Bipolar vs. PMDD & How to Deal With Post Episode Guilt with Robyn Tamanaha LMFT
Have you ever said or done something in luteal that left you cringing with guilt and shame?
Have you wondered whether you might have bipolar disorder or PMDD or both?
Want to know how to tweak your daily routines to help boost your mood?
This episode is for you!
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On it, I chat with Robyn Tamanaha, LMFT, a Licensed Marriage & Family Therapist, based out of California. Robyn specializes in Bipolar Disorder and OCD, and works with clients who have PMDD. She and I talk about:
The differences between Bipolar Disorder and PMDD and how they are diagnosed.
How you can learn from an episode or meltdown to balance your mood a bit better and perhaps prevent one in the future.
How you can use symptom tracking to look out for the 'yellow flag'.
The #1 daily habit you can start changing now to improve your mood.
About RobynRobyn Tamanaha is a Japanese American Licensed Marriage & Family Therapist in Orange County, CA. She provides video therapy to individuals that live in the state of California. She has been a therapist for over 10 years and has her own private practice where she specializes in helping people who are living with Bipolar Disorder and OCD.
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Title: Bipolar vs. PMDD & How to Deal With Post-Episode Guilt with Robyn Tamanaha, LMFT
EXCERPT (00:00)
Robyn: It seems small, but it's actually quite huge because you're helping to regulate your body. It's huge for mood disorders. I work with anxiety too, and like panic attacks and stuff like that. And like, that is also something we discuss.
INTRO (00:13)
If you want to learn how you can live better with PMDD, this podcast was created for you. This is Mindfulness for PMDD with Diane. I'm Diane and I'm a registered dietitian and lactation consultant. I'm also a mom, a PMDD warrior, and a trauma-informed mindfulness teacher. And this is where I discuss topics related to PMDD through the lens of mindfulness and meditation and where I share all about how mindfulness has gotten me to a place of greater peace and acceptance with my PMDD.
I also chat with people who have helped and inspired me along the way so they can share their wisdom with you too. So let's get started.
SAFETY NOTE / DISCLAIMER (01:05)
This podcast is not a substitute for psychological therapy or medical advice. Please take care when listening to this podcast, as some may find certain words or subjects triggering or difficult to hear. Take only what serves you and leave the rest behind.
WHEN POST-EPISODE GUILT DOESN’T FEEL LIKE THE REAL YOU (01:22)
Have you ever felt so guilty or shameful over something you said or did in the luteal phase that just wasn't the real you and you wish you had handled it differently? That's exactly what Robyn Tamanaha and I chatted about in this episode.
We also discussed bipolar disorder, what it is, and how it's often a misdiagnosis or a comorbidity in people with PMDD, meaning some people actually have both diagnoses. And Robyn explains to us how our daily activities influence our mood and how we can use that to our benefit.
Robyn Tamanaha is a Japanese American licensed marriage and family therapist in Orange County, California. She provides video therapy to individuals that live in the state of California. She's been a therapist for over 10 years and has her own private practice where she specializes in helping people who are living with bipolar disorder and OCD. So without further ado, please enjoy my chat with Robyn Tamanaha.
Diane: So Robyn, I am thrilled to have you here today. Welcome.
Robyn: Thanks for having me. I'm happy to be here.
Diane: So Robyn, just jumping straight in. Can you tell us a little bit about yourself and what it is you do and your connection to the communities around bipolar disorder and PMDD?
Robyn: Yeah. Yeah. So I'm in California, Orange County specifically, but I have clients all over the state of California. I've been a therapist for over 10 years now. I actually started in like nonprofits and community health, community mental health facilities. And then in 2018, I shifted into private practice, which was always my intention from the start of college.
Robyn: And my goal was to actually focus on mood disorders. I love working with them. And then I later added on OCD. But yeah, so that's my specialty is actually like bipolar disorder and mood disorders. It's my passion. I love working with them. So yeah, it's a little bit about me.
Diane: That's awesome. So I actually started learning more about bipolar disorder when I stumbled across your YouTube channel. I was looking for some information about PMDD, and in fact, what I found first was a blog post that you had written for your website, I believe, about PMDD, and that led me to some of your content around bipolar disorder, which was, I don't know, that was just exciting to stumble across because it's one of the subtopics under PMDD that I've really been interested in covering for some time now, but was looking for the right person to chat with.
