Mindful Nutrition for PMDD with Mandy Rother, RD, LDN, FMNS
Join me on a transformative journey as we welcome the profoundly inspirational Mandy Rother, a functional dietitian with an abundance of personal and professional experience. Gifted with a unique perspective, Mandy brilliantly intertwines data, scientific evidence, mindfulness, and intuition to guide her holistic approach to Premenstrual Dysphoric Disorder (PMDD) management.
-
Join me on a transformative journey as we welcome the profoundly inspirational Mandy Rother, a functional dietitian with an abundance of personal and professional experience. Gifted with a unique perspective, Mandy brilliantly intertwines data, scientific evidence, mindfulness, and intuition to guide her holistic approach to Premenstrual Dysphoric Disorder (PMDD) management. Our enlightening conversation delves into the significance of understanding cravings, luteal phase changes, and cycle syncing, while highlighting the connection between mindful and intuitive eating and PMDD.
Navigating through Mandy's personal PMDD journey, we shed light on the battle of balancing the need for rest with the urgency to stay active. We explore the potency of micro moments and the extraordinary impact of minor alterations on our overall wellbeing. By tuning into our body's signals, we can foster a healthier relationship with food, thus creating physical stability that makes trusting our bodies simpler and more intuitive. This empowering conversation will underscore the importance of recognizing our needs before reaching a crisis point.
Tackling the often tricky subject of food cravings and appetite changes during the menstrual cycle, we examine how these fluctuations can significantly relate to PMDD and often lead to feelings of shame and perfectionism. Unveiling the science behind emotional eating and PMDD, we discover the neural pathways developed when we use food as a coping mechanism for our emotions. This candid conversation will inspire you to take small steps towards noticing and addressing your needs, building trust in your body, and ultimately breaking the cycle of emotional eating. Join Mandy and me as we explore the often uncharted terrain of PMDD, offering fresh insights and practical advice to aid in managing your symptoms.
-
Title: Mindful Nutrition for PMDD with Mandy Rother, RD, LDN, FMNS
Episode number: 5
Date: September 29, 2023
Speakers:
Diane (host)
Mandy Rother (guest)
EXCERPT (00:00)
So that is where mindfulness really incorporates all of that, where they stay connected to themselves and their needs. And then we're bringing in the science-y stuff to make that plan more effective.
INTRO (00:15)
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.
MANDY ROTHER, FUNCTIONAL NUTRITION DIETITIAN & PMDD SPECIALIST (01:21)
Welcome, friends. In this episode, I chat with someone who I have so much respect for and who I am just in awe of. Mandy Rother is a functional dietitian who specializes in a holistic approach to PMDD. She combines 15 years of professional experience with her lived experience of PMDD to guide her comprehensive data-driven approach. She specializes in using blood work and functional lab testing so that we can stop guessing and take strategic steps towards sustainable relief. Her mission is to provide trauma-informed, compassionate coaching so that her clients can take empowered steps forward with hope and confidence and reclaim their lives.
When I first reached out to Mandy, I had gotten to a place in my PMDD where I felt like I had plenty of tools that were helping me with my psychological symptoms, but that weren't helping as much with some persistent physical symptoms, and my doctors didn't feel they had much more they could offer me. As a dietitian myself, I wondered if perhaps a dietitian could help me work through some of that, and I was so pleased to find that Mandy is a functional nutrition specialist and a mom and a PMDD warrior herself. I want to read a little bit of a testimonial that I wrote for Mandy, because it illustrates the impact that working with her had on me. So here it is.
MY PMDD TRANSFORMATION WITH MANDY (03:08)
In order to keep my head above water and keep my life from imploding, I had to make my life very small. Every month, for two entire weeks at a time, I experienced a wide range of severe symptoms that affected both my physical and mental health. I could no longer be myself. I had thrown absolutely everything I could think of at this problem. Then I found Mandy. Mandy is not only a dietitian specializing in integrative and functional nutrition, she's also a mom living with PMDD. I felt Mandy was able to empathize, understand what I was going through and offer a truly holistic assessment and plan designed to help me tackle the areas that were the most problematic for me. Whenever I found challenges in actually implementing one of our plans, Mandy always had excellent tips for how to make our plan work within the context of my real life. I've experienced a 98% decrease in symptoms after three months of working together. I'm able to have more fun with my son and my husband. Working with Mandy provided the most dramatic positive results of any healthcare provider I have worked with. It was everything to me. I respect and value her work.
Yeah, all true. I will give a little disclaimer and say that I don't consistently live at that place of 98% reduction of symptoms. I definitely have months that are worse than others, sometimes way worse. That's definitely where mindfulness comes in to help me accept the challenges of my life with PMDD and be kind to myself and still find a way to move forward in a life that I can feel good about.
Having said that, before working with Mandy, I reached a point where I was stuck in bed or otherwise just stuck at home quite a lot with really severe physical and cognitive symptoms of PMDD. I had cut back on work and I would drop off my son at preschool and basically just try to accomplish three things each day: make the beds, do one task related to laundry, and empty the dishwasher. Because the domino effect of those three tasks, if I could get through all of them, helped the house stay pretty tidy and also got me out of bed and moving around. Mandy helped me to discover root causes and triggers for a lot of my symptoms, so that after a few months of working with her I was able to begin engaging with my life again and being more active. I was shocked and blown away by how much of what I had been experiencing was drastically improved.
