Written by Sam Wilde

Premenstrual dysphoric disorder (PMDD) is a much more severe form of premenstrual
syndrome (PMS) that can occur among people who menstruate. It includes emotional, physical, and behavioral symptoms that usually resolve with the onset of menstruation. Symptoms include significant shifts in mood (sadness/tearfulness, hopelessness, suicidality, irritability, anger) that disrupt interpersonal relationships and impact the individual’s ability to work and engage in hobbies as well as physical symptoms of breast tenderness, bloating, fatigue, cravings, and more. Behavioral symptoms include increased impulsivity, lack of interest in usual activities, and difficulty concentrating (Mishra et al., 2025).

Research has shown that exposure to American culture increases the likelihood of PMDD symptoms in ethnic minority women (Pilver et. al, 2012). This is one example of how racism, pressure to assimilate, and restricted access to resources, impacts the physical health of people of color in the United States. Research has also shown that neurodivergent people are significantly more likely to experience PMDD (Dorani et al., 2021 and Obaydi and Puri, 2008). Though the cause of PMDD is still being researched, it may be correlated with sensitivity to the hormonal changes that occur during the menstrual cycle. Given that neurodivergent people often have more sensitive nervous systems than those of a more “typical” neurotype, it makes (unfortunate) sense that they may experience harsher symptoms during their menstrual cycle.

Treatment of PMDD currently includes birth control, selective serotonin reuptake inhibitors (SSRIs), or surgery (oophorectomy or hysterectomy). Lifestyle adjustments such as reducing caffeine, alcohol, sodium, and sugar can help alleviate symptoms. Regular physical activity and maintaining a good sleep schedule are beneficial.

If you or someone you know experiences PMDD, be gentle with yourself (and/or them). Treat yourself with all five of your senses - perhaps a candle or a bubble bath of your favorite scent, watch a comfort show or observe nature outdoors (if accessible), eat your favorite snack, listen to your favorite music, snuggle up in your softest blanket, and allow yourself the time and space to simply exist without doing. Know that the pain will pass and you WILL feel better. Reach out to a trusted friend, make art, journal, or record a voice memo. Move your body in whatever way is accessible to you. Allow yourself to feel the emotions and then release them. Honor your experience as you move through this cycle.

Written by Sam Wilde

What is Somatic Awareness?
The term somatic refers to the body (Merriam-Webster, 2025). Somatic awareness is the ability to notice and track physical sensations in the body. This might be easier said than done, depending on one’s relationship to their body and whether or not they have experienced trauma. Dissociation is a common coping strategy and survival tool used by those who have experienced trauma. Trauma occurs when something is too much, too fast for us to handle. Dissociation is one way the brain protects us from experiencing the weight of a traumatic event as it occurs or thereafter. The problem is that unprocessed emotions live in our bodies and can create muscle tension and chronic pain. Somatic therapy can provide a safe container for clients to sequence unprocessed emotions through their body and release them.

Here is a simple assessment of somatic awareness that you can try at home. Choose a song to listen to. Find a comfortable position, take a few cycles of deep breaths, and begin to bring your awareness to your body. What sensations do you feel in your body as you listen? What emotions do you notice? What thoughts do you notice? Try not to attach to any thoughts that arise, simply let them come and go, like passing clouds. Do you notice any movement impulses in your body? If so, maybe see what it’s like to follow them. When the song ends, take a few moments to journal what you noticed. Use the form below for inspiration. If you don’t notice any physical sensations during the song, that is good information too! Do you feel numb? Can you feel your heartbeat or find your pulse? Can you feel your feet on the ground or your back against a chair? No sensation is too small to notice.

Practicing somatic awareness is one way to reclaim your sovereign right to inhabit your body fully. This is a life-long journey that is best practiced both solo and in community, with trusted guides and compassion for self and others.

Somatic Awareness Assessment
Instructions: Choose a song to listen to. As the song plays, notice what emotions, physical sensations, thoughts, and movement impulses arise for you. Circle them below or fill in the blanks. 

Emotions
Happy
Sad
Fear
Disgust
Anger
Surprise
Curious
Depressed
Anxious
Aversion
Aggressive
Excited
Proud
Lonely
Embarrassed
Disappointed
Annoyed
Confused
__________
__________
__________ 

Physical Sensations
Smile
Tears
Tense
Face scrunch
Clenched jaw
Sweaty palms
Warmth
Emptiness
Racing heart
Nauseous
Feeling hot
Brow-furrow
Calm
Numb
Frozen
Lump in throat
Clenched fists
Quick breathing
__________
__________
__________ 

Movement Impulses
Wiggle
Curl into a ball
Run
Cover face with hands
Stomp
Raised eyebrows
Spin
Hide
Shaking legs
Push away
Punch Jump
Open arms
Lay on floor
Wringing hands
Back up
Headbang
Kick
__________
__________
__________ 

What thoughts arose for you during this exercise? 
_____________________________________________