The Matterhorn in Switzerland.

words by Adrienne Pastula; photo above by Dave McCollum ::

Of all the mountain faces to view as ordinary, I never thought I’d count the Matterhorn among them.

The Matterhorn in Zermatt, Switzerland is objectively gorgeous. It’s tall and chiseled, continually tempting many into climbing its summit.

I frequently caught myself staring at photos of it with a fixation similar to that of my 13-year-old self viewing the cover of the newest N*Sync album. When my family started planning a trip through Europe, I adamantly included the Matterhorn.

I expected to be star-struck by the mountain when I witnessed its glory in person. I didn’t predict that expectation would be thwarted by a unique antagonist — my own brain.

A hopeful beginning

Swiss mountain village with the Matterhorn in the skyline

It’s a vibrant September morning in the little town of Zermatt. I wake up and slip on my pre-packed Salomon vest and running shoes before the waves of cool dawn air evaporate into mid-morning heat.

I map out an 18-mile run on the trails surrounding the Matterhorn. I’m brimming with excitement at the prospect of feasting my eyes on the mountain over the next few hours. It peers shyly at me over the tops of Swiss cottages. I quickly make my way up to a trailhead, eager for an unobscured view.

As I twist my way up one pleasant trail, I feel something tearing at the edges of my upbeat mood. I’m wary of the feeling; it has been a frequent visitor for most of my adult life. It often results in failed goals and disappointment…

I consider turning back but then chide myself. “If I turned back every time I started to feel a little anxious about what might be ahead, I’d never see or accomplish anything new,” I remind myself. I tuck the thoughts into the back my mind and continue on.

A battle of mind and body

A pond reflecting the sky in a mountain meadow by the Matterhorn.

As the miles pass and elevation climbs, the Matterhorn grows in prominence. The mountain’s face changes colors from a vivid orange to a mellow cerulean-grey that contrasts with the cloudless sky. The sight is awe-inspiring, bringing to mind my smallness against a backdrop of such scale.

While running through the bright green hills dotted with wildflowers and tiny lakes, however, my mind begins to change in a way I can’t ignore.

One moment, I am breathing in the fresh air and glorying in the vibrance of my surroundings. The next, I feel the colors fading, my pace slowing, and my good mood vanishing. My chest suddenly tightens and the wariness that plagued me only a short while ago escalates into panic.

My breathing becomes heavy, my feet shuffle, and tears come pouring out of my eyes as I slow to a defeated stop. I look up into the face of the Matterhorn, desperately searching for beauty, awe, anything… but it transforms into a wholly unimpressive pile of rocks.

This sudden switch is depression and it hit me six miles deep in the hills of Zermatt.

Understanding PMDD

Mental health and adventure: A woman wearing a Salomon running vest looks out over snowy mountains.

I knew this was depression because it wasn’t my first brush with it. I suffer from a mood disorder called Premenstrual Dysphoric Disorder (PMDD), an under-diagnosed and under-researched illness that is thought to affect one in every 20 women.

For 5 to 18 days a month, my mind reacts poorly to the natural cycling of my own hormones. On better days it results in depression, anxiety, and rage. Or full-blown panic attacks and suicidal episodes on the worst ones.

Because PMDD happens within the same timeframe as PMS (in the weeks leading up to a woman’s period, also known as the luteal phase) the two are often conflated and also mutually dismissed even by mainstream doctors.

Getting help

At the age of 12, shortly after I started menstruating, I started experiencing panic attacks (dismissed as a fear of death), suicidal ideations (dismissed as teenage angst), and cramping painful enough to miss school (dismissed as normal “woman problems”).

Because doctors frequently failed to recognize my PMDD, it wasn’t until 26 that I recognized the relationship between my volatile mood changes and menstrual cycle through monthly tracking. I finally received a proper diagnosis and began to receive treatment for PMDD with the help of a clinician.

Given the obscurity of PMDD even to health professionals, it took time to experiment with treatment. I tried birth control, antidepressants, dietary changes, and finally, hormone replacement therapy before I noticed any significant improvement.

Most standard treatments failed. Some even made my symptoms worse due to my particular sensitivity to fluctuating progesterone. I slowly started improving my mental health when I decided to risk the long-term health problems associated with taking unopposed estrogen in order to reduce the likelihood of an early death by suicide.