Diane: And so one of the things I've known for a little while now, or as I've understood it, is that it's not uncommon for a person with PMDD to be misdiagnosed with bipolar disorder. But then as I was getting more and more into your content, I began doing more and more research into bipolar disorder and I stumbled across something from the IAPMD, which is the International Association for Premenstrual Disorders.
Diane: And I learned there that it's possible to have any of a number of combinations of PMDD, bipolar disorder, and/or PME. So, for example, they say it's possible to have just PMDD and not bipolar disorder, and the reverse, bipolar disorder and not PMDD. But also PMDD and bipolar disorder with premenstrual exacerbation of the bipolar symptoms.
Diane: So this is like the part that's all new for me, right? They also said you can have PMDD and bipolar disorder not with premenstrual exacerbation of the bipolar symptoms, and that you can have premenstrual exacerbation of your bipolar disorder symptoms, but not PMDD. So this is all like new territory, new information for me. And I bet it is for a lot of people.
Diane: And I'm, so I'm wondering if you can sort of talk a little about that, meaning like, what exactly is bipolar disorder? How does it differ from PMDD and PME? And like, what are some of those experiences someone might have, or what might it look like in real life if you have some combination of those?
WHY PMDD AND BIPOLAR DISORDER CAN BE SO HARD TO UNTANGLE (06:37)
Robyn: Yeah, it's a good question. And going off of what you first said too, like, as far as like misdiagnosis, that's something that unfortunately is not uncommon. Whenever I think of that, I always think, like, I kind of look at the timeline of the symptoms and when they occur, right?
Robyn: We know with PMDD, when it's starting, it's like week before menses period, right? And then going into menses, the symptoms start to improve, and then throughout, you know, it continues to do so. And that's not necessarily the case with bipolar disorder. So PMDD is more like cyclical, you know, kind of around that menses period, whereas bipolar disorder, that's not necessarily what the timeline may look like.
Robyn: So what I've noticed, and I'll kind of shift into bipolar here, is like, when it comes to bipolar disorder, this is what I do as the clinician first, no matter what, no matter what the mood disorder is, even if it's something like just depression. I'm getting a sense of: when did your symptoms occur? And what were they?
Robyn: And so I'm literally writing it down on like a line and throughout therapy, we're getting an idea of more information. Some people come into therapy and they're like, I know exactly when these symptoms occurred. I know when they stopped. I know how many.
Diane: Yeah.
Robyn: And that doesn't always happen, though. So sometimes it's kind of us along the way, like discovering like, okay, here's how the symptoms are manifesting now. It's now in this time period. Maybe it's around the menses. Maybe it's not. So that's helpful. That's helpful information.
Robyn: I think with PMDD, we usually say, like, have you been tracking the symptoms for at least like two months? I'd even go a step further sometimes depending on like the time of year, because with bipolar disorder, there's a lot of things that can influence mood episodes. It may not necessarily be menses. It may be irregular sleep. It may be stressors. You know, is there family history of bipolar disorder? Were there lifestyle changes?
Robyn: So with bipolar disorder, there's a lot of moving parts that can influence an episode. And we're trying to also narrow down, like, okay, what are the things that trigger your episodes? Whereas with PMDD, it's like, okay, we know it probably is centered around the menses, right? So I don't know if that kind of answered the question. I can go a little deeper into it, but I don't know if that answered the questions.
Diane: I think it does. I think I'm also a little bit curious. I mean, have you seen situations where someone is perhaps experiencing bipolar disorder and kind of in the same stage of life?
Robyn: So, technically, like, if I go DSM criteria —
Diane: Which is the Diagnostic Statistical Manual.
Robyn: It's usually like, you know, the question has come up, like, can you have both?
Diane: Yeah.
Robyn: And so we have to really, really look at it because is it actually like the bipolar symptoms? This is what I've seen since I predominantly treat bipolar disorder: is the bipolar symptoms exacerbated pre-menses? Like, is that what happens to be the time period that they're experiencing a bipolar episode? It can influence it, especially, you know, with women and like hormones and all different things.
