4.33 How to cope in academia with menstrual dysfunction (a double coaching episode!)

In the second of my April coaching series, we hear from Til and Alex who both experience pre-menstrual dysfunction that impacts their ability to work on their PhDs. We discuss how they’re affected (including how it exacerbates their ADHD) and coach around the tricky balance between achieving their goals and looking after their health. This is a must-listen for everyone, whether you have these symptoms yourself or you care about and/or work with someone who does. 

If you liked this episode, you should check out my episode on doing a PhD with chronic illness. 

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I'm Dr Vikki Wright, ex-Professor and certified life coach and I help everyone from PhD students to full Professors to get a bit less overwhelmed and thrive in academia. Please make sure you subscribe, and I would love it if you could find time to rate, review and tell your friends! You can send them this universal link that will work whatever the podcast app they use. http://pod.link/1650551306?i=1000695434464

I also host a free online community for academics at every level. You can sign up on my website, The PhD Life Coach. com - you'll receive regular emails with helpful tips and access to free online group coaching every single month! Come join and get the support you need.

Transcript

Vikki: Hello and welcome to the PhD Life Coach podcast. And this is another in my little mini series of coaching sessions with current members of the PhD life coach membership. And this week we are talking about something that we've never taalked about on the podcast before, but which affects a good portion of the audience, and that is the range of premenstrual experiences that people can have and how it impacts their PhD lives and their productivity and motivation and emotions and all of those things. And we have just happened by chance also to have ended up with a couple of people coming on who have these challenges, but who also have A DHD so we will be thinking a bit about how those things interact with each other now.

Vikki: As usual, you know that coaching is not about me giving advice about things, and this is one where I'm gonna put a big fact disclaimer out there that I am in no way an expert in this topic. I do experience premenstrual symptoms myself, although not to the same level that we're gonna be talking about today. So I have some lived experience. I'm not gonna be sitting here saying, oh, the best advice, the evidence-based whatever, is to do this. What we're gonna be doing instead is talking through how it affects these members and how they can make decisions based on their own lived experience as to how they want to manage these difficulties.

Vikki: It's gonna give you a really good insight as usual into what it's like being in a coaching session in the membership. So we are going to talk with one, I'm gonna give them a second to introduce themselves in a second. We will talk with Alexandra first and then we will talk with Til afterwards and you'll get to hear how they learn from listening to the other person getting coached too.

Vikki: So thank you both so much for coming on. Alexandra, do you wanna just introduce yourself first? 

Alex: Yes. Thank you for having me. So, my name is Alex. I am a second year PhD student from the uk. I am looking at the psychological and physiological effects of exercise in general, healthy, elderly and psychiatric elderly populations.

Vikki: Perfect. And what stage of your PhD are you at? Remind me. 

Alex: So I am second year now. 

Vikki: Second year. So we are right in the midst. Perfect. Okay. And Til, 

Til: hi, I'm Til, I'm from Melbourne, Australia. I'm also in my second year, and I look at comedy and mental health.

Vikki: Perfect. Okay. So what we're gonna do til we're gonna ask you to turn your camera off for a moment, and I am gonna speak with Alex first and then we will get you back on in a little while. So Alex, maybe let's start telling us just a little bit more about how this condition affects you and particularly in relation to your PhD work.

Alex: Yes. So I have PMDD, so premenstrual dysphoric disorder and ADHD. And um, so I guess with the symptoms of PMDD, it's a severe response to normal hormonal fluctuation. So in the luteal phase of my cycle, so just after ovulation, so the late phase of my cycle, I experience extreme mood swings, low mood anxiety, panic attacks, extremely low motivation, insomnia, trouble concentrating, and severe ADHD symptoms and I guess sometimes it gets to the point where I really struggle to get out of bed. So that then kind of impacts my PhD because obviously, you know, when you had missed data collection and having to do like general PhD admin work. And also I'm a research assistant on another project. I still have to show up and turn up for those responsibilities. But it's really hard to do that when you can't even do normal daily tasks such as getting outta bed or even brushing your teeth. So it is a struggle for at least two weeks of the month, maybe sometimes more. 

Vikki: Yeah. And for anybody listening who's concerned, obviously Alex is well aware that today doesn't replace other psychiatric care and medical care and all of those things and everything who are dealing with the sort of the severity of some of these symptoms, we are gonna be focused really on what does this mean for you attempting to do your PhD and your work while experiencing these symptoms? So how do you do it at the moment? 

Til: Um, I honestly don't know. So I cannot attain treatment for PMDD due to other health issues. So that in itself is an issue. I've recently started titration on ADHD medication so I think I'm eight weeks in now, so that has slightly helped, although it doesn't help as much in the luteal phase. I guess at the minute I have a really supportive supervisor and she has told me to kind of take time off when I'm really struggling and to make the hours up, but that's been really hard to do at the minute due to, like, my cycle is really irregular at the minute for some unknown reason.

Til: I dunno if I'm going into perimenopause. So it is a real struggle and I think at the detriment to my own kind of self-care, because sometimes it can be one extreme. Like I'll be trying to make up for the lack of work when I'm really struggling by working 15 hour days. And that in itself takes a toll on my mental health in other ways.

