Prioritizing Mental Health in PCOS

by Dr. Geeta Komar, Sr. Consultant – OBG at Kinder Women’s Hospital and Fertility Centre, Bengaluru

Polycystic ovary syndrome (PCOS) isn’t a new concept anymore and is largely associated with several health problems related to menstruation in women. A complex and chronic lifelong problem caused due to hormonal imbalances results in different physical health problems as well as mental health. Women with PCOS are usually diagnosed to be insulin-resistant, have inflammation throughout the body with high levels, are obese and lead a stressful life.

In fact, women who are diagnosed with PCOS are three times more likely to suffer from symptoms of severe anxieties and depression than the others. And the link between both can be due to various physical, emotional, and social reasons.

PCOS and Mental Health: Establishing the link
Although the reasons behind why women with PCOS are more likely to be at an increased risk of depression and anxiety are unclear, it is true that their symptoms are often overlooked and stay untreated.
Emotional health for women with PCOS can be particularly influenced by factors such as continuous physical and psychological changes that they go through, declining self-esteem, altering body-image, lifestyle and inability to cope up with stress. Upon diagnosis, it can unleash an ocean of emotions that may not be similar for everyone but can have an astounding effect. While some may experience frustration and anger, or shock and disbelief, for many it can be simply fear of facing uncalled for challenges with health.

PCOS causes an elevation in the level of androgens and DHEAS (testosterone hormones) that may be associated with depression and anxiety. Several research studies have also suggested that low levels of serotonin (a chemical in the nervous system associated with igniting positive feelings) are found in people with PCOS which can lead to feeling depressed and anxious more often.

Taking care of Mental Health with PCOS
The key to managing PCOS is to be aware of things that may trigger mood swings and managing lifestyle. PCOS is a complex disorder and if left untreated for long, it can affect one’s overall wellbeing. To improve emotional wellbeing, it is necessary to understand and educate oneself about PCOS, its treatment and avenues of getting the right support.

The good part of treatment for PCOS is that it can also treat the many other specific underlying causes. For instance, women who are diagnosed to be insulin-resistant may be advised to consume low-carb and low sugar diet. This will also help in keeping obesity at bay and maintain healthy weight, thus making a significant lifestyle change. Birth control pills may be prescribed to cure hormonal imbalances and regularize menstrual cycle.

Feeling depressed, anxious, or experiencing mood swings often are common among people with PCOS but can be tackled better with the following tips:

Change your lifestyle habits for better. Focus on improving your lifestyle in general instead of making short-term changes like following a particular diet, learning a sport, and meditating for a few days. Exercise regularly for at least 30 minutes daily, meditate to help yourself calm down, manage stress, and stay focused on your goals. Eat a balanced diet that includes fiber, protein, and carbohydrates.  

While there are no concrete studies that prove taking anti-depressants also help treat PCOD as they might for people without PCOD, medications like metformin that help the body use insulin, Omega-3 fatty acids, Vitamin D can help in decreasing the symptoms of anxiety and depression.

Practicing mindfulness exercises like yoga, guided meditation, breathing exercises, relaxation techniques can help in improving the symptoms of anxiety as well as quality of life.

Living with PCOS can be stressful. It can take a toll on both physical and emotional well-being. Factors such as changing body image and size, excessive facial and body hair, facial acne, lack of physical fitness and motivation can be difficult to cope up with. Therefore, it is crucial to take charge of emotional health and well-being right from teenage years and adopt a healthier lifestyle to maintain healthy body weight, eat healthy and exercise regularly. Having open conversations with parents, teachers or counselors can help too.

How can therapy help?

Therapies or counseling can work wonders and show effective results in treating depression if diagnosed with PCOS. Therapies such as Talk Therapy (to talk and counsel), cognitive behavioral therapy (to identify patterns that indicate negative thinking and teaches how to cope with the situation) and sharing issues with people from support groups and looking for solutions together can be beneficial.

Remember, there is no doubt that PCOS and depression are often interrelated but with timely treatment, the symptoms can be reduced significantly.

PCOS can make you feel depressed and anxious at least 3 times more in comparison to when do not have PCOS, although the reasons stay unclear
To get relief and improve the symptoms, seek therapeutic help and medications to treat both PCOS and depression. Taking the right medication will help in getting the menstrual cycle back on track and improve lifestyle.
If necessary, consult a mental health expert to treat depression and anxiety or join some support groups that can offer the required help.