Free The Female Brain by Louann Md Brizendine Page B

blocked from producing fluctuating hormones. It may be, they conclude, that women with PMDD are in some sense “allergic” or hypersensitive to fluctuations in estrogen and progesterone during the cycle. Fifty years ago, one successful treatment for PMDD was removing the ovaries surgically. At the time, this was the only way to remove the hormone fluctuation.
    Instead of removing Shana’s ovaries, I gave her a hormone to take every day—the continuous birth control pill—to keep her estrogen and progesterone at moderately high but constant levels and prevent her ovaries from sending out the big fluctuations of hormones that were upsetting her brain. With her estrogen and progesterone at constant levels, her brain was kept calmer and her serotonin levels stabilized. For some girls I add an antidepressant—a so-called SSRI (selective serotonin reuptake inhibitor)—which can further stabilize and improve the brain’s serotonin level, in other words, improve one’s mood and sense of well-being. The following month her teacher called me to report that Shana was back to her good old self again—cheerful and getting good grades.
    R ISK T AKING AND A GGRESSION IN T EEN G IRLS
    The day Shana screamed that she wanted to go to the beach, Lauren had been concerned about her daughter’s boyfriend, Jeff. Jeff was from a very wealthy and permissive family, and at fifteen, Shana had already had sex with him. Jeff ’s parents allowed them to do it in their house, a fact Shana had kept hidden from her parents until she had a pregnancy scare. Since Jeff wasn’t going away, Lauren decided it was best to get to know him. And the more she did, the more she liked him. Jeff was lavishing Shana with gifts (something Lauren wasn’t thrilled about, but she didn’t want to hurt his feelings), and Shana was happy when he was around. She made deals with her parents: “Come on, Mom, I’m really stressed out, and if he comes over for an hour I’ll feel better. I promise to finish my work after he leaves.” She often snuck him back in, and the two were thick as thieves.
    Shana had been seeing Jeff for eight months. The day after she told her mom how much she loved him, Shana showed up at home after school with Mike, a boy she had sworn was just a friend. When Lauren went up to check on them, the door was closed. When she opened it, they were, as she put it, “sucking face.” Since she had allowed Shana to be sexually involved with Jeff, Lauren didn’t know what to do. It was clear that Shana’s impulses were getting out of control.
    A girl’s emotional centers become highly responsive at puberty. Her brain’s emotion-and impulse-control system—the prefrontal cortex—has sprouted many more cells by the age of twelve but the connections are still thin and immature. As a result, a teenage girl’s mood changes, resulting in part from the increased emotional impulses blasting in from the amygdala, are more rapid and dramatic. Her prefrontal cortex is like an old dial-up modem receiving signals from broadband. It can’t handle the increased traffic from the amygdala, and it often becomes overwhelmed. Teenagers, therefore, often cling to an idea and run with it, not stopping to consider the consequences. They become resentful of any authority that wants to head off their impulses.
    My patient Joan, for example, remained in upstate New York the summer after she graduated from boarding school there. An honors student, she had been involved with a local guy who didn’t graduate high school, had been in juvenile detention, and at age sixteen had fathered a child. She ran around with him all summer, and when it came time to leave for college, she thought twice about it. She wanted to stay with him. When her parents threatened to come up, take the car, and drag her off to college, she ran away with her boyfriend. She did come to her senses and go to college, but it was a long time before she spoke civilly to her parents again. It’s tough