Episode Details

The week before your period can feel like a different personality takes the wheel and it’s terrifying when no one can explain why. Gabby Rivas-Field, MA, LPCC, a somatic psychotherapist who works at the intersection of hormones, mental health, and the female nervous system, joins me for an honest, clinical, body-based conversation about PMDD and what actually helps. We name the lived reality: irritability, rage, anxiety, depression, shame spirals, sleep disruption, and that disorienting “light switch” after ovulation. Then we ground it in a clearer model: PMDD is often a nervous system sensitivity to normal hormone fluctuations, not a moral failure and not proof that you’re too much. [Work With Gabby!]

We also talk about why PMDD is so often misdiagnosed, including the painful and common confusion with borderline personality disorder, and why cycle tracking is essential for getting the right diagnosis and support. We walk through the menstrual cycle as inner seasons, with practical nervous system tools for each phase: rest and warmth in inner winter, gradual momentum in inner spring, connection and preparation in inner summer, and boundary-setting plus vagus nerve support in inner autumn.

From there we widen the lens to trauma physiology and attachment. We explore how early life stress can sensitize cortisol and survival responses, why somatic therapy can reach what talk therapy can’t, and how relational safety, co-regulation, and community support can lower stress and increase steadiness over time. We also discuss the fuller treatment picture beyond “just birth control,” including SSRIs that can be used cyclically, integrative lab work, and realistic lifestyle shifts that honor the world we actually live in. [PMDD Wellness Guide by Casey]

If you want language for what’s happening in your body and a path forward that includes both psychology and the sacred, subscribe, share this with someone who needs validation, and leave a review with the one insight you’re taking into your next cycle.

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Intro music composed by my dad, Mike Dunne: [Spotify link]