A few months ago, I was driving my kids home from the grocery store, playfully arguing over which song to play next on our Spotify account (my son wanted Kendrick Lemar; my daughter and I Taylor Swift). I was in early luteal, so my PMDD symptoms were mild. Before I realized what was happening, a cyclist (who I now realize was drunk) swerved in front of me at a green light, barely missing my vehicle. I gasped while he locked eyes with me and laughed, and immediately, I shut down. My kids were terrified, as it was rare for their mother to go for more than a minute without speaking. My window of tolerance had slammed shut without much warning, an unfortunate symptom of my PMDD.
PMDD (Premenstrual Dysphoric Disorder) is a severe form of premenstrual syndrome (PMS) that affects millions of menstruators globally. It brings intense physical and emotional symptoms that can disrupt daily life, relationships, and work during one’s luteal phase (the time between ovulation and menstruation).
One concept to help understand our emotions and reactions is the window of tolerance. This concept, rooted in trauma therapy and emotional regulation, can help PMDDers better understand how our bodies and minds react to stress, hormonal fluctuations, and issues during our cycle.
The Window of Tolerance: A Key to Emotional Regulation
The window of tolerance is a term used to describe the optimal zone in which our bodies and minds can process stress, emotions, and external stimuli. The window is a metaphor, and when we are feeling okay – we can think clearly, respond to challenges with calmness, and healthily regulate our emotions – we are in our window.
When the window starts to close, we begin to feel dysregulated. This can happen more easily during our luteal phase, and our responses become heavier, more exaggerated, and we find ourselves However, during times of extreme stress or hormonal fluctuations (like during PMDD), individuals may find themselves outside of their window of tolerance. When this happens, emotional responses become exaggerated, and coping mechanisms may be impaired. Understanding and working with the window of tolerance can help people with PMDD gain better control over their emotional and physiological responses during this challenging time.
The Three Zones of the Window of Tolerance
- The Optimal Zone (Window of Tolerance):
- In this state, we are calm, grounded, and able to think clearly. We can manage stress, handle emotions effectively, and engage in everyday tasks. During PMDD, staying in this zone would mean being able to handle symptoms without being overwhelmed or shutting down. You can still experience discomfort, but you are better able to manage it.
- Dysregulation (When the window begins to shut):
- When our window starts to close, we feel heavier feelings. We begin to notice our irritability or anger increase, and our emotions start to feel out of control.
- Hyperarousal (Above the Window) and Hypo-arousal (Below the Window):
- When the window “slams shut,” we go into a state of either hyperarousal or hypo arousal, or what might be commonly known as fight/flight/freeze states (fight/flight – hyperarousal; freeze – hypo-arousal). When in hyperarousal, we may are in a heightened state of anxiety, and may feel bursts of anger, meltdowns, or even panic attacks. During hypo-arousal, we feel numb and detached, and my disengage from others during this time.
How PMDD Affects the Window of Tolerance
During our luteal phase, our window is more sensitive, and we may find the window closing and/or shutting more often, and faster than usual. To help with our PMDD symptoms, we want to be mindful of our window, and alert those closest to us (partners, friends, children, etc.) when the window may be closing.
Tips for Staying Within Your Window of Tolerance During PMDD
- Mindfulness and Self-Awareness:
- Tracking your symptoms and emotions throughout your cycle can help you anticipate when you’re likely to move outside your window of tolerance. When we feel our windows closing, we can use techniques like mindful breathing to help open our windows up.
- Emotional Regulation Techniques:
- Developing healthy coping strategies is key to managing PMDD symptoms. Techniques like grounding exercises, progressive muscle relaxation, or journaling can help keep our windows open.
- Establish a Routine:
- A predictable daily routine can help your body feel more in control. This includes regular sleep patterns, nutritious meals, and physical activity. Regular exercise, especially activities like walking or swimming, can help regulate mood and prevent overstimulation.
- Stress Management:
- Since stress can easily push you outside your window of tolerance, finding ways to manage and reduce stress is essential. This may include engaging in hobbies, spending time with loved ones, or practicing relaxation techniques. If you feel like you’re approaching hyperarousal, try a calming activity like listening to soothing music or taking a warm bath.
- Seek Support:
- When you’re struggling with PMDD, having a support system in place is invaluable. At Impart, we focus on DBT and other talk therapies to help our clients during this time. Other providers, like massage therapists, acupuncturists, and naturopaths can be extremely helpful in managing our overall symptoms.
Recognizing our windows and the role our PMDD has on it helps our emotional regulation.
About the Author: Nadine Evans
Nadine was diagnosed with PMDD nearly a decade ago and subsequently left her corporate career to become a therapist. She and other therapists at Impart Therapy all focus on PMDD treatment and therapy, and her book, Mastering the Monthly Madness provides a DBT-focused guide to help with PMDD.
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