Depression and Anxiety in PCOS, 3- prong approach to PCOS

Majority of the patients with PCOS, if not all, complain about mood swings and emotional disturbances.

Some of them feel extremely distressed and guilty about how it affects them and their families. Most of them are not aware that they are prone to depression and anxiety due to the PCOS condition.

Here are a couple of studies about prevalence of depression and anxiety in PCOS.

• Depression in women with polycystic ovary syndrome: clinical and biochemical correlates

Findings suggest a high prevalence of depression among women with PCOS, and an association between depression and PCOS markers.

• Prevalence and risk of depressive disorders in women with polycystic ovary syndrome (PCOS)

This comparative cross-sectional study found that women with polycystic ovary syndrome are at a significantly higher risk of depression compared with non-PCOS women.

Women with PCOS may experience uncontrolled and sudden anger, unpredictable mood disturbances, feeling of worthlessness, lack of motivation, over reaction, low stress threshold and disturbed sleep. They may find themselves being forgetful, feeling scattered, finding it difficult to focus for long duration and also brain fog.

The first step to deal with this is acceptance. The awareness that the PCOS condition is causing these symptoms helps to understand the symptoms from a different perspective. The awareness that the symptoms are not caused by lack of will power and one is not ‘losing it’ can bring a shift in how the patient can deal with it more effectively.

Depression and anxiety can affect your quality of life in various ways. Physically, it can bring about extreme fatigue, disturbance in eating and sleep patterns and vague feeling of body pain and heaviness. Body image issues can crop because of weight gain which can cause low self esteem affecting the patient personally and professionally.

I highly recommend PCOS patients to discuss their symptoms with their doctors and seek help. Some pointers, which may help are listed below.

• Acceptance: As I mentioned before, awareness of the condition and learning more about what it entails can help bring about acceptance. Involving family members in this journey can help getting more support and understanding and reduce the negative impact of volatile mood disturbances on relationships.

• Exercise: There are several studies which conclude that regular and moderate exercise is an all natural treatment for depression.

• Multi tasking: This seemingly advantageous looking skill can increase the stress levels and leave you drained. Even though you may be functioning as a multi tasking wizard for many years, it may be a good time to start unitasking and do things mindfully and with focus. It may seem inefficient in the beginning, but in the long run, this change of habit can help in reducing frustration and feeling out of control.

• All or None: This is a mindset when you either do everything perfectly or do nothing when something does not meet your expectations. It could be with taking medicines regularly, exercising, eating better or any goals you have made for yourself to deal with PCOS. Remember you will have good days and bad days. But you do not have to slide downhill if you can’t tick one thing on your list. Do your best AND forgive yourself! Do check if your goals are reasonable.

• Reminders: Many patients experience reduced memory and brain fog moments. There is no point ruing about how quick and efficient you were in the past and how you have become a ‘bird brain’ now. Taking help of our smartphones to save alarms, reminders and detailed to-do lists will help get through the day as efficiently.

• Triggers: It is a good idea to watch for triggers and work around them. It could be something your family says, or something which bothers you at work, try and identify it. Do mull on what you can do differently to not set off that trigger or how you can avoid it completely if possible. Most often, the awareness of the trigger itself brings with it a potential solution.

• Body image: Body hair, acne and obesity are common symptoms of PCOS. Think about how this is affecting your self confidence in personal and public life. Seek therapy to help you deal with it. Always remember that this is a medical condition affecting both your body and mind. So, it is important to take help to heal both physically and mentally. Meditation and Pranayama can also help increase the stress threshold.

• Last, but not the least, do not fear to examine all aspects of your life which may not be helping you in this journey. It could be your job profile which forces you to work at nights, long commutes and work hours which do not leave you with much time for personal fitness and other reasons which make you eat at erratic hours. It may not be always possible to make changes immediately, but considering how it is affecting your health, will help you to make the right choices and prioritise your health. It could lead you take small steps like reworking your schedules and looking for healthy alternatives.

The above pointers are the gist from my experience with patients suffering from PCOS. I will be happy if they prove to be useful to you all.

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