Therapy for PCOS

Nearly half of women with PCOS live with some degree of anxiety and depression.

 Anxiety can feel like tightening in your chest with worrisome thoughts racing through your mind making it impossible to focus or find peace, such as: What if my symptoms never go away? What if I caused my own suffering? What if I’m never able to have the relationship or family I’ve dreamed of? 

Depression, on the other hand, is the quiet robbing of your energy, motivation, and joy. Tasks that once felt simple now seem insurmountable. You question your worth and wonder if you’ll ever manage your symptoms and experience vitality. It’s hard to shake the sense of grief for the life you imagined you would live.

Over a third of women with PCOS have a comorbid diagnosis of binge-eating disorder and/or food addiction. The hormonal imbalances and insulin resistance inherent to PCOS magnify cravings, making the pull toward food almost “primal”. Our willpower is no match for our biology. Food becomes a source of comfort, a way to numb the feelings of disconnection, inadequacy, and shame that often accompany the condition.  Many find themselves struggling with relentless binge-and-restrict cycles that can feel like being caught in an unending war with their own body and mind.

Binging begins with a sense of unease—a gnawing tension or emptiness that demands to be filled. The act of eating becomes automatic, as you consume far more than your body needs, often of foods you might usually avoid. As the binge continues, guilt and shame creep in, mixing with the physical discomfort of overindulgence. When it’s over, there is a familiar  sense of loss of control and self-respect.

The regret induces a desire to restrict food, in hopes to regain control through rigid discipline. It starts with an intention to "undo" the binge, to prove to yourself that you can master your impulses. You might skip meals, count every calorie, or cut out entire food groups, convinced that this restraint will bring you closer to a healthy relationship with food. At first, restriction can feel empowering, like you’ve finally seized control over the chaos, but as hunger builds and your body cries out for nourishment, the fleeting nature of willpower becomes apparent. The deprivation only feeds the cravings, the pendulum is about to swing back towards the part of you that is susceptible to binging. 

One feeds the other—a binge driven by the rebellion against deprivation, and restriction fueled by the shame of overindulgence. 

I am interested in the way your relationship with nourishing yourself has led to changes in how your body works and maybe has led to an impediment in you doing the things in life that matter to you and being able to live your goals and values. 

For a woman suffering with PCOS, every glance in the mirror is a confronting reminder of the symptoms that indicate your lack of well being—unwanted hair growth, acne, weight that stubbornly resists even the most diligent efforts, and thinning/balding of the scalp. 

The emotional toll is exhausting. You might withdraw from social situations, feeling too self-conscious to be truly present. There is a sting of judgment, whether real or imagined, in every glance, every unsolicited comment, and every piece of “advice” on how to better care for yourself. The energy spent worrying about how others perceive you becomes a constant background noise, robbing you of joy and connection. PCOS doesn’t just alter your body; it can chip away at your confidence and your view of your own beauty and femininity.

The number one cause of infertility in women is PCOS. The experience of infertility can feel like an excruciating, silent heartbreak. For many there is a profound yearning to have a family of their own where they can nurture a child in a more attuned way from what they experienced growing up. Others feel a duty to pass down all the wisdom they’ve gained throughout their lives. Unfortunately, more often than not for women with PCOS, this hope is shattered by the stark reality of a body that doesn’t cooperate.

Every month becomes a rollercoaster of emotions. There’s the tentative hope when you track your cycle, schedule tests, or try new treatments. You want so desperately to believe that this time it will be different. Then comes the crushing disappointment when the test comes back negative, again. Each failed attempt feels as though your body is betraying you in the most intimate and fundamental way.

Between the time you start experiencing symptoms and when you get an official diagnosis, many years of unnamed suffering can pass by. Oftentimes, unless a woman is actively trying to conceive, doctors treat this condition symptomatically and un-urgently. Many are referred from doctor to doctor, all of whom specialize in one of their many symptoms. When we entrust healthcare professionals with our wellbeing and they can not help us, time and time again, we begin to question the hierarchy of expertise, after all only you live in your body 24/7. This is the experience of medical trauma. Every chronically ill patient has felt the deep seated hopelessness that arises when several “specialists” provide you with bandaids for your symptoms rather than putting in the time and effort to address the root cause. With each appointment, a core belief that no healthcare provider will ever care enough to get to the root cause is reaffirmed.

PCOS doesn’t just affect your body; it seeps into the fabric of your connections, influencing how you see yourself and how you believe others see you. It’s hard to explain the emotional toll to others who haven’t lived through it. Even well-meaning reassurances from friends and family can feel hollow and deepen loneliness.

Every failed attempt to “fix” yourself can feel like a personal failure, feeding a vicious cycle of frustration and hopelessness. On top of the stress of trying to manage symptoms. There is the lingering stress of uncertainty. Will I be able to have children? Will these symptoms ever get better? Will I ever feel comfortable in my own skin? Even the act of seeking help can be stressful. Navigating doctor’s appointments, managing medications, and advocating for yourself in a system that often dismisses women’s health concerns can feel exhausting and disheartening.