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Depression in Women with PCOS

a woman sitting at the foot of her bed, bent over with her head in her hands

Depression is a common mood disorder with significant impact on daily life. Approximately 5% of the general population is dealing with depression at any given time. Women are twice as likely to suffer from depression as men, although men are less likely to get help. Depression may be related to experiencing a major life event such as a loved one’s death, or not situational and may recur over the course of an individual’s life.Major depressive disorder causes many symptoms that result in an inability to function in daily life in contrast with feeling “sad,” or “down in the dumps.” People experiencing major depression cannot simply “lift themselves out of it,” and usually require psychotherapy and/ or medication to feel better.

Depression and Women

As many as one in four women will suffer from depression throughout their lifetime,and often will experience it during the childbearing years, during pregnancy and within the first year after delivery. Deborah Kim, MD, a Psychiatrist at Penn Center for Women’s Behavioral Wellness and Assistant Professor of Psychiatry in the Perelman School of Medicine states, “If a woman is experiencing prolonged sadness guilty feelings, hopelessness or low self esteem,she may be suffering from depression or an anxiety disorder.”

Depression and PCOS

Depression, anxiety and eating disorders often occur in women with PCOS. A 2005 research study of 206 women conducted by Anuja Dokras, MD, PhD and Elizabeth Hollinrake, MD found that 35% of women with PCOS had depression. The study found that women with PCOS are more likely to develop depression or depressive symptoms. Dr. Dokras noted that depression in PCOS patients is significantly associated with both high body mass index (BMI) and insulin resistance. This may have some correlation with the psychological and metabolic effects of obesity. Women with PCOS often have abnormal levels male hormones such as testosterone but there is no clear evidence to link these to depressive symptoms.

Another possible contributing factor to depression is that women with PCOS often struggle with the physical symptoms of the disorder such as weight gain, acne, increased facial hair and hair loss. These symptoms can often lead to feelings of frustration, lack of control over one’s appearance and isolation. Whatever the cause, both Drs. Kim and Dokras believe that PCOS women should be treated with a holistic approach. Women with depression and anxiety disorders show improvement when treated with psychiatric medications and to some extent, with a healthy diet and exercise program, nutritional supplements and stress management. Weight loss also helps reduce insulin resistance.

Women with PCOS should be screened regularly for depression and anxiety. According to Dr. Dokras, "Between 50 and 70 percent of women who are treated for depression recover completely, so this is an important target population that we should be both screening and treating." If you are experiencing some of the physical signs of depression (depressed mood, loss of motivation, insomnia, overeating, sleeping too much and not eating) and feel that you are very overwhelmed with PCOS, you may benefit from seeing a therapist with experience in reproductive issues, infertility or women’s health.

The Penn Center for Women's Behavioral Wellness is a collaboration between the Departments of Psychiatry and Obstetrics/Gynecology in the Perelman School of Medicine at the University of Pennsylvania. The center provides clinical consultation and treatment, as well as opportunities to participate in research focusing on conditions related to women’s behavioral health across the lifespan.

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