A MINDFUL & HOLISTIC APPROACH (05:49)
I also was really surprised to find that so much of what Mandy does with her clients, both one-to-one and in her group program, PMDD Revealed, incorporates mindfulness, meditation and mindset work.
In this episode, Mandy and I discuss:
The difference between mindful eating and intuitive eating and their relationship to both the nervous system and PMDD
Understanding cravings and appetite changes in the luteal phase and how to mindfully navigate that
What cycle syncing is and where you can get started with cycle syncing and
How Mandy offers her clients a holistic approach to PMDD management by combining data and scientific evidence with mindfulness and intuition
So, please enjoy my chat with Mandy Rother.
TUNING IN TO OUR NEEDS (06:43)
Diane: Hi Mandy, welcome to the podcast.
Mandy: Hello, so glad to be here.
Diane: I'm so glad to have you. I'm so excited. I think I'm really excited because we get to chat today in a way that's slightly different from how we normally do. Right? Because we know each other from me being a client of yours. We've worked together on many nutrition-related topics with you know, related to my PMDD. But now today I get to kind of pick your brain and go a little deeper into some of the mindfulness-related stuff that I'm really interested in.
Mandy: Yeah, it's like we've come full circle. Like somehow I knew you would end up doing something like this, like I'm just so proud of you and like where you're at and how far you've come. Like not just with your symptoms but just really attuning to yourself and like your purpose and like look at you here with this podcast. It's so fun to see this launch.
Diane: Oh, my goodness, thank you so much. Honestly, I could not have been here without your help and your support. You know there's a few key people and resources that have been so huge along the way for me in terms of getting to a really stable place with my PMDD, and for sure you're one of them. So, thank you.
Mandy: Yeah. It's been an honor. That's my purpose is the, I call it, the ripple effect of my purpose is helping people stabilize so they can fulfill their purpose and like, look at you, what you're doing, like the ripple effect and I've seen it with so many other clients and, yeah, it's so cool to see.
Diane: All right, I'm so excited, let's get into it. So I was mentioning to you before our call that when I am doing this podcast myself, I like to mention what day I'm on and kind of how I'm feeling related to that, and I thought that would be fun for us to do today because we are both PMDDers and we can kind of compare notes today. So today, as we record this, I'm day 21. Today I actually feel pretty good but I have to say, most of the past week I have been experiencing lethargy and brain fog. Surprisingly, my mood has been really good. But yeah, it's very shocking and it's interesting to feel the extremes. I definitely feel like you know, my symptoms are in these three buckets, like physical, cognitive and emotional, and it's always interesting to see each luteal phase how much I'm experiencing in each area. So I felt very useless some of the last few days, but I actually took it as a really good thing that my mood was in a good place.
Mandy: Were you able to rest? Were you able to follow that need and rest?
Diane: Yes! Especially on the weekend days, I just leaned into it and let myself just give myself what I needed and, honestly, I think that's why I feel okay today. It's because I really just let myself go with it. So okay, where are you today?
Mandy: I am day one, kind of day two. I started bleeding yesterday afternoon and I had this, every luteal phase is always a bit different and you know, for me I, a few days before my period, I feel this like letting go. Like you know, we have, we're actually preparing for our dog to have a litter of puppies. So much to do and we had committed of like, okay, we're going to do all this cooking and cleaning but, like you know, to get ready for you know, and we, by the way, for anyone who doesn't know me, we have two year old twins and a seven year old and two dogs and like our house is chaos. But I just was like you know what, whatever, and I took naps while my kids were napping and I felt this lift of energy yesterday after my bleed started and it wasn't even fatigue, you know, this weekend, it was more like the world felt like too much. I get kind of like sensory sensitivity, so I just like wanted to be in my bed with a book and, you know, take a break from the world. But I got this burst of energy and I sent my husband to soccer with all the kids and I went for a bike ride. And I haven't been biking by myself without like towing kids behind me for a long time and it felt really good and freeing and so it was kind of this balance of like lots of indulgent rest and then all of a sudden I was like, I want to move! And I enjoyed some time outside biking.
Diane: That's so good. Do you find that you often start to feel that good that early in the cycle, like that quickly after the bleed starts?
Mandy: For me, my bleed, my actual bleed, is fairly easy, like I don't get a lot of the physical cramping or like physical symptoms anymore. I will have, it's more of like an internal shift in like deeper spiritual need of like, I need... So it's not so much about physical energy for me, but it's like I want a lot of space of just time to be in my own head, think, reflect, not having to talk a lot, and it's interesting being on a podcast, like talking so publicly on day one I'm like, oh, what would I be doing if I weren't doing this? And knowing that like this is something I love to do, but it takes energy. I spent some time, you know, like sitting on my floor this morning and like journaling, a little bit, like reflecting on my last cycle, and what was coming up for me is like this need to like simplify some of my routines and thinking about ways that there can be less in my brain that I have to remember, that's just like automated in my life. And so that's what I was just doing, some journaling and reflecting this morning and getting some of that alone time.
Diane: Oh my God, you're already giving us so much good wisdom and good gems. No, because I love that. You said that you're coming into this aware that your needs are different right now, and so you took the time to give yourself some quiet time, some reflection. I just love that, you know, that you're kind of like, okay, I'm going to do this, but also, let's prepare myself and give myself what I need.
MICRO MOMENTS, EARLY & OFTEN (13:37)
Mandy: Yeah, and I think you know, sometimes I find my body just needs a little bit of a reset, whether that's in between clients or after doing something like that and I'm an introvert by nature. So if I'm presenting, like I could present to a group of hundreds of people and feel okay but I'm going to need some extra tending to after. Like, after we wrap up I have a meeting with my assistant but I'm probably going to take the first part of the meeting outside, get some fresh air, like put my feet in the grass, you know, refill my tea, and you know it's just about that and that's what mindfulness is right, this gentle noticing. And my group will, they'll, you know, share that I'm always saying ‘early and often, early and often.’ Like, how can we notice these needs all the time, be tending to them all the time until, essentially, you know, rather than waiting until shit hits the fan, so to speak.
Diane: And when we are able to do that, what I find is then it is easier to do these really tiny little things that can kind of fit anywhere into your day, and I feel, my experience anyway, is like you get a bigger impact on those smaller things If you're able to kind of take that time more regularly to tune in with yourself.
Mandy: Yeah, I call them micro moments. I think with PMDD–and it might be as a perfectionist I attract perfectionists and then we have PMDD–I feel like there's a trend of perfectionism and so I think that idea of like the tiny, tiny things and how that builds up to make such a difference, is so key. Because that way it doesn't, especially when you're feeling really symptomatic, if you were to think about ‘oh my gosh, I want to do a 30-minute meditation to help myself’, or some big mindfulness practice, likely in that symptomatic moment you're going to be like, no, I can't do that, I'm not capable of that. So really bringing it down to that tiny micro step is calming to the brain and your nervous system, like, hey, she's paying attention to me, she's doing something here to help.
GETTING TO THE ROOT OF PMDD (15:49)
Diane: Yes. 100%. All right, Mandy, I love this because we're already diving right into the mindfulness but let's back up a second because, for the listener, I would love it if you could share a little bit about yourself in terms of what you do but also what got you here.
Mandy: Yeah, and so, as I was sharing, like my mission, my purpose is really to help people kind of access that level of stability and vitality where they can fulfill their purpose. And specifically I specialize in PMDD. I also see a lot of PME, so premenstrual exacerbation where someone doesn't just have PMDD, they have anxiety and depression or PCOS or IBS or other health concerns, and we're looking at, from a functional medicine lens, how does it all connect? And so I always like to share, I'm the most stubborn practitioner out there so, I tend to find people, or people find me rather, that have tried a lot of different things, things that have not worked, even people that have seen multiple naturopaths or even tried the holistic perspective.
And what I like to do and where I get really stubborn is, okay, did we really get to the root of it? And how do we connect the dots between someone's cyclical experience and their PMDD symptoms and what's underneath? Because until we get to what's underneath, we're always going to be playing the Band-Aid game. And so I'm a dietitian by training and I have extensive functional medicine training and so that is a big part of what I do. And then I love to weave in–which we'll talk about today–other mindfulness connection components, nervous system components, because we have to, we're whole people, we have to address everything altogether. So my goal was to create a program that offered everything I needed or everything I would have wanted.
You know, when I was struggling with severe PMDD symptoms and, as someone may have guessed already, like I've had very, very severe periods of time where my symptoms were debilitating, like rock bottom, had to take medical leave and mine was kind of that mixed soup I was talking about, where it was, you know PMDD, more accurately probably the PME, with depression and anxiety and then you know some other hormonal issues. I got diagnosed with PCOS and digestive issues and all this thing, you know, mixed kind of combo. And for me, through that journey, I've just realized time and time again how essential it is to weave together all these components. And it can be complex and feel complex, and you know someone needs that guidance. But I also like to emphasize that it can also be simple. Each step can feel simple and doable. It just can be hard to piece it all together by yourself. So that's what I do and why I do it.
Diane: Absolutely. I think a lot of what you mentioned is kind of how I came to you feeling, 1) feeling, as you mentioned, like I had sort of exhausted all the things I could do, all the various healthcare practitioners or resources or self-management tools and techniques. And 2) was, yes, I also felt like, well, maybe there's some other stuff going on here to adjust to things and stuff, but it's well, it all felt so tangled up together and I sort of didn't know how to approach teasing these things apart and I'm a dietitian, right–so I'm not a functional medicine nutrition but I'm a dietitian–and I felt really overwhelmed.
MINDFUL EATING AND INTUITIVE EATING (19:31)
And so I reached out to you and was so excited to find not only a dietitian who worked with people with PMDD but also had PMDD. And then I was also really excited to learn over time how much kind of mindfulness you incorporate in your work because that has also been such a huge part of my journey. So I wanted to ask you about something that we started covering in our early days of work together, which was mindful eating and intuitive eating, and I was wondering if you could chat a little bit about how how you see the relationship between mindful eating and intuitive eating and PMDD and looking at it from this functional nutrition perspective and things like the nervous system and stuff.
