
Symptom Spotlight: Anxiety, Depression, And Binge Eating

Founder & Director, Integrative Medical Group of Irvine
Symptom Spotlight: Anxiety, Depression, And Binge Eating
Felice Gersh, MD
Full Transcript
PCOS Summit Course Overview 0:00
Hi. I'm Dr. Felice Gersh, your host for the PCOS SOS Summit. And here is the exciting news. I have created a unique never before done course six modules on PCOS just for you. This course is going to cover the six most prevalent issues that women with PCOS face. And each module will be a deep dove with a formal lecture followed by Q&A to go all into the ins and outs and talk about the whys and the what to dos for each one of these topics. It includes such things as insulin resistance, mood, how to regulate and optimize normal periods, improving fertility.
How about issues like weight loss, resistance, and of course other issues involving things like your skin? That's not an optional thing for having a happy life. So we're going to deal with all of this and more in my sixth module course on PCOS. Now for this little talk that I'm giving to you right now,
Mood Disorders in PCOS 1:24
I want to talk about one of the important topics. It's not a little topic. It's huge. It's all about mood disorders in women with PCOS and how to optimize your mood. Lower anxiety and lower depression. Women with PCOS have 2 to 4 times the average from the regular population of women, incidence of anxiety and depression. Let me say that again 200 to 400% more anxiety and depression in women with PCOS than in the general population of women. This transforms the quality of lives of women with PCOS and there are a multitude of reasons for having these problems and many of them deal with the underlying issues of metabolic dysfunction, hormonal imbalances and often reactions to visible things such as overweight acne, hair loss and so on.
So there's a multitude of reasons why women with PCOS have such high rates of anxiety and depression. Another one is sleep problems. It turns out that women with PCOS have twice the incidence of sleep disordered breathing or asleep apnea, and any person who leads a life of sleep deprivation is going to have mood problems. What else? Women would PCOS often have? Binge eating disorder. They often eat abnormally restrictive diets, go on fed or fasting diets that are not appropriate. Fasting is great and I'd talk all about that and we'll talk all about that in my modules.
But fasting inappropriately without knowledge can be harmful. Just like everything you know, it's all about balance, about doing things correctly. And that's what I'm all about, is educating so you can make the best choices for your health and for your life. So having optimal mental health is not optional for having a good quality life. So many women with PCOS suffer from unrelenting anxiety and depression. Sometimes this is exacerbated by early age use of oral contraceptives, birth control pills, because they can actually impair mental health in a variety of ways.
And they're given to teens like even 12 year olds, 13, 14 year olds. And this can actually promote
Gut-Brain Axis and Nutrient Deficiencies 4:12
mental health problems in some young women. So these are really important things to know. And I want to impart all this knowledge to you. Now, women with PCOS who have emotional problems can benefit from a wide array of therapeutic options. Number one, like so many things involving PCOS, you have to do a deep dove into what is going on in that individual because often it could be nutrient deficient. It could be something as simple as a B-6 deficiency, B12 deficiency, B one deficiency, other types of deficiencies.
And why would women with PCOS have such deficiencies? Well, for reasons I mentioned, they often have very restrictive diets and they also often have malfunctioning of their intestinal tracts. And now we know this is like amazing. There's a gut brain axis. So if you have gut issues, you're also going to have brain issues and vice versa. If you have brain issues, you're going to have gut issues. We now know that women with PCOS almost inevitably have a leaky gut. And I'll talk to you about what does that mean?
It's impaired gut barrier. Toxic chemicals and bacteria that reside in the intestinal lumen in the area that should be contained and not invading our own body. Those chemicals and and microbes can actually pass between the wall lining cells, the the cells that become separated to a small degree, creating gaps. And that's what we call impaired gut barrier or leaky gut. And when those toxic materials come in,we call them endotoxins. They get into the body proper and can create inflammation. And the inflammation can be widespread involving the vascular system and can promote things like hypertension, but also the brain.