Til: At the minute, I guess, i've just been setting checklists of like order of priority of the work that I need to do and just trying the best that I can. But it's a lot harder now in second year now that I'm trying to run two simultaneous data collections and a data analysis and my other part-time roles as well. So I'm kind of a bit clueless on how to make things better for myself to help like improve my overall wellbeing. 

Vikki: Yeah. And you mentioned making up time a bit there. Tell me a bit more what you mean by making up for it. 

Alex: So my supervisor suggested that instead of trying to push through when I'm struggling and my output not being as high and it being more detrimental to me, she suggested to take, you know, a few days off and then to work longer hours and we only had that discussion maybe a couple of months ago, so that's like two cycles ago. So I did try and implement that and I think the problem with ADHD is when you are very passionate about your subject, you are all or nothing. So I've had a few days off, felt very guilty about doing that even though my supervisor said it was fine. So then I've tried to compensate by working 15 hours a day, which then, you know, affects my sleep and I don't feel like I'm managing that very well 'cause it's one extreme to the other. And also the guilt surrounding that as well. Taking time off. 

Vikki: Tell me about that guilt.

Alex: I think a lot of guilt for me is from feeling like I am not living up to what a standard PhD student would look like. So, typically what I would perceive a PhD student would be someone you know who works consistently. Like these are my old kind of like ideologies around what a PhD student should look like. And obviously I know that that is kind of rigid and wrong thinking. So then I start to feel guilty about, you know, I'm not living up to this expectation of what a PhD student should be. And then I think because I'm quite a high achiever in the sense of I like to push myself, I see having a day off as like detrimental to my PhD. And I feel like I'll be behind on my PhD work when in fact, no, it would actually benefit me in the long run. But it's really hard to escape that feeling of guilt. 

Vikki: Mm-hmm. And do you feel that guilt sort of all through your cycle as it, I know you're not having the time off in the other bits, but as in when you are in a phase of your cycle where you are not experiencing extreme symptoms, do you still feel like you shouldn't be having time off that it would make you feel guilty to have time off during your difficult times? Or is it when you're in the midst of that dysphoria that you feel guilty? 

Alex: Um, no. So I, I still feel guilty even in like my good phase, so to say. And I think that is just because of my own expectations of myself and my ideology of how I feel like I should be working. So it's, it's constant. It's just worse during that worse phase.

Vikki: Yeah. And you mentioned, or you called it wrong thinking. I'm not sure we're gonna label any thinking as wrong, but what did you mean by that? 

Alex: To me, if another student had to take time off due to a certain health condition, I would not look at it like that. I would be really supportive of that, so I think it's more so the thinking around myself, and I know it's wrong because if another student was to do that, you know, I would think that that was a very good idea. But when it comes to myself, you know, there's that perception of I'm not doing good enough because I'm having time off. So I know it's wrong thinking as in the sense of well, if I feel like that's okay for other students and would actually be a good idea because it would benefit them mentally and physically, well then why not myself. But it's really hard to see it like as a good thing for myself. 

Vikki: Mm-hmm. Why do you think it feels different for you? 

Alex: Um, because I know that I place really unrealistic expectations on myself. And I feel like if I'm not working at a hundred miles per hour, then I am really hard on myself. 'cause I think the problem with having ADHD and you know, PMDD or other health conditions in general, I feel like you have to work a little bit harder, you know, due to the symptoms that we have. And yeah, I just, I feel like if I'm not working at a hundred miles per hour when I am feeling okay, then I'll get behind. So I do place like really unrealistic expectations on myself, and I know, I know that I do. It's just how do you change that mindset? 

Vikki: And that is the a hundred million dollar question, isn't it? Right. How you, how you change mindset. And one of the things I think is really useful to start with is deciding what you want to feed your brain with. So we have these thoughts that pop up, right? I should be working harder, I shouldn't have to have this time off and all those things. And I believe it is actually pretty hard to stop those thoughts popping up. They come from a lot of places. They're reinforced by our histories, they're reinforced by our social conditions, the hierarchical institutions we work in and all these things.

Vikki: It's really hard to stop those thoughts bubbling up. But I do believe we have a choice about which thoughts we continue to feed ourselves. So do you have other thoughts that you also believe that sometimes feel plausible, they might not be the first thought you go to or whatever, but that when you consciously choose them, they feel true to you?

Alex: Oh, yes. Massively. So in PMDD, I can't explain it, but I have this way of thinking where I feel like, it doesn't matter what anyone else says, like if I'm stuck in my mindset, that's just how I feel. So during PMDD, I'm actually really quite horrible to myself with self-talk. So. It can be so many different things, but it can be such as like if I'm having a really bad day and I'm struggling, you know, I'll be quite horrible to myself in my thought process. Like, oh, you're just lazy. Why can't you just do this? Well, the main thing, the, the biggest thing for me, and this presents the whole month, but especially in PMDD, is you are not good enough. 

Vikki: Mm-hmm. 

Alex: And there's a lot of imposter syndrome there of you are not good enough for this PhD. You're not good enough in general. Like that's probably the biggest one. 

Vikki: Yeah. How do you respond to that? 

Alex: Um, so. 

