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PMDD Safety Plan Template

A PMDD safety plan template for high-risk days, warning signs, support contacts, crisis steps, and private storage choices.

Make this plan on a steadier day if you can. The point is to reduce decisions when your PMDD symptoms rise.

This page is educational. It is not a diagnosis, treatment plan, or crisis service.

Get help now if danger is immediate

Use emergency services now if there is immediate danger to you or someone else.

If you are in suicidal, mental health, or substance use crisis and not in immediate physical danger, contact 988 or a local crisis line.

If you have a clinician, therapist, or crisis plan already, follow that plan.

1. Name your high risk window

Use your tracker if you have one. If you do not, start with your best guess.

Question Your answer Symptoms often begin how many days before bleeding? Which days are usually hardest? When do symptoms usually ease? What makes the window worse? What has helped before?

Use the PMDD two cycle symptom tracker if you need to find the pattern.

2. List warning signs

These are signs that your risk is rising.

Warning sign What it can look like for me Sleep changes Strong anger Panic or dread Hopeless thoughts Urge to disappear Urge to self harm Thoughts of hurting someone More alcohol or substance use Pulling away from support Other

You do not need to share this whole list with everyone. You do need to know it.

3. Choose safer places

Pick places that reduce harm. They do not need to be perfect.

Place Why it is safer How to get there

Examples:

A room away from things you could use to hurt yourself A friend's couch A public place where you feel calm An urgent care, ER, or crisis center A quiet outdoor spot where you can call support

4. Pick support people

Choose people by role, not just closeness. One person may be good for texting. Another may be good for driving. Another may be good for sitting quietly.

Person or service What they can do How to reach them Stay with me Take me somewhere safer Help with food, kids, pets, or work Help me contact a clinician 988 or local crisis line Crisis support

Write one short message you can send:

Use the PMDD relationship communication script if you want a lower stress way to explain this before symptoms rise.

5. Reduce access to harm

Fill this out before the hard days.

Risk My safer step Medications or supplements Weapons Alcohol or substances Car keys Social media or conflict texts Being alone Other

Ask a trusted person or clinician for help with this section if you need it.

6. Decide what not to do

High risk days can make big choices feel urgent. Use this list to slow things down.

During high risk days, I will wait on Safer next step Ending a relationship Write it down. Revisit after symptoms ease. Sending a long conflict message Save a draft. Ask someone trusted to read it. Quitting a job or class Use the work plan first. Stopping a medicine Contact the prescriber unless urgent safety guidance says otherwise. Deleting all records Make a copy or ask for help first.

If you are not sure whether something can wait, contact a clinician or crisis support.

7. Plan the first hour

When risk rises, the next hour matters.

Minute Step 0 to 5 Move away from harm. 5 to 10 Text or call one support person. 10 to 20 Drink water or eat something simple if you can. 20 to 30 Go to a safer room or place. 30 to 60 Contact crisis support, a clinician, or emergency help if risk stays high.

Keep this table short. You need steps you can follow when thinking is hard.

8. Store the plan with care

A safety plan can include mental health notes, conflict details, medicines, crisis contacts, and private locations.

Storage place Better for Watch out for Paper Private, easy to hand to someone Can be found or lost Local note file Easy to edit May sync if settings allow it Period app note Tied to cycle timing May store more sensitive data than you want Shared document Easy for support people Other people may keep access

If you use Floriva, keep the note short. Track the timing pattern, then store the full safety plan somewhere you trust.

For data choices, use the PMDD data privacy checklist.

One page plan

Copy this into a note or print it.

text My PMDD safety plan

My high risk days:

My warning signs:

My safer places:

People or services I can contact:

What I will move away from:

What I will not decide during high risk days:

First hour steps:

Emergency or crisis steps:

Where I will store this plan: