Ep 99: Ask Charlotte - Your Mental Health Questions
By Charlotte Cummings | Feel Better Podcast
When I was little, I’d flip straight to the Agony Aunt pages in my mum’s Woman’s Day. These days, I’m a counsellor with 20 years’ experience, answering your real-life questions every fortnight in Ask Charlotte. Today’s theme is mental health — three big listener questions and practical answers you can use right now.
Want to submit a question? You’ll find a question box on my Instagram Stories every Tuesday, or ask anonymously via my Instagram bio, the show notes, or charlottecummings.nz.
1) What is PMDD — and how do I know if it’s affecting me?
PMDD (Premenstrual Dysphoric Disorder) is like extreme PMS — a severe, cyclical condition that impacts mood and body in the luteal phase (from ovulation to the start of menstruation), with symptoms that often lift rapidly once your period begins.
What it can look like
A sharp drop in mood linked to hormonal shifts post-ovulation
Marked changes in serotonin pathways (hello, brain chemistry)
Two weeks a cycle of major-depression-like or anxiety-like symptoms
Physical symptoms: extreme fatigue, headaches/migraines, feeling physically “off”
Significant distress and disruption to daily life and relationships
Around 1% of women experience PMDD. It’s distinct from common PMS and from conditions like endometriosis or PCOS (though they may co-exist). A striking — and concerning — feature: many women with PMDD report suicidal thoughts, and there’s a notable overlap with historic trauma (which researchers are paying more attention to).
What helps
Medical support: some take medication only in the luteal phase; others use continuous medication to blunt the monthly crash. Speak to your GP.
Therapeutic tools: emotion regulation skills, relationship supports, planning your workload and interpersonal demands for the tougher weeks.
Lifestyle layers: sleep, nutrition, movement, and targeted supplements (discuss with a clinician).
Tracking: chart your cycle and symptoms for at least three months — patterns are powerful.
If this sounds like you, please book your GP and consider therapy. You do not have to white-knuckle this alone.
2) How do I parent while struggling with my mental health — and how do I talk to my kids about it?
It’s hard — and it’s also a chance to teach your children something deeply valuable: that mental health challenges are human and manageable, and that getting help is normal.
What to say to your children
“This isn’t because of you.” Even if your difficulties bump into their world, they didn’t cause it. Say this clearly and often.
“Lots of families experience this.” Roughly 1 in 4 adults struggle with mental health at any time. Use concrete examples (e.g., “On your football team’s sideline, several parents will be finding things hard too”).
“There are helpers for this.” Normalise care: we see hairdressers for hair, mechanics for cars, doctors for bodies — and counsellors/GPs/psychiatrists for minds.
Share your plan in simple terms: appointments you’re attending, routines you’re using, people who are supporting you. This builds safety and trust.
How to manage the load (practically)
Reduce expectations. If you were post-op, you’d lower the bar. Do the same here: a “survive, not thrive” season is wise and temporary.
Press pause on perfectionism. Choose rest, therapy and basics over spotless floors. Excellence can wait; recovery can’t.
Set recurring supports. Cleaner, meal deliveries, car pools, regular grandparent help — make help automatic so you don’t have to re-negotiate through guilt every week.
Know your “unbearable feeling”. (If you know, you know — it’s my most-listened-to episode.) Mental health dips often trigger the very feeling you least tolerate (rejection, failure, being unheard). Name it and get support to expand your tolerance.
Back to basics: sleep, movement, daylight, hydration, simple nourishing food, tiny pockets of joy.
You’re not failing if it’s hard. You’re doing something brave: parenting and healing at the same time.
3) How do I protect my own mental health when my partner is struggling?
We want to support our partner and avoid a parallel crash if we can. Here’s how.
Get clear on “the basics that matter”
Life rarely stops completely. Agree the minimum viable contributions that keep the wheels on: e.g., bins/lawns, school runs, one bedtime routine, or handling bills. Make it specific and realistic for this season.
Identify what you’re missing — and backfill it
When your partner is low/anxious, what goes missing for you? Lightness? Adventure? Physical touch? Conversation? Plan alternative sources for a while: friends, family, hobbies, groups, a class, nature days. You’re allowed joy.