Mandy: Yeah, it's like a little web of connections, right? And I think for anyone listening, let's first explore what it is and the difference between the two, because often they're used interchangeably.
And so think of mindful eating as paying attention on purpose to the present moment and then that specifically applied to food; Where you're experiencing eating, you're paying attention in that moment without judgment or noticing the judgments that come up, because they're always there, right, noticing the judgments that come up and just observing and letting them be there. And some people will think about things like minimizing distractions while eating, being very present moment, and then engaging the senses and the experience of the food and savoring that food, chewing really thoroughly, those sorts of things. And so these are great practices and a great place to start and it can increase the enjoyment of food, help with digestion, things like that. But sometimes it's not enough when we're looking at the food relationship.
And so if we look at intuitive eating, anyone can Google the 10 principles of intuitive eating and so this really refers to a, think of it like a, broader philosophy that like rejects the diet mentality and then focuses on eating for that like physical nourishment rather than emotional coping, which we'll come back to that emotional eating part, while trusting your body and relying on hunger and fullness cues. So this might look like, see ya later diet culture and now let me honor myself and my body, nourish my body without restriction.
And what I'm seeing out there is there's so much information on social media and otherwise about mindful and intuitive eating and it is such an important tool but sometimes I see those principles being taken and used as a weapon rather than a tool. It becomes kind of like for some people, again bringing back in the perfectionist perfectionism piece, it can become kind of a measuring stick where people feel like, ‘oh, this sounds so simple in theory, but now I'm doing it wrong.’ And so I'm often asked the question of like how, you know, intuitive eating sounds great, but like, how can I trust my intuition? When I’ve been so out of control with food or bingeing episodes or patterns of restriction in the past, or even if someone has had a diagnosed eating disorder, they feel very disconnected with their body and it can feel hard and scary to just like leap and trust their intuition. So I think we should talk about that a little bit because that's common. I don't think enough people are talking about that.
TRUSTING YOUR BODY AND YOUR INTUITION (23:04)
Yes, so how do you start down that path with someone, with a client? And I think that relates to how mindfulness and meditation sometimes can be really scary or uncomfortable for someone, particularly if they've experienced some trauma it can be really uncomfortable to sit with what it is you're feeling and experiencing and also, sometimes the experience can be well, I don't know what to do with this, I don't know what to trust, I don't know where to go from here. So, yeah, can you talk about that more?
Mandy: Yeah. Well, sometimes it helps to think of, like the backstory first, of how someone may have arrived in this place where they feel like I'm sure my body is sending me signals but I either don't hear them, I don't know how to listen to them. And if you think, for listeners, think about like a child in their life, when you look at children and how they eat, like they know when they're full, they know when they're hungry and they're going to tell you and there's no guilt or shame about it, and oftentimes, if you think about, sometimes we can push children to like, finish your plate and just one more bite. It's like we gradually coach them out of that, unknowingly, unconsciously. And then, you know, as we grow into adults, we're bombarded by societal messages about how we should eat, how we should look, and even you know, you look at any influencers out there of, like you know, having more motivation, more willpower, more control around food. Right? That's like, presented as what we should be doing, and so it can just add to that shame pile. And then we look at, you know there's different things in someone's upbringing, where either food was used as a reward or as a punishment, or, you know, healthy eating behaviors and a healthy food relationship wasn't modeled to someone. It can get really, really muddy and so I think understanding that and having that awareness helps to strip away some of that shame of like, oh, it makes sense why my relationship with food is really challenging.
EVOLVED INTUITIVE EATING (25:13)
And so I started teaching a concept that I called evolved intuitive eating and what I mean by that is we need to look at what's happening, not just with the psychology of it, but the physiology, what's happening internally in someone's body. Because if that is a mess, right, if someone has unstable blood sugar that's, you know, blood sugar roller coaster all day, if they have insufficient nutrient levels, if they have imbalance brain chemistry–which is exactly the shifts that we'll talk about that happens with PMDD–it can feel harder, like an uphill battle, to trust the signals that your body is sending. So we have to take care of the physical part as well as looking at how we're using food to cope with emotions and the you know, more traditional intuitive eating strategies. And when we do both of those things together and I see it happen with, I would say, almost every single client, where they learn to trust their body and trusting their body feels easy because we have that physical stability at the root of it too.
Diane: Yes, you, I want to come back, you said something about kind of understanding why it's, why this is happening, where this is coming from right. That reminds me of something that my coach said in our interview together, Nikita Williams. We were talking, I forgot what we were talking about, but she said ask yourself, Why is this normal? Why is this normal? And so, it sounds like you're saying a similar thing, like if first we can understand that actually this is completely normal, there's a whole reasoning behind it, that is almost the first step to kind of taking away some of that associated shame and some of those difficult feelings. I feel like this relates to my next question too.
CRAVINGS AND APPETITE CHANGES (27:01)
So, if it's okay with you, I want to talk about like cravings and appetite changes and stuff, because that similarly can be just like a real mess in the mind to have to confront, right, and it may be something that you're dealing with all the time or that gets worse or comes up in the luteal phase, but either way it's, I feel like that's a thing that has a normal reason for it–there's a reason that's happening–but we attach a lot of shame, maybe try to kind of put some of that pressure on ourself and that perfectionism. So, 1) I feel like that must be really common, so I wonder if you come across that a lot with clients? But also, 2) can you speak a little bit to like how you do work with clients on that, the idea of cravings and appetite changes and things?
