Hello everybody. Welcome to a very special bite-size episode from Vet Chat as part of the webinar vet's new initiative to support and empower women in the veterinary profession. We'll have very open and honest conversations with ladies from the profession who really want to share their experiences with us to help to make a difference.
We hope you enjoy. Hello everybody, and thank you so much for joining us for today's episode of Vet Chat. Today we are delighted to be joined by Katie Ford.
Katie graduated with distinction from the University of Liverpool in 2012. Since then, she's continued to work in small animal first opinion practise, gaining her RCVS certificate in internal medicine in 2017. Realising the power of preventive mindset strategies through her career and journey, she trained as a coach and now teaches other professionals how to use these techniques to thrive in the veterinary world.
She regularly helps individuals and companies on topics such as gratitude, self-wear, and dealing with impostor syndrome. So welcome, Katie, thanks so much for joining us today. Thank you so much for having me again.
Lovely. So today, we thought we would have a little chat, around hormone battles and in particularly shining the lights on PMDD. And I must admit, until we decided that we were going to do this podcast, I'd never heard of, of PMDD or what it was.
And I asked the webinar vet team this morning and I stand up if they were aware of it, and 94% of people said that they went. So maybe Casey, if you could start, just by explaining to us what PMDD is, please. Of course I can, and thank you so much for giving the platform to raise awareness for this really important topic.
It's quite different from what I normally talk about, and this is something I've experienced personally over the last year or so, and it will have been present before then. So PMDD stands for premenstrual dysphoric Disorder. And essentially it's a cyclical hormone-based mood disorder that's got symptoms that arise in the last couple of weeks of the menstrual cycle.
So it's normally like a week before a period is due, 2 weeks before then. But the really staggering thing, whilst you say only 94, well, 94% aren't aware of it, we think that as many as sort of 5.5% of women or those that are assigned female at birth are actually affected by it, which is 1 in 20.
While we see that it's actually directly connected to the menstrual cycle, it's not a hormonal imbalance. It's actually suspected to be a severe negative reaction in the brain of people that are affected, to the rise and fall of oestrogen and progesterone, and they think it's actually like a cellular disorder in the brain which can then worsen over time and at times where Hormones are very implicated. So, for example, pregnancy, birth, starting periods, perimenopause, lots of external contraceptives and things like that as well.
So it's certainly something that's not talked about a lot, but as you can see, one in 20 women are quite affected. And I know we'll go on to the signs and symptoms that people will see, but I think it's really important to lay down from the beginning that It is a potentially a cellular abnormality where your brain just says, whoa, these hormones have just changed right now, we're not happy, you get histamine release, there's all sorts of reactive things that happen in the brain at this point. Yeah, OK, wonderful, thank you.
No, that's, that's interesting. And what what was sort of, you know, your symptoms that kind of makes you think, OK, this doesn't, you know, just feel like normal PMS, you know, what are the common symptoms that that you tend to suffer with with PMDD. Yeah, I mean, certainly it was a really interesting thing for me and I'm very grateful for all the the work that I talk about already and self-awareness and being self-compassionate and kind to myself and I was starting to realise that every month and I didn't know at first.
That it was cyclical. I'd have around a week where actually I'd go from being mega enthusiastic, super keen on all the projects that I was doing, full of energy, excited about my life to zero energy, feeling really anxious without a reason. I'd be sat there like almost curiously looking at myself saying, you feel like someone's put like an iron jacket on you.
You're really worried. It's like an impending sense of doom that would just appear out of nowhere. As well as just feeling generally very unmotivated, not very interested in any any of the things that I do, having a lot of difficulty concentrating, I'd have brain fog, everything that normally I'd be mega switched on for, I'd just end up turning up and thinking, oh my goodness, I can't even think what I'm going to say, the words aren't coming out.
I'd start being a bit more irritable, things that would never normally bother me ever. I'd find that I was ruminating over and thinking over a lot. And being quite self-aware, I'd sit back and go, this is really strange.