Build hope with a visible plan
It’s reasonable to want to see steps: GP/therapy appointments, medication reviews, sleep plans, gentle movement, a WRAP (Wellness Recovery Action Plan) if they’re up for it. A plan helps both of you believe in the path ahead.
Schedule a weekly check-in
A brief, predictable slot to cover: How was this week? What’s coming up? What do you need from me? Here’s what I need from you. Keeping communication structured protects connection.
Team up against the problem
Frame it as “our issue with mental health”, not their flaw. If possible, also schedule your time out: a night away, a mini-break, a day with a friend. Relief moments reset your nervous system.
Create your own wellbeing plan
Write down your red flags (sleep changes, irritability, withdrawing), what helps, who to call, how to simplify life fast. If helpful, make your own mini WRAP — templates online are great.
Remember: the issue is the issue. Your partner is still your partner.
Three very different questions, one through-line: you’re allowed to get help and make life gentler while you do the hard things. Whether it’s PMDD, parenting through a tough patch, or supporting a partner, small, repeatable steps beat heroic bursts every time.
If you’d like your question answered on a future episode, pop it in my Instagram Stories on Tuesdays, submit via the show notes, or head to charlottecummings.nz.
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Thanks for joining me for this episode of Ask Charlotte, part of the Feel Better podcast. Well here we are for another episode of Ask Charlotte, and in this episode, I'm answering your questions on the theme of mental health.
You've sent through some really interesting questions, and I can't wait to dive into this with you. Today we're going to be talking about PMDD, and if you do not know what that is, then you're going to have to listen along. We're going to talk about parenting through mental health challenges, and how to talk to your kids if you're struggling with your mental health.
And we're going to talk about some ideas on coping well when your partner is struggling with their mental health. So let's get into it. Firstly, PMDD, or premenstrual dysphoric disorder.
This is something that I learned about about 12 years ago. And just to set the scene, I was studying at the School of Medicine, doing some postgrad qualifications, and we were hearing from the very best of some of New Zealand's psychiatrists. Now this lovely old man, I cannot remember his name, he was a retired psychiatrist, and he was talking to us about PMDD.
And he said, this is something that is so much more of an issue than anyone is recognising. And it is one of the top contributors to distress, to suicidality, to a real reduction in quality of life for a chunk of women. And it is something we are not understanding enough.
He went on to talk about this disorder. And the moment I had a break, I ran out of the room, rang my friend and said, oh my goodness, I have got something to tell you about, because this was her to a T. Now I have not made a habit of doing that as a therapist, of learning about something and then going, calling my friends, going, I've diagnosed you with whatever it is, that is not my role and function. But this is something that not enough people know about.
So PMDD is like extreme PMS. And the real giveaway with this disorder is that the symptoms occur in the luteal phase of a menstrual cycle. So from the time of ovulation to the time of menstruation, that is when these symptoms emerge.
And usually they are relieved pretty much as soon as menstruation starts. The symptoms are intense, they're really distressing and disruptive. And this is an issue that affects about 1% of women.
Essentially what it is, is it's our brain's response to the massive hormonal shift that happens after ovulation. It's our brain's response to that hormonal change. It really impacts our serotonin levels and the pathways within our brain that make some of our happy hormones to the extent that it becomes such a sharp drop.
Some people's brains really struggle with that adjustment and it is so sharp for them that they end up with a whole lot of physical and emotional symptoms. Extreme tiredness, fatigue, migraines, headaches, feeling really blah physically accompanied with extreme distress. So it is like having, for some people, a major depressive episode for two weeks of a month or an anxiety disorder for that two weeks.
And the relief is palpable from when they start menstruating. So it is like the month, or however long their cycle is, is really defined between the time that they are feeling good and the time that they are absolutely not themselves. What is particularly concerning for women with PMDD is that 70% of women with this disorder experience suicidal ideation.
And very interestingly, there is a strong link between historic experiences of trauma and the incidence of PMDD. Now that is not to say that everyone who has PMDD has had an experience of trauma, but there is a very interesting phenomenon going on here around the number of women for whom there has been some trauma within their lives who end up experiencing this disorder. That is something that is being researched and noticed more now.
I'm really passionate that we need to acknowledge this disorder more. Women need to know about it. I have even reached out to some people over time and said, hey, have you heard about this? When I've seen various social media characters talking about their lives and what is happening.