Mandy: Yeah. Let's dig into that because I think we can look at first why it's happening and normalize it and I think when you understand the why, that leads to the what to do. And even I want to just emphasize a point that you made that I think is so important before we dive into the other stuff is sometimes it is the meaning we make of it or that we attach to it. And I like to share with my group of, like you know, for me, I love french fries. If someone were to tell me like, oh, you're craving french fries, that means you know you shouldn't do that during your cycle. I’d be like, no, I'm gonna eat my french fries. The difference is that, like you know, let's say, if I want to eat french fries during my luteal phase or any other part of my cycle, having them and making that a conscious, intentional choice and really enjoying it, and then it's done, it happened, no big deal, is very, very different and the stress that it places on us and the emotional toll if I had the french fries and then that led to a spiral of, you know, self-deprecation and beating myself up about it, or the spiral of how it could impact other food behaviors for the rest of the day, the rest of the week, etc.
And so sometimes it is just allowing that flexibility and releasing the need for perfection. Most people can have beautiful, amazing menstrual cycles with like a, B+ diet, meaning 80% of the time they're eating whole foods that nourish them and then the other 20%, you know, in my case, is like, yeah, french fries and chocolate and some of those more indulgent things. And so I think, with the cravings, it is normal, it's just think of it like a volume dial, like is it way turned up where those cravings feel like they're controlling you, they're all consuming? That is typically something that we want to look at the physiological undercurrent of and start to address, and then the emotional connection to it too.
If it's like a slight desire or in the mood for a food, I think that is where we want to normalize it as part of the cycle. So what happens is hormones fluctuate throughout the menstrual cycle and those changes impact our brain chemistry and our appetite and even our caloric needs. Our calorie needs actually go up a little bit during the luteal phase, that week or two before the cycle. And so when, during the first half of the cycle–for anyone unfamiliar it's called the follicular phase, so let's just call it the first half–cravings are typically lower during that time because we're more sensitive to insulin, to manage our blood sugar, and we’re more efficiently processing carbohydrates and so, typically it's easier to stabilize blood sugar and that leads to fewer cravings.
Now this might be different for everyone, especially if someone, I see this a lot in someone who's like over exercising, lots of high intensity workouts without adequate nourishment, maybe they're restricting carbs or unintentionally reducing carbs too much during certain parts of the cycle. And then during the second half of the cycle, the luteal phase, the shift in hormones kind of revs up our metabolism and our appetite. And when the hormones dip, especially estrogen, we're less sensitive to insulin and it becomes a little bit harder to regulate blood sugar. And when estrogen goes down, so does serotonin. So that's like our calm, content, feel good, brain chemical and when that's low, it, you know, not only is our mood dysregulated or sleep can be dysregulated but we can have more cravings for carbohydrates.
So this is just like extra, extra pronounced with PMDD because of what causes PMDD, with like the shifts in serotonin and GABA and such in the brain. I made a note of a statistic to share just for people to understand how common this is. So it's, these appetite and eating behaviors are well documented in PMDD and there's over a 16% comorbidity with eating disorders in PMDD compared to only like a 2.3% in the general population. That's a huge difference and I was looking up research on this a few months ago and this is especially prevalent with people with personality signs of harm avoidance.
So harm avoidance looks like a ton of self criticism, lots of self doubt, trouble saying no to others or setting boundaries with others, sometimes conflict avoidance, and anyone listening might be like yep, yep, that's me. You know that can be very, very common and this makes sense because it's deeply painful, you know, to be overcome with self doubt and worry and those feelings towards ourselves. It makes sense that our brain would want to find an alternate route, like to hide away or avoid those negative feelings, and for some people that happens with food.
Diane: Okay, oh, my goodness.
Mandy: Yeah. So many things to think about and we can shift to like okay, what do we do? But any questions on that or thoughts on that.
Diane: Well, I want to thank you firstly for kind of just pointing out the difference between yes, there's a reason this is happening, an underlying cause, and normal. ‘Cause, I had said the word ‘normal,’ but like, yeah, there's a like, even just looking at a particular craving, it might be normal but it might bleed over into something where there's something more more extreme happening or more beyond, like a normal level of craving changes, appetite changes, that could probably be addressed to to change that. But, oh my gosh, I didn't realize the, you mentioned the statistic about the comorbidity of PMDD and eating disorders and that is just huge, which makes sense, or or makes me even more, you know, grateful that you do so much of like this–tell me if this is the right word or not to use but–I kind of think of it as like a very holistic work that you do, cause it's like you really can't, you really can't look at one without the other. You really can't. You really can't, like look just at what's happening physiologically and not consider all these other elements of things that are happening with us, you know, emotionally and mentally. Okay, so I want to ask you about cycle thinking, because…
Mandy: Sorry to interrupt. Do we want to talk about the nervous system connection? I realized I skipped over that totally. Should we dive into that first?
Diane: Wait, just in general with kind of like–
Mandy: With the mindful and intuitive eating. I made a mental note. I'm like we've got to come back to that.