You can have neuroinflammation inflammation that occurs in the brain that can trigger emotional problems. So whenever we think of anxiety and depression, we have to consider repairing the gut. The gut is like the center of the universe we now understand. And coming from the gut comes everything good and bad. Short chain, fatty acids, all kinds of neurotransmitters, peptides, so many things. Vitamins are produced in the gut that involve all aspects of health, including mental health. So in my module on PCOS and mental health, we're going to talk a lot about the brain, the neurotransmitters in the brain, like acetylcholine and dopamine and serotonin.
And how you can optimize these neurotransmitters that are so important for cognition and mood. And by the way, those are two that are in evidently
Lifestyle and Nutritional Approaches 7:18
interlinked mood and cognition. So many women with PCOS who have mood disorders also have some degree of ADHD or focus problems or brain fog. And my goal is to help all of these problems to be improved through lifestyle. I'm going to deal with only nutraceuticals, herbals and lifestyle medicine. I do not prefer to start, except maybe we're talking about this would not be in my scope of practice. Someone who is actively suicidal. So I'm not talking about that group. Okay? I'm talking about people who just have and I wouldn't use the word just because this is huge, pervasive, just unrelenting anxiety and a low mood.
But they're not suicidal. Okay. So we'll call, you know, depressive states. We can deal with that using lifestyle medicine. In fact, when they did a study comparing exercise to SSRI, the most common types of antidepressants that are like Prozac and Lexapro and such. Guess which one? Exercise. Yes. Exercise did better to improve depression. Then the pharmaceuticals did. So I'm going to talk all about how to heal the gut, how to use herbal medicine, other forms of nutrients, what to test for all about the gut brain immune because we're talking about inflammation in the brain often and this new field of psychiatry called nutritional psychiatry and how changing the diet can affect the brain.
So there is so much that we're going to cover now. I am going to always include in all of my little talks what I'll call my Tip of the Day, because when we do the course module together, I'm going to do a deep dove into all of these things and more talking about mental health challenges and solutions for women with PCOS. But here's my Tip of the day. Guided meditations. I love guided meditation, so people may say, What is that? They're also called guided imagery. Now I am totally in favor of all forms of energy, medicine and different forms of meditation, all of them body work, which is also amazing acupuncture.
All of these are amazingly effective,
Guided Imagery for Vagal Tone 10:03
but some of them take more effort or training. One thing you have no need to get training in in is guided imagery. Guided imagery is how you can really transform your autonomic nervous system and increase vagal tone. And we're going to talk about the autonomic nervous system. It controls everything we don't think about. And there's two halves to it. Like everything the yin yang, there's the sympathetic, which is part of the stress response and the parasympathetic, which should be the baseline state, which is calm and even keeled.
And women with PCOS have more sympathetic and less parasympathetic. And the nerve that controls parasympathetic is the vagus nerve. So what we want to create is what's called more vagal tone, and we can do that through guided imagery. So guided imagery is where you listen to a beautiful voice with music in the background. It's wonderful. And it takes you on a visualization or a mind journey where you get to imagine yourself in a beautiful place and it takes you into a zone. Okay. And it is comparable to going through hypnosis or a deep meditative state, and you don't need any training.
All you need is to put your time into it. You have to devote yourself to acquiring restored mental health by taking the time out from your day to listen to a guided imagery or meditation for about 20 to 30 minutes because it doesn't work if you don't listen and then do what they tell you to do. Imagine yourself in beautiful places and imagine whatever they tell you as they take you down this journey in your mind to this beautiful place of peace and increasing vagal tone, which will improve your overall health and definitely your mental health.
And there are many different companies that have guided imagery, which I'll share in my actual module. But in the meantime, you can even go on Google and you know, you could put in a, you know, a Google search for guided imagery and you'll find them readily available and do it. Listen to them every day. You can get them for stress. You can get them for fertility, for pain, for insomnia. Get a couple, listen to them every day. Your mood will be better. Your overall health will be better. Mental health is not optional for a quality life.
And remember, there is no distinction between mind and body. These are interconnecting. The brain is not separate from the rest of the body. So better mental health, better body health and vice versa. And like I said, the gut and the brain are bi directional in their influences. So you won't want to miss this module or any of the modules in my PCOS Course I am putting my heart into this to help you to do better in every way with your PCOS.
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