Robyn: With PMDD it's like, what I've seen — and this isn't, you know, a large, I mean, the biggest sample size would be if somebody did research on all of it, which I'm sure everybody did — but in my case, I've noticed it's like, well, these symptoms are actually exacerbated by the menses or menstrual cycle starting.
Robyn: That doesn't mean somebody can't have both, but it really takes going at, like, really meeting with a specialist who's familiar with bipolar disorder to really tease out the symptoms, when they're occurring, how they're showing up, what's triggering them, and is it, you know, where is it around the menses?
Robyn: Because, again, like with bipolar disorder, it's not always predictable around menses. It literally may be other things like lifestyle factors, all different things that actually could influence an episode. So it takes a lot of teasing out.
Robyn: And so, realistically, I do have clients where they've come in, they're already diagnosed with bipolar disorder, but now we're trying to just get them more familiar with their symptoms. But then I also have clients who are like, this is brand new to me. I think this is what I may have. And then through meeting with them, it's like, okay, yeah, looking at your history. And then now let's go forward and let's see how these symptoms kind of pan out as I'm giving you treatment. It takes some time to narrow down, just like with PMDD, right? It's looking at like a few months and what symptoms occur, and did they occur within that particular timeframe?
Diane: Yeah. And I can imagine that it's got to be a really tangled web to kind of tease apart because as I'm hearing you talk, I'm thinking one, you could potentially just have your symptoms exacerbated by the menstrual cycle and not have PMDD. But also, to your point of how mood states can be affected by so many different things, perhaps it could be that during the menstrual cycle, there were other factors that changed that then exacerbated the symptoms, right?
Diane: Because if you think about someone who has a menstrual cycle and how so many of our lifestyle factors or our appetite or our sleep or what have you changed during that time, like it may not be the menstrual cycle itself or PMDD itself that's causing those changes in the symptoms. So it does sound like it's quite a lot of untangling to be done.
Robyn: Yeah, it is. And like, so whenever somebody, say somebody comes to me and they're like, you know, I'm experiencing mood shifts, like up and down, or whatever, whichever direction, I'm like, okay, what does it look like? What are the changes? How is it showing up? Like, how is that manifesting for you? How are you expressing those mood changes or those symptoms?
Robyn: And then, what's going on around that time period, right? Is it menses? Is it other things? Was there a promotion at work? Was there seasonal change? And then how long did it last? So I really like, whenever somebody says one symptom, that's just one. I'm going through each one with them asking those questions.
Diane: Yes.
Robyn: And them sharing as much as they feel comfortable. And I always say, we're going to do this nonjudgmentally. If anything, this will be helpful information and data moving forward so that you can get to know yourself more when it comes to these symptoms. And then also, so I can best help you when these symptoms show up in a way that works for you.
HOW DAILY RHYTHMS CAN BECOME PART OF MOOD SUPPORT (14:05)
Diane: Yes. If it's okay with you, I want to dive into this a little more because this is one of the things that you — I did find you talking about on your YouTube channel that I felt like, oh, my gosh, I feel like in the clip, you are kind of speaking more toward your bipolar disorder clients or someone interested in bipolar disorder, but I felt like it was so relatable for people with PMDD. And that is where you talk about how mood states can be connected to daily activities.
Diane: So you mentioned like, not just daily activity, but like general lifestyle or your routines. And I feel like that's something that is also a huge part of life with PMDD, is kind of learning how your lifestyle, your environment, your sleep, your diet, all of these things can affect your PMDD.
Diane: So realizing that bipolar disorder is your specialty, but also knowing that you do work with clients with PMDD and that a lot of it is relatable back and forth, are you happy to share a little bit more about this idea of how mood states can be connected to daily activity?
Robyn: Yeah, it's one of the foundations. And for me as a therapist, when I'm working with clients, it's actually the starting point. So I get a picture of what they're called daily rhythms, but you know, all of that, what that looks like. And then also stress and responsibilities when it comes to adults, getting an idea of that first.
Robyn: And then if there's anything that they're struggling with surrounding those things, because that is the foundation for mood management in general too, is lifestyle and stress management. And if those things are discussed and kind of problem-solved in a way that works for the person, then we get to take it a step further and really kind of process diagnosis and all that.