Diane: Oh good, Thank you. Yes, thank you.
THE NERVOUS SYSTEM IN PMDD (35:01)
Mandy: Now I'm like where was my train of thought? So you know, we're talking about, like, what causes this right and it can lead to these patterns of emotional eating and what happens, and you know and if anyone wants to dig into this, I have an e-book on my website for free, like all on this topic that people can download. But what can happen if we think about those neural circuits, is like our brain learns, hey, I'm feeling stressed, angry, depressed, sad, whatever, I eat this thing and then I feel better. It doesn’t remember how long that lasted or how you felt after and when this happens over and over again, it's like we keep, you know, fortifying that neural circuit of like, okay, this food makes me feel better and that is why it can be hard to break that vicious cycle. And so the first step really is that awareness and acceptance, understanding the science of it, like we've been talking about, can be very validating. And then I really encourage people to explore, like, what is the need underneath? What is the need underneath that emotion and what can we notice somatically? And what that means is like, what do we feel in our body, even outside of the thoughts that may be a jumbled mess inside the mind, what is your body experiencing and that can start to signal us of like, what's happening in the nervous system.
And think of the nervous system as like a surveillance system with way too many cameras and people with PMDD, let's say, if the average person has like five surveillance cameras, with PMDD, especially during the luteal phase, you might have like 50.
So we are more hyper vigilant, looking for threat, looking for signs of danger. So, when we start to feel that emotion popping up–which the emotion in and of itself can feel dangerous and unsafe, especially there can be almost a degree of trauma with PMDD, of experiencing such severe symptoms month over month–and so really pausing to tune in of like what's happening in my body, what sensations are there, and that can start to tune us into that nervous system need and like we were talking about when we opened the call, that looks like these tiny micro steps of noticing, tending to and meeting those needs.
Our body learns like, hey, I can trust her, she's got my back. And it's like a sigh of relief really, for our nervous system, when we are following up with okay, my body is telling me I need a break from this conversation I'm in right now or I need to step away and go step outside, or whatever that small action step is when people learn to follow that early and often, like we were talking about. Sometimes things don't mount up as much, where it can end up with some of these emotional eating symptoms or other ways of coping.
Diane: Yes, okay, can I try to like summarize that to make sure I got that? Because I feel like there's like two parts. So you mentioned how, when we look to a particular food to soothe a particular emotion, we begin to lay down these neural pathways where, and especially once we start doing it over and over, we're laying down this neural pathway and we're telling the brain that this is making us feel better, even though in the long term, or maybe just even just a little bit after that meal or snack, we're not feeling so good. It remembers that immediate kind of reward. And then, on top of that, in PMDD we tend to, well, oh God, there's so many things…
One, many of us come into PMDD with trauma but two, PMDD makes us very hypervigilant and just the experience of going through PMDD month to month can feel very traumatizing. So now, if we aren't able to find a way to take a pause and listen to what we need, why we're grabbing that bag of chips or whatever it is–for me it was always chips–that can lead to a pattern of our brain just immediately wanting to reach for that to soothe what we're feeling and if we can break that cycle, that pattern, by taking those little moments early and often whenever we can, to check in with ourselves, what are we feeling, what am I needing right now that's causing this feeling or this desire for whatever this snack is, we can break that pattern. Otherwise, that's how it kind of becomes like an autopilot thing that we go to each time.
Mandy: Yeah, and what I often see happen is someone will recognize hey, this is a problem, I'm emotionally eating or bingeing or whatever it may be. And their first step is often well, I got to stop doing that, I got to stop reaching for the chips or whatever it may be. And I would argue that the first step is actually different. It's learning your body's needs and starting to build your toolbox of what does my body need and what works for me. So then you feel safe to try other things. If you just take away your only coping mechanism, that's kind of scary, and so oftentimes we need to start in a slower, more gentle fashion, versus just like thrusting ourselves and trying to white knuckle through it. That is really stressful and then we can feel horrible if we fail and it doesn't work. And so I think that's the biggest thing I see, that we actually need to start in a little bit of a different place to build up that self-knowing and that toolbox.
Diane: Yes. Yes, you're totally right. Preparing ourselves first, getting to the root of the problem and setting ourselves up to have other things that we can reach to, rather than just trying to kind of pull this away from ourselves. And now what? Now we feel kind of lost and threatened again. Yeah, that makes a lot of sense.
CYCLE-SYNCING (41:15)
I wanted to bring up cycle-syncing because you talk about cycle-syncing. For me, cycle-syncing is something that I initially was, like I don't know why, I felt resistance toward it. Even when I found it to be interesting or fascinating, I couldn't lean into it in my own life. And at some point I did and now I'm hooked and I want to cycle-sync everything. I love cycle-syncing. So can you talk about that a little bit? And also, maybe not everyone knows what cycle-syncing is, so maybe can we get into that a little bit.
Mandy: Yeah, cycle-syncing can refer to a lot of things. Some people are syncing with their different phases of their menstrual cycle, different lifestyle aspects, like when I flow with my cycle, with my self-care, my style of work and work productivity, nutrition, fitness supplements, et cetera. And I have an idea, if I may offer, why you were resistant to it in the beginning. And this is why I actually don't talk about it in the way that we're going to talk about it until phase three of my program, because when you're feeling really, really unstable and you're having severe symptoms, you're not going to care if your workout is conducive to your phases. Nobody cares about that or should care about that at the beginning. It's too much. It's too much to think about. And I also think if you were to look at, online, of cycle-syncing nutrition and fitness, there's tons of charts and tons of information. Again, when you're in survival mode, it's too much. It's not the place to start.
