In my own dark luteal days, my brain feels hijacked. Everything I feel a little early in my cycle, in my luteal phase, it’s intensified. I’m overwhelmed and I just want to shut down. Or yell. Or cry, and cry. If you, like me, are navigating Premenstrual Dysphoric Disorder (PMDD), one Dialectical Behavior Therapy (DBT) skill that can be especially powerful is “Doing the Opposite,” also known as Opposite Action.
Originally developed by Marsha Linehan as part of DBT, Opposite Action is based on a simple but profound idea: our emotions urge us to act in certain ways — but those urges aren’t always helpful or aligned with our long-term goals. When emotions don’t fit the facts, or when acting on them would make things worse, we can choose to act opposite to the urge.
For people with PMDD, this skill can be a lifeline. However, it is also rather difficult during our luteal phase to do this, so I suggest trying it during follicular so you can begin to get used to it.
Why PMDD Makes Opposite Action So Relevant
PMDD is a hormone-sensitive mood disorder that can bring intense depression, rage, shame, anxiety, hopelessness, and even suicidal thoughts during the week or two before menstruation. The emotional mind can feel completely convincing, with thoughts like “Everyone hates me,” “I’m a failure,” “I’ll never feel better,” or “I should quit my job.” In those moments, we want to withdraw, lash out, numb our feelings (often with unhelpful distractions like cannabis or alcohol), or do impulsive things like end our relationship or our employment.
Opposite Action creates space between the urge and the behavior.
Step 1: Name the Emotion and the Urge
During a PMDD flare, pause and ask:
- What emotion am I feeling?
- What is this emotion telling me to do (what urge am I feeling)?
For example:
- Emotion: Shame → Urge: Cancel plans and hide.
- Emotion: Anger → Urge: Send a harsh text.
- Emotion: Hopelessness → Urge: Stay in bed all day.
Naming the pattern reduces its power.
Step 2: Check the Facts
With PMDD, emotions often feel real but are hormonally amplified. Ask:
- Is there concrete evidence for this thought?
- Would I feel this strongly in my follicular phase?
- Is acting on this urge likely to improve or worsen my situation?
Sometimes the emotion fits the facts — and action is appropriate. But often during PMDD, the intensity is disproportionate. That’s when Opposite Action is most useful.
Step 3: Do the Opposite — Fully
This is the hard part. Opposite Action only works if you commit to it with your body language, tone, and behavior — not halfway.
- If the urge is to isolate → reach out to someone safe.
- If the urge is to attack → speak gently or wait 24 hours.
- If the urge is to quit → delay the decision until after your period.
- If the urge is to stay in bed → take a five-minute walk outside.
You don’t have to feel like doing it. In fact, you probably won’t. The goal is behavioral change first; emotional shift often follows.
Why This Works
Behavior influences emotion. When you act opposite to an unhelpful urge, you send new data to your brain. Over time, this weakens the emotional spiral. For PMDD, where emotional intensity is cyclical and temporary, delaying irreversible decisions is especially crucial.
Opposite Action isn’t about invalidating your feelings. It’s about recognizing that during PMDD, your emotional system is temporarily distorted — and you deserve tools that help you ride the wave without blowing up your life.
If you live with PMDD, consider tracking your cycle and planning Opposite Action strategies in advance for your most vulnerable days. You’re not “crazy.” Your brain is reacting to hormonal shifts. And with skills like this, you can respond with intention instead of impulse.
Even in your hardest week, you are still in there — and you are capable of choosing differently.
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.