Vikki: Not when you're in the midst of, when you're in the midst of dysphoria, I'm sure you respond to it just by believing it and diving straight. Yes. Yeah. And that's fine, that's absolutely understandable. But like when you are at your most kind of regulated, you're at your most thinking about it sort of intellectually almost, what's your response to those thoughts? 

Alex: So when I'm regulated, I kind of accept the thought and just kind of let it pass. Like be present with it, but let it pass without kind of influencing any emotion. And then depending on what it is, I'll kind of counteract that with like, what evidence do I have for that fault? And sometimes it'll just pass. And generally it's quite easy to kind of get out of that thought process when I am regulated, because I'll just look at the evidence against it.

Vikki: The evidence that you are good enough? 

Alex: Yes. 

Vikki: Okay. And how much of the time does that feel accessible to you? 

Alex: Um, it is very much dependent on so many external factors. So generally, like when I'm regulated, things are going quite well, it's very easy, easily to kind of like remove that thought. But if I'm having a bad day, it's really hard to get out of that thought process. Especially when I kind of go on a downward spiral. Say if there's like multiple factors where things are going wrong, like I get very emotive with it and then it just sends me on this very negative thought process and then it just continues and spirals and gets bigger.

Vikki: Yeah. I think sometimes one of the things I notice, and I wanna get back to this notion of guilt in a minute, 'cause I think that's really, really crucial here. But one of the things I've noticed a lot when people tell themselves they're not good enough is that the counteracting thought they go to is evidence that I am good enough.

Vikki: And that feels really logical, right? If it feels painful for me to think that I'm not good enough, then I should reassure myself that there's lots of evidence that I am good enough and I just notice sometimes that that is quite a big jump though, from I don't believe I'm good enough to actually, maybe there is evidence that I'm good enough and I just wonder whether there's anything that sort of sits in between that might feel more accessible than actually maybe I am good enough.

Alex: Yeah, I mean there must be because the fact that it doesn't particularly work when there's negative external variables going on. There must be what it is though I do not know. 

Vikki: So things I've seen is gonna sound strange. Thoughts that I found useful and I've seen people find useful are things around. I don't know if I'm good enough. 

Alex: Okay. 

Vikki: But I'm gonna do this bit next anyway. 

Alex: Yeah. 

Vikki: Because this notion that, I don't know if I'm good enough, derails us from doing things, relies on the fact that we have to believe that we are good enough in order to do those things. 

Alex: Yeah. 

Vikki: And that bit, I'm just not quite sure is true. I don't think it has to be true. And if we believe we can only do things to move our PhDs forward when we think we're good enough, then we have to work on making ourselves feel good enough all the time. And the problem is we're in this weird world where we're working right at the edges of our own knowledge, in the edges of other people's knowledge a lot of the time. Right. And so it's quite a big jump to whatever good enough even means. Because it's also pretty difficult to define in our, in our world. 

Alex: Yeah. 

Vikki: I just wonder whether there's a way of almost putting it to one side of, I have no idea. Might not be, who knows? What's the next thing I need to do? 

Alex: Yeah, no, that makes a lot of sense. So I guess kind of, kind of flipping it a little bit and instead of just saying, yeah, that does make sense. So instead of trying to bridge that gap and trying to make myself feel like I am good enough, just saying, well, I dunno if I am, but I'll try and do my best anyway because I know ultimately with the support that I have from my supervisors, you know, I'll get to where I need to be.

Alex: So instead of trying to overreach and use that evidence of why I'm good enough, because to be honest, you know, when you are a second year PhD student. You are still very much learning about the whole PhD process itself. So you know, there's gonna be things that you aren't good at anyway. So I do think that is a good way to reframe and approach it. 

Vikki: Because I mean, and I think you're totally right. Because what even does good enough mean for a second year PhD student? It definitely doesn't mean knows everything, right? Because you've still got a load of your PhD still to do. You've got your academic career if you're gonna choose one. So it's never gonna be knows everything. And I think it's really hard to define what good enough for a second year is 'cause apart from anything else where you are at in second year varies so much. You know, some, I mean, you talked about you're doing data collection and things like that. Some second years are coming to me saying, I'm not even collecting data yet. I'm still looking at literature. I don't have a clear research question. And they would think you were really ahead. And then other people are like analyzing and feeling like they're, very on top of thing. It varies hugely where you're at. And remember those, we have an international audience, so remember those of you in the US second year is about middle of a UK PhD. I wanna go back to this idea of guilt though. Because you said that that's there, even when you are not feeling the sort of dysphoria symptoms and things like that. 

Alex: Mm-hmm. 

Vikki: And I wonder whether there's a similar kind of place. Where on one hand we've got, I should be working more than this. I should be doing what a quote unquote normal PhD student would be doing all the way through to I guess the other extreme of that is I'm doing fine that this is what, you know, this is what it is. I'm just wondering whether there's a sort of middling place with these guilt feelings, these guilt thoughts as well. 

Alex: Um, there must be. I've just, I've never thought about it in that context. So I guess, I mean, from my most recent experience, so, my supervisor's very helpful and she's very good, especially when I'm kind of dysregulated. So recently I've just sent my first paper off for publication or to a journal to you know, and as I said, I'm just about to start two data collections and analysis. And I said to her like, I'm really struggling with kind of with all of that feeling like I'm not where I should be and then that's when the guilt comes in. And she just said to me, like, obviously as you said, students are gonna be at different points in their PhDs. It doesn't mean anything. But she said to me like, how can you not objectively see with the amount of work you've done you are kind of on the right path of where you should be.

