Do you have PCOS but also feel like your mental health has been struggling? Do you notice these changes in your mood around the time of menses or like it’s all in your head? Well, I am here to tell you that what you are experiencing is completely valid. Those with PCOS are three times more likely to experience depression, anxiety, insomnia, body dysmorphia, and/or eating disorders. Our mental and emotional health goes hand-in-hand with fluctuations or imbalances of our hormones and understanding this connection can provide answers to why many people with PCOS also have struggles with their mental health as well. In this blog post, we will dive deeper into how our mood is influenced by our hormones. So take a deep breath and let’s get started.
PCOS is designated as a “syndrome” because the cause is still unknown. It is important to distinguish that PCOS is less about actual cysts on the ovaries and more so due to a variety of factors like hormone imbalance, insulin resistance, inflammation, genetics, and/or environmental stressors that can lead to symptoms like irregular/absent period, difficulty getting pregnant, hair loss from the scalp, weight gain/difficulty losing weight, darkening of skin, excess facial/body hair, oily skin/acne, fatigue, and/or intense food cravings.
Research shows that insulin resistance (impaired insulin response in the body) affects about 50% of those living with PCOS. Insulin resistance can lead to increased risk for depression and anxiety symptoms.
People with PCOS also commonly present with hyperandrogenism which is higher levels of androgens (aka our sex hormones) due to excess production of these hormones from the ovaries and andrenal glands. Having elevated levels of hormones like testosterone and DHEA in relation to lower levels of progesterone can cause anxiety, depression, and insomnia.
I know we’ve covered a lot of different topics thus far but another big piece of the PCOS puzzle is cortisol. Cortisol, also released from the adrenal glands, is the #1 stress hormone. Our bodies need cortisol for normal day-to-day functioning with peaks and bows throughout the day. The problem arises when we are exposed to chronic stress - meaning higher levels of cortisol in the body. Cortisol is important to consider because it affects every single hormone we’ve talked about - it increases insulin, testosterone+estrogen production and decreases progesterone.
HOW TO SUPPORT MENTAL WELL-BEING WITH PCOS
Stress Management: Partaking in meditation, tapping/breathing exercises, journaling, Yoga, and/or going to therapy allows for peace in your life while building resilience to stressors by encouraging “rest & digest”.
Prioritize Sleep: It’s easy to put sleep on the backburner, especially when we’re stressed but the less we sleep, the more cortisol is flowing through our bodies…and we know where that leads us. My favorite ways to unwind after a long day is to sip on some sleepy-time tea, turn my phone on DND, and read a book or listen to a guided meditation on InsightTimer or Liberate. Herbs can also really help with reducing anxiety and encouraging restful sleep such as chamomile, lavender, lemonbalm, and california poppy.
Daily Exercise: We hear it all the time but daily gentle exercise for 30 minutes really is so amazing for PCOS and for our mental health. Exercise shouldn’t feel like a chore so whether it’s walking around the block, dancing in your living room, lifting some weights, swimming, or anything else your heart desires - just remember to make it fun! While incorporating physical activity into your lifestyle, remember to also honor your body and listen to the cues it is trying to communicate; if you need rest, there is no shame in doing something more relaxing.
Balance Blood Sugar: We want to avoid huge dips in our blood sugar highs and lows. More and more research is showing that glycemic dysregulation (often present in insulin resistance) leads to irritability, anxiety, sleep issues, and worry. We NEED carbs but a simple way to avoid blood sugar spikes if insulin resistance is present and to increase satiety is by incorporating sources of fats and protein to a meal. Instead of restricting from foods, let’s switch it to ways we can elevate a food. Let’s start with a basic bowl of cereal - add a cup of berries/fruit and a handful of nuts/seeds or some nut butter to get a nice balance of carbs, protein, fats, and fiber. Certain supplements and medications like berberine, inositol, magnesium, and metformin also aid in blood sugar regulation.
Reduce Inflammation: Managing underlying inflammatory processes can help reduce symptoms of depression and anxiety. Making slight changes to diet by incorporating foods like salmon, ginger, turmeric, olive oil, and nuts+seeds is an easy way to mitigate those inflammatory processes. Supplements that reduce inflammation and are also helpful for PCOS management include curcumin, fish oil, vitamin D, green tea extract, and resveratrol.
Navigating a PCOS diagnosis can be very confusing and dealing with symptoms of PCOS can come with shame, frustration, and guilt that can lead to disordered eating and/or body dysmorphia. If there is one thing I want you to take away from this is that you remember to be gentle with yourself. As someone living with PCOS, it hits close to home knowing that proper holistic care for mental illness and PCOS is unfortunately overlooked more often than not. It can take a few months to see a substantial difference but all hope is not lost.
If you’ve made it this far, thank you. As always, none of the information on this blog is medical advice. This is purely for educational purposes that everyone should be able to access and not a substitution for proper medical diagnosis+treatment. If you suspect you have PCOS or are struggling with mental illness, please seek the advice of your trusted naturopathic or integrative healthcare provider.
Dr. Avni Dalal
If you feel called to receiving naturopathic care for your concerns, I offer a complementary 15-minute Discovery Call. Durhis time, we will discuss your health concerns & see if we would be a good fit to work together!