The Emotional and Mental Effects of PCOS

Polycystic Ovarian Syndrome affects the lives of millions. Apart from the physical symptoms associated with the condition, PCOS has also been linked to emotional and mental concerns. Studies have found that women diagnosed with PCOS are also more prone to emotional and medical conditions such as anxiety, panic attacks, depression, and fatigue.

Adding infertility concerns to this concoction can present substantial emotional consequences. Dreaming of Baby speaks with Crystal Clancy, MA LMFT, a Licensed Marriage and Family Therapist, Co-Director of Pregnancy and Postpartum Support MN, and Director at Iris Reproductive Mental Health Services, on mentally and emotionally dealing with the symptoms of PCOS.

Daniela: Good morning Crystal, and welcome to Dreaming of Baby. Today we will be discussing PCOS and infertility, more specifically on how to deal with the condition and its symptoms mentally and emotionally. Before we start our questions, grateful if you could introduce yourself to our readers.

Crystal Clancy, MA LMFT: I am a licensed marriage and family therapist, with a specialty in perinatal mental health. I see anyone having difficulty getting pregnant, staying pregnant, or any complications postpartum. I am also the Co-Director of a non-profit called Pregnancy and Postpartum Support MN. I have personally experienced infertility (due to PCOS) and postpartum depression.

PCOS and Mental Health

Daniela: Thank you for this overview. To start with, and based on your wide-ranging experience in this field, how does PCOS affect mental health?

Crystal Clancy, MA LMFT: I am not sure that has a simple answer, and such an answer would be different for everyone. Because it can be a difficult disorder, and many times not diagnosed appropriately, it can contribute to both depression and anxiety. In addition, some women with more advanced symptoms (the hair growth on their face and back, for example, or acne) can be terribly self-conscious or ashamed of their appearance.

Even if the disorder has been appropriately diagnosed, many women with PCOS also have anxiety symptoms as part of the syndrome.

Daniela: So, would you say that there is indeed a link between PCOS and mental health?

Crystal Clancy, MA LMFT: For many, yes. And if they are experiencing infertility, in addition to the PCOS, that can further cause or exacerbate depression or anxiety.

Daniela: In this regard, what would be the first step in addressing the feelings and emotions associated with PCOS and its symptoms?

Crystal Clancy, MA LMFT: Start by finding someone who understands PCOS. That may or may not be your doctor or current therapist. Look for an organization that works with PCOS, or a support group that supports those with PCOS. Therapy can also be helpful- it would be ideal to find someone who works with women’s health, infertility, etc. And if you find that the anxiety or depression is difficult to manage on your own, consider a psychiatrist or psychiatric nurse practitioner to discuss medication. There are also holistic options, such as naturopathic doctors, acupuncture, essential oils, and much more!

How to Emotionally and Mentally Deal with PCOS and Infertility

Daniela: It’s good to know that there are options and support systems available to assist women experiencing PCOS. Are there any lifestyle changes which can also help in dealing with this condition, mentally and emotionally?

Crystal Clancy, MA LMFT: As with any other health condition, managing symptoms physically goes hand-in-hand with mental health. A huge factor in PCOS is diet. Many women struggle with food intolerances (especially gluten and dairy), and are insulin resistant, setting them up for Type 2 diabetes. So, limiting unhealthy carbs is key. Exercise is also wonderful, as well as relaxation and anxiety reduction techniques, such as meditation and yoga. There are also supplements that can be helpful.

Educating yourself on how PCOS affects your body will help make these changes more bearable.

‘As with any other health condition, managing symptoms physically goes hand-in-hand with mental health’

Daniela: In your experience, what would you say was the greatest worry for women dealing with PCOS?

Crystal Clancy, MA LMFT: The majority of the time when I am working with a client with PCOS it is because they are going through infertility. So their worry is that they will never get pregnant. Or that they will have to spend a ton of money, or already have, in order to have treatments to become pregnant.

Daniela: In this regard, how would you assist women experiencing such concerns? Are there any measures that can help reduce this stress?

Crystal Clancy, MA LMFT: Yes! Relaxation techniques and meditation can be very helpful for anxiety. There are many apps, and I have my favorites, but it tends to work best to have people play around and find one they like. They are more likely to use it!

Exercise and/or yoga, talking about the process, and validating their grief and anxiety can also be helpful. I generally ask their partner to be involved, as appropriate, as relationships can be struggling during infertility.