And when people who experience this disorder learn about it, they often feel like their entire lives since adolescence is explained. Now remember, it is not that common. It is not the same as standard PMS that a lot of women experience.
It is not necessarily related to things like endometriosis, polycystic ovaries. It's not the same as painful periods and the impact that having painful periods can have on our mental health and our well-being. This is a separate disorder where people experience really acute symptoms for half of their cycle.
Now for some women, they will use medication just over those two weeks of the month. For other women, they will take medication on a regular basis that helps to even things out when that hormonal shift happens. But there are some really good medical options that you can explore, as well as, of course, therapy, particularly looking at emotion regulation, how you manage your life and your lifestyle over those two weeks of the month, managing interpersonal distress that can be really significant with PMDD.
And of course, there are a bunch of lifestyle changes that you can make in terms of nutrition, exercise, and supplements. So PMDD is a not very well understood disorder, but is something that affects 1% of women and deserves to be better understood, particularly because of the extent of the distress that people experience when they are living with this disorder. If you're listening to this and you're thinking, gosh, this is me, feel free to drop me a message to talk about some next steps, make an appointment with your doctor.
It is really important that you get some further help because you do not have to live with this disorder without support. Okay, so the next question today is, how do I parent while I'm experiencing my own mental health struggles? And how do I talk to my kids about what is going on with my mental health? I'm really pleased that you have asked this question because this is so tough. Meeting the demands of raising children while also struggling with your mental health is really tough.
And then your children are watching you and having their own challenges in relation to what is happening for you. And communicating with our children about this is something that's really helpful to have a plan around. So firstly, one of the things I want to reframe for you if you're a parent who's currently struggling with their mental health is that when your children experience something with you, that is a learning opportunity for them.
As much as that might have some really tough moments, one of the things I think about as a parent when something difficult happens within our family or for one of us is that this is another thing that we add to the list of experiences in life that are quite normal that we get to go through with our children. Now the chances are your children will have something that happens at some point in their future when it comes to mental health. One in four people at any time are struggling when it comes to their mental health.
This is a learning opportunity just like all of the other things they're learning and growing around through their experience of childhood. Now you might not wish this on anyone and this is difficult and uncomfortable and comes with a whole lot of challenges but this is yet another experience that you get to guide your children through while they are under your wing. And there are lots of things that will happen in their adult life where you'll be less present for those challenges but think about this as an opportunity to show them some steps through dealing with something that is difficult.
Now the absolute key thing when it comes to communicating with your children about your mental health challenges is to talk to them about the reality that this is not something that they have caused. They are not to blame for this. This is not because of them.
And this is a really important distinction to make because what they will often experience is ways in which your mental health challenges are connecting with them. So you might be especially worried about something to do with them or you might be in a depressive state and really struggling to get motivated to get out of bed or you might be missing something important that is going on for them. So there might be times when what is happening with your mental health is really connecting with them and their lives but it is so important to mark the point that this is not because of them.
There might be times when you're worried or something is happening that is to do with them. Yes, but this is not caused by them. It is not their fault.
It is not because you're unhappy with them. It is not because they have done something that has brought this on. All children need to hear that message and that is really paramount in terms of what you communicate.
The other thing to talk to your children about is that this is normal. Sometimes sharing the stats, one in four adults will be struggling with their mental health at any given time. That means if we think about your friends, let's take your sports team.
There are 10 families that stand on the sports sidelines because of the 10 people in your team. That means that it's not just me who's struggling with my mental health right now. There will be other parents in that group who are also struggling.
So getting them through the reality that they'll be feeling like this is only us, this is only our family, there's something wrong with you, there's something wrong with us, we're doing something wrong here is very helpful when it comes to getting your child to understand mental health in context. This is an issue for lots of people. The other opportunity that you have is talking to your child about the importance of getting help when something is difficult and really highlighting the point that there are people who do help when something tough is going on in our lives.
Just like when we need to get our hair cut, there's a hairdresser we can go to. When the car breaks down, there's a mechanic we can go to. When we're physically unwell, we can go to the doctor for that.
