PCOS Impact on Mental Health
Women in Canada with PCOS have a 4-fold and 2-fold higher incidence of Type-2 Diabetes (T2D) and cardiovascular disease (CVD), respectively.
Women in Alberta with PCOS:
- 3-fold higher incidence Type-2 Diabetes (T2D)
- 2-fold higher incidence of cardiovascular disease (CVD)
- Based on risk factors of increased body weight and altered blood glucose and fat metabolism
- Increased incidence of other adverse health outcomes.
- Respiratory disorders and mental health.
Common Emotional Challenges
Women with PCOS have a greater risk of emotional challenges such as anxiety and depressive symptoms. These challenges may be due to a combination of hormonal influences and dealing with the symptoms of PCOS.
Symptoms such as acne, weight gain, excess hair and difficulties getting pregnant may cause women to feel they do not fit the image of how females are supposed to look. Feeling different may affect overall quality of life for girls and women with PCOS. Women with PCOS also say they experience challenges with sexual relationships.
It’s important to seek help, because it can lead to a variety of emotional and physical problems and can reduce your ability to function. It is very important to recognize the signs and symptoms of mental health issues and seek help early.
Stress is defined by (Damone et al., 2018) as:
- Chronic stress is associated with depression and anxiety in the general population.
- Chronic illness is a stressful condition.
- Women with PCOS report a significantly increased physiological reaction to stress:
- Pathophysiological features of PCOS:
- Hypothalamic-pituitary-adrenal axis (HPA) and sympathetic nervous system (SNS) hyperactivity.
- Low-grade immune system inflammation
- Low levels of perceived stress may have a clinically significant impact in women with PCOS.
Treatment for Stress:
- Sleep deprivation is a contributor to being vulnerable to stress. For more information: Myhealthalberta.ca / Health Information and Tools > Sleeping
- Most people need between 7 and 9 hours of sleep.
- Examples of sleep hygiene:
- Maintaining a regular bedtime and rising time
- Having appropriate darkness and quietness to ensure that your environment is conducive to sleep
- Coffee, tea, caffeinated soft drinks, chocolate can increase the body’s level of cortisol, or “stress hormone”.
For more information on stress treatment:
- Myhealthalberta.ca / Health Information and Tools > Sleeping
Strategies for Stress Management (adapted from Paterson, 2000)
- Delegating, asking for help, knowing your limits and boundaries.
- Consult with your physician.
Nutritionally Balanced Meals:
- "Some people find that the simple sugars found in sweets cause roller-coaster changes in mood ranging from speediness to lethargy" (p.35).
- Progressive muscle relaxation exercises, visualization exercises.
Anxiety (according to the APA): https://www.apa.org/topics/anxiety:
- An emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.
- Recurring intrusive thoughts or concerns.
- There may be avoidance of certain situations out of worry.
- There may also be physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat.
Treatment for Anxiety:
- One well-known, supported, evidenced-based treatment for anxiety would be the use of Cognitive Behavioral Therapy (CBT). It is a therapeutic modality that can be used in counselling.
- Alongside talk therapy, you can take a look at a website that has great, valuable information on anxiety and the use of CBT: anxietycanada.com
Depression (according to the APA): https://www.apa.org/topics/depression:
- More than just sadness.
- People with depression may experience a lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide.
Treatment for Depression:
- CBT – once again, is a therapeutic modality that can be used in psychotherapy. Behavioral activation has strong research support, and that is a component of CBT.
- Alongside talk therapy, patients can obtain a copy of Mind Over Mood--Authors, Dennis Greenberger & Christine A. Padesky. It is accessible at the library for instance. Mind Over Mood is a hands-on workbook that teaches CBT skills in a clear, step-by-step format.
- There is also CCI website (Centre for Clinical Interventions – Australian website).
Infertility can be viewed from a grief and loss perspective:
- Grieving the loss of the ability to conceive.
- Working with a therapist who has experience with grief.
Acceptance and Commitment Therapy (ACT):
- You can also work with a therapist who is trained in ACT (Acceptance and Commitment Therapy) in order to do some values work and explore meaning in one’s life.
- Some ideas of questions that can be explored in session: (e.g., What matters to you in the “big picture”?; What do you want to stand for?)
Eye Movement Desensitization and Reprocessing (EMDR):
- Another way to address infertility can be through the use of EMDR to help address certain limiting beliefs/negative cognitions: it can be belief about doing something wrong, excessive guilt, not deserving. Providing room for the adaptive belief and instilling the adaptive belief (e.g., I can accept myself; I am good enough)
- Themes: acceptance, respect, appreciation, liberation, empowerment.