That doesn't mean that we're ignoring cyclical needs, but we need to start in a different place. And if we zoom out and think about, we are all cyclical beings, PMDD or not, we have cyclical needs. I feel like, PMDD, when those cyclical needs are ignored, it comes out with a slap on the face like, hey, you've got to pay attention to this.
Oftentimes, people with PMDD symptoms tend to be highly sensitive individuals, sometimes highly empathic, and so we notice those shifts in a more intense, significant way. And I would say that that also comes with some pretty cool gifts of being the type of person who is highly sensitive and we can get into that. So, with all this buzz, it's like, crowd out the noise or whatever you're reading on social media and I would say, start in a slightly different place. And that really is like the first step, is like being okay with not following the generic charts in the beginning of you know, and really starting with, as simple as it sounds, accepting your cycle for where it is now symptoms and all knowing that your cycle is offering you information, is offering you data that you can then decode to really uncover your physical and emotional needs.
And then, naturally, the next step is tracking. Tracking in whatever way works for you. Oftentimes simpler is better. You know, a notebook or cycle journal, like, physical kind of journal or an app or whatever that looks like, and then not just zooming in on the symptoms but tracking other things. If we hyper focus on symptoms and what's going wrong, we miss the goldmine of information that can help us really begin a truly intuitive cycle syncing process of what those needs are.
For example, yesterday was my first day of the bleed and I shared I went for a long bike ride. If I had just looked at the charts I would have said, oh, I should have only napped, not gone on my bike ride, but my body was like you want to be outside, you want to move. And so, you know, in one of my favorite books, Wild Power, they talk about the big red rule, and that is essentially that there are no rules, and this is where the nature of mindfulness and the intuitive nature of cycle syncing really need to be protected first. And so, learning and using those charts is really helpful and I teach on that in my program and in workshops and such but we have to start with knowing yourself first, so then you can take the pieces of that that are important to you and apply to you and actually are going to work without causing stress on your system.
Diane: Yeah. I think I really love one of the first things you said. I think it's so huge. Which is, the first place to start is actually really simply–although it might feel really tough–just accepting your cycle for what it is, the changes you are going to experience as you go through the cycle. That is so huge. I think you're so right. I think that is the first step, before anything else. Then just starting to observe. Just starting to collect that information without judgment, without giving ourselves a hard time. Just collecting it, as you say, as data for how we can then move forward to work with our cycle, rather than against it. But I really, really, really love that you said start there, just kind of like with the first step of just accepting the cycle for what it is.
Mandy: Often in the next question people will ask, so if someone has taken the step of learning about their cycle, their cyclical needs, they naturally would be like okay, so how the heck am I supposed to do this in my real life? And this makes sense, right? Again, if we normalize how hard this is, we live in a linear world that expects us to be the same every day. We're expected to show up to work with the same capacity and productivity and energy and brain power. We could add a feminist lens to this and talk more about that. But it kind of goes without saying that the world, and especially in American society and, I would argue, globally is not set up to honor this more like feminine rhythm for people with menstrual cycles where we are different. And this can happen in partnerships too, where, I know I feel like I had to train my husband, Ivan, of like, hey, I'm different, I have different, you know, fluctuating levels of energy where I'm going to be more or less involved in housework, my libido and sexual desires not going to be the same day in day out and this is nothing against men like, but they're kind of the same every day where you know they don't have these hormonal fluctuations that we do. Did we lose our connection?
Diane: I lost you for a second. I heard you say men, and so if we could just go back, I think you were explaining how their kind of, their rhythms are different from ours.
Mandy: Yeah, you know, it's like we have to learn it ourselves so that we can share with them, hey, I'm different. You know these different phases. Here are my different needs. It's almost like coaching them and really advocating for your needs. And even for parents listening, sometimes we feel, or have this expectation, that we should be like supermom all the time, every day, every week, every month of the year, where how you are, you know, parenting your children, might look a little bit different. There are sometimes that might feel easier than others. And so, really knowing okay, it makes sense that this is hard and now that I know my needs, is thinking of really practical ways to start advocating for that. And really being grounded in, I need this and that's okay that I need this, because oftentimes it can feel like the world's kind of against us when we start trying to do some of those self-care practices.
Diane: Yeah, because it's not easy to do within the structure of the world we live in.
Mandy: Yeah, for sure.
Diane: Mandy, I am mindful of the time, but I really want to give you a chance to talk about, like, why you offer the things you offer and you know your unique kind of offering because I, you know, aside from the things we've talked about, you offer things that maybe someone wouldn't expect in your group program, which I also did, called PMDD Revealed. Things like yoga and meditation and exercise resources and all these different things. As I mentioned, it's been so lovely working with you because it feels very holistic and I know that that's very intentional, and also there's probably some other things I'm not even considering in that. So can you talk a little bit about that?
