5 Strategies for Managing PMDD Symptoms at Work

Jan 24, 2022

Jenny Fairhurst, Author

Juggling work of any kind can be extremely challenging when you’re living with PMDD. The unpredictability of symptoms, the swing from feeling competent and confident to self doubt, fatigue and paranoia, to name but a few, have a negative impact on our ability to perform to our full potential. 

We all have our coping strategies for various aspects of life with PMDD. These are some of the things which have had a positive impact on both my ability to manage my work, but also my relationship with work and how I feel about myself in my job. They have brought me back to a place of enjoying my work and feeling like I can do a great job, despite continuing to live with PMDD symptoms each cycle.

I’ll give a caveat up front that these may not work for every job role out there; obviously there are huge differences in what a ‘working day’ looks like, the ability someone has to dictate their work diary or activities, and therefore some of these may not be realistic for everyone. I hope they still give a little inspiration to encourage you to think about whether there are tweaks or changes you could make along the same vein to make them relevant to your personal work arrangements. 

1. Map your cycle in your work calendar

This is PMDD management 101 – know your cycle and learn to predict and anticipate your ups and downs. The days you will feel ‘on it’, and those where crawling out of bed will be a challenge. Use this knowledge to plan your work diary. If a meeting request comes in for day 28, which you know your head will be foggy and you won’t be firing on all cylinders, it’s ok to propose a new time for the following week. Don’t feel guilty about this! You don’t need to give an explanation why. Rather than feel like you’re causing an inconvenience, consider that the other meeting attendees will have a much better experience of you if you’re feeling confident and like you’re at your best rather than worrying, overthinking and struggling to participate.

2. Find your safe zone

Let’s be real – there are going to be days where you don’t feel your best, however that manifests for you. On those days, having a fall-back stash of some of the unexciting but essential work activities, which don’t require a huge amount of brain power, is such a relief! This could look like any number of things; filing, organising your email folders, compulsory training or pulling laborious reports, submitting expenses. It could be anything, and may even be the stuff that you usually put off because it’s not so fun or interesting, but these are the perfect things to work on when the brain fog kicks in and you can tick the boxes, and be productive, doing stuff that you do need to get done. There is nothing more soul destroying than battling away with a complex piece of work when your brain is foggy and it’s taking you twice the amount of time to complete something. Do yourself a favour, park that and schedule to complete it on a better day (if you can) and get on with something which takes half the brain power. The flip side of this is that you then don’t end up having to do those dull tasks on days when you’re firing on all cylinders and feel able to take on the world!

3. Flex to your needs and prioritise comfort 

The Covid-19 pandemic has thrown a lot of people into a different work set up, with so many now working from home rather than in an office, and for lots of us, looks set to continue and become a new norm. There are some great benefits to this, but on the flip side, you can feel tied to your desk and the lines between ‘home life’ and ‘work life’ becomes blurry. Work-life balance, what even is that? When managing a condition like PMDD a work set up like this can be really helpful because you can give yourself the space to honour how you’re feeling and what you need on any given day without having to ‘fit’ in with the normal office requirements. If getting out of bed was hard, can you bring your work to bed and work from there? Or if getting showered and dressed takes too much energy, it’s ok to work in your pyjamas. I’ve lost count of the number of days I’ve not brushed my hair on a bad PMDD day because it just seemed like a pointless waste of precious energy. A definite ‘no camera’ zoom day on those days!  Mid afternoon fatigue can also be a big issue for me, so where my schedule allows, it’s not unheard of that I will block out an hour and take a nap to recharge. That little refresh can sometimes make a huge difference in giving me a boost to see the end of the day with a clearer mind, rather than struggling on feeling like I’m wading through treacle.  If I was having to venture into an office it would be extremely difficult to do some of these things, but my point is, find ways to prioritise, and conserve the little energy you have. If you have to venture into work, how can you make the process easier for yourself, can you pack a bag the night before? Lay out the comfiest office ensemble you can get away with wearing so all you have to do is throw them on in the morning. It’s little things but anything that helps make those days easier and more bearable. 

