Depression And Anxiety: Polycystic Ovarian Syndrome And Your Mental Health

Polycystic Ovarian Syndrome (PCOS) is a condition that affects how your ovaries function. It is thought to affect up to seventeen million women living in the US alone, and is one of the most common causes of infertility. PCOS affects you in three ways: by causing cysts (fluid-filled sacs) to grow on your ovaries, by preventing ovulation, and by causing high levels of male hormones (androgens) to be released into your body. The cysts are benign (harmless), but can be up to 8 mm each. Considering that a normal ovary is three to five centimeters in a woman of childbearing age, these cysts can vastly increase the size of the ovary.

Symptoms of Polycystic Ovarian Syndrome usually become apparent during your teens or early twenties, and there are many signs that could suggest this diagnosis. Common symptoms include: irregular menstruation, or amenorrhea (absent menstruation); hirsutism (hair-growth on the face, back, chest or buttocks); infertility (due to changes to, or absent, ovulation); weight gain; thinning hair on the head, occasionally leading to alopecia (hair loss); and acne due to oily skin.

That is the effect that PCOS can have on your mental health.

Depression, Anxiety And Polycystic Ovarian Syndrome

If you are suffering with Polycystic Ovarian Syndrome, you are more likely to experience anxiety and depression than women without Polycystic Ovarian Syndrome. Even hostility and agression can be a part of the psychologial effects of PCOS. Polycystic Ovarian Syndrome can even make a woman seven times more likely to commit suicide.

Clearly, there is something about PCOS that causes mental health issues.

Depression In Brief

Depression is an often misrepresented condition. People think depression means that you feel a bit down, a bit fed-up. But there's far more to depression than that. Clinical depression can take over your life. If you suffer from depression, you may lack interest in doing things — even activities that previously gave you pleasure. You may lose concentration at work. You may start eating more, or needing to sleep more or less. 

READ Depression & Anxiety Solutions: Zoloft, Lexapro or Prozac

Anxiety In Brief

Anxiety is another misunderstood condition. When people think about anxiety, they think of eccentric characters in a Woody Allen film. However, an anxiety disorder can paralyze your whole existence. Not only do you feel a pervading sense of dread, restlessness and irritability as you're constantly on edge, you can also suffer drom physical symptoms including dizziness, headaches, nausea, palpitations (a strong, fast and irregular heartbeat), insomnia, and stomach aches.

But are depression and anxiety really that common in women with PCOS, and what can you do if you suffer from it?

Frequency, Causes and Treatment

How Common Are Depression And Anxiety Among PCOS Sufferers?

A lot of literature has been produced on the subject. In a meta-analysis (an analysis of previous literature) of twelve similar studies, Barry et al (2011) looked at research surrounding 910 women with PCOS and 1347 women without PCOS, examining them for depression. The researchers noted a difference in the rates of depression between women with Polycystic Ovarian Syndrome and women without.

Analysis of the 12 studies revealed a higher incidence of depression and anxiety in women with PCOS than in women without. Another study by Judy et al (2014) studied 126 women with PCOS, assessing their mental health and comparing them to women in the general population. The researchers found higher levels of psychological distress in women with PCOS.

What Causes Depression And Anxiety In PCOS?

It's thought that low self-esteem might be part of the reason that women with Polycystic Ovarian Syndrome suffer with mental health issues. Low self-esteem can cause depression and anxiety by causing you to think negative thoughts, which makes you feel anxious and depressed. 

It's very common for women with PCOS to suffer with low self-esteem, especially if they experience hirsutism or fertility problems. These noticeable symptoms strike at the heart of what it means for a woman to feel attractive and feminine. A woman who experiences obesity alongside her PCOS may be more prone to irritability along with her depression.

It is also possible that some medicines for PCOS may make a person more prone to experience depression. In the meta-analysis study by Barry et al (2011), it was noted that women who took medication for their Polycystic Ovarian Syndrome were more likely to experience depression than women who took no medication for their condition.

It has also been suggested that stress, which may occur due to feeling anxious about the condition, can cause a peak in levels of the male hormone testosterone, which makes aggression and irritability worse.

What Can You Do To Feel Better?

A number of approaches have been suggested to help ease the psychological symptoms associated with Polycystic Ovarian Syndrome.

There is some evidence that losing weight may ease depression in obese women with PCOS. It's true that losing weight may be very difficult for women with the condition, but if you are overweight or obese and suffering with PCOS and depression, you should ask your health care provider for help to lose weight. They might be able to suggest a PCOS diet plan or a local group that could help you.

There are also several types of medication that may be effective.

Anti-androgens (such as Co-cyprindiol) suppress the release of male hormones. They may help to treat extreme hirsutism, raising your confidence levels, and may also reduce feelings of aggression and irritability. However, they are not a magical cure. They are not suitable for long-term use, due to the risk of developing a deadly blood clot. They can also cause side-effects, including breast tenderness, changes in body weight, nausea or vomitting, and headache. Conversely, they can also lead to mood changes and make you more depressed.

Insulin-sensitizing medications (such as Metformin) have been suggested for patients with PCOS and obesity. However, even slender women with PCOS have been found to suffer with decreased insulin sensitivity. Not only can losing weight help a woman to conceive, even with PCOS, but losing weight can reduce symptoms of depression in PCOS patients. 

Corticotropin-releasing Hormone (CRH) receptor agonists (such as Metyrapone or Ketoconazole) have been suggested as an effective way of reducing depression and anxiety scores in women with PCOS. It's still unknown, however, whether these drugs treat the underlying condition, or merely the symptoms.

READ Cognitive Therapy Exercises

It's also thought that Cognitive Behavioral Therapy (CBT) may reduce feelings of depression and anxiety by challenging your negative thoughts about the condition and changing them into positive, healthy thoughts. If you feel it may help you, ask your doctor to recommend a suitably-qualified practitioner.

What Do I Do Now?

If you're experiencing anxiety or depression alongside your PCOS, talk to your doctor or the gynecologist treating you. They will be able to work with you to decide on the best course of treatment.

As the old ad slogan has it, "It's good to talk."