MANDY’S HOLISTIC APPROACH (50:14)
Mandy: Yeah, so I, you know, we are whole beings and so I wanted my program to encompass the whole person and, like I said at the beginning, of like everything I wish I would have had or didn't know I needed at the time. And when I think about my PMDD journey, I feel like these deeply painful moments have also led to me just collecting like, okay, this is essential and this is essential. And with my program I work with people in, it's a hybrid format where we have the beauty of group and a community and the solidarity of that, along with the deep personalization of the one-on-one work and a functional medicine approach. And so, because we're not all the same, what helped me get to the place that I'm at is not the exact path that helped you or my other clients. And so I always hold at the center that each person is unique and they have not only unique physiological root cause driving factors but a unique system of values and life experiences and beliefs, et cetera, that we need to honor in the process. And so, you know, a big part of what I do and why a lot of people come to me is I'm kind of a data junkie. I have extensive training in using functional lab assessments and blood work and you know, gut health testing, hormone testing, et cetera, and so that is a piece of it. But what I found is that when we combine that with these other factors of this intuitive way of cycle-syncing, the intuitive movement and mindfulness, the nervous system toolbox that I help my clients build, then it's powerful beyond measure, when we bring all those components together.
And so, you know, for me there was just this deep calling to really help people to stop having to take masking tape and duct tape and piece things together themselves because that is super damn hard to do when someone's very symptomatic, to really create a path where people are guided step by step with the level of personalization.
And so, it's just something I feel super passionate about, and I think part of my role in the world is to help act as a bridge between a couple things: conventional medicine and holistic medicine.
They don't have to be mutually exclusive, where people have the right to have a choice in their care and what's going to work for them and sometimes that's a combined approach or bringing in the others or having other options when medications and birth control et cetera haven't worked. And the other is acting as a bridge between the objective hard data that we see in someone's lab tests, along with bridging that with their self-knowing, their intuition and their needs. And so, in that way I'm just a conduit in providing my expertise to help people get there. But really, and I share with my clients all the time, that, my goal is to keep them in the driver's seat, because people feel safest in the driver's seat and they know themselves best. So that is where mindfulness really incorporates all of that, where they stay connected to themselves and their needs. And then we're bringing in the science-y stuff to make that plan more effective.
Diane: I love it so much. What you're doing is really so unique, for better or worse, right, like, thank goodness you're out there but it really is quite unique what you're doing and I feel like we need more of it. It's just phenomenal what you're doing. I feel like we've just gotten to the tip of the iceberg today. I feel like we need to do this again, for sure, at some point. In the meanwhile, for anyone listening, who wants to connect with you and learn more, possibly work with you, can you let everyone know how they can do that, where they can find you?
WHERE TO FIND MANDY (54:07)
Yeah, and so I'm sure you'll link below the episode to my website and such but I would love to just hear from people. Feel free to reach out on the contact form on my website. Tell me how this episode impacted you. That just fills my cup and helps re-energize me to keep fighting the good fight. But if anyone is interested in this type of work, I have a button on my website to schedule a strategy session where we would be face-to-face over Zoom and really dive into someone's personal history, where their symptoms are at now, what they've tried, what's worked, what hasn't worked. And that is the beginning to start to decode and untangle all this.
And then for free resources, I have a Moody and Menstrual newsletter, I call it, where I'm emailing clients, or not clients, my email list, most weeks, just musings and reflections and science on PMDD and the menstrual cycle. And there's a free e-book on my website and I'll be launching a free PMDD course soon, in the nearest future, as my capacity allows.
So lots of different ways to connect, but the best way, hop on my email list. I intentionally don't spend a lot of time on social media. My nervous system doesn't like to be on social media every day. So jump on that email list and then reach out for a one-on-one session if you're feeling ready, and called to dive deep.
Diane: Perfect. Yes, I will absolutely put your website in the show notes. Can I just tell you, I love the newsletter so much because, as I've told you, you really put a lot of yourself. You're just very open, honest and transparent in general, but in your newsletters in particular and I think that's so important in general, but in particular with dietitians, because I've often found, as a dietician, that people kind of, I don't know, they think that we're kind of these perfectionists or this like this thing that you can't reach, like they kind of put us in a pedestal. So to have someone who's a dietic\tian, who you can reach out to, who not only has PMDD but also is just like showing you, I am a human being too, just like you, it's so helpful, it's so validating and it just, it's, I think helps even more, everything that you're doing. It makes your impact so much bigger. So thank you so much.
Mandy: Yeah, that's my goal, to be writing to thousands and thousands of people every single week. Eventually I'll have my own podcast, I'm sure. But I think, yes, I had to press the pause button on myself because I am like I can't overwhelm myself or then I won’t be helping anyone. But I'm just really on a mission to help people not feel so alone in this. I think that's the biggest thing, where, for anyone listening, you are not alone. This is real. It's a real condition but hope is possible. It's not a life sentence.
Diane: Well, that was a beautiful, perfect ending. Thank you so much, Mandy.
Mandy: Thanks for having me.
Diane: Thank you for joining me today. We will definitely be talking soon. Thank you, okay, bye.
OUTRO (57:22)
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 de Jesus, on Instagram @mindfulnessforpmdd. Now I invite you to pause, take a breath and look around.
