Premenstrual Disorders

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had been left home with her five younger siblings while her par-

ents went to a party. Kendra was not happy because she had wanted

to attend a party at her best friend’s house. One of her brothers

was fooling around with the TV remote when suddenly there was

no picture; none of the children could produce one, even though

they tried continuously for about an hour. Kendra could feel herself

get angrier and angrier. Finally, she grabbed her brother’s arm and

began to twist it behind his back. Then she hit him over and over,

screaming, “Why can’t you leave anything alone?”

The other children watched with their eyes wide. When she was

done, Kendra sent them all to their rooms. She sank down on the

floor with her legs tucked under her arms and cried. Her parents

came home late and did not discover the television problem until

the next day. No one mentioned Kendra’s fit.

As time went on, Kendra had various “fits of anger” and began to

engage in destructive behavior, almost always during the days right

before her menstrual period. Once she stole a motorcycle and sped

through a huge empty lot; she remembers thinking, All I want to do

is drive all this meanness right out of me. Can’t I ever feel good about

myself? She drank, started using recreational drugs, and was failing

most of her classes—even though she had scored high enough on

her SATs to gain a scholarship to a good college.

When she got caught drinking on her college campus, Kendra

finally had to look at the issues causing her behavior. She was very

fortunate to have been assigned a counselor who knew and cared

about women’s issues. Her counselor asked questions about Ken-

dra’s past, about her eating habits, about her menstrual periods,

about relationships, and how Kendra felt about herself. It didn’t take

the counselor long to help Kendra see the influence her menstrual

cycle had on her moods and her decision-making process. The coun-

selor worked with the physician at the school, and Kendra began

taking a low dose of an antidepressant.

When she first learned about the PMS and the use of antidepres-

sants to help control the symptoms, Kendra told her counselor, “Just

give me the pills and I’ll be okay. I don’t need to talk about all this