What actually is going on here? The fact that this bothers you so much more than it would do at any other time of this month. And I quite often reflect back and think, you know what, even through my times in practise over the years, even sort of 10 years back.
There would have been times essentially when I never knew that this affected me at all, but I'd have certain cases that, yes, would bother me through the month. People have heard me talk about my struggles with imposter syndrome and self-doubt, but there'd be days where that would be significantly worse. And I'd almost then overreact in my mind to that.
And I'd look back a few days. Later and think that was really strange that you took that so personally, or you took that so much more on board than usual. But again, I never saw a cycle to it.
But it was really, probably, to be honest, Katherine, it was my partner that said, you know, we, we keep having the same conversations very frequently now. And it would always be similar conversations of. Be like totally honest and open for people here.
I, I don't know why I'm doing all of this. I don't know whether to carry on doing it. I just don't seem to enjoy it anymore.
But then if you, maybe a week later, I'd be back to loving it again. And it was only then that I started thinking and taking a really non-critical, non-judgmental step back and looking at myself and saying, You know what, this does happen quite frequently and it does seem to be in a cycle, and I start crying for no reason. I remember being away for a weekend with my, my partner and his family when we were on holiday and just wanting to cry continuously and almost not laughing at myself, but being like, what is happening here?
And it wasn't like a jolly funny cry of, oh, aren't I so hormonal and we'll come on to that. It was more of a I can't settle. I'd go up, I'd have a walk, I'd go and lie on the bed, I'd think, no, I need to be up and about and my partner would keep coming and talking to me and saying.
You know, are you OK? Has anything happened? I'd be like, no, nothing has happened.
This is really, really strange. I'm not even particularly listening to any thoughts or any narratives that are throwing this up. There's nothing that I have to be worried about, but all of a sudden I'd feel like the world was about to end, and that was probably the the start of me beginning to track my symptoms and starting to say.
Hey, you know what, there is, there is a pattern to this because the other 3 weeks of the month, I am on form and I'm me and the person that everybody knows on social media. Yeah, absolutely. How long would you say you have to, you sort of tracked it for Katie, before you realised, you know what, there's something that's not quite right here and you realise, you know, you needed to look into it further.
I'd say I officially tracked it for 3 to 4 months. Prior to that I'd say there were about 3 months where I had half an eye of it and started thinking, you know what, this is the week before menstruation, this does seem to be around this point, but I wasn't officially tracking it. And the irony almost is that I look back way back over the years, even so when I was in practise, and I remember when I was worse with a lot of my, my symptoms that were already going on.
So I'd say way back 10 years ago when I was in practise, it was exacerbating something that was also going on rather than me going back to normal in between if that makes. Sense. And my boss at the time used to say, Do you think this is like a monthly thing?
And at that point I almost just discarded that straight away and said, No, no, it definitely isn't. It definitely isn't. I don't know what you're talking about.
I never gave that the time of days, but I think that did stick with me as well. So yeah, I'd say 3 to 4 months officially tracking and a couple of months before then. Me having it peripherally in my mind.
Yeah, OK. And then when you kind of, you know, discovered that there was a bit of a sort of routine to it, what did you do? How did you kind of officially, you know, get diagnosed?
And the next thing that I did from there was that I started advocating myself and doing some research because I thought before I even knew that PMDD existed, I realised that there was this pattern. So I started just putting my symptoms in saying very anxious just before menstruation, and I found it and I came across it and I started doing some reading. And then I realised that there is no specific test for it.
A lot of it's a diagnosis of exclusion, as a lot of us will be very familiar with. And also tracking symptoms is a big part of it too. So I actually went to the GP but I'd educated myself to advocate myself enough because when I started to look around and read case studies and read information out there about other people that had it, some of them got lucky and they had a GP that was very aware of this as a condition, and others maybe had GPs that weren't as Aware of it, which I don't think is uncommon.