Alex: And even then, like with her words and she's very, very helpful. I still feel this guilt a lot and it's really hard to get out of that mind frame as well. Because I still really struggle with getting out of that. So I think the extreme of, before when we were saying like when I would use evidence against it, I can't even use that because I think guilt is a massive thing for me.

Alex: So I guess the middle ground that you suggested would be really helpful because it would probably be more attainable. So I guess with your experience with coaching and working with a lot of people, like how would you address that? 

Vikki: Well, let's have a think about what the kind of, so at one end we are saying, I should be doing more than I am. And therefore kind of deserve to feel guilty about this because I should be able to perform the way a quote unquote normal student would. 

Alex: Mm-hmm. 

Vikki: And I guess the other extreme, it's what I'm an excellent PhD student who's doing all the things they should be, I guess is the, maybe the other extreme. So let's think about what might sit along that continuum between, I definitely should be doing more than this. 

Alex: Yeah. 

Vikki: And, but that comes before we get to, I'm doing a great job. 

Alex: Yeah. So, I don't know, just saying I'm ticking off the boxes that I need to in survive and count.

Vikki: Mm-hmm. 

Alex: I guess, I guess that would be like the next one along for me would just be, you know, doing the main important things that I need to be doing and ticking those boxes while also having some semblance of work-life balance would be the next one for me, and I guess further from that, slightly would be being able to increase output whilst maintaining like mental health, self-care, but only when I feel able to.

Vikki: Okay. Like, 

Alex: I guess, 

Vikki: so we've got a sort of I am prioritizing, 

Alex: yeah. 

Vikki: I'm ticking off the things I need to tick off. 

Alex: Yeah. 

Vikki: I'm doing my best to look after my health. 

Alex: Yeah. 

Vikki: Do those things feel true for you? 

Alex: They feel what they should be, but they feel what I'm not doing as in like, prioritizing my health.

Vikki: Okay. And it, is it the guilt that makes it hard to do?

Alex: Yeah. Yeah, for sure. 

Vikki: Okay. What thoughts would help you prioritize that health, do you think? What would that look like? 

Alex: So being kinder to myself and speaking to myself how I would speak to other people because how I speak to myself, there's no way I would ever speak to someone else like that because I just know that it's not feasible.

Alex: So yeah, I guess it's just trying to learn to be kinder to myself and speak to myself how I would speak to other people. Like if someone else come to me for advice and I'd say to them, you know, are you prioritizing your health? Um, and I guess it's like I'm a personal trainer as well, so, you know, it would be how I'd speak to like my PT clients and it's knowing how to apply that to myself without feeling guilty.

Alex: So I guess in that respect, speaking to myself, like saying things like, you know, you have a health condition, give yourself some leeway. Your supervisor has told you you are doing fine. And has said to you like, take time off when you need to to make your health better.

Alex: And she's also said to me like, explicitly, if you are not like at the most optimal health that you can be, then you're not gonna be able to put out optimally into your PhD. And that's something she keeps trying to reinforce that my health comes first, because then I can't be the best version of me for my PhD, but yet I'm still sacrificing my health thinking that it's going to help my PhD.

Vikki: Hmm. 

Alex: When actually it probably not because I'm not at my best version because effectively I'm worsening my health. 

Vikki: Do you think you've accepted that this affects what you can do? 

Til: No. No. And you know, I've never actually thought, you've probably the first person who's ever asked me that. Um, you know, my ADHD diagnosis was only in December. I've had PMDD for quite a while, but I think because of like, you know, my own experiences with like medical misogyny and, you know, just, you know, societal expectations. I've always felt like, yeah, I, I haven't accepted, I definitely have not accepted that, you know, these conditions do impact me and therefore it is okay to make accommodations for myself. I haven't accepted it and I'm still trying to power through as someone who can function typically. So, yeah, that's actually kind of blew my mind. They've said that and I've had that kind of thought. Yeah.

Vikki: Because it strikes me that guilt comes when you think you should be doing something different. 

Alex: Mm-hmm. 

Vikki: And that if you are somebody who hasn't accepted, and I think it's understandable, especially with, you know, relatively late diagnosis on the ADHD and as you say, all the perceptions there are out there in the world with the PMDD stuff.

Vikki: That sort of guilt to me feels like it's got this premise of I should be able to do more than this. I should be able to be behaving the way that somebody without health conditions would be behaving. 

Alex: Yeah. I actually think you've fully hit the nail on the heads there. Like, I've never thought of it like that and I think I've got a lot of internalized, what's the word is, is the word able ableism?

Alex: I've got a lot of internalized ableism about myself and yeah, I have definitely not accepted it in the slightest whatsoever and, you know, I'd speak openly about having these conditions, but I don't think I've actually accepted myself that I have them and that it does impact me because I am trying to operate and function as someone without health conditions.

Alex: Literally, as you just kind of said. And that is probably just right now has been a very big revelation for myself. 'cause I've never thought of that before. So thank you. 

