Apart from the plethora of physical manifestations of PCOS, here are 5 unseen drivers that are linked to Depression in PCOS. We share some of our learnings to help you tackle them!
Well, if you’re a female and surrounded by many awesome women around, you would know one of the increasingly common and prominent menace in the lives of females: PCOS – a commonly known endocrine disorder that affects the functionality of ovaries through disturbing the hormone levels affecting our ovulation and dysregulating our menstrual cycle. According to the Pakistan BioMedical Journal, the prevalent rate of PCOS in Pakistan is more than 50% and it is increasing day by day in young females.
PCOS is known to impact the lives of most women in many ways, most common symptoms of the disease include irregular menstrual cycle, infertility, abnormal hair growth on face and body, acne and weight gain and if the physical manifestation wasn’t enough, it ends up impacting your mental health too. One of the possible consequences of this syndrome is depression. The array of hormone imbalances that PCOS brings with it affect your mood regulation increasing the risk for depression.
We share below the 5 key drivers of depression in PCOS and how you may be able to tackle them, if not completely defeat them:
1. Fight Low Serotonin With Diet & Exercise
Serotonins are a neurotransmitter and to simply put it, our happy hormone, often called the body’s natural “feel good” chemical.
Low serotonin levels can cause irritability, fatigue, and mood swings as it disrupts mood regulation considering serotonin is known as the happy hormone. One way you can increase serotonin levels is through diet. As per healthline guidelines, one should increase their uptake of serotonin-rich foods.
This includes egg, cheese, salmon, nuts and seeds, tofu, pineapples. Exercise can also increase serotonin as it lowers stress levels, so anything from a walk, run or weight training can help, even dancing it off – shows that regular exercise can have antidepressant effects. Also, research shows making sure to get plenty of sunlight in encourages an increase in serotonin production, so be sure to go out and bask in the sun or even run some errands to get some vitamin off the sun! Science shows a clear relationship between being exposed to bright light and increased serotonin levels.
2. Combat Low Progesterone With Supplements
Progesterone is one of two female sex hormones, the other being estrogen. Its main functions are regulating menstruation and supporting pregnancy in the female body.
Considering progesterone also acts as a natural antidepressant and has a calming effect, in the case that it is limited in supply, the said calming effect is eliminated and replaced by feelings of anxiety, irritability and mood swings. Progesterone also plays a role in stress regulation and a lesser level of progesterone means the body responds more actively to stress, which can be a leading factor for depression. While science says there are no foods that contain natural progesterone, there are those that promote an increase in its production such as greens like broccoli, kale, brussel sprouts, cabbage, nuts and whole grains.
If you want to take aid from supplements, you can look towards zinc and vitamin B6, after a consultation from your GP or endocrinologist.
You can also load up on Zinc in its natural forms which help fertility, the foods that contain high levels of Zinc are cashews, almonds, chickpeas, kidney beans and shellfish. Vitamin B6 also plays a vital role in progesterone production with foods like chickpeas, tuna, spinach, bananas, potatoes and lean red meat.
3. Regulate Insulin Levels With the Mediterranean Diet & More!
Insulin is key in managing neurotransmitters like serotonin in the body thus it directly affects mood. Therefore low insulin levels mean low serotonin levels and a greater risk of depression. (Ugh, disappointing to know science telling us sugar sure doesn’t make us happy)
According to scientific research, insulin resistance causes unbalanced blood sugar levels. If blood sugar is low this causes lack of energy, which leads to fatigue and demotivation. This may cause feelings of hopelessness similar as in the case of depression. On the other hand, high blood sugar levels can impair cognitive function in terms of memory and the brain’s ability to make decisions. This can cause frustration and contribute to depressive symptoms. It is more common than we think as when researching we found it is one of the leading factors in PCOS. “Insulin resistance has a strong and independent association with depression in PCOS and may serve as a physiologic mediator. Our findings corroborate a growing body of evidence linking insulin resistance to depressed mood.”
