i’m a therapist at an outpatient mental health clinic seeing 35-40 clients per week. i have wednesdays and sundays off and then all the other days i work 11 AM until 8/9 PM give or take. i do schedule 15 minute breaks between sessions and a one hour lunch break. and i work from home.

i’ve had PMDD as long as i can remember. unfortunately im extremely sensitive to most anti-depressants as well as extremely allergic to mood stabilizers, so medication isn’t really an option to manage it. i take latuda and wellbutrin but im not very consistent with them.

those who have also struggled with PMDD will likely know what i mean when i say it’s all-consuming and terrifying. i haven’t been actively suicidal since high school yet when my leutal phase comes around, i have to have friends safety plan with me. this month ive also developed homicidal ideation. the irritability scares me with its intensity. not to mention the overwhelming despair and anxiety. and then on top of it all, i have no energy. literally i’ve spent this entire day off asleep. and then yesterday if i wasn’t in a session, i was in bed (including during those 15 minute breaks).

i feel so horrible because i do love my job and i care so much about my clients and normally im an excellent clinician. but when this hits, everything feels so impossible and upsets me and i don’t feel like im able to do my job effectively.

if anyone has figured out how to manage this condition while working in the field, id love to hear what worked for you. thanks!

Originally posted by u/Same-Nectarine-785 on Reddit.

Top comment by u/anticyclops

I have PTSD and depression with psychosis, so not quite the same but maybe applicable advice?

I prioritize my well-being. I sleep enough and won’t compromise on that in most cases. I take my meds dutifully (maybe get better about taking them the way they are meant to be?). I make sure I eat and don’t skip meals. I try to have a good routine with going outside too.

And if my symptoms become beyond my ability to care for, I take myself to a hospital or residential. It sucks and isn’t ideal but my life is important too.