Vikki: Okay. And this is something we can continue to talk about in the membership sessions and things, right? Yeah. Because I think sometimes when you hit a moment like that, it's useful to take a breath and be able to kind of reflect on it yourself, maybe discuss it with loved ones or anything like that. And just take a minute with those thoughts. Because if we can start to recognize, oh, because you are not stupid, right? You know that if it was somebody else, like when Till comes on, there is no way, I know you are not gonna be sitting in the background going, well, she should just pull herself together and get on with it, shouldn't she? I know there's no way. So there has to be a reason you're not applying that to yourself. 

Alex: Yeah. 

Vikki: And so. Continue to have a ponder on this sort of acceptance thing, this piece that maybe you are still telling yourself that if you just find the right system and the right way of doing things and sufficient motivation, you can behave exactly the same as somebody who doesn't have health conditions.

Vikki: And then we can revisit it. Obviously you can come to a live coaching again, or as you know, you've got your questions for Vicki channel as well. So if you want to put questions in there, then I'll do your voice note too. And we can continue to then go, okay, if that is the case, if this is about me not accepting it, where do I want to go from here? How might it feel different if I'm planning my workload from the perspective of somebody who actually is impaired a couple of weeks a month at least, and needs a plan that goes from there, what would that look like? 

Alex: Yeah, thank you. I, I actually feel like I could cry now 'cause um, yeah, I've never thought of that before, so that's really helpful. Thank you. 

Vikki: Okay. You take care. What I'm gonna do, I'm gonna ask Til to come on, and if you want, if you want to pop off and just have, you know, have a glass of water, um, have a moment then please do, do feel free. Thank you.

Vikki: Hey. So how was that, how did you find watching somebody else getting coached on these issues?

Til: Yeah, it was very interesting, very useful, very relatable. I don't know if Alex can still hear me, but, um, certainly with what you were just talking about in that sense of not accepting, your limitations or that you are living and experiencing things differently. I relate to that too. I don't know that I have fully accepted that.

Til: And I think for me, part of that is not knowing what the alternative actually looks like. Before I did my PhD, I worked nine to five. I worked a nine to five all through my undergraduate degree. Before that I was in high school. So, you know, I've had a very nine to five life and a PhD and so thinking outside those boxes, um, and outside the externalized, requirements of office jobs and school and those sorts of structured environments in into a, you know, humanities PhD where my time is essentially my own, um, is really challenging and I still haven't worked out to the extent that I've accepted

Til: this about myself with the ADHD or you perhaps around the the PMDD or PME as well? I still don't know what other options are, which is partly why I joined the membership. And then I think the other thing is as well that, that I was thinking about when Alex was talking is that, that like we do have this huge capacity for going at 150% and it's not sustainable, but you also, at least I find, I also know that I can go at 150%. And so like, why aren't, why aren't I doing the time or at least a hundred percent all the time, but why is it, why is the ADHD experience so inconsistent? and yeah, once you add in menstrual cycles and things like that, but yeah, a lot of what both you and Alex said really, really resonated there, I think.

Vikki: Yeah absolutely. A couple of things out of that, I think in terms of the acceptance piece, I wanna make really clear. I know, but I think both of you know this, but for the listeners the solution here is now not going, oh, I just need to accept it. Right? Okay. I accept it. Problem solved. But what we do instead is kind of recognize, oh, the fact I don't accept it at the moment makes it really hard for me to plan for it. To allow for it. That might be where some of these high expectations are coming from. 'Cause sometimes you can just feel like you're being a little bit. I don't understand why I'm like this. 'cause I know I should be making allowances, but I can't and I just don't know why.

Vikki: And even just having a little bit of a, oh, that might be why kind of moment. We don't have to necessarily switch immediately to, oh, okay, therefore I accept it and everything will be okay. But we get to go, okay, that's making this more difficult. Right? What could we do? And I think you are also completely right to flag I think this interaction with ADHD is fascinating because I think that ADHD has this somewhat unique feature of having sometimes the capacity to work at an incredible level to just smash it out and sit and that, and I get this done, I get that done and those moments, and I am not gonna be somebody who calls them a superpower or anything like that because I think as a whole, that's not a helpful notion.

Vikki: But we have these moments where it does go like that. And it's really hard not to hold that as your benchmark as to that's what performance should look like. That's what I'm capable of. And it's this sort of expectation that that's what it should look like all the time. When in reality that is usually way above a standard person's productivity and focus and all of those things.

Vikki: And I think recognizing that is, is really, really useful. So let's move on then to you Til. And Alex is gonna be watching this and we'll bring her on again at the end. So tell us a little bit more about your experience and how this is affecting you.

Til: Yeah, sure. So, um, I don't have a formal diagnosis of PMDD but I relate to the symptom list, um, and I've possibly sit somewhere between PMDD and what I've seen referred to as, premenstrual exacerbation, which is basically all of your existing underlying chronic health conditions feel worse, in the lead up to your period, and then when you're on your period at the start, at least. So I get a bit dysphoric. I get a lot more emotionally sensitive, a lot more tired, a lot more irritable, a lot more overwhelmed. And it's much harder to concentrate. My ADHD medication doesn't work as well during this time so it makes it really hard to just like, sit down and do stuff, which is something that I struggle with already. But during that time it feels worse. And I think I have a bit of a tendency to, when I'm at a slightly lower point, raise my expectations for myself and be like, oh, if I am, you know, at 40%, I should be at 140%. But it, that, that pressure doesn't necessarily result in, in any, in any action. It often just results in avoidance and internal spiraling. So, yeah. 

