Prioritizing Your Mental Health Amid PCOS
- A recent study published in the medical journal Annals of Internal Medicine this week, has revealed PCOS (a hormonal disorder that millions across the world are living with, like fitness guru Jillian Michaels) to be associated with an increased risk of suicide. The findings highlights the importance of maintaining awareness and better surveillance of mental health for anyone living with this disorder.
- Polycystic ovary syndrome (PCOS) stems from a hormone imbalance impacting women during their reproductive years.
- The term mental health refers to both our emotional and psychological well-being. Our mental health can affect how we think, feel, and behave. Certain triggers like stress, traumatic events, or change in your physical health can affect mental health.
- It’s really important to keep tabs on your mental health and, if necessary, seek treatment. This doesn’t necessarily mean traditional therapy because while it may be really helpful (even life-changing) for some, that doesn’t mean it’s for everyone.
- There are many ways to address mental health issues. Options may include meditation, practicing mindfulness, talking with a therapist, joining a support group, and medication, such as antidepressants.
- Check out SurvivorNet’s other great mental health resources for you. Additionally, the 988 Suicide & Crisis Lifeline offers a 24-hour, toll-free, confidential support for people in distress.
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Read MoreThe study, which consisted of more than 18,000 women found that patients with PCOS were 8 times more likely to attempt suicide when compared to a control group of those without the disorder.
Data from the Taiwanese nationwide database, taken between 1997 to 2012 for 18,960 women with PCOS, was studied by researchers from Taipei Veterans General Hospital .
The study’s authors concluded, “This study underscores the heightened risk for suicide attempt that persons with PCOS face, even after adjustment for demographics, psychiatric comorbid conditions, physical conditions, and all-cause clinical visits.
“This suggests the importance of routine monitoring of mental health and suicide risk in persons diagnosed with PCOS.”
According to Medical News Today, the study authors also said, “Challenges associated with fertility and the management of PCOS symptoms could further compound existing mental health challenges.
“Women with PCOS face stigmas due to obesity, hirsutism, menstrual irregularities, and infertility… The stigma linked to PCOS seems to be rooted in societal expectations, further adding to the burden of this condition.”
PCOS’ Link To Health Problems
Prior to this study, a Swedish study in 2016 found that women with PCOS were 40% more likely to attempt suicide than other women.
Meanwhile, an earlier study from 2018 found that acne that formed amid PCOS was linked to depressive thoughts among women. Married woman with infertility caused by PCOS were also cause to have an increase in depression.
According to the U.S. Department of Health & Human Services‘ Office on Women’s Health, studies have found connections between PCOS and other health problems, including diabetes, high blood pressure, unhealthy cholesterol, sleep apnea, depression, anxiety, and endometrial cancer.
“Researchers do not know if PCOS causes some of these problems, if these problems cause PCOS, or if there are other conditions that cause PCOS and other health problems,” the office explains.
The Office on Women’s Health also notes that PCOS affects 1 in 10 women of childbearing age.
Jillian Michaels On Living With PCOS
Fitness guru Jillian Michaels, 49, who created The Fitness App, was diagnosed with PCOS as a teen and often takes to social media to inspire others and offer advice on living with the disorder and prioritizing wellness.
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“PCOS – Polycystic Ovarian Syndrome. This is probably one of the most common questions I get. I actually had PCOS as a kid but haven’t struggled with it since 17. It IS possible to lose weight, although it can be challenging,” Michaels wrote alongside one of her Instagram posts.
“Of course – talk to your doctor FIRST. I am not a doctor or an endocrinologist. But, these are some things you can do that may help. I’ll have a full YouTube video coming out on this soon, so keep an eye out!”
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Michaels urges anyone living with hormonal imbalances not to feel discouraged because they can lose weight even though they are dealing with a health disorder. She also stresses the importance of exercise and medications (if needed).
“Talk to your doctor about medications, because even though I’m not on any medications, there are medications that can help you jumpstart this [weightloss] … because once you start to dig your way out of this hormonal imbalance, the body can begin to get on track and stabilize itself.”
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Learning About PCOS
Polycystic ovary syndrome (PCOS) stems from a hormone imbalance impacting women during their reproductive years.
While health experts can’t pinpoint the exact cause of PCOS currently, the CDC says women with higher-than-normal androgen levels play a role in developing the condition. Other risk factors include being insulin resistant or overweight if you have a family history of PCOS or type 2 diabetes.
