Premenstrual Dysphoric Disorder (PMDD)

“For those with PMDD, like me, the wheels fall off for a week or two a month, and symptoms are relieved only when we begin to bleed. (What a trip! You only feel better once you START bleeding?!) 

I would feel absolutely great on the day I ovulated, but then wake to a hellscape the following morning—cold, lost, overwhelmed, and panicking. Every. Single. Month. 

Often, I’d end a relationship that very day. I could barely make it into work, and would blow through all the chocolate and Kleenex in my house in a single episode that evening. Because I wouldn’t begin to bleed until a couple of weeks later, this crash was so far removed that it didn’t occur to me that the two things—crisis and menstrual cycle—could be connected.”

View Heather's Story
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Reconnect, Communicate, and Grow Together

Relationships are one of the most meaningful, and sometimes most challenging, parts of life. When communication breaks down or distance begins to grow, support from a compassionate couples therapist can make all the difference. I’m Julia, a Registered Clinical Counsellor (RCC) with the BC Association of Clinical Counsellors (BCACC). 

I offer Online Couples Therapy in BC, providing a safe and supportive space for couples to explore challenges, strengthen connection, and rediscover understanding in their relationship.

Some cycles are harder than others

For some people, the days before their period bring more than physical discomfort. Mood shifts that feel out of proportion. Anxiety that's hard to explain. A heaviness that lifts almost as soon as bleeding begins. If this sounds familiar, there's a name for it, and there's support available.
View our Women’s Health Program

Why Choose Online Therapy?

What is PMDD?

While research still lags, Premenstrual Dysphoric Disorder is a hormone-related mood disorder that affects roughly 1 in 20 people who menstruate. It goes beyond typical PMS, causing significant emotional and physical symptoms in the one to two weeks before menstruation that can disrupt daily life, relationships, and sense of self.

Common symptoms include:

  • Mood swings, irritability, or anger that feel intense or sudden
  • Anxiety or a sense of being on edge
  • Low mood, tearfulness, or hopelessness
  • Feeling overwhelmed or unlike yourself
  • Difficulty concentrating
  • Fatigue and changes in sleep or appetite
  • Physical symptoms like bloating, breast tenderness, or headaches

Symptoms typically ease within a few days of your period starting. That cyclical pattern is one of the key markers of PMDD.

Why Nature-Based Counselling?

Research shows that time in nature reduces stress, improves mood, and increases clarity. When combined with therapy, the results can be deeply healing.

Benefits of walk & talk therapy include:

  • Movement: Walking naturally reduces tension and supports emotional flow.

  • Nature’s Support: Forests, rivers, and mountains create a grounding presence.

  • Connection: Talking side by side often feels less intimidating than sitting across from a therapist.

  • Flexibility: Therapy on the go — outdoors in Squamish, Whistler, or nearby trails.

  • Bilateral Brain Stimulation in Nature
    Many successful therapeutic approaches for trauma resolution, such as EMDR (Eye Movement Desensitization and Reprocessing), use bilateral stimulation — activating both hemispheres of the brain — to support processing and integration. The natural rhythm of walking, with its left-right movement, may offer a similar calming effect, helping the nervous system regulate and opening space for new perspectives. While not the same as EMDR, walk & talk therapy draws on this bilateral rhythm in a gentle, supportive way.

Why does PMDD happen?

PMDD is believed to stem from a heightened sensitivity to the natural hormonal shifts that occur across the menstrual cycle, particularly the drop in estrogen and progesterone before menstruation. For people with PMDD, these shifts trigger a significant neurological response. It is a physiological pattern, not a personality trait.

What Happens in a Session?

We meet at an agreed location — a forest trail, a riverside path, or another safe, accessible spot. Sessions follow the same structure as in-office therapy, with the added richness of being immersed in the outdoors.

Some sessions may include:

  • Pausing to notice your surroundings

  • Gentle breathing or grounding practices

  • Reflection exercises inspired by ecotherapy and forest therapy

  • Exploring the metaphor of your healing journey in connection with the land

    Clients often describe walk & talk sessions as freeing, calming, and even transformative.