Vikki: Absolutely. And you mentioned when we were talking before we started recording, that your cycle is somewhat predictable at the moment and so we thought we would think about kind of almost planning for these times. So with Alex, we talked a little more about what it's like in the midst of this time. But because yours are predictable, we'd focus on thinking about that. 

Til: Yeah. 

Vikki: So tell me how, if at all, you plan for this at the moment. 

Til: I dunno if this is an ADHD thing or just, you know, maybe it's not worth pathologizing, but, but it'll be a day or two out and I'll be like, I feel like shit. And then I look down at my pill packet and be like, oh, that's why I feel shit. Yeah. Okay. Like, whoops. 

Vikki: Everybody hates me. I don't understand why everybody hates me. Oh yes, absolutely. And then when you realize, right, you, you look down at your pill packet and you go, oh yeah, maybe it's that. Maybe everyone doesn't quite hate me. What happens then in terms of, 'cause obviously in the membership, especially this quarter, we've been thinking a lot about planning, about setting goals, about our sort of systems for deciding what we do when. And I wonder whether when you look down and go, oh, at your pill packet and realize that you are heading into that phase, whether that changes anything

Til: at the moment it's not changing anything. I think it probably should be. I would say that I would expend more effort and energy than usual trying to keep myself on routine in life rather than in PhD work. So I would spend more effort trying to make sure that I make it to the gym and go to bed on time and make home cooked meals and those sorts of things. Which in some ways then leaves me with less energy to focus on maintaining any PhD routine. But yeah, I think that's where I try to focus. 

Vikki: Yeah. And do all of those feel helpful for you? Is expending more energy to do those things coming from a place where they actually help you during your, during your sort of premenstrual period time.

Til: Yes. Yeah. 

Vikki: Okay, cool. Because one of the things that we want to make sure is that any of the things that we're kind of putting effort into making sure they still happen are things where that effort is worthwhile and useful for us. So the only one that my ear flagged up a little bit, and I just wondered whether this is a space for, this is outside of PhD stuff, but looking after us, mind and body is part of it, right was around the homecooked food. So I think the continuing to get yourself physical activity is somebody with ADHD continuing to get yourself physical activity even when you don't particularly feel like it physically, sounds great to me. Um, sleep great. Brilliant. Good food. Yes. What's the deal with this, the homecooked version of good food here?

Til: Well, it's cheap and easy. 

Vikki: And do you find it easy to get yourself to do it and things, even when you're feeling dysphoric? 

Til: The process of actually cooking? Yes. All of the admin to get to that point. No. Hate going to the supermarket, I don't know if it's a COVID thing, just develop a aversion to it, trying to do it once a week maximum. But, so I think the planning component of cooking, okay. No, but I, but. Will expend mental energy thinking about that, um, feeling like, well, if I haven't already planned and made a choice about what I'm doing for dinner, yeah, I'll spend a lot of time throughout the day like, what, what all the supermarket do I need to go to? Do we have all those ingredients?

Vikki: Okay, how could we, so one of the things we talk about in the membership a lot as you're aware, is being a good boss for yourself, right? Is thinking, okay, what would make this easier for me? What would make this feel better? And I think what can be really useful is if you were a nice about, you know, so Alex talked about having a lovely supervisor who's really helpful and think with all of this stuff is thinking, right? If I was a boss who had an employee who I knew was coming up to a period of time where they were gonna be experiencing mood difficulties, physical symptoms, all these things, and I wanted them to feel supported. What things would I put in place for them? Okay. And let's start with food and then we'll get onto PhD stuff in a second. If you were a boss, what things would you want to help this person put in place food wise to make it feel a little easier for them.

Til: Regular meal breaks and like, just setting aside the time so that they know that it's there and they don't have to think about it. 

Vikki: Yes. Making it as yeah, easy as possible. Making it feel like they don't have to think. So what would that look like? What could you do for yourself in advance that would make it feel like you don't have to think?

Til: So batch cooking and freezer meals.

Vikki: Is that something you enjoy? Does that feel plausible? Does that feel like, yeah. Never. Great idea, but never gonna get around to it. 

Til: Plausible. It just, it just makes me feel sad eating freezer meals, like multiple days in for. 

Vikki: Why does that make you feel sad?

Til: Because it's not freshly cooked. I get a fair amount of joy from the actual active cooking. 

Vikki: Okay. 

Til: And I don't have a microwave, so, it's harder to reheat freezer meals. They get soggy. It's not as nice. 

Vikki: So you don't necessarily wanna take away the act of having to cook. 

Til: Not necessarily, but I want to take away some of the mental load that comes with the, the lead up to the cooking. 

Vikki: Yeah. So how could you do that? 

Til: Make my partner do it. 

Vikki: Okay. 

Til: Ask really nicely and they would 

Vikki: Okay.

Til: Is one option. But yeah, like sharing some of those things. And then pre-planning meals outside of work time. So like on a Sunday, that sort of thing. Not in a cooking sense, just in a, these are the sorts of ingredients that will be in the house and there will be enough vegetables in the crisper for the rest of the week, so don't need to go back to the supermarket. There will be enough milk for a cup of tea, those sorts of things.

