PMDD helpline and crisis lines: who to call now

If you're thinking about ending your life, call or text 988 in the US, or your local emergency number. That's true at any hour, on any day of your cycle.

Beyond that first call, it helps to have a short list ready before a hard week starts. A friend or family member who knows your pattern and has already said yes to being called at 2am. Your GP or gynecologist, especially if you've talked about the week before your period before. A trained crisis line counselor, who doesn't need your full history to help you through the next hour.

PMDD carries real weight here. Women with PMDD are more likely to think about suicide or attempt it than women without PMDD (Journal of Affective Disorders, 2021). This is the reason to name a person and a number now, while you're not mid-crisis, so you don't have to find them during a hard night.

You don't need a diagnosis, or proof, to make either call. A hard night is reason enough.

If these thoughts are new, frightening, or return each cycle, PMDD (premenstrual dysphoric disorder), explained and How to get a PMDD diagnosis can help you understand the pattern and what comes next.

There isn't a PMDD-specific crisis line in most countries, but every line below is trained for a crisis whether or not you name the cause. Each one is free, confidential, and staffed by someone trained to help you through the next hour.

• United States: call or text 988, the Suicide and Crisis Lifeline, any time of day.
• United Kingdom: call Samaritans at 116 123, free and available 24 hours.
• Canada: call Talk Suicide Canada at 1-833-456-4566, or text 45645 from 4pm to midnight ET.
• Australia: call Lifeline at 13 11 14, available 24 hours.
• India: call or message iCall at 9152987821, Monday through Saturday.

If you're outside these five countries, your local emergency number can connect you to crisis support, or a search for your country's name plus 'suicide prevention helpline' will find the right one. Numbers and hours shift occasionally. If a line doesn't connect, try your local emergency number instead, or go to the nearest emergency room.

Not knowing what's on the other end of the line stops a lot of people from calling. Here's roughly what to expect.

A trained counselor answers, usually within a minute or two. They'll ask what's going on, and you can describe it in whatever words you have, including 'I don't know how to explain it, but I need to talk right now.' They'll ask directly whether you're safe at this moment and whether you have a plan or means nearby.

These calls are free from most phones, including prepaid ones. If talking feels like too much, text or chat options exist in several countries, including the US text line to 988.

Counselors work with you on what happens next. Many calls end with a plan you agree on together, like staying on the line until the feeling passes, calling someone on your list, or not sleeping alone tonight. Emergency services get involved only if you're in immediate danger and the two of you can't find a safer option together.

You can give your name or not. You can hang up any time. The call is confidential, and it exists for exactly the moment you're in, not for a report that follows you afterward.

A crisis moment usually peaks and then eases if you can get through the first few minutes. A few things make that first minute easier.

• Name five things you can see, four you can hear, three you can touch.
• Breathe out for six counts, longer than you breathe in, for about a minute.
• Hold something cold against your wrists or face for thirty seconds.
• Move to a different room, or step outside, even for two minutes.
• Call or text the person on your list, even if all you write is 'call me.'

None of this replaces a crisis line if the pull is strong or the thoughts don't ease. It's what to do in the gap before, during, or right after that call.

Once the worst of it has passed, it can help to write down what happened, especially if a fight or a thought you said out loud is still looping. Niyora is a PMS and PMDD support app, and its Moon feature lets you write what happened, see it from another angle once you're calmer, and draft a reply you can hold onto instead of sending right away.

A safety plan is a short, specific document you write when you're calm, so you don't have to think clearly when you're not. Write it on paper or in your phone, and keep it somewhere you'll actually see it.

1. Your warning signs. The exact thoughts or feelings that show up before a hard day, like 'everyone would be better off without me.'
2. Things that help without anyone else. A shower, a specific playlist, writing in a notes app.
3. People to call, in order, with their numbers already saved.
4. A safer place to be than alone, like a parent's house, urgent care, or an emergency room.
5. A way to make acting on an urge harder, like giving medication or anything risky to someone else to hold during the week before your period.

If dark thoughts come back every single cycle, or last longer than the days right before your period, see a GP or gynecologist and bring two months of daily notes. A DRSP chart makes that pattern easy to show someone else.

You don't have to build this plan alone either. Finding a PMDD support group connects you with people who already know what this week can feel like.