Robyn: But I think first, you know, that is the anchor, which is the lifestyle, and everybody's is different and everybody wants theirs to look different. So it's very much unique to the individual, and factoring: are they married or are there kids? Are there other responsibilities that they have towards others? And then kind of what's workable there, what could be assisted so that, you know, stress, especially when I think PMDD, especially like pre-menses.
Robyn: Ideally overall to have a good rhythm down, but especially pre-menses, we may even add in like some extra things, extra assisters or things that may really be helpful because during that time period, if there's some irritability or feeling down or anxious, it'd probably be super helpful to add in a few more things to get them through that.
Diane: Yeah.
Robyn: Absolutely. Absolutely.
MAKING A PLAN FOR THE MOMENTS THAT LEAVE YOU FEELING GUILTY (17:09)
Diane: Okay, so we're going to get a little more into the mindfulness part of this, I think, because another really fascinating thing that you talk about is this idea of post-episode guilt, which, I mean, I think it says it all right there in the book, you know, the way you describe it. But you say that post-episode guilt is when, you know, if you're living with bipolar disorder — and I would even say PMDD — experiences guilt for perhaps something they said or maybe something they did during an episode. Or we can even say during the luteal phase.
Robyn: Mm-hmm.
Diane: Because I think people with PMDD or PME, and definitely myself, I think we can all relate to that. And you also go on — well, let's talk about that for a second. Do you, like, yeah, let's talk about that for a second, if you're happy to talk a little about post-episode guilt.
Robyn: Yeah, so it can be for both PMDD and bipolar disorder. And the reason being, I mean, with bipolar disorder, there's one of the questions I ask is when you're experiencing episodes, or if we're trying to kind of decipher, is this them or the episode? It's like, are you doing anything that's uncharacteristic, like outside of something you would normally do?
Robyn: And with PMDD, what I've noticed is when it comes to the sadness or especially irritability piece, they're like, whoa, who am I? Like, what did I — what happened? Because it was just like a rush of emotions, understandably, given what they're going through.
Robyn: So naturally with that, there's going to be some, oh no, like feeling bad either right after, maybe later, and trying to pick up the pieces or really having a lot of self-judgment. So naturally, I always say, it's a manifestation of a symptom. It doesn't sound like that's you, really. It just sounds like that's what had occurred.
Robyn: And then again, I'm like, okay, now, moving forward, this was something that was triggering or stressful or whatever it may be. If this happens to happen again, what could maybe we kind of pre-plan out and game plan so that, if anything, you could take better care of yourself during that time, whatever it was that had happened? So yeah, it definitely occurs for both PMDD and bipolar disorder.
Diane: And I love, as you were talking, I wrote down, is this characteristically me? Because I love that. It's so true. We can really be so hard on ourselves because of whatever action that was that we took and sort of forget to have compassion for ourselves that this is something that's happening as a result of whatever condition we have.
Diane: And yeah, we can use that information going forward to make a plan for the next time it comes around, but also to remember that, no, this isn't characteristically me necessarily, and maybe give myself some grace for that.
Diane: And the reason I say that I feel like this is more kind of going into the mindfulness element is when you talk about some of those things we can do to plan ahead, for me, I can't help but see the sort of mindfulness connection. Because mindfulness really, ultimately, is being able to connect with your experience in the present and just be accepting of what you find there without judgment, with kindness, with self-compassion.
Diane: And then, if you can take that even further, it's how do we take meaningful action going forward out of that? And you talk a lot about — and I invite you to talk here — about some of the ways you can, like, make a management plan and look at the factors that maybe caused that action that you didn't feel so good about, and what we could do going forward to try to help better manage those symptoms or maybe alleviate some of that post-episode guilt in the future. So if you want to share some thoughts on that.
Robyn: Yeah, I'm very much a visual person, and I do predominantly video therapy. And so I do a lot of share screens where I have these different kind of boxes and handouts where we're literally both looking at something and we're like, okay, here's the symptom, and what does that look like for you? And I'm kind of jotting down how they express it so that also speaking to what you said, to mindfulness, when it does show up in that way, they're better able to recognize it quicker.
Diane: Yes.
Robyn: Right. And then on that, we're talking about what are maybe triggers to it. You know, are there things that make it better or worse? And so I'm doing all of this and I'm typing away, and I give it to them so that they have it all down and they can take a look at it and reference it. And that's something we're kind of building along the way throughout therapy together.