Now in terms of what could help you regulate your insulin levels are supplementing with Myo-inositol and D-chiro inositol, naturally found in foods such as corns, beans, fruits and nuts. You can even get the supplement after a consultation with your endocrinologists. The blend of the two supplements helps in restoring ovulation, lowering insulin levels and improving insulin resistance. Making changes to your diet is imperative too and known to improve the condition. Emphasizing on vegetables, fruits, healthy fats and the Mediterranean diet is known to be highly effective and beneficial for people with PCOS. Last but not the least exercise helps lower cardiovascular risk in people with PCOS and may improve insulin resistance. It may also improve mood and cognition, reduce risk for disease, improve strength, and help you manage existing health conditions.
4. Cut The Caffeine, Cut The Cortisol & More!
PCOS naturally comes with high cortisol levels, aka our body’s stress hormone. This means it is responsible for our stress response, regulating metabolism and has a lot to do with immunity. While low immunity can leave one at a greater risk of depressive symptoms , additionally if stress is not regulated, it can be a major factor leading to depression. Cortisol also affects your nervous system, immune system, cardiovascular system, respiratory system, musculoskeletal system and reproductive system. The higher levels of cortisol have a domino effect, increasing androgens and insulin resistance leading to many health conditions, including PCOS.
In order to lower cortisol levels many healthcare professionals recommend limiting intake of high in sugar and processed foods, performing simple deep breathing exercises 4-5 times a day can aid in keep ourselves stress-free and lowering our elevated cortisol levels. Daily exercise for at least 30 minutes can help too. (Though not making sure to not overdo it). All the above, has shown an incredible ability to improve symptoms of PCOS. Specifically, results have shown it to reduce anxiety and improve menstrual frequency, testosterone levels, the LH:FSH ratio, metabolism, hirsutism, cholesterol levels and insulin resistance.
Did you know caffeine can be an amplifier for your stress and anxiety? Research points to reducing or eradicating caffeine as it raises cortisol levels. Also make sure to maintain a fixed sleep cycle, waking up and sleeping at a fixed time! Avoid added sugars, canned and processed foods. Bananas, garlic, dark chocolate help in balancing cortisol levels along with foods that are high in vitamin C such as fruits and black or green tea. \
5. Pro & Pre Biotics To Balance Gut Health
Gut imbalances essentially mean lower levels of healthy gut bacteria contributing to lower levels of serotonin (your happy hormones). Diets that consist majorly of processed and sugary foods can be a cause of impaired gut health. As unbelievable as it sounds, gut imbalances can consequently result in inflammation of the digestive tract, A LEADING FACTOR for depression. The inflammation can extend to the brain disrupting the mood regulation regions in the organ.
Yes, your gut health is mysteriously highly related to your PCOS flaring up too. Too much bad bacteria and not enough good bacteria are a significant cause of this. When leaky gut occurs, harmful substances like toxins and endocrine disruptors can leak into the digestive system causing damage and inflammation that can worsen insulin resistance and symptoms of PCOS.
To reduce the risk of inflammation, one should implement a balanced diet and healthy lifestyle which includes exercise. You should also increase your intake of prebiotics as well as probiotics as they promote what’s known as good bacteria in your gut. Examples of prebiotics are garlic, onions, bananas and apples and for probiotics items like kimchi, sauerkraut, yogurt. Eating more fiber can also help supporting the good bacteria including beans, lentils, vegetable and whole grains. Incase you are out conquering the world and missing out on sleeping well, remember sleep is also impacting your inflammation and gut dysregulation. You should aim to get at least 7-9 hours of sleep per night because researches have also found a link between stress and gut dysregulation which leads to a plethora of illnesses and factors such as PCOS and depression.
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Sources: Pakistan BioMedical Journal, Healthline, PCOS nutrition centre,
*Please consult your health care professional or visit your doctor before embarking on any diet or health program. This article is merely meant to inform and create awareness*