Vikki: Cause sometimes even just deciding, I'm just gonna eat the same things when I'm on my period. These are the five meals that I eat. So that there's minimum, it's like, okay, it's that time of the packet. We need to make sure we've got X, Y, and Z in the house. Because I'm having, and I'm not saying eat the same thing every night, but if you had like four or five meals that you eat during that time, I've tried to get in the habit and I've actually forgotten this time. So I need to remember that. I was trying to get in the habit of just always buying myself steak in the first couple of days of my period. Not because I necessarily believe it's the perfect sort of source of iron or anything like that, but it feels as fun a reason as any to buy myself nice food. Yeah. But anything that feels like that for you, right? Where it's like, you know what, I like this. I like making it, it's easy to make. It's stuff that maybe can be made with stuff that's in the cupboards rather than having to buy it the day I make it or whatever.

Vikki: So we are thinking about where we are expending effort that doesn't feel good and saying, okay, how can we just smooth that? How can we make that feel simpler so that there aren't really decisions. That week we just grab a week's meal plan and we always do that meal plan the rest of the month we can be imaginative and try new recipes or whatever if we enjoy it. But that week we do those recipes 'cause we like them and they're nutritious and they're easy.

Vikki: How does that feel is a sort of, 

Til: sounds good. Yeah. 

Vikki: So let's think about translating that then into PhD work. How could you change the way you plan your PhD work when you know you've got this kind of coming up?

Til: Hmm. I mean, I think there are some things that fit the analogy better, like in terms of thinking about specific tasks that can just be, you know, like a meal plan for the PhD. Is some reading and then I write up my notes from the reading and summarize it, and then can look at certain types of data or do some archival research. 'Cause that involves, a bit less analytic thinking. Those sorts of things come to mind. In a super helpful counter thinking way then I immediately was thinking about, well, some of that then depends on what phase of the PhD I'm in, and trying not to borrow worries from the future too much and just bring it back to the phase I'm in. So, yeah, data collection summaries and archive analysis and a bit of reading. But not more than like an hour of reading at a time. Otherwise I'll just fall asleep while doing it.

Vikki: So knowing what types of tasks tend to feel more accessible to you and feel more like things that it's like, okay, I can crack on with those bits. How about the quantity of work you expect from yourself?

Til: Yeah. That could probably drop a little as well. If I still wanna feel like I'm doing a certain amount of hours a week or something, switching to tasks that are a lot less initial effort. So because I write about comedy, watching a comedy special is a legitimate form of research that I could definitely always do more of. So things like that, um, are probably quite helpful reminders as well in terms of kind of low, low physical energy tasks, that are still engaging.

Til: I find it quite hard to assess how much I actually get done in a week and assessing what my actual capacity and capability is really difficult for me at this point in time. And part of that is linked to what Alex was saying about, you know, we, we are still students. This is, this is all a learning process, so there's still a fair bit of that for me. So I think that's the other, that's the other big unknown for me when I'm planning my weeks at the moment in general. Let alone then trying to assess, okay, well I know I'm, gonna be at reduced capacity this week.

Vikki: Yeah. So it sounds as though the idea of deciding that you would work fewer hours feels like it 

Til: stresses me out. 

Vikki: Tell me more about that. 

Til: You saying that I'm like, well, but I already, I already feel like I'm not working enough hours

Vikki: And then what happens if you end up not working the hours you intended to work because you're having the symptoms?

Til: I feel bad about it. Similar feelings to what Alex was describing. Guilt, frustration. I think, I think I have a little bit more acceptance around some of it, but it's, it's a question of extent or degrees. I think like moving beyond, I'm either at 150% or I'm at 0%.

Vikki: Yeah. 

Til: But I would like to have more kind of, you know, 60 to 80% days and create some sort of consistency. That's just one of my key goals at the moment, still being able to do some things when I'm feeling bad. It doesn't have to be all or nothing. So it's not a total kind of, um, self-flagellation exercise, uh, at this point in my life, but yeah, it's still frustrating. 

Vikki: Yeah, no, definitely. And I think it's so interesting that you are saying that you want to find more days where you are doing 60% or 80%, but that you are also still quite resistant to the idea of reducing the hours you're planning to work that day.

Vikki: And I think that's really useful. And again, I think that's something for us to continue to work on in the membership because one of the things I notice a lot with members is that they'll tell themselves, I should be working normally. I've got this thing, but I don't have time to deal with that.

Vikki: I should be working normally. And what they then end up doing is either doing all those hours, but finding them not productive and not getting, or not doing those hours because they then eventually convince themselves that it hurts too much or they're too distracted or they're too whatever and them feeling bad about the fact they didn't.

Vikki: Rather than kind of deciding in advance, you know what, today's a three hour sort of a day and doing your three hours, and then being able to actually enjoy the remainder of the day, or at least look after yourself during the remainder of the day because you are intentionally not working. And sometimes you know the difference between doing three hours work on a day you intended to do eight hours work and how that feels versus doing three hours work on a day where you intended to do three hours work And how that feels.