Robyn: Because first it takes kind of reflecting back nonjudgmentally on past experiences. And then through that, through therapy, I'm like, okay, if you're experiencing that now, or if I notice that maybe kind of budding, or maybe we're getting towards that pre-menses phase, I'm keeping an eye on it too with them and being like, okay, how do you feel now? Do you feel different? Do you notice anything? Is anything a little more sticking with you a little longer as far as triggers or sadness or irritability?
Robyn: And then hopefully the goal is where they can do what you said, where they've done so much practice reflecting back and then me really having dialogue with them in sessions to where they can be like, okay, I know what I'm experiencing. Like, they feel the emotion and then they're also able to pause and be like, oh, I see where it's coming from.
Robyn: And then the next thing is like, okay, what action am I going to take? Because you can have the emotion and you can have the symptom. And then next usually is the expression of it, which sometimes has led to post-episode guilt or anything like that. So then it's like, okay, what are maybe some things that might be helpful to do instead?
Robyn: And that's where, like, what makes it better and what makes it worse questions come into play because then I get an idea and they do for themselves on, like, okay, here's some things that I can practice doing. Or maybe it's even releasing stress. Like, if you have a lot of tasks, like household things or errand things or whatever, dinner, whatever it may be, would it be helpful to get some help with that? Would you like to hand that off to your partner during that period? And maybe so there could even be things that are kind of stress relievers to help kind of manage the symptoms from potentially expressing too.
THE BASIC TOOLS THAT CAN MAKE A BIG DIFFERENCE (24:34)
Diane: Yes. As you're exploring all of this with your clients, I wonder if there are practical tools that people tend to like more or that you find really useful. For example, you talked about potentially getting help with something that's causing a lot of stress. Are there any practical tools that you and your clientele particularly like, either for doing that kind of backwards reflection and understanding our triggers and symptoms better, or for looking forward and sort of making a game plan to how to manage symptoms better in future?
Robyn: Yeah, there's a few. I think one, at least initially, is tracking. I know there's the app, the PMDD tracker. Very rarely do people write things down, even myself included. So starting to kind of log and track your symptoms. If anything, I'm usually curious on like, what one is starting to express first? What symptom? Because sometimes that can be like a little yellow flag here. So definitely tracking symptoms, like, for sure. And then that also helps with that mindfulness.
Robyn: And then also stress management. In my practice, I have a lot of high achievers. Very successful, very driven. Great. But sometimes they want to do it all. And so really taking a look at what things that you notice are like stressors, or you feel like you have to do, but you don't really want to do. And kind of taking a look at that or thinking, how can you best take care of yourself after you're doing those things?
Robyn: Is there something helpful as far as, you know, yoga? Is it a few moments of silence? Is it calming music? I listen to lo-fi music. You know, what can you do to kind of counterbalance that if you have a lot going on so that you're not so, like, charged? Because that can influence stress and stuff.
Robyn: And really adhering to sleep and eating. For sure sleep schedule. Making sure to eat too. So sometimes it's just the foundational things: sleep, eat, stress, and then kind of tracking the mood. I would say start there.
Robyn: And then I know you mentioned that the website, the one for PMDD, the IAPMD, that has a load of resources. I know they have a lot of different handouts, which is actually similar to some of the stuff I mentioned, like tracking your triggers. But just starting out, I would say, just start with the basics.
Diane: Yeah.
Robyn: Yeah.
Diane: Which oftentimes I feel like — and I'm a lactation consultant as well, and I've seen this in my lactation work as well — I think sometimes people can feel a bit hesitant or, oh, maybe like, the basics are just too basic. And yet often when we, if we can kind of step back and shift to focus on the basics, often that can have such a huge impact before we even move to anything more complicated. I mean, do you find anything similar like that with your clientele?
Robyn: It seems small, but it's actually quite huge because you're helping to regulate your body. It's huge for mood disorders. I work with anxiety too, and like panic attacks and stuff like that. And like, that is also something we discuss. Because the body is kind of dysregulated a bit. Sleep is the best way to start regulating the body.