When it comes to mental health, there are people who can help us too. So you're going to talk about how they haven't caused this, you're going to normalise what is going on and you're going to really highlight the point that there are people who help when it comes to mental health. That's significant and making sure they know that you and your family are not alone with this.
The other thing that you can normalise is that everyone has tough stuff that's going on or things that they're working on. And for you right now as one of their parents, your mental health is something that you're working on. But they have things that they're working on too.
Maybe they're working on giving things a go even when they feel really hard. Maybe if there's another parent in your family, they have something that they're working on, managing stress about work. Maybe they have a sibling who's working on getting ready on time in the morning or whatever it is.
Everyone at all times has something that they're working on and this for you right now is your something. In our family we talk about this a lot. We've all got things we're working on.
Now when it comes to you managing the demands and challenges of parenting alongside journeying through a mental health challenge, one of the top things to say is that you need to reduce your expectations. Now this would be much easier if it came to a physical illness. Let's say you were recovering from treatment or an operation.
You would undoubtedly reduce your expectations. And it is so sad that when it comes to mental health, because it is an invisible struggle, we don't so easily do that reduction of expectations. But it is something that is really important that is worth bringing your attention to.
So what does it look like to have a chapter of our lives now as a family where it's about surviving and not thriving? The thriving days will come and they might even come faster the more attention you can place to getting through this well, to reducing your expectations, to allowing yourself the time and energy that you need to recover and rebuild. Get some help with this if you need to because it is really tough. But reducing your expectations will certainly be significant through this period of time.
Now with that comes the challenge of managing perfectionism. If you're struggling with your mental health and your mental health is needing some attention right now, you're needing some space to get through something that is challenging. This is not the time for perfectionism and so many people struggle with that.
The day will come again when you can apply your perfectionism and your desire for excellence where you want it to the things that matter for you. But now is not that time. This is a time for getting through and our struggle as a society with perfectionism can really intersect when someone is struggling with their mental health.
The house might look like more of a disaster because that nap or that walk was important to your mental health and more important than spending time tidying up. Actually you needed more rest. Actually you needed time for that therapy appointment.
So you couldn't make it to something at school or there was another impact on your family. It is a real mind game to lower our expectations and to battle those internal voices around perfectionism that make getting through a mental health challenge even harder. So please get help for this if this is something you need support around.
Another thing I see as a common challenge for parents who are struggling with their mental health is the need to build some consistent supports because they feel guilty about asking for help with basic things that they feel like they should be able to do. So maybe it's a priority for a period of time to get a cleaner or to have some meals delivered or to have some more regular weekends off where family members or friends are stepping in with your kids. If you're having to get through parenting guilt every single time you are asking for some help and support that is going to be extra tough.
So where you can build some good routine around getting help. Get those things set up so they're recurring wherever you possibly can. And the other thing I'd encourage you to do is explore your unbearable feeling.
If you're going through a time of struggling with your mental health your unbearable feeling is likely going to be pushed. If you don't know what this concept is go back and have a listen to the unbearable feelings episode. But this is the idea that we all have a feeling we find particularly difficult and we try and avoid.
It might be feeling unheard. It might be feeling rejected or left out. And you can already hear that if you were struggling with one of those feelings and you really wanted to avoid it an experience of a mental health issue is going to push your buttons when it comes to your unbearable feeling and that can make you feel so much worse.
So identifying and journeying through your unbearable feeling is a key part of the puzzle if you're experiencing mental health difficulty right now. If you're a parent struggling with your mental health I see you. I know how tough it can be.
And my encouragement to you is to embrace this time of lowering your expectations taking the time and the space that you need and remembering that this can be a learning experience and something that is normalising and helpful for your children. Don't forget to share your plans with them. These are the things that I'm doing to get better.
These are the things that I'm bringing my focus and attention to. These are the people I'm going to for help so they know what it is that you're doing in response to this that you're doing your very best to move through whatever is happening. Work out what is most important for your family right now get back to basics and take the time and space that you need.
Okay so the last question I have today is how do I protect my own mental health when my partner is struggling with theirs? Well we definitely do not want you to experience a slump in your own well-being while they are going through their own journey if we can possibly avoid it. So let me give you some ideas. Firstly I'd encourage you to think about what matters most.