Vikki: They're just poles apart. They're exactly the same amount of work done. But they feel incredibly different. Now I'm gonna let you in a little secret 'cause I know you guys like to know how I'm a work in progress with all these things alongside you guys. I'm still quite bad at planning for this.

Vikki: So I, at the stage, at the moment where I still have quite regular periods and I still plan a reasonably normal week because for some reason I always slightly believe that this month's gonna be different. Why At my age I think it's getting better. I don't know. But anyway, that's a whole other story. So I've still got work to do in terms of the actually planning for this week to be like that. So, like yesterday I ran my two sessions yesterday for you guys. I did not do a lot else. I have to say. And you know what? I am fine with that because it was definitely what I needed and I'm now shifting things around in the rest of the week to make sure the urgent things get done.

Vikki: And there's no part of me that's telling me I should have done more yesterday. I'd love to get to the stage and I'm working on getting to a stage where I'm planning this in advance so I don't have to do the last minute shuffles of it, but I'm much, much better now at saying, you know what, that was what I needed. I needed that quiet time. I can do a few hours of this. I can do my face-to-face bits. I can do a few hours of these couple of bits of jobs, but I'm not expecting a full day of myself. I find that enormously easier now than I used to, and it feels so much better than telling yourself you just have to be normal.

Til: Hmm. 

Vikki: Okay, so I want us to practice that kind of looking ahead and going, okay, even if it's just today, we're not looking that far ahead today. These are the symptoms I'm experiencing. Put my good boss hat on. What's actually reasonable today? And I think the fact you've used the kind of 60%, 80% language yourself without me bringing that up, asking yourself, what would 60% look like today? If this is not gonna be a nothing day, what is 60%? What might that look like? How could we speculate? How does that feel?

Til: Yeah. Very reasonable and achievable it doesn't stress me out as much. Think we have to remember after having reframed it a bit. Pardon? It doesn't stress me out as much. Now that you've reframed it a little bit. 

Vikki: Yeah. Because often it is like, well I'm probably only gonna do 60% anyway, so I can either do 60% while pretending I'm trying to do a hundred percent and sitting at my desk hating myself. Or I can do 60% and then actually leave, or I can do 60% in manageable chunks and do other things in between. So some of it is, I think the acceptance that it's probably not gonna be a hundred percent day, even if I plan it as a hundred percent day and even if I sit here attempting to make it a hundred percent day, it's probably not going to be. So I think that can sometimes sort of help is reminding ourselves, I wish it was a hundred percent due, but it is not gonna be. So what are we gonna plan? 

Til: Okay. 

Vikki: Perfect. Because I think the more we can try and be intentional and meet ourselves where we're at. It makes it actually, ironically easier to do the little bits because I think there's something that rebels against. If you are going, oh, no, no, you need to work. Normally there's part of your brain that's like, but I don't wanna, everything hurts and I feel rubbish. That kind of fights back against it whereas if it's like, you know what? Let's just do two hours or three hours on this one thing. We'll take it slow, we'll work it through.

Vikki: Then it's a little easier to kind of go, yeah. All right. That seems reasonable. Yeah, we can, we can do that bit. 'cause that does actually feel vaguely achievable and I won't be beating myself up afterwards. Okay. And we will talk in a future coaching session, more about keeping track of what you have done in a week.

Vikki: I dunno if you're using our quarterly planning document and everything. But us practicing that recognition of what we are achieving is hugely important and something that we can continue working on in future sessions. Okay, perfect. Alex, are you in a position to come back on? Are you good? Fabulous. How was that? Watching Til getting coached? 

Til: Um, really good. So I just wanted to say I could relate to a lot of what Til said, so thank you because it actually made me feel less alone. Just having someone with like similar shared experiences, it definitely helps and I feel like a lot of your suggestions Vicki, were really helpful, but in true ADHD fashion, my brain has gone completely blank. I just feel like the last hour, 20 minutes I have kind of felt really relatable to everything that's said and there was a lot of really useful stuff, but my brain has just gone really blank. So I'm gonna have to go back and watch through this.

Vikki: Yes, not a problem at all. Obviously in this case, 'cause we're recording for the podcast, you've got the perfect resource. You are gonna get an audio, video, and transcript version of this. Now, as you know in coaching sessions, normally we don't record them, mostly because of sort of privacy and things like that, but also because I know where you guys are like and you all want to watch all of them. And so I don't want you to end up with a huge backlog of coaching calls.

Vikki: But yes. Something I a hundred percent recommend where I really encourage people during the coaching sessions to not just sort of passively watch the way you might watch sort of reality show, but to be thinking, right, what do I want to take from this? And jotting down those notes. And we often, as you know, will be chatting in the chat box as well.

Vikki: So that's quite a nice way to be sharing. Oh, actually I wanna remember that is in the chat box is another good way to do that. And obviously you guys can find each other in the community as well, so if you want to carry on any of these conversations, you wanna have coworking sessions together, anything like that, you can find each other in the community too.

Vikki: I just wanna finish by saying thank you so much for coming on. Thank you for discussing this and all the compassion that you've shown each other and the sort of understanding that you've opened up in yourselves as well. I really appreciate you coming on and I know lots of people will have felt very seen or have felt a new understanding for something that they've never experienced before too, which I think is, is equally important. So thank you both so much for coming on. Thank you everyone for listening, and I will see you next week.