Robyn: And I think given that a lot of my clients are very like, oh, big goals, big goals when it comes to therapy, which I think is great. I'm like, we'll definitely get there. But starting out with the sleep as one of the foundations. And when they do that, they actually start to notice how the other things become easier. The management of stress becomes a little easier, right? Their mood becomes maybe a little more moderated.
Robyn: So it does sound like, really, that's it? But it's like, it's one of the things, but it's one of the main things starting out. Like, especially with bipolar disorder too, that's also an indicator of a potential episode, is sleep that's really off. So that's something we have to really make sure to figure out how to get it back to something that is a little more regulated, because that will help regulate the person that's experiencing that diagnosis, because usually that's one of the first things to go. Is too much sleep if they're in a major depression.
Diane: Yes. Yes. So regulating that sleep and cleaning up, as they call it, our sleep hygiene.
Robyn: Yeah. And the way I talk about it with my clients is like, let's start small. What if you get in bed like 20 minutes earlier than usual? We don't know when you're going to fall asleep, but at least — because realistically, when it comes to sleep hygiene and really getting it to an ideal time, whatever time that may be for the client, it's usually like hours earlier. It's like incrementally doing it over a few weeks.
Robyn: So like the first week, it's like, can you start your nighttime routine a little bit sooner? So then you get into bed like 20 or 30 minutes earlier than you usually do, and then do that for a week. Try it out. And then if that goes according to plan, then the next week, okay, let's take it a step further, 20 minutes, 20 to 30 minutes earlier than that. So any change realistically happens like in a gradual way. It's not like a huge shift, it's actually small increments.
Diane: Yes.
Robyn: That in itself can take time.
Diane: Sure. Yeah. Small incremental goals. I just interviewed one of my mindfulness teachers and we were talking about, sometimes it can feel overwhelming to do, to remember to do, to create a habit around mindfulness exercises, habits, what have you. And we were saying the same thing about talking about, what's just the 1 percent version of the change you want to make? Or can you do 100 percent but like literally for a minute? Like, how do we find different, like, smaller increments of that goal to help ourselves to have a better chance of getting there?
Robyn: Yeah.
TRACKING YOUR EARLY CLUES WITHOUT TURNING IT INTO PRESSURE (31:29)
Diane: You talked about mood tracking. Yes, I'm familiar with different PMDD trackers out there. And I can also kind of name some of them in the show notes or point to that page. However, what I'm not familiar with is different ways of tracking mood for bipolar disorder. So I wonder, one, if you'd like to talk about that, and two, related to this, you talked about early symptoms and maybe how we can use that tracking to catch symptoms early. How do you do that with bipolar disorder? Do you have specific ways that you like?
Robyn: So I wish there was — there used to be a really good app out there for actually tracking any symptom because you could just customize it. I know the PMDD tracker, you can add in symptoms. So for me, I actually have like a handout that I have that has all the episode symptoms. But again, it's like one of those things where it's kind of hard to do for some.
Robyn: From my experience, the clients that do like writing things down and that are open to tracking end up finding different mood journals. There's a lot of different mood journals out there, or just a journal in general. And so what I have them do, if they would like, is at the end of each day, kind of writing down what their emotions were and then anything that was stressful or highly activating or something that brought their kind of mood down in a way.
Robyn: So that's kind of a more simplified way, is just writing down the emotions itself, and then any triggers or whatever was going on that day in like a few words or a phrase. It doesn't have to be anything big. And then that's, I think, probably the easiest form.
Robyn: But again, I mean, it's not something that everybody kind of does. I feel like I have a lot of pretty successful clients that are super busy, or they got kiddos, and I forgot. And so if not, I'm like, well, let's — you know, I'm seeing them weekly — so it's like, let's really reflect back on this week. And then I'm able to ask them questions about their emotions in general. What was it like? Because I can get a sense of whether or not they were experiencing potent symptoms.
Robyn: And if they're seeing me, I can also sometimes see it, like just in their behavior, kind of how they're showing up. So if they're seeing me weekly, I can pretty much just discuss it. But if not, yeah, there's always the mood journal or there's like the different mood tracking apps out there.
Robyn: I think the better ones are the ones where you can like click the little plus sign and like, I will be with my clients like, okay, let's add this symptom and now we're going to add this one. That way they can easily check it off. And we're making sure to catch the symptoms that are actually a full episode rather than sometimes the apps have maybe a few, but it doesn't catch everything.
