Jess's Really Good Day

How microdosing psilocybin mushrooms helped Jess manage PMDD symptoms when traditional treatments failed

*MICRODOSING HARM REDUCTION GUIDE for female biology.

For two weeks out of the month, Jess suffered from migraines, inflammation and mood disturbances. Seeking help from her doctors, Jess was diagnosed with premenstrual dysphoric disorder, or PMDD.

Jess’s symptoms correlated directly with her menstrual cycle. By her early thirties, symptoms became disabling and unbearable; the transition from having children to regular menstrual cycles put her migraines and mood swings on full display. For two-weeks before her period started - half of the month - Jess struggled to perform basic tasks like grocery shopping and cooking for her family.  

PMDD affects an estimated 5-8% of women of reproductive age. The often misunderstood condition produces symptoms in the one to two weeks before the periods starts, also known as the luteal phase of the menstrual cycle.

First line treatments for PMDD include birth control and SSRIs. Jess tried birth control for a while, but has an increased risk for stroke and decided birth control wasn’t a great option long term. Serotonin reuptake inhibitors, or SSRIs were the next option. After a few months, the side effects and limited efficacy forced her to seek out alternative options.

Ayelet’s Really Good Day

Desperate for solutions, Jess stumbled across Ayelet Waldman’s best-selling book, A Really Good Day: How Microdosing Made a Mega Difference in My Mood, My Marriage and My Life. Ayelet is a fiction novelist who suffered from mood swings for years before being properly diagnosed with PMDD. Misdiagnosed with Bipolar II at first, Ayelet tried a myriad of traditional treatments including SSRIs and even anti-psychotics to stabilize her mood.

After getting a proper diagnosis and discovering that her mood symptoms correlated with her menstrual cycle, Ayelet was better equipped to manage her symptoms. She lived according to her calendar, scheduling important meetings around her menstrual cycle, and taking SSRIs during the luteal phase. For a while, symptom management was working and she felt like she had control over her condition and her life.

Once she entered into perimenopause, however, her cycle became irregular and the tools she once relied on became ineffective. She could no longer time her periods and couldn’t schedule her life around them. She didn’t know when to start her medication. Her mood disturbances escalated rapidly and intrusive, suicidal thoughts began to overtake Ayelet’s life.

Desperate for solutions, she turned to her bookshelf and read Dr. James Fadiman’s Psychedelic Explorer’s Guide. A former public defender and drug reform advocate, Ayelet was somewhat familiar with psychedelics, but Dr. Fadiman’s book introduced her to microdosing.

Microdosing is a relatively new term for small, sub-perceptual doses of psychedelics designed to produce a positive effect on mood, creativity and well-being. A microdose does not produce the hallucinogenic effects experienced with larger doses.

A middle-class mom of four and former public defender, she wasn’t interested in watching the trees melt, kaleidoscopic color patterns or becoming one with the universe, she was just trying to feel normal.

Out of options, Ayelet embarked on a microdosing journey with LSD - also known as Acid or Lucy - taking a small fraction of a normal dose to ease her premenstrual symptoms. With microdosing, the fog that clouded Ayelet’s life began to lift and the suicidal ideation was soon replaced with what she describes as A Really Good Day.  

Jess’s Journey to A Really Good Day

When Jess picked up Ayelet’s book, she was hesitant at first. Her mother suffered from substance abuse, and Jess witnessed the fallout firsthand. Ensuring that she didn’t follow in her mother’s footsteps, she avoided drugs growing up and even participated in the D.A.R.E program as a preteen.

The Drug Abuse Resistance Education program, or D.A.R.E, is a drug abuse prevention program founded in 1983.

Reading Ayelet’s book opened her eyes to the wide range of what we consider to be drugs, and armed with new information, Jess confronted her preconditioned beliefs about psychedelics. Halfway through reading the book, she decided to try it out and see if it helped.

Turning to a local mushroom community in her area, Jess found guidance and help with the process. Her friend helped her carefully measure doses and she started out with the smallest dose possible in early experiments. A microdose does not make you “high” or impair you from performing daily activities, rather it is taken like a supplement to boost mood and well-being.

Immediately noticing the effects of such a small dose, Jess was surprised at how her condition improved. Previously suffering from severe driving anxiety, she noticed an immediate and distinct difference in the calmness of her mind. Rather than intrusive thoughts about a car accident and hypervigilance about the other cars on the road, she was able to focus and drive with more clarity.

