Megan Luscombe works in mental health as a counsellor. But after she went off the Pill in her mid-twenties, she started to think she was losing her mind.

“I was getting really anxious, really withdrawn, really panicked,” she tells Mamamia. “I felt like I was going crazy.”

Luscombe felt she needed to be on her own, away from everybody, including her partner.

“I couldn’t be around her. I just had to go in another room.”

She found herself thinking irrational thoughts.

“‘How come somebody hasn’t texted me back in the past four hours? I know they’re on social media – why aren’t they messaging me back? Is my sister angry with me? I haven’t heard from her in four days.’

“It was just dumb stuff. My rational brain, I never think that stuff. I work with people and help them not think about that stuff.”

It was Luscombe’s partner who pushed her into doing something about it.

“My partner said to me, ‘I want you to mark an X on the calendar and tell me when you actually start feeling better.’ I put an X on the calendar and I kept putting Xs on. I went, ‘There’s something seriously up.’”

Luscombe could see that it was connected to her menstrual cycle, as the depression and anxiety were kicking in 12 days before every period. She went to her doctor, who did blood tests to check her hormone levels before diagnosing her with premenstrual dysphoric disorder (PMDD).

PMDD is a form of premenstrual syndrome (PMS), but as Luscombe puts it, “magnified by 15,000”. It’s estimated that somewhere between three and eight percent of women who suffer PMS have PMDD.

Dr Rosie Worsley, endocrinologist at Jean Hailes for Women’s Health, says she sees lots of women with PMDD.

“But because it’s been under-recognised and under-researched and we haven’t had great treatments for it, it’s probably something that a lot of people still don’t know about, both doctors and patients,” she explains. “A lot of people are suffering in silence.”

Dr Worsley says the symptoms can be “quite disabling”.

“I’ve had quite a few women who take days off work every month. Some women stay in their beds for a day or two every month, or more. I’ve had women who report feeling quite suicidal at that time as well.

“They’re often told that they’ve got depression or anxiety. People just don’t connect the dots.”

She says once women realise that what they’re suffering is real, and that other women are also going through it, it’s “very validating”. The most common treatments are low-dose anti-depressants, sometimes just for two weeks of the month, or the Pill, to prevent ovulation.

“Or, in extreme circumstances, women can use medication to induce a medical menopause, so that the ovaries are just turned off,” she adds.

Luscombe had originally gone off the Pill because it was “doing my head in”. She tried antidepressants but found that they made her “a little bit spacey”, and also didn’t want to be on them because she was going through IVF. She now works to manage her mood through exercise and diet, and also through taking time to do what she needs to do.

If she feels the need to be on her own, she spends the day in her home office.

“I’ll just get up in the morning and go, ‘All right, I’m on retreat,’” she explains. “My partner will go, ‘Cool, no worries, see you at dinner.’”

If she has clients to see that day, she’ll go to the gym for an hour and a half in the morning, running for up to 10km on the treadmill, then doing weights.

“It’s just like an endorphin high for me, going to the gym,” she adds.

Luscombe still gets panic attacks, but she knows how to deal with them.

“I’ve been sitting down watching a movie, and all of a sudden this impending sense of doom comes over my body and my mind. I will have to say to my partner, ‘I’m about to have a panic attack. Just give me 10 minutes.’”

Now that she’s 32, Luscombe finds that her PMDD doesn’t last as long as it used to. It might be over in as little as three days, instead of lasting for 11 days every month. She and her partner, who recently became her wife, will be trying IVF again soon, and she’s hoping that if she falls pregnant, that will also help her PMDD.

“Once you have a baby, your hormones change,” she explains.

Luscombe feels lucky that she’s had a very supportive partner, and that because she works in mental health, she’s been able to articulate how she feels. She empathises with any women out there with PMDD who feel like they’re “going crazy”.

“I just want to cuddle all those women because it’s full-on.”