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PCOS and depression: what’s the link?

People with PCOS have a long list of symptoms to contend with including irregular periods, acne, oily skin and carb cravings. But what about PCOS and depression? That’s right, the mood disorder has been linked to PCOS but what does the evidence say?

What is PCOS?

PCOS is a common condition affecting 1 in 10 people assigned female at birth in the UK. There are many symptoms someone may experience from irregular periods to excess body and facial hair, to oily skin and acne. Symptoms vary from person to person.

To be diagnosed with the condition, an individual must meet 2 of the following 3 criteria: irregular periods, high levels of testosterone and polycystic ovaries.

>> Read more PCOS 101 | A beginner’s guide to PCOS

What is depression?

Depression is a mental health condition. Depression is more than feeling unhappy or sad for a few days. It is a low mood that lasts for weeks and months and impacts your daily life. It is a common but serious mood disorder. It affects how a person feels, thinks and handles daily activities.

Doctors categorise depression into three categories:

  • Mild depression: has some impact on daily life
  • Moderate depression: has a significant impact on daily life
  • Severe depression: makes it nearly impossible to get through your life day to day

Signs of depression

There are several symptoms of depression which can be categorised into psychological, physical and social symptoms.

Psychological:

  • Continuous low mood
  • Losing interest in things that previously you enjoyed
  • Feeling tearful, guilty, anxious, irritable, hopeless and/or worried
  • Thinking about suicide or harming yourself

Physical:

  • Speaking or moving slower than usual
  • Unexplained aches and pains
  • Changes in appetite or weight
  • Constipation
  • Loss of interest in sex
  • Disturbed sleep
  • Lack of energy
  • Changes in the menstrual cycle

Social:

  • Avoiding speaking to friends and family
  • Spending less time being social
  • Neglecting interests or hobbies
  • Performing poorly at work

How is depression diagnosed?

Although there is no physical test for depression, if you experience signs of depression most of the day, every day for more than two weeks, you should visit your GP. This is particularly important if you have thoughts of self-harm or suicide.

Suicide Hotline Numbers

  • United States: 988
  • United States: 988
  • United Kingdom: 0800 689 5652
  • Australia: 131114
  • India: 8888817666
  • China: 800-810-1117

Your GP or primary care doctor may perform blood and urine tests to make sure there isn’t another condition causing your depressive symptoms like thyroid issues.

PCOS and depression: are you more likely to have depression if you have PCOS?

Research in individuals has suggested there may be a link between PCOS and depression, but does this mean you’re more likely to have the two? Studies that have compared women with PCOS with those without it have found that those with PCOS are at a higher risk of depression. Anywhere from 27% to 50% of people with PCOS report being depressed, compared to about 19% of those without PCOS.

What is the connection between PCOS and Depression?

Although we need more evidence, we do have some potential connections between PCOS and depression.

Symptoms of PCOS

Many researchers have suggested that depression may be a result of PCOS symptoms, however, this may be a case of over-simplifying a very complex disorder. In fact, research on 135 people with PCOS, that screened for depression whilst accounting for symptoms and circumstances found that while 64% of those with PCOS had depression, a correlation was not found between depression occurring and the severity of symptoms or an individual’s social situation.

Chronic inflammation

It has been suggested that depression may be a result of chronic inflammation and inflammation has also been linked with PCOS.

Some inflammation is good as it is a normal and essential function. However, when your immune system response is constantly activated, like in chronic inflammation, this can begin to cause health issues.

Chemicals, called cytokines, are produced during an inflammatory reaction and produce a variety of symptoms which also appear in depression. These same cytokines, appear to be reduced when some types of antidepressants are taken.

Research has found that artificially inducing inflammation, in normally ‘healthy people’, can lead to the onset of depressive symptoms. Some inflammatory markers have been found to be 96% higher in women with PCOS compared to those without.

Therefore, inflammation could in part explain the higher prevalence of depression in those with PCOS. It is important to remember this is just one theory to explain the connection, and whilst there is some evidence to support this, further research is needed.

Insulin resistance

It is estimated that up to 80% of people with PCOS have insulin resistance, regardless of body weight. Individuals who met all 3 diagnostic criteria of PCOS have the highest prevalence of insulin resistance. Evidence suggests insulin resistance and inflammation are closely connected.

>> Read more | How does insulin resistance impact PCOS?

Vitamin D Deficiency

One study found around 67-85% of individuals with PCOS were deficient in vitamin D. Interestingly, vitamin D, has been linked with helping to improve mood, with some research suggesting supplementation can help to manage mood. A systematic review and meta-analysis found that vitamin D supplementation had positive effects on people with major depressive disorder and reduced negative emotions.

>> Read more | Vitamin D and PCOS: benefits, sources and supplements

Lack of sleep

Sleep disturbances such as sleep apnea and insomnia, are more common in those with PCOS, linked with lower sleep quality, which may exacerbate PCOS symptoms. Interestingly, studies have found that reduced sleep can increase inflammatory markers and poor sleep also contributes to the development of depression.

>> Read more | Sleep and PCOS: what’s the connection?

What is the treatment for depression?

Working with a professional is essential for treating depression.

Seek medical help

If you have symptoms of depression for the majority of the day for two weeks or longer, see your doctor. If you have suicidal thoughts or think you may harm yourself, seek immediate medical support.

Suicide Hotline Numbers

  • United States: 988
  • United States: 988
  • United Kingdom: 0800 689 5652
  • Australia: 131114
  • India: 8888817666
  • China: 800-810-1117

Antidepressants

Your doctor may prescribe antidepressants to help manage depression. Antidepressants may affect blood glucose levels which could impact your PCOS symptoms. Your doctor will advise you of the best medical advice.

Therapy

Talking therapy in the form of counselling, CBT or IBT for example may be helpful to manage depressive symptoms. Your doctor may refer you to a therapist, or you may want to find one privately.

Key takeaways: PCOS and depression

Whilst, the reasons behind the connection between PCOS and depression require further investigation, there does appear to be an increased risk of depressive disorders in individuals with PCOS. This does not mean you will get depression if you suffer from PCOS by any means, it just means you may have a higher likelihood compared to someone without the condition.

If you are concerned you may be suffering from depression or the onset of it, it is extremely important to consult with your healthcare professional.

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Annabel Sparrow ANutr Author at The PCOS Collective

Author | Registered Associate Nutritionist

 
Annabel is a Registered Associate Nutritionist and pilates teacher with an interest in gut health and pre-and post-natal nutrition. She has a BSc degree in Psychology and is passionate about building healthy relationships with food and understanding the connection between food and mood.

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