. And mental health medication saves lives. And some conditions like PMDD are chemically driven and respond to treatment. And my ancestors didn’t have the option I do.
Both can be true. Western medicine can be flawed and helpful. My culture’s values can be rooted in resilience and rooted in stigma that kills people.
The tension isn’t either/or. It’s both/and.
And what I realized standing at that tipping point, is that my values taught me about inner fire. About ancestral strength. About surviving without modern intervention. But my ancestors survived because they had to, not because suffering was noble. They would have taken the help if it existed. And refusing help isn’t honoring them. It’s romanticizing their pain.
What I Chose:
I’m not going to tell you whether I took SSRIs or didn’t. That’s not the point. The point is: I listened to my intuition. Not my culture’s shame. Not Western medicine’s promises. Not the guilt or the pressure or the stigma. I asked myself: What do I need to survive this?
And I honored that answer. For some people, that’s medication. For some, it’s therapy, cycle tracking, supplements, lifestyle shifts. For most, it’s a combination. There’s no moral hierarchy. There’s just: what helps you stay alive and whole.
What PMDD Actually Is (And Why It Matters):
If you’ve never heard of PMDD, you’re not alone. It affects 5-8% of menstruating women, but most don’t know what it is. They just think they’re “crazy” two weeks a month.
Here’s what it actually is: a severe sensitivity to the hormonal fluctuations in your menstrual cycle. When progesterone drops in the luteal phase (the two weeks before your period), your brain’s serotonin plummets. For most people, this causes mild PMS. For people with PMDD, it causes clinical-level depression, rage, anxiety, and sometimes suicidal ideation. Then your period starts, hormones stabilize, and you’re back to yourself. Until next month. It’s cyclical. Predictable. And debilitating. And if this sounds familiar, if you’ve spent years thinking you’re just “difficult” or “too emotional” or “can’t handle stress”; track your symptoms against your cycle. You might not be broken. You might have PMDD.
The Cultural Weight:
I don’t expect everyone to understand the cultural clash around mental health medication.
But if you come from a culture where therapy is taboo, where medication is seen as Western weakness, where you’re supposed to just pray/endure/be strong, you know what I’m talking about. You know the weight of feeling like taking help is betrayal. You know the isolation of suffering silently because asking for help feels like failing your lineage. And I want you to know: your ancestors were strong and they would want you to survive. Honoring them doesn’t mean suffering the way they did. It means using the tools available to you now that they didn’t have. Inner fire doesn’t mean refusing help. It means doing whatever it takes to keep the fire burning.
What I Want You to Know:
If you’re struggling with PMDD or any mental health condition and you’re standing at the same crossroads I was: Your culture’s stigma is real. And you can challenge it.
Western medicine isn’t perfect. And it can still help. Medication isn’t weakness. And it’s not the only answer. Your intuition knows what you need. Listen to it. Not your family’s shame. Not the pharmaceutical ads. Not the guilt or the pressure or the fear.
You.
Listen to the full episode where I go deeper into:
• What PMDD felt like at its worst
• The cultural weight of mental health stigma
• Why “our ancestors survived without meds” isn’t the argument people think it is
• How I made my decision (and why yours will look different)
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Your Turn:
Have you navigated PMDD, or the decision around mental health medication? What helped you decide? What do you wish someone had told you? Drop me a message. Let’s break the silence together.
RELATED EPISODES:
• Episode 24: Your Intuition Is the Holy Trinity
• Episode 25: Cultural Disparity
• Episode 21: The Women in My Bones