Daniela: If I understand well then, communication remains key in coming to terms with the situation? How can partners be more involved in this journey?

Crystal Clancy, MA LMFT: For sure. Partners can be helpful by being a listening ear and a soft place to land. Typically, the partner is a male, and desperately wants to fix the woman’s pain. But he can’t. However, most women will say that they don’t expect to be “fixed”- they just want someone to be there, in it, with them.

On the flip side, partners often have their own feelings about infertility, and hold those inside to avoid causing their partner more distress. Don’t! She needs to know that this is hard for you too. Even if your feelings are different- talk about them.

If they aren’t talked about, it is easy to feel like the other person isn’t as upset or worried about it. And even if they aren’t, it’s nice to get reassurance that they too have their own worries and fears about infertility.

It should be understood that anxiety can make fears catastrophic, and the best way is to offer reassurance, versus dismissing the fear. A common example is women worrying that their partner will leave them if they cannot get pregnant. Generally, the partner has not thought about this at all.

‘It should be understood that anxiety can make fears catastrophic, and the best way is to offer reassurance, versus dismissing the fear’

Daniela: This is very eye-opening. Taking this subject from a different angle, and also based on what you have just shared with us, can stress and feelings of anxiety, potentially worsen PCOS? Does it create a vicious cycle?

Crystal Clancy, MA LMFT: That is a great question, and there are some common misconceptions. So- the short answer is that it is definitely not uncommon for those experiencing anxiety or depression, who also have PCOS, to engage in poor self-care, which can exacerbate the symptoms both emotionally and physically. So, in that vein, it is a vicious cycle that can feel like self-sabotage.

On the other hand, it can be very very hurtful for those going through infertility to be told by others things like, “If you would just relax, you would get pregnant”. Or, “if you would just stop trying, then you would get pregnant”. Most women are already blaming themselves, while PCOS may mean better self-management, it is hurtful to be telling moms that they are causing their infertility.

I coach clients on ways to respond to hurtful or ignorant comments, even though people are generally well-meaning, and want to be supportive.

Daniela: That is so very true. Most comments come from well-meaning persons but indeed, they can be quite hurtful for the person experiencing this. What would be one mechanism for overcoming such comments?

Crystal Clancy, MA LMFT: I remind them that most people don’t intend to be hurtful or rude; they just don’t understand. So, take a deep breath, and try something like, “I understand that you likely mean well, but did you know that saying {insert comment here} feels very hurtful? Relaxing will not make my PCOS go away.” If you know the person well, you can even offer them an article to read about PCOS, so they can be better informed. An analogy can sometimes be helpful too. Something along the lines of, “If someone you know had cancer, would you tell them to relax? To me, PCOS and infertility is causing my stress, and not the other way around”.

Daniela: Great tips to keep in mind! Are women with PCOS more prone to experience post-partum depression? If yes, is there anything that can be done in terms of prevention?

Crystal Clancy, MA LMFT: I don’t know that they are more likely, but they are equally likely. And the challenge with PCOS and/or infertility, and then experiencing PPD is that there is an additional layer of guilt because this is what they have wanted for so long. Sometimes years. And then to feel depressed about your postpartum experience, and/or anxious, is a reason why a lot of these women end up not seeking help. Or if they do, and don’t speak with someone who “gets it”, are further shamed (inadvertently). Women who adopt also experience PPD, and feel similarly.

Daniela: Thank you for this. As a final question, if there’s one piece of advice that you would give a woman experiencing mental anguish associated with PCOS, what would it be?

Crystal Clancy, MA LMFT: The more awareness, the better. My advice would be if you are struggling with PCOS or infertility, to find qualified support. Find someone who understands and has training working with these types of issues. Don’t try to go through it alone.

Daniela: Thank you for the insight shared Crystal; I am more than sure that many women will find your advice very helpful. Thank you for your time today

Crystal Clancy, MA LMFT: My pleasure!

Let the Professionals inform you about PCOS. Read more here:

What you need to know about Polycystic Ovary Syndrome (PCOS)

How Lifestyle Choices Affect Fertility in PCOS patients

PCOS: The Truth About Your Eggs

Diagnosing PCOS in Adolescence

PCOS: A Personal Journey to Motherhood

PCOS: Preparing for your OB-GYN Appointment

The Effects of a Healthy Diet on PCOS

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