- Working with shame, insecurities.
- Working with beauty ideals (i.e. culturally, society).
- Body neutrality, body positivity.
- Self compassion.
Dealing with a chronic medical condition, such as PCOS can be challenging and so it's important that you do give room for self compassion. The three components of self-compassion.
1. Self-kindness rather than self-judgment:
- Providing ourselves with warmth and understanding when we suffer, fail, or feel inadequate.
- Imperfection, failure, being confronted with life difficulties is inevitable
- Being gentle with ourselves rather than getting angry when life falls short of set details.
2. Common humanity rather than isolation:
- Feeling connected to others in our shared struggles.
- e.g., social media: Facebook support groups.
- Recognizing that suffering and personal inadequacy is part of the shared human experience.
- Awareness of our thoughts and feelings.
- We are not minimizing or exaggerating our difficulties, emotions and thoughts.
- “Mindfulness is a non-judgemental, receptive mind state in which one observes thoughts and feelings as they are, without trying to suppress or deny them. We cannot ignore our pain and feel compassion for it at the same time. At the same time, mindfulness requires that we not be “over-identified” with thoughts and feelings, so that we are caught up and swept away by negative reactivity”.
Note: The above information was taken from Dr. Kristin Neff’s website. Her website provides different ways of practicing self-compassion, putting it into practice through exercises, guided practices and tips for practices.
For more information: selfcompassion.org
Relationships with Food
The following information is ‘under License with Craving Change Inc.’:
Increase your awareness of why you are eating. Types of hunger:
Stomach Hunger: This is the physical need for food. It’s been five or six hours since you've eaten. Your stomach is growling. Stomach hunger also refers to times when you might eat for a medical reason, for e.g. to prevent low blood sugar if you’re on insulin. You are eating for the well-being of your body.
Mouth Hunger: Have you ever stood in front of the fridge or cupboard looking for something to eat with a certain taste, texture, or smell? “Where are those salty, crunchy chips? No that’s not it, I want creamy…where’s the ice cream?” You crave pleasure in food. This describes mouth hunger.
Heart Hunger: This type of hunger refers to when you are eating in response to your emotions or how you’re feeling mentally, not physically. Heart hunger can also refer to a learned behaviour around food or eating such as having dessert after every meal.
For PCN workshops on relationships with foods, visit the PCN Workshop and Services website.
For More Information on Mental Health Resources
PCN Workshops & Programs:
Psychologist Association of Alberta:
American Psychological Association:
- Website: apa.org/topics/depression
Monash University ASK POCS Evidence-based information for women with Polycystic ovary syndrome:
- free PDF booklet
Depression, anxiety and perceived stress in women with and without PCOS: a community-based study:
- Psychol Med. 2019 Jul;49(9):1510-1520.
- doi: 10.1017/S0033291718002076.
Centre for Clinical Interventions (CCI):
- Australian website: cci.health.wa.gov.au
Book: Mind Over Mood:
- Website: mindovermood.com.
- Authors, Dennis Greenberger & Christine A. Padesky.
- Also available at the Edmonton Library
- Website: anxietycanada.com.
American Psychological Association:
- Website: apa.org/topics/anxiety
Self-Compassion (Neff, K. 2022):
- For more information: selfcompassion.org
Government of Alberta-My Health:
- Website: Myhealthalberta.ca / Health Information and Tools > Sleep Better
The Assertiveness Workbook: How to Express Your Ideas and Stand Up for Yourself at Work and in Relationships (Paterson, R. 2000):
- Overcoming the stress barrier (pp. 34-35)
- For further information on this book, click here. To view it at amazon.ca, click here.
Rivers Edge Counselling Centre:
- Grant Wardlow (works with EMDR, Trauma, Anxiety, Depression, LGBTQ+ and more)
- Website: riversedgecounselling.com
University of Alberta Hospital:
- Outpatient Psychiatry Clinic
- Instagram: @heytiffanyroe
- Website: tiffanyroe.com
The Food Psych Podcast:
- All episodes: christyharrison.com/all-episodes
- Website: christyharrison.com
Michaela Putala, RDN:
- Instagram: @food.peace.nutritionist
- Instagram @pcossupportgirl
- Instagram : @pcos_nutritionist
- TikTok: pcos_nutritionist
Erin Nesbitt, RD (Edmonton) IE & PCOS:
PCOS Challenge: The National Polycystic Ovary:
- Facebook: PCOS Challenge: The National Polycystic Ovary Syndrome Associate
- Website: pcoschallenge.org
You Can Totally Cyst With Us: The Happy Gurls PCOS Support Group: