Can PMDD Really Make Me Feel This Disconnected from Myself?

Having a week where you look in the mirror and don’t recognize the person staring back at you can be terrifying. Some women with severe PMS/PMDD describe it as “becoming a stranger in my own skin”. Clinical experts call this experience “ego disruption” a hormone-driven shift where your mood, thoughts and sense of self feel distorted. In other words, PMDD can indeed make you feel disconnected from yourself. It’s not your fault or a sign of a deeper illness, it’s a very real symptom of the disorder. Doctors and support groups report that during PMDD episodes women often say they feel “not themselves”, or even “crazy”. The good news is this feeling is temporary and linked to your cycle, and there are ways to manage it.

PMDD’s physical root is cyclical hormone changes. Research shows that people with PMDD have completely normal estrogen and progesterone levels, but their brains respond to those normal hormone swings in an exaggerated way. As estrogen and progesterone rise and fall each month, neurotransmitters like serotonin and GABA are affected. In PMDD, this leads to a “switch flipped” effect on the brain: mood, cognition and perception can go off-balance. Essentially, your brain is more sensitive to hormone fluctuations, which can literally change how you see yourself and the world for a week or so. Neurochemically, some doctors liken it to the brain entering a temporary fog. This helps explain why brain fog, derealization or depersonalization (feeling emotionally numb or detached) can happen with PMDD.

Common experiences during PMDD include:

• Feeling alienated from your own thoughts and body, as if watching yourself from outside.

• Questioning your identity or major life choices (“Am I really happy? Is this the real me?”).

• Intense self-criticism or worthlessness that seems out of character.

• Worrying you’re losing control or going “crazy,” because the feelings are so overwhelming.

These symptoms aren’t illusions. For example, one woman shared that four days each month “PMDD knocks me down so hard…it feels impossible to get back up”, describing her mind as “drowning in an overwhelming sadness that logic can’t fix”. Another PMDD therapist notes that patients often feel “not themselves,” as if someone flipped a switch on their personality.

Why does this happen?

PMDD is fundamentally a brain-based sensitivity to hormones. One leading theory is that normal drops in estrogen/progesterone alter GABA (a calming neurotransmitter) or serotonin function in the brain of PMDD sufferers. This can trigger anxiety, depression and cognitive symptoms. These neurochemical shifts can literally change the lens through which you see yourself. Importantly, PMDD symptoms always come on in the luteal phase (after ovulation) and lift shortly after your period starts. This pattern is key: it shows the symptoms (including that disconnection) are tied to your cycle, not a permanent change to who you are.

It may help to think of it like a seasonal storm in your brain. During PMDD you might feel like a totally different person for a brief time, but once the hormones stabilize, the “storm” passes. As one HealCycle article puts it, this isn’t your “real” personality permanently, but a temporary state influenced by your hormones. In other words, the distorted self-perception is part of the PMDD episode, not something fixed or weird about you. Realizing this is the first step toward coping.

Recognizing the signs: If you’re wondering whether your disconnection is due to PMDD, look for patterns. Do these feelings only happen in the one or two weeks before your period, then lift once your period begins? Are they accompanied by other PMDD symptoms like extreme mood swings, irritability, anxiety or physical pain? A PMDD diagnosis typically requires at least five specific symptoms (including mood symptoms) recurring each cycle. Feeling emotionally numb or detached (sometimes called depersonalization or derealization) is often listed as a possible cognitive symptom. The International Association for Premenstrual Disorders explicitly notes “depersonalization (emotionally disconnected)” and “derealization (feeling the world is distorted)” as PMDD symptoms. So if you check your calendar and see this pattern, rest assured it’s a known part of PMDD for many.

Coping Strategies: While living with PMDD can be exhausting, there are steps to help you feel more grounded:

• Track Your Cycle and Symptoms: Use a detailed diary or Healcycle App to record not only moods and physical symptoms, but also moments when you feel detached. Journaling helps you see the pattern and “reality-check” later, writing down your mood, energy, self-perception, and relationship perceptions in each phase. Seeing that the intense “stranger-to-myself” feelings always fade after your period can remind you they aren’t permanent.

• Self-Compassion: Remind yourself that PMDD is physiological. Treat yourself with kindness during this time, not criticism. Small acts of care (resting, gentle yoga, hot bath) go a long way when you’re feeling off.

• Grounding Techniques: When the disorientation hits, try grounding (e.g. naming 5 things you see, holding onto ice, mindfulness breathing) to anchor yourself in the present. Remind yourself: “This feeling is temporary.”

• Talk It Out: Tell a trusted friend or partner what you experience (if you feel comfortable). Sharing how it feels can make it less scary and helps others understand why you seem so different some days.

• Professional Help: If these feelings are overwhelming, talk to a gynecologist or therapist who knows PMDD. Treatments like SSRIs (antidepressants) or certain contraceptives can significantly reduce PMDD symptoms for many women. Getting a proper diagnosis can also be validating – no one should tell you it’s “just in your head.”

Remember, you are not broken or alone. Many women with PMDD describe the same jarring identity shift. The key is to recognize it as part of the cycle. Developing a proactive plan (tracking, self-care, therapy if needed) can help you feel more in control. Over time, you will learn what helps you stay connected to yourself even when hormones are surging.

Conclusion:

In summary, yes – PMDD can absolutely make you feel disconnected from yourself. This phenomenon has real name (derealization/depersonalization) and is a documented part of PMDD. It stems from how certain brains respond to normal hormone changes. But it does pass each cycle, and there are supportive strategies to cope. By educating yourself and practicing gentle self-care, you can ride out these weeks and remember the strong sense of self you have at other times is still there, waiting for the storm to clear. Stay compassionate toward yourself and seek support; understanding PMDD is not a personal failing but a medical reality is the first step to regaining your footing.

Disclaimer:

This article is for educational purposes and does not replace professional medical advice. If you suspect you have PMDD or any other health issue, please consult a qualified healthcare provider.

References:

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

Cleveland Clinic. (n.d.). Premenstrual Dysphoric Disorder (PMDD): Causes & Treatment. Cleveland Clinic.

Johns Hopkins Medicine. (n.d.). Premenstrual Dysphoric Disorder (PMDD). Retrieved 2024, from Johns Hopkins Medicine website.

International Association for Premenstrual Disorders (IAPMD). (n.d.). What is PMDD? (Factsheet).

Mayo Clinic. (2023). Premenstrual dysphoric disorder (PMDD). Mayo Clinic.

Rosen, P. (2022, November 7). PMDD and relationships: Help for you and your partner. HealthCentral.

Schmidt, P. J., & Rubinow, D. R. (2011). Neuroendocrine aspects of premenstrual dysphoric disorder. Psychoneuroendocrinology, 36(3), 355–370.

Yonkers, K. A., O’Brien, P. M. S., & Eriksson, E. (2008). Premenstrual dysphoric disorder. Lancet, 371(9618), 1200–1210.