We know the same thing in veterinary practise that if we've had cases again and again of a certain condition, some of us can end up very clued up on it. And if something is news to us, then we might not be so much. So whilst I didn't want to be that person that comes along and says, I've got this and this is what I have, I kind of had it in my periphery to say to the doctor, Look, I've started to notice this as and the symptoms.
And from there, they actually asked me again to track my symptoms further. They have an official. Survey almost that they give you that is the standardised document that you have to go through and you have to track symptoms that come up because the ones that I've listed are some of them and essentially you've got things like mood and emotional changes, you've got irritability, anger, or increased interpersonal conflict, you've got depressed mood, feelings of hopelessness, feeling worthless or guilty, anxiety.
Feeling a bit on edge. They're the four main ones, but then there's a few more, and we have certain numbers of them that have to be present. So the others are things like decreased interest in activities, difficulty concentrating, tiredness and low energy, changes in appetite, food cravings, overeating, binge eating, excessive sleepiness, feeling overwhelmed or out of control, and, and sometimes physical symptoms like a lot of pain and discomfort.
So I think specifically when you have a diagnosis, you need At least 5 of those symptoms, but one of them has to be one of those 1st 4. So that was the next step was me going to the GP which if there is anyone that listens to this and thinks, you know what, actually, I could see that being me. I'd really implore you, first of all, track your symptoms.
Secondly, educate yourself, and thirdly, go and speak to the GP as well, because from there I did start having a few tests just to exclude other things like abdominal scans, blood samples, make sure there was nothing else that could be going on, and then ultimately a referral, because this is a, an endocrinology, issue rather than being a mental health primary disorder. It tends to be dealt with like, gynaecology and obstetrics rather than being anything to do with. Mental health, although they do bring psychiatrists in, they do bring therapists in for some people as well because you can understand there's a lot of mental health side effects of this reaction that happens in the brain.
Absolutely. And. Did you have, you know, with the people around you that you, you know, could speak to about it.
So obviously you have the doctor where you had the, you know, diagnosis, then did you then feel comfortable enough to take that back in, you know, with your work and with your family and people around you to get some emotional support because it sounds, you know, really, really tough, and you know, will really impact your mental health as well along with your physical health. Yeah, absolutely. I mean, to be honest, I feel incredibly fortunate that my partner is so supportive.
And when I started explaining it to him, I gave him the resources that are out there for partners of people with PMDE to understand it a little bit better because I know that for so many people out there with this, they can understandably be very difficult to live alongside. It's difficult to live as them. It's difficult to live during that those few days, especially if You are being mean to yourself or you've been harsh to yourself, but having somebody around that maybe is acting quite differently for a week could be quite tricky.
And to be honest, I do feel very grateful, like I said before, that I am very self-aware I'm very aware of how I respond and how I set myself up for success and how I treat myself in that time and I, I don't bite back at my partner. I'm not cruel or mean, but I know a lot of people that maybe are probably even worse affected do end up saying things that they regret and so on. So it's been nice that my partner's been so supportive and understanding, and he always just says to me, you know, this is going to pass again, it's going to disappear.
Let's just keep looking after you. And it does, sure as sure as day and night, it disappears after. About 5 to 7 days, some days are much worse, some months it really doesn't hit as hard as usual.
My family have been supportive. I mean, certainly, I know that there's always the backup if I did need to go and speak to anyone on like a therapy level because there are so many different treatments out there for this and just like our own patients, it's finding the one that works for individuals. So I've got a set up now with things that help me specifically, and there'll be other people that will take certain medications for it.
There'll be people that have certain modalities of therapy, there'll be people that find that other things help them, but support system wise, I felt very, very lucky, but There have been times of almost gas gaslighting to an extent of people saying, oh, isn't that just PMS? And actually it's far, far, far from just PMS. I, I begin, I really wish I could begin to explain this to people sometimes of.
Just how much of a light switch it is from having 3 weeks where I feel like one person to having those 5 days where you feel like a massive storm just appears and yeah, I just feel incredibly lucky that I've been through what I had until that point to be able to be compassionate enough to myself when it does come, but it doesn't make it comfortable. It doesn't make it any more enjoyable. It just helps me understand it better.
Yeah, absolutely. And do you find that you sort of plan your work in your everyday life, I guess now, you know, you always in the back of your mind, you know, having your sort of cycle on the brain, so you're giving yourself that time when you know that it might hurt to really, you know, relax and have that break and give your body that break, you know, versus the other 3 weeks of the month, so. Yeah, definitely Catherine completely so.
I always have it just in the back of my mind when roughly I think that time will be. And there have been times where I'm sure many of you that listen to this have turned up and see me do a talk, and I will look like I am fully on form and won't look like anything is happening for me at all. But the rest of that day, I will just do nothing else because I'll be absolutely exhausted and I'll just need that time.
To recharge and look after me, and I tend to structure my diary around that. And again, I realise that I'm incredibly lucky to have that autonomy and that freedom of running my own business and working for myself because I know in practise it was completely impossible for me to do that and I think that if I'd had a diagnosis at that point. I know that I would have been able to go and speak to my team and say, look, this is what happens to me at this point.
And it might be that at these times, I need just to accommodate me better. And I think because PMDD is an official diagnosis, I do believe that there are things like where you can bring in an occupational support and talk with them and Talk with your teams and find out what the best way is to work with them there. So for me as an individual, yeah, I 100% work my diaries.
Sometimes there's times where I look back and I think, you know what, I am busier than I would have liked to be at this point. I really need to actively advocate me and do what works for me and helps me. And there are the people that I work with the closest and on the most regular basis, know that I have this and I completely understanding if I just say to them, Look guys, can we just reschedule this meeting for a couple of days from now?
In the same way that I had to reschedule this podcast with you guys, because there was one day we were scheduled to to record this and actually it really was a more difficult day and I don't think I would have showed up and given my best at that point, and it really wouldn't have been me role modelling what I want to role model by me coming along when actually what I needed the most that day was was rest. Yeah, absolutely. And you know, I think.
Having open conversations about it, you know, I think really does help as well, doesn't it, not only to take the pressure off and you, but you know, allows me and the team not to be slightly bothered by the fact that you cancelled it because you just needed that time for you. You know, yeah, definitely, and I think that's something that I'm getting better at and I'm learning more about and I'm sure that a lot of us to an extent, still need to learn a lot about it too, looking into what at that time gives me energy, what drains me of energy, and also just taking the judgement of myself and forgiving myself for the fact that this is a negative reaction in my brain. This isn't something that I chose.
This isn't something that I bought into. This isn't something that I can prevent, but it's something that I can try and make it as easy for myself to navigate as I can do. And one of the things that I know it's not a jokey matter by any means, but sometimes I just have to make light of it because it's something that's gonna hang around for a long time now is that.
I always say, you know what, if I was on farm 24/7, it probably would have taken over the world by now. So this week just slows me down. And then I can get back on track next week, but certainly, yeah, you're absolutely spot on.
I think it's important that we, we all have these open conversations and actually are forgiving of ourselves to mean that sometimes we do need to slow down to speed up. Yeah, absolutely. And if you know people are listening in now, maybe in, you know, practise, and, you know, are struggling with PMDD, what sort of advice would you have in terms of what can people do to be more supportive and you know, to, to keep the conversations going around PMDD.
I think first of all, things like this, I was talking about it openly, if it is that it's something that you experience personally as somebody that is an individual in practise, maybe asking your colleagues to listen to something like this podcast so they can understand that even me as someone that advocates a lot of well-being and self-care and looking after ourselves and mental health and so on, it's something that massively, massively affects me and I never chose it, the same as any of you out there that are struggling with it too. I think the second thing is take the judgement of yourself and be as compassionate to yourself as you can be. Again, you didn't choose this.