How therapy can help

PMDD often benefits from a team approach that includes your doctor or a specialist. Therapy plays a meaningful role in that picture. At True Nature, we support people with

PMDD by helping them:

  • Track and understand their cycle and emotional patterns
  • Build tools for the harder days
  • Process the exhaustion and frustration that can come with this condition
  • Navigate relationships that have felt the impact of PMDD
  • Reconnect with themselves across all phases of their cycle
Nature-based therapy can be especially grounding here. The rhythms of the natural world remind us that we too are cyclical, and that every phase has its place.

Where to get help

PMDD is best supported with a team around you. Here are some places to start:

Talk to your doctor or OB/GYN A medical provider can help rule out other conditions, discuss treatment options, and refer you to specialists. Being specific about when your symptoms occur in relation to your cycle is really helpful.

Work with a therapist Cognitive Behavioural Therapy and mindfulness-based approaches have solid evidence behind them for PMDD. We're here if you'd like that kind of support.

  • Connect with the PMDD community
  • IAPMD is the leading global resource for PMDD support, research, and community
  • Vicious Cycle is a peer support and advocacy community
  • Reddit's r/PMDD community is active and full of people who understand

Pick up a copy of Heather’s memoir Where The Eff Is My Red Tent from your favourite local bookstore or library. Follow along @heather.hendrie and @truenaturewildernesstherapy on socials.

You’re not alone.

Visit Heather's Site
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Where the Eff is My Red Tent

For personal and intimate insights into the experience of PMDD, pick up a copy of "Where the Eff is My Red Tent" - an unflinching, visceral memoir a by Whistler-based wilderness therapist and clinical counsellor Heather Hendrie.  It chronicles her lifelong struggle with Premenstrual Dysphoric Disorder (PMDD). Part medical mystery and part feminist reckoning, the book aims to end the shame around women's health and highlight conditions that are dangerously underdiagnosed.
Buy Book
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Step Into Healing: Walk & Talk Therapy in Squamish & Whistler

Sometimes healing comes more easily when we move. Our Walk & Talk Therapy sessions invite you outdoors into the beauty of the Sea to Sky Corridor — forests, rivers, and trails — to explore your story while walking side by side with a therapist.

Blending the proven benefits of counselling with the grounding, calming effects of nature, nature-based therapy helps you reconnect with yourself, with the land, and with a sense of your infinite potential and possibility.

Support is available across your whole cycle

We're building a dedicated space for this exact experience. Our Cycles Program for PMDD & Women's Health launches January 1st, with room for an initial intake of five clients.Add your name to the list to be the first notified when enrollment opens.

Frequently Asked Questions

Frequently Asked Questions

Online Couples Therapy takes place over secure video sessions. You and your partner can join from separate or shared locations, allowing for flexibility while maintaining the same level of confidentiality and care as in-person therapy.
Yes. Research shows that couples therapy online can be just as effective as in-person sessions. Many couples find it easier to open up in a comfortable, familiar environment — helping progress happen more naturally.
The number of sessions varies for each couple. Some experience meaningful change after a few meetings, while others choose longer-term support to deepen understanding and maintain growth. We’ll discuss your goals together and create a plan that works best for you.

Yes. While PMS is common and can bring physical and mild emotional discomfort before your period, PMDD is more intense. The mood-related symptoms, like anxiety, low mood, and irritability, are significant enough to interfere with daily life, relationships, and work. The key marker is that symptoms follow a clear cyclical pattern and ease once your period begins.

No. If you're noticing a pattern in your cycle that's affecting your wellbeing, that's enough reason to reach out. A therapist can help you track and understand what's happening while you pursue a formal diagnosis through your doctor if that feels right for you.

Yes. We offer virtual sessions across BC and Canada, so wherever you are, support is available.

Start Your Couples Therapy Journey Today

Whether you’re seeking couples counselling in BC, or online across other provinces in Canada, we’re here to help. Book Your session and take the next step in your healing journey.

Learn More About TrueNature WIlderness

In a world that constantly demands our attention, it's easy to lose touch with ourselves. We believe healing, growth, and transformation begin when we reconnect with who we truly are. That's why we're here.
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