A story of stigmas

Imagine spiraling like clockwork every month into a vortex of anger and despair. Journalist Shalene Gupta, A&S '09, lived this way for more than a decade confronting premenstrual dysphoric disorder, a condition she describes in her forthcoming book, The Cycle: Confronting the Pain of Periods and PMDD (Flatiron Books, 2024).

Part memoir, part journalism, Cycle seeks to raise awareness about a medical condition suffered by millions worldwide but scarcely known outside a narrow community. Gupta's story starts with a conversation with a friend as she explains life with PMDD. "For a few days a month, right before my period, I morph from a quiet, conflict-averse introvert to an implacable storm of anxiety, depression, and rage," Gupta says. "I scream; I throw things; occasionally, I attempt suicide. Then, just as suddenly as the storm appears, it vanishes, only to come back next month."

Like many women with PMDD, Gupta suffered in silence and uncertainty before knowing what wreaked havoc on her mind and body. "I assumed I was a bad person with poor emotional control," she says of the disorder caused by a reaction to menstrual-related hormonal changes. Yet even with a diagnosis, Gupta, like many doctors she saw for treatment, second-guessed whether it was real.

In Cycle, Gupta delves into treatment and the stigma of antidepressants to the eventual listing, in 2013, of the condition in The Diagnostic and Statistical Manual of Mental Disorders. The story is wrought with politics and even backlash from feminists, who viewed PMDD—and PMS—as inventions of a sexist society, with no basis in biology.

"What does the public discourse become when you combine one stigmatized condition—menstrual health—with another stigmatized condition—mental health?" Gupta asks tongue-in-cheek. "Bloody hell."