In my last post, I talked about the relationship between depression and PCOS; this post addresses anxiety and PCOS. Although we may tend to think of anxiety and depression as two different and distinct conditions or diagnoses, in fact, there's a lot of overlap. As a therapist, I end up assessing to see whether depression or anxiety is the more dominant condition, but I almost always end up treating some degree of both conditions.
Women with PCOS are well aware that their state of well-being is affected by their hormonal balance. Estrogen, progesterone, testosterone, melatonin, and cortisol all play vital roles in mood regulation as well as physical well-being. Depression is often a symptom of estrogen deficiency. Irritability and anxiety can be indicators of progesterone deficiency or estrogen excess. Likewise, testosterone deficiency can contribute to symptoms of anxiety, not to mention reduced energy and initiative (which is where you can start to see the overlap with depression symptoms). Melatonin deficiency contributes to anxiety and nervousness and disrupts sleep, which can further contribute to development of insomnia and depression. Inadequate cortisol as a result of too much stress can also result in symptoms of anxiety and depression.
The endocrine system is so complex, and PCOS patients typically are managed with hormone-affecting medications such as birth control pills and diabetes medications. If not properly balanced, side effects of such medications may include moodiness, irritability, and other symptoms that either mimic or exacerbate anxiety conditions. Medications that are prescribed for treatment of anxiety may include special anti-anxiety medications, but anxiety symptoms are often treated with depression medications, like the SSRIs (Zoloft, Celexa, etc.). Some anti-anxiety medications can be addictive if overused or misused.
To further complicate matters, your physician may not be aware of the complex interaction and possible healing benefits of proper nutrition and PCOS-specific supplementation that can dramatically lessen symptoms, and even eliminate the need for some medications. All of our neurotransmitters (those things in the brain that help generate the happy, sad, and anxious feelings) can be positively affected by the proper fuel as well as mind/body treatments that include stress management, meditation, mindfulness, exercise, yoga, hypnotherapy, etc. Just as the body yearns for homeostasis, so does the brain. The brain actually reshapes itself in response to stress, trauma, and our interactions with other people — that's true for the good as well as the bad.
So even if you have experienced a lot of negative things that are contributing to feelings of being anxious, there are many ways to approach the problem — and medication is only one of the possibilities in a big bag of therapeutic tools. Although your hormones are powerful influencers of mood and anxiety, so are nutrition, supplementation, and a proactive approach to therapy and other forms of support.