You're still enough, you're still valuable underneath all of it. It's all like the weather, it shows up and we don't have to pretend that we're we're enjoying it when it's there, but it, it doesn't mean that you're broken, it doesn't mean that you're not enough. It doesn't mean that you're not valuable.
And secondly, educating ourselves, I think as well, and there's a fantastic resource which is the International Association for Premenstrual Disorders, which is IAPMD that has lots of resources on there. And finally I say advocate yourself, just remember again that this isn't something that you. But it is something that if you seek the support, there are things that might make it a little bit more navigable and a little bit easier, not being afraid to actually speak with your employers about the fact that that's a diagnosis that you've had and seeing where they can help to accommodate you.
And finally, for anyone that doesn't experience it but can see that someone maybe has something cyclical would be again, just helping educate everyone in the team saying, look, this exists, this affects one in 20 women. So there's Potent that there's a good number of veterinary professionals in our industry that have this and don't realise. And just being understanding and being kind to others and realising that sometimes if they do act a little bit out of character, that might not necessarily be a reflection on us, but it might be a reflection on, is there something that's going on for them and maybe for us just to, to be a little bit kinder and a little bit more understanding and sometimes just, are you OK?
Like, are you, are you really OK? And being gentle with each other because I think that was probably one of the things that helps me the most is actually at that point when I'm feeling that way, the last thing that I need is for someone to be more mean to me because there's a lot going on between my ears at that point, which thankfully I know isn't me and I can kind of watch it. It doesn't make it enjoyable, but I understand why it's there and and what's going on.
But yeah, just being kind to each other, educating ourselves, advocating ourselves and realising that. I think it's really easy for us to make throwaway comments about hormones being like, oh, is it that time of the month or are you being a bit moody? Oh, it's a woman thing, but actually they're really powerful things and they can have a really big effect.
And obviously in this case it's the brain's negative reaction to them, but also PMS can be difficult as well, especially in a very emotional profession that we're part of anyway. So yeah, let's all be kind to each other, educate ourselves, advocate ourselves, just. Take the judgement of ourselves as well.
Absolutely. I think that's, that's a wonderful note to end on. I think, you know, if we continue to talk, if we continue to, educate ourselves, you know, continue to, do things like these podcasts to hopefully raise awareness around, you know, conditions such as PMDD hopefully.
The world will become a much better place. So thank you, thank you, Katie so much. Honestly, the amount of information that you shared today, you know, I've learned an awful lot, and I'm really sure that our community as well will really enjoy listening to this.
So thank you so much and take care and hope to see you soon. Thank you so much for having me, Catherine, and I just really, really quickly add to that just as we're wrapping up that. I know it seems like I've described a lot of symptoms there, but everyone does experience this on, on a scale and unfortunately, when you start reading some of the symptoms of this, there are some quite triggering symptoms.
So I just warn anyone that's going to look it up, but it It just adds to the gravitas of how important it is that we talk about this as a topic when you do see how seriously this can affect a lot of women. So that's why we're here talking about this now, and never underestimate how much of an impact it can have on people. No, absolutely.
I think what might be really useful as well, see if any sort of resources or anything that you think might be useful for people to have to refer back to, maybe we could pop them all on our blog along with the podcast, and then, you know, if there are people who are seeking advice or want to find out a little bit more, they can find all the information there in one place. Definitely we can do that and obviously always remembering it's good to talk and we're very fortunate in this profession to have that life, for example, that are there too. Sometimes what we need in that moment, whether this is something that we've got or something that we're watching someone else with, sometimes we just need a listening ear, and that's a fantastic service to you.
So yeah, I'll put lots of resources together for people to have a look at and yeah, just be kind to yourselves out there and to each other because we never know what's going on for anyone else. Absolutely. That's great, Katie.
Thank you very much again, and yeah, I hope to speak to you very soon. Take care. Bye, thank you.