4. Know your limits and protect your boundaries

This is a really tough one at first, but it gets easier the more you do it. First, you need to be honest with yourself about your triggers and tipping points when PMDD kicks in. This is very personal. For some, it could be about physical triggers, maybe on certain days your fatigue kicks in and you absolutely can only do the bare minimum working hours so you can finish your shift at 5pm and crawl straight into bed to be able to recharge for the next day. When a last minute request comes in for a meeting at 5pm it can be really easy to let your intended boundary slide, you don’t want to let people down after all, and what’s an extra half an hour? It’s a slippery slope once you start flexing on your boundaries, and every time you do this, you are telling yourself work is more important than your own health and wellbeing. Yes it may be half an hour, but it’s half an hour where you could be resting, and not doing so could have a knock on effect onto other issues or symptoms for you. Knowing what your hard limits are and being honest with yourself about that can help you recognise when something is going to cause you an issue. Practice pushing back to protect those boundaries, e.g. “I’m sorry I can’t make that meeting time, could you do 9am tomorrow instead?”. The more you do it the easier it gets. Maybe you find that a lunchtime walk, or taking a proper lunch break (or lunch time nap) helps you clear your head and manage through the afternoon better, if so, hold yourself to these strategies because they will pay off for you in the long run when you consistently prioritise your own needs and wellbeing and will therefore have a positive effect for you both in your work and in your personal/home life. Remember that no one else will protect your boundaries for you, so you have to do it for yourself.

5. Celebrate your wins and bank the proof of what you can achieve

When PMDD kicks in, it often tells us that we are not capable or worthy. This internal whispering can make us forget who we are, our achievements, our abilities, because let’s be honest, that voice is pretty convincing! It can make us completely unwilling to even try, to have a go, because the fear of failure, the paranoia of it, we just don’t see how we could even begin to successfully complete that task, or piece of work. However, while there are some days that start with me feeling like I absolutely cannot do anything, I have, through using the techniques above, been able to tick off items from my to do list. To finish a day and reflect back and think, ‘I was pretty productive’, it may have been a slog, and tough to get there, and I may not have had a smile on my face or spring in my step as I got there, but the sense of satisfaction of proving myself, and that voice, wrong, is HUGE. Every time you achieve something despite being so sure beforehand that you couldn’t possibly do it, it’s a win to be celebrated, to marvel at your ability to overcome. To give a middle finger to PMDD. Every single one of those wins is evidence, proof of what you can do, and the more of that evidence you stack up, the easier it gets to face those challenges, because you’ve seen yourself overcome time and time again, and you know you can do it. Keep track of them, have a list, in a journal or notebook, of every ‘win’ you’ve managed, piece of work you produced, difficult meeting or situation you dealt with which you never thought you could. Then on those days which start with dread and self doubt, grab a coffee and that list, and show PMDD what you can do, give that voice a reality check and approach the day with the evidence fresh in your mind that you have faced those days before, and you’ve come out the other side!

Looking for support on PMDD and work? 

We recommend  the following webinars


PMDD, Work and Careers Panel Discussion: discover some incredible insights, top tips and a huge dose of honesty from other PMDD Warriors.


Understanding PMDD & Employment Law: in this webinar, employment lawyer Carrie-Ann Randall helps us to understand our rights when it comes to PMDD and work – is it a disability? What support can we get? What can we do if we’re treated unfairly or lose our job because of PMDD?


Returning to Work after PMDD Related Absence: lots of us have to take time out of work because of PMDD, ranging from the odd day here and there to months or even years – often as a result of debilitating symptoms that can make work impossible, or following surgery. In this webinar with Occupational Psychologist Dr Joanna Yarker, we considered some of the challenges of returning to work after periods of absence and what we can do to cultivate a positive return, without compromising our health and wellbeing.



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