Diane: Yeah. Yeah. So it really is down to the person. You can use an app, you can use a journal, but you don't need anything fancy. You can kind of create, grab a notebook or a pad of paper, jot down maybe what you're finding in your own experience, start keeping a track of it. Yeah, some people, that works for some people. It doesn't.
Diane: You talked about early symptoms. This really rang some bells for me because it took me a while, but in my own experience, I did start to learn kind of how to catch those earlier signs so that I wasn't so blindsided by really big, really uncomfortable symptoms later on. Can you talk a little bit more about that? About early symptoms and how we can start to acknowledge them or identify them?
Robyn: Yeah, everyone's is going to be, might be different too. So, like with bipolar disorder, we're looking at, is it mania, hypomania, or depression? I noticed it's easier to identify the depression ones.
Diane: Okay.
Robyn: The other, at least with bipolar disorder, because like if they're in mania or hypomania, they're kind of like, this is great. Like, or I'm just doing all these things. There's not really a lot of — they're kind of going. So everyone's starting symptoms may be different. And then how it's expressed may also be different as well.
Robyn: So that's why I was like, well, if they're doing, let's say they're doing a mood journal, right? Or bipolar, when we look back at the pages after where they felt kind of neutral or moderated, it's like, okay, what was that next page? What was on there? Is that something, were those starting things something that was triggering or is that actually one of your starting symptoms? So that's something where we're kind of gathering over time.
Robyn: And then the same thing with PMDD, it could vary a little. So maybe for PMDD, it could also include like, are there things that you notice might generally kind of trigger you or trigger some emotions?
Diane: Yes. Yeah. I think that in general, as much as you can, it can be a good idea to capture as much information as you can to start to get to know your own experience better. I know, and again, I am more of like a type A person. I like to write, I like to keep lists. But for a period of time, I had a notebook where each day I would track not just mood, but like, did I exercise? Did I take a walk? Did I, like, I don't know, do mindfulness exercise? What did I eat?
Diane: Because by then I learned that like, histamine and gluten were big triggers for me, so did I get any of that or did I not? And then like, how was I feeling? When did I go to bed? Like, over time it became more and more, but that's because the more information I started to track, the more I started to see those patterns and see which things I was reacting to and which things really had a major impact on my mood.
Diane: And so again, like, obviously for everyone, one, their experience will be different, but two, the way that they like to, or find easiest for beginning to be more aware of all those factors around their symptoms and their experience. It sounds like in many different situations, regardless of what type of condition or mood disorder we're talking about, it sounds like it really can make a huge beneficial impact if and when we can find ourselves kind of collecting as much information as we can to start to look for those patterns.
Robyn: And too, especially if a person has a routine down, like they're doing certain things a week, certain exercise activities, or they have a pretty good rhythm down, then it's like, when does it change? What do you end up noticing that you're not really interested in doing as much or you kind of fall off? Because that's also helpful information too. Especially with, let's say with depression, there is that not really being interested in things you're usually interested in or feeling down, and so that could also be helpful information. And that could be one starting sign of something, you know, is like something I usually do. I noticed I like didn't really have motivation to do it or it felt different when I did do it. You know?
Diane: Yeah.
Robyn: Yeah.
Diane: Yeah. Yeah. And I think that's huge too. I think when we can start to have that awareness of those early clues —
Robyn: And again, you know, I think it can sound like a lot of so many things to think of and track, but being patient with yourself and like, this is kind of a new discovery process and you're taking the time in bits throughout the week to get to know yourself. It's not going to happen overnight. It doesn't have to.
Robyn: So sometimes it's just getting bits of information over time. And in the long run, when somebody looks back, they're like, whoa, now I have a lot of information that's helpful. Because this can feel like a lot of sometimes self-imposed pressure or pressure in general to like, oh no, and I got to figure out all these things, and then now what, and then what is it? And it can be a lot. So I always say, just go at a steady pace. You don't have to be in like the fast-track lane here. It can take time and that's okay.
Diane: Yes. It is a process. And I'll add that, like, often, depending on the stage we're in, in whatever condition we're living with, we just may not be ready for it at all. Like, if we haven't even gotten a diagnosis yet, or if we're just like really in survival mode or just been diagnosed, just figuring things out, we may not be ready for that at all.