Like most health decisions, this was a personal decision I’d never recommend to others. However, it gradually allowed me to restart my life and my running again.

A debilitating challenge

Mental health and adventure: A stormy sky and sunburst surrounding the mountains and peak of the Matterhorn

Three years after receiving my PMDD diagnosis and two years after my treatment decision, I found myself on that trail. It felt like the color had drained out of the world as my body surged with progesterone.

When my depression arises, it has a special gift of stealing away the beauty from experiences that seem untouchable. Like this one. It also amplifies any negative experience to nearly unbearable levels of psychological pain.

My run through the valley surrounding the Matterhorn was supposed to be enjoyable, energizing, invigorating. But the experience turned to ash in my hands. The disappointment in my own mind for ripping away what I’d thought would be untouchable joy was inescapable, and it exacerbated my feelings of despair.

I understood that this struggle arose from my mental health struggles and physiological problem with hormones. But that didn’t take the sting away from the subjective sadness overwhelming me.

Taking control of PMDD and my mental health

I knew that PMDD was coming when I set out in the morning, but how could I, with only a few days to explore the vast neighborhood of single-track in Switzerland, simply sit back in fear rather than tackle the run I’d been dreaming about for years?

Yes, I was slouched over with an un-abating deluge of tears, but it had been a worthwhile risk to run. I knew that the passive suicidal thoughts trickling through my mind would have manifested even if I hadn’t been running. In fact, given the links between improved mood, nature, and exercise, maybe I’d staved off an even worse episode.

Not only that, but wasn’t it better to experience this depression outside, soaking up the cool smell of pasture grass and padding along smooth dirt trails, rather than sitting curled up in a dark room?

Before lacing up that morning, I concluded that part of the adventure was in taking steps forward — even if I couldn’t be certain what experiences were around the next corner or over the next incline. If this mindset could pull me out the door, it could also push me through my suicidal thoughts.

The way back

Mental health and adventure: Old, wooden trail signs pointing different directions in the mountains

I wouldn’t finish my adventure as planned. But I could begin anew by starting the trek downhill back to my Airbnb and embracing each moment as it came, depressed or not. With that thought and puffy eyes, I turn around to head back the way I came.

I covered 12 miles and three hours later shuffled into my Airbnb with the same fatigue I’ve seen in ultra-runners. I cried a lot, stopped a lot, and experienced a particularly nasty 30-minute bout of suicidal ideations. But I made it back under the protective shadow of the Matterhorn.

It would be another 14 days before the shadow of PMDD lifted with the onset of my period and opened my eyes to the beauty of nature again. I spent the next two weeks trail running anyway.

Embracing adventure

I didn’t enjoy my run around the Matterhorn. The pristine trails and expansive views were no match for my depression. While it was not the adventure I expected, it had been an adventure.

Depression didn’t prevent me from seeing the Matterhorn, trail running, or internally appreciating the image of fuzzy sheep bobbing up and down the hillside. This mental health obstacle merely made my morning (much) more difficult. I had come expecting to adventure through the unfamiliar landscape of Switzerland, but instead PMDD pushed me to explore the boundaries of my own mind.

An adventure is endeavoring toward the unknown in spite of risks and obstacles that may stand in our way. I chose to set out with this goal in mind. While the road has been difficult, learning that it wasn’t impassible allows me to hazard more risks, both in trail running and, even more importantly, in coping with my mental health and illness.

. . .

If you believe you or someone you know may be suffering from Premenstrual Dysphoric Disorder, contact the Peer Support Team at iapmd.org. IAPMD, a 501c3 non-profit organization, dedicates itself to education, awareness, support, and advocacy for individuals with Premenstrual Disorders.

A woman wearing sunglasses standing on red rock.About the author

Adrienne spends her time pretending she isn’t humble-proud of being a trail runner while her greatest accomplishment to date is running for an entire year without falling down. Adrienne’s greatest regret is that, clearly, not falling down for a whole year means she isn’t challenging herself, as her coordination hasn’t magically improved since the age of five. She is a mental health advocate and volunteers as a Peer Support with the International Association for Premenstrual Disorders (IAPMD), one area where she is quite competent. She lives in Colorado with her dog Felix who is often, but not always, happier than her, which means sometimes, but not always, they’re both really happy.