How PCOS and Mental Health Are Linked and What to Do About It

    Updated 02 February 2023 |
    Published 01 September 2019
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    Reviewed by Kate Shkodzik, MD, Obstetrician and gynecologist
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    Your hormones and your emotions are connected. This is why mood swings are a symptom of PMS and why women can experience everything from the baby blues to postpartum psychosis. Because polycystic ovary syndrome is a hormonal disbalance, it can also take a toll on your mental health. Here's how PCOS, depression, and other mental health issues are linked and what you can do about it.

    The link between PCOS and mental health disorders in women

    Women are usually diagnosed with PCOS after they start trying to have a baby and find that they're experiencing fertility problems. It can take up to a year without conceiving before your doctor will order tests to see if PCOS is present. While PCOS may not be diagnosed until later in life, once it is, many people recognize the symptoms as something they have been dealing with for years, often since they were teenagers.

    The main indicators of PCOS are physical, such as irregular periods and excess facial hair, but many women are surprised to find out that there's often a connection between PCOS and their emotional and mental well-being as well. Women with PCOS may find that they are always tired, have less patience, and have a lower stress tolerance, but they often attribute it to normal life and accept it as normal. While the link between PCOS and depression has been seen anecdotally for some time in women across the world who suffer from the issue, the scientific community is starting to catch up.

    Women with PCOS may find that they are always tired, have less patience, and have a lower stress tolerance, but they often attribute it to normal life and accept it as normal.

    According to a study conducted by researchers with Cardiff University's Neuroscience and Mental Health Research Institute, women with PCOS are more likely to be diagnosed with various mental health conditions. This gives people who are struggling with PCOS and their mental health a jumping-off point to discuss the issue with their care providers so they can move toward a treatment plan and, hopefully, a decrease in symptoms and a better overall quality of life.

    Why does PCOS cause mental health issues?

    When it comes to depression and PCOS, more research is needed to know exactly why and how PCOS affects mental health, but there are several components that are likely factors. The first is hormones. Women who have PCOS have hormones out of balance. This includes having excess amounts of androgen hormones, like testosterone, and, in some cases, a lack of progesterone. All of this can lead to brain fog, irritability, depression, and anxiety that can be severe and debilitating. It can also lead to severe mood swings, which can cause a general feeling of instability. Women who experience these symptoms may also feel guilty for not being able to deal with life as they think they should and may feel ashamed to talk about their difficulties — all of which can further increase the symptoms of depression and anxiety.

    The physical effects of PCOS can also play a role. PCOS can cause thin, limp hair, as well as excess facial and body hair. It also makes it difficult to lose weight. All of this can cause self-esteem and confidence issues that can lead to depression and eating disorders. Women who are trying to get pregnant but experiencing issues may also struggle with depression and anxiety caused by infertility.

    What mental health disorders can be caused by PCOS?   

    Mood swings, difficulty getting out of bed, failing to maintain social relationships, and a lack of self-care all come into play with PCOS and depression. However, PCOS can also cause a host of other mental health issues, including but not limited to:

    • Anxiety
    • Bipolar disorder
    • Major depressive disorders
    • Bulimia
    • Other eating disorders
    • Somatizations (physical manifestations of negative mental states)
    • Interpersonal sensitivity

    Mental and physical health are interlinked, and it's important to understand that even if your periods are normal, you can still have PCOS and be at an increased risk for these and other mental health issues.

    Ways to treat mental health issues caused by PCOS

    Mental health issues caused by PCOS can be treated in two ways: by treating the underlying PCOS and by treating the mental health symptoms themselves. One of the most common treatments for PCOS is to take a medication called metformin, which can help balance your blood sugar and insulin levels, which can help with weight loss and getting your hormones back to a more balanced state. Women with PCOS have also experienced favorable results by focusing on eating a healthy, low-sugar diet and getting plenty of exercise. PCOS patients may also take birth control to regulate their periods and help deal with other symptoms like acne, mood swings, and excessive hair growth.

    Mental health issues caused by PCOS can be treated in two ways: by treating the underlying PCOS and by treating the mental health symptoms themselves.

    Treating the mental health issues themselves usually involves a multifaceted approach. Cognitive behavioral therapy can be helpful in treating PCOS and anxiety attacks, and talk therapy can help people who are experiencing PCOS-related depression or general self-esteem issues. Journaling your feelings can help you keep track of patterns and triggers, and practicing self-care and stress reduction through meditation, massage, essential oil baths, or whatever helps you feel calm and cared for can help too.

    When to see a health provider

    Taking care of your physical and mental health is important, and you don't have to do it alone. Treating your PCOS and depression, anxiety, or any other mental health issue starts with talking to your doctor. If any of the following symptoms are impacting your daily life or causing you distress on a frequent or ongoing basis, it's time to see a health provider:

    • A feeling of dread or doom when you wake up and are faced with tackling the day
    • Excessive sleeping or napping 
    • Difficulty falling or staying asleep
    • Persistent negative thoughts about yourself
    • Difficult enjoying personal relationships
    • Avoiding hobbies or activities you used to enjoy
    • Experiencing generalized anxiety
    • Panic attacks
    • Paranoia
    • Suicidal thoughts or actions

    While depression, anxiety, and PCOS can go hand in hand, mental health issues can also have different causes, and you'll want to make sure that PCOS is the real culprit to be able to treat your symptoms effectively. It may be a good idea to get tested for PCOS — which usually involves blood work and a simple ultrasound — if you are experiencing:

    • Recent weight gain, particularly around the stomach
    • Difficulty losing weight despite diet and exercise changes
    • Thinning or loss of hair
    • Excess facial and body hair
    • Irregular periods
    • Long cycles in excess of 35 days
    • Long or short periods
    • Difficulty getting pregnant
    • Miscarriages

    The link between PCOS and depression and other mental health issues is real, and if you've been dealing with these things, you're not alone. It's easy to think that the symptoms you're having are caused by the usual hustle and bustle of life, but there may be treatments that can help you feel more like your normal self and get back to your usual daily activities. If you aren't sure whether you have PCOS or whether it could be affecting your mental health, talk to your health care provider about your symptoms and possible treatment options.

    History of updates

    Current version (02 February 2023)

    Reviewed by Kate Shkodzik, MD, Obstetrician and gynecologist

    Published (01 September 2019)

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