The National Institutes of Health points to the following symptoms that are associated with the condition.
- Menstrual irregularities (missed periods, no menstrual periods, very heavy periods)
- Excessive hair growth
- Severe acne
- Weight gain
- Oily skin
- Patches of thick discolored skin
While there is no cure for PCOS, leading a healthy lifestyle that includes proper diet and exercise helps. Medicines can also help with associated symptoms.
According to the National Institutes of Health, “PCOS increases the risk of some types of cancer. For instance, some research has shown that risk of cancer of the endometrium, the inside lining of the uterus, may be higher for women with polycystic ovary syndrome (PCOS) than it is for women without PCOS. Irregular periods, or a lack of periods, can cause the endometrium to build up and become thick. This thickening can lead to endometrial cancer.
“Data on links between breast cancer, ovarian cancer, and PCOS are limited. While some small studies have suggested that a lack of ovulation, as occurs with PCOS, is linked with an increased risk of breast cancer, other studies have not shown an association.”
The NIH adds, “While some research has shown more than a doubling of the risk of ovarian cancer in women with PCOS, scientists have not confirmed these links in large population studies, and further studies hint that women with PCOS may have a lower risk of ovarian cancer. Therefore, any associations between breast or ovarian cancers and PCOS remain inconclusive.”
Mental Health: The Basics
The term mental health refers to both our emotional and psychological well-being. Our mental health can affect how we think, feel, and behave. Certain triggers like stress, traumatic events, or change in your physical health can affect mental health. It’s really important to keep tabs on your mental health and, if necessary, seek treatment. This doesn’t necessarily mean traditional therapy because while it may be really helpful (even life-changing) for some, that doesn’t mean it’s for everyone.
Problems with mood and overall mental well-being can be attributed to several factors. For some people it’s genetic, while others may be experiencing a response to some sort of stressor or past trauma.
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In order to keep your mental health in check, it’s important to be aware of signs which can be subtle that there is something affecting your mind. These signs include:
- A change in eating or sleeping habits
- Losing interest in people or usual activities
- Experiencing little or no energy
- Numb and/or hopeless feelings
- Turning to drinking or drugs more than usual
- Non-typical angry, upset, or on-edge feelings
- Yelling/fighting with loved ones
- Experiencing mood swings
- Intrusive thoughts
- Trouble getting through daily tasks
These symptoms can be wide-ranging and vary a great deal from person to person. Everyone experiences grief differently, for example. However, if you are feeling unusually sad, on-edge, or like you’re no longer interested in activities you used to love, know that there are many treatment options available and many different healthy ways to help you cope.
Coping With Depression
Dr. Scott Irwin, a psychiatrist and Director of Supportive Care Services at Cedars-Sinai Medical Center, says it’s crucial for patients to talk to their care team about their mental health.
“We all get depressed from time to time, have a sad day, feeling down and blue – that’s part of normal human emotion, part of normal life,” Dr. Irwin explained.
“Some of us, when we’re dealing with difficult things such as a diagnosis of cancer, may be sad or down or blue more often. And sometimes it gets to the point where that depression can be a little bit overwhelming, and we help them through therapy, through non-medication interventions.”
There are many ways to address mental health issues as a cancer survivor. Options may include:
- Meditation
- Practicing mindfulness
- Talking with a therapist
- Joining a support group
- Medication, such as antidepressants
Medication
When doctors and patients together decide that medication is necessary, it’s important that doctors choose wisely.
“I often try to choose medications with the lowest side effect profile,” Dr. Irwin said. “If patients are getting hormonal therapy, there’s particular antidepressants that we can’t use because they may lower the effectiveness of that hormonal therapy and so we choose antidepressants that don’t impact the cancer care.”
This shows how important it is to have communication between everyone you’re seeing, so they can be on the same page about your treatment and options.
Dealing With Grief Related to Health Problems
Another way doctors can tailor mental health medications for their patients is through genetic testing.
Psychiatrist Dr. Lori Plutchik says genetic testing through companies like Genomind can help doctors understand how likely it is a patient may respond to different types of psychiatric medications.
“Doing the genetic testing has absolutely transformed the landscape of psycho-pharmacology,” Dr. Plutchik told SurvivorNet. “It’s something that I highly recommend for anybody who is taking medication, whether they are being treated for cancer, or not.”