So if we're in a partnership with someone usually life can't grind to an absolute standstill where we have no expectations of them whatsoever there's no support or contribution from them but if someone is struggling with their mental health they likely are not in a position to contribute as much as they would like to or as they possibly would if times are normal. So get clear on what matters most. What are the basics that are still important to keep your life running as it needs to? What are the things that matter most for you that you can ask for from them and agree together? Talk about what's achievable for them and get really clear on the things that are fundamental to you through this time that you are going to hold on to.
So maybe they can't pitch in around the house as much as they usually would maybe outside is going to be a bit of an overgrown wilderness for a period of time. What is it that matters though? Is it mowing the lawns? Is it them helping to put the washing away? What is it that you can agree that just helps you have a clear definition on how you're going to survive this time? The next thing I encourage you to think about is what is it that you miss as a result of what is happening for your partner with their mental health? Maybe they're low or anxious maybe there is something going on in terms of their mood right now. What is it that that impacts in your life in terms of what you miss out on? Are you missing lighthearted time? Are you missing adventure? Are you missing fun? Or are you needing distraction? What is it that you might need to backfill that is usually part of your life and your relationship with them that you could pursue through this time for yourself? And how are you going to fill those needs? This is a great time to be leaning on friends and other family members but you're right that it is not possible to just get through an extended period of time without joy, without some good things going on in your life too.
So think about what your emotional needs are and how you're going to meet those perhaps elsewhere for a period of time. The next thing I think is really important is you have to build hope and as the partner who's not experiencing the mental health challenge there needs to be a plan that you can feel confident in going forward. One of the hardest things about mental health is it can be something of an enduring journey.
It can have twists and turns and it is not necessarily a linear recovery when we're experiencing something difficult mentally and emotionally. But it is really important for your sense of hopefulness as a partner that there is a plan that is being followed and it is absolutely okay if you're in a relationship with this person to ask them for that and to support them with that where they need it. I'd encourage you as well to schedule a time during the week where you're communicating about what is happening.
How have they been this week? What is it they might need from you coming into this next week? What is it you need from them that you could ask for going into this new week? Set a time aside where you are having the conversations that you otherwise might put off and make it something that you both know is coming where there is some time reserved within your week for these chats. But keeping up your communication through this time and your sense of partnership is so important. One of the things I say to couples is there is no such thing as your issues and their issues.
There is just the issues and they affect both of you. So this challenge to their mental health is something that has an impact on you and on them. It is really helpful to team up against an issue.
This is not you and your stuff. This is us and something we both have a relationship with for this time. Now consider if you can if your lifestyle allows it to have some time away.
A night off, a break, taking children away for a holiday, going and doing something with a friend, doing something that allows you to have some time away, particularly if things are chaotic or low or there are some challenges that are coming out that are as a result of what's going on with your partner's mental health. Work out how can I get some relief from this to kind of lift the pressure valve and have some time away from these issues. Remember the issue is the issue, they are not the issue and it is okay that you need some time away.
The other thing I encourage you to do is to develop a bit of a mental health plan for yourself. What are you going to do to ensure your well-being through this time? What is getting through this well look like for you and if you need to have a chat with a friend or a therapist to help work that out, that can be incredibly helpful but have your own plan around your well-being and if you haven't heard of it before, there's an amazing little formula or template that you can look up, a WRAP so a Wellness Recovery Action Plan. It is so helpful if someone is struggling with their mental health.
I've had one of these myself at different periods of time where I've looked at what are the early warning signs that I'm not doing well? What can people do to help me? What is it that I find irritating? Having that WRAP is a really helpful model. There are templates online of the kinds of questions that you can cover. This is something that has come through the mental health peer support movement that I absolutely love.
It's been around for about 15 years, something people just don't know enough about but I encourage you to dive into developing a WRAP if that is something that your partner is up for. So there you have it, three responses on three very different mental health questions. PMDD, working through a mental health challenge while you're parenting and talking to your kids about it and how to survive well through a time when your partner is struggling with their mental health.
Thanks for the great questions this week and remember every Tuesday on my Instagram account there is an anonymous question box popped up where you can ask me any questions that you want to see answered as part of Ask Charlotte. Thank you so much again for allowing me to speak into what is going on in your life at the moment. Some tough stuff raised today but it's a real privilege to be able to share on these topics.