A microdose is sometimes compared to drinking a cup of coffee. The effects can provide a boost in mood and well-being without the impairment associated with larger doses. As with coffee - or any substance - effects vary widely based on the individual.

Microdosing also helped Jess with the crippling inflammation she endured during the luteal phase. Previously, migraine headaches and inflammation kept her in bed.  Small amounts of psilocybin, however, helped Jess regain her quality of life and now, she’s able to carry on with many of her normal activities in the two weeks preceding her period.

Jess’s experience with the anti-inflammatory effects of psilocybin is not uncommon. Classical psychedelics like psilocybin mushrooms are serotonin receptor agonists and have shown potent anti-inflammatory effects in animal models of human inflammatory disorders.

“Overall, psychedelics regulate inflammatory pathways via novel mechanisms, and may represent a new and exciting treatment strategy for several inflammatory disorders.”

Psychedelics as anti-inflammatory agents, Thomas W Flanagan , Charles D Nichols

Experiencing the profound effects of such a small dose, Jess reframed her relationship with psychedelics and with the help and support of her husband, she embarked on a macro journey with psilocybin mushrooms. Her husband helped guide her through two challenging experiences – also known as bad trips. Psychedelics in larger doses have the potential to surface past trauma and allow the individual an opportunity to work through them.

Challenging experiences and working through trauma is not uncommon in the psychedelic community, but it isn’t always the goal. Experiencing happiness and joy is just as important as working through painful memories.

After Jess’s initial journeys, she decided macrodoses of psilocybin weren’t right for her. LSD, on the other hand, was a better option for her macrodose journeys and offered Jess a more comfortable experience.

“I feel like mushrooms force you to face your traumas and work through them, and I’ve done that a lot in my life so I don’t always want to do that. I think LSD made that less of a traumatic experience; it was more happiness, I didn’t have to face the traumas, I could walk past them if I needed to.”

After her initial experiments, she found that microdosing psilocybin every day during the luteal phase combined with quarterly LSD trips is the right mix for her to optimize benefits and manage symptoms. She found that after 3 or 4 months of microdosing, quarterly macrodoses worked like a “reset button” optimizing the effectiveness of psilocybin microdoses.

Psychedelics effect people differently. For some, LSD can be challenging and for others, like Jess, psilocybin mushrooms can be ruthless in their pursuit of surfacing traumas.

Harm Reduction

PMDD can be crippling and disabling and current treatment options don’t always work. There is no one size fits all solution for PMDD, but for some, psychedelics can make a mega difference in our moods, our lives and our relationships.

To date, there are no studies on premenstrual dysphoric disorder and psychedelics. However, they are being studied for a myriad of other disorders including PTSD, Major Depression, Generalized Anxiety, OCD, Substance Abuse Disorders and even eating disorders.

Seeking alternative treatments is not uncommon in the community, but considering psychedelics can be a challenge. Everyone is different and the risk-benefit analysis varies based on individual circumstances like health history, location and support systems.

For tips on harm reduction, check out psychonautwiki.org, the most comprehensive website on psychedelics to date.

Whether they are prescribed, cultivated or purchased from a reliable source in the community, learning as much as possible beforehand is vital. Altered states of consciousness are unique and being comfortable with the substance of choice beforehand is important.

In Jess’s case, her husband served as a trip sitter and guide, helping her through challenging experiences, an important and sometimes necessary component of psychedelic journeying.

Jess’s story is one of many. As psychedelics enter mainstream medicine, I’m optimistic they will be made available to more women suffering from a variety of mental health issues, including PMDD.

Big shout out to @JessCadena for being vulnerable and sharing her story openly and authentically. As we work to destigmatize both psychedelics and PMDD, sharing personal stories is freeing and helpful for others interested in pursuing them. The psychedelic space can be hard to navigate, and the stigma of drug abuse certainly doesn’t help.

“I think psychedelics are going to be a revolution in psychiatry.”

Professor David Nutt, Director of Neuropsychopharmacology Unit in the Division of Brain Sciences, Imperial College London

Do you have a personal relationship with psychedelics and PMDD? If so, drop me a line at tina@womaninthebasement.com. I’d love to connect, create community and help you share your story!