Diane: It's 100 percent a process. And yeah, it's definitely something that comes more easily as you begin to practice it. But yeah, 100 percent, like, even if you do start getting into it and finding it easier to start tracking, there may still be phases where once again, it's not so easy. It may go up and down. But yeah, I think when you can get there, I think we're just saying that there can be huge benefit in terms of getting to know our own symptoms and like getting to know what helps us going forward.
Robyn: Correct.
FINDING SUPPORT THAT FITS WHAT YOU ARE ACTUALLY EXPERIENCING (42:37)
Diane: Here's a question, because I'm aware of like, binaural beats, I don't know what else they call it, but what's lo-fi music?
Robyn: Oh, yeah. How do I explain it? It's just —
Diane: I mean, maybe they're similar. Like, for example, I don't even know that I could even really define like binaural beats or binaural frequencies, but I know like when I'm trying to set kind of a peaceful environment for myself, I'll tell like the speaker — I'm not going to say the name because I know she'll start talking to me — but I'll say, please play binaural beats and I'll put on like my essential oil diffuser and you know, all the stuff. But I never heard, okay. Or maybe I haven't paid attention. I don't know what lo-fi music is. Maybe it's similar.
Robyn: It's kind of, so I think the best way I could try to explain it is like think sort of classical music but with a bass in the background. Yeah, there's different tracks on YouTube. So if you just search like lo-fi, I like the ones where there's animations in the background, like a different cartoon or sort of cartoon going. And it's usually like nature or space. So there's no vocals. It's just, yeah, it's just kind of like a few isolated instruments and then like a bass beat that's in the background that's constantly playing at a particular beat.
Diane: Yeah. When we get off, I'm going to go put them on my YouTube. Okay. Listen, I'm mindful of time, Robyn, but I want to give you an opportunity to, I don't know, maybe share anything you think I might have missed or just let us know, well, and/or just let us know how people can connect with you, where people can find you.
Robyn: Yeah. Yeah. I'd say as far as anything else, I think if anybody does, you know, they're curious, like, what do I have? Like, is it this or that? Because sometimes symptoms, they're stated the same, but then when we really dive into it, it can be, we're kind of ruling out, is this PMDD, bipolar, depression, all these different things.
Robyn: So if you are curious, I'd say meet with a therapist, especially someone who's specialized or really experienced in what you think you might be experiencing. I know there's a lot on social media as far as self-diagnosing, so just kind of be mindful of that. So I'd say definitely reach out.
Robyn: If you are curious, if you want to find out more about me, I have blogs on my website. So it's RobynTamanahaTherapy.com. I post a lot of blogs there on like a monthly basis with various mental health information. Sometimes it's mood, and sometimes it's just general, like kind of stress, like relationship stress type of blogs as well. And then my Instagram handle's the same, Robyn Tamanaha Therapy.
Robyn: And then I have a few podcasts, although I've paused the recording of them right now.
Diane: Okay.
Robyn: But the ones that have been recorded, they're up for anybody to listen to if you like books or just general mental health. The books podcast is Books Between Sessions and it's on all platforms. And then the general one where I interview people who have lived experience or professionals who treat different diagnoses and conditions is Open Mind Night. That's the podcast.
Diane: Open Mind Night.
Robyn: Yeah. Yeah.
Diane: And I will put this in the show notes.
Robyn: Cool.
Diane: Well, thank you so much, Robyn. It has been such a pleasure to chat with you and a really good learning opportunity for me as well.
Robyn: Yeah. Thanks for having me. This was fun. I really enjoyed doing this.
OUTRO (46:28)
Hey, PMDD friend. If you want to be the first to know when a new episode is coming out, head to the show notes to join the Mindfulness for PMDD email list. I'll send you a heads up when I've scheduled a new episode to be published. I'll also give you sneak peeks at topics I'm working on and guests that I've booked. And maybe you can even submit your requests and suggestions for upcoming episodes. Get on the list of the show notes below this episode.
Thank you so much for listening. If you liked the show, please subscribe wherever you get your podcasts. For links to everything mentioned in this episode, you can check out the show notes and you can find me, Diane DeJesus, on Instagram @mindfulnessforpmdd. Now, I invite you to pause, take a breath, and look around.