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Dr. Plutchik also explained that genetic testing can be specifically helpful for cancer patients because it may help avoid trial and error when it comes to choosing a mental health medication that does not interfere with their cancer treatment.
“So, a person who is dealing with this and may have to go on chemotherapy has already enough on their plate that they don’t really want to start dealing with trial and error with medications,” she said. “So, it gives me information about which medications are likely to work without having problematic side effects, and it also gives information about interactions between any of the psych medications that we choose and the chemotherapy agents that they may be taking.”
Support Groups
Whether you’re coping with an illness, an emotional problem, or life transition, a support group can be a place where people in the same boat, or a similar situation, can come together.
But maybe you’re a little unsure or skeptical about joining a group. What will it be like? Are you expected to share your story?
Dr. Amy McNally, gynecologic oncologist with Minnesota Oncology, tries to reassure her patients that chances are, they’ll derive some benefit.
“I think in a support group you’re going to find women who are in similar situations but yet can share their unique stories,” she says.
“Just being there is worth it. You don’t have to share a thing. You can just sit and listen, or you can be part of the conversation and offer your thoughts. And it can be different every time you go, it’s your choice as to how or whether to participate and what you decide to get out of the group.”
McNally thinks it can be helpful and comforting to be around people who know what you’ve been through, or are going through, and that in and of itself is reason enough to try it out.
Therapy
“People that are struggling with coping with the experience, coping with body image should reach out to their doctors, find a therapist in the community,” says Dr. Irwin.
A patient navigator or social worker can also help connect you with a mental health professional that you can talk to to help process your emotions.
“It’s about meeting the individual patient where they are and their feelings, how they’ve always dealt with their body image, what the body image changes mean now in their lives and their relationships, and how they can move forward given the new reality,” Dr. Irwin said.
Mindfulness
Jon Kabat Zinn, founder of the eight-week stress-reduction program, Mindfulness-Based Stress Reduction (MBSR), a course that has entered the mainstream of health care, scientific study, and public policy, describes mindfulness as “paying attention in a particular way: on purpose, in the present moment, and non judgmentally.”
Mindfulness is often suggested for cancer patients to reduce high levels of anxiety and distress associated with diagnosis, treatment, and anticipation of possible disease recurrence.
Both the American Society of Clinical Oncology and the Society of Integrative Oncology recommend meditation as part of a multidisciplinary approach to reduce stress, depression, and mood disturbance, and to improve the quality of life in cancer patients. But the question remains: does it really work? We think it does.
5 tips for practicing mindfulness:
- Choose one daily activity to practice mindfully (e.g. eating your lunch, brushing your teeth or taking a shower). During this activity notice your breath and activity of your mind for a few moments.
- Take a pause throughout your day. During your day, find a moment to stop and take 5 deep breaths with your eyes closed.
- Kindly acknowledge a moment you’re experiencing a difficulty, by putting your hand on your heart and saying, “Feel my pain. How can I be kind to myself in this moment?”
- Get curious about your emotions. Experiment with welcoming your emotions as they come, instead of pushing them away.
- Become aware when you’re in a rush. Ask yourself, “Do I really need to hurry?”
Meditation
Regularly meditating allows people to start to become more aware of the emotions in the physical body and the thoughts running through the mind, to acknowledge their thoughts as they arise, and then gently let them go.
Shannon Masur, a colon cancer and Lynch Syndrome survivor, describes this as “when a thought comes in, to feel it, feel the fear, but let it go after a few seconds.”
All of this is said to result in an overall reduction in stress and anxiety in the body. It may also help patients to control problems such as pain, difficulty sleeping, tiredness, feeling sick and high blood pressure.
For help getting started with meditation, here’s a guided session to try.
WATCH: A Guided Meditation for the SurvivorNet Community
Overall, don’t forget to prioritize your mental health if you’re facing cancer or battling a condition like PCOS. You might feel like your mind is the least of your worries while fighting the disease, but it’s important to know just how big of an impact your mental well-being can have on your health as a whole.
“Actually, there’s data that if you have extra stress or depression that you may not recover or you have a higher risk or recurrence,” Dr. Irwin said. “So… in treating the depression, we’re actually impacting the cancer care outcomes.”
Contributing: SurvivorNet Staff
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