PCOS, Depression, and Me

Before I begin this post, I'd like to note that some topics may be a little uncomfortable or too much information for certain individuals. Please continue at your own risk, and don't come after me with pitchforks.

Ever since I was a young girl, I've been poked and prodded by doctors attempting to put a name to the condition I find myself in now, and every time my labs would come back essentially normal and the doctors would write me off as a fat kid, tell me to eat healthily and exercise more, and send me on my way.

This was at my mother's wedding,
before I began taking medication
for depression and to regulate my
periods.I know, I look thrilled.
2007 I think?

When I was about twelve, I started to get visits from someone people call "Aunt Flow." As is typical when you've never experienced something before, I just took what I'd been given as a natural part of life and moved on. It was also that year that I fell into a deep depression, often considering suicide, but knowing it was wrong and miserably trudging on. I went without treatment, and to this day often tell the story of standing in a lunch line when a boy with which I didn't typically get along asked if I had been "hit in the face with a football" because the circles under my eyes were so dark. 

Another oldie with (mostly) our dogs. We were babysitting
the retriever and the papillion. That little white mop was my
favorite dog ever - I miss her.

A couple years later, I saw a new doctor and was informed my periods were considered "irregular," at which point I began taking both birth control to regulate my periods, and an anti-depressant, because I guess it was clear I was in need of some kind of psychological intervention as well. My periods became regular, and I noticed an improvement of my moods while on the anti-depressant. For a while, everything was fine. Eventually, though, the prescriptions ran out of refills, and, because I didn't "feel" like I needed the medicine anymore (and I dislike taking medicine in the first place), we didn't make an effort to obtain more. 

March 2011 in front of my mother's house. About 240 pounds.

Fast forward to college, where I found myself speaking to a guidance counselor about my classes. Inexplicably, I began to sob. I was utterly confused, because she had treated me with nothing but kindness, was answering my questions satisfactorily, and I didn't feel particularly stressed about anything. She suggested I take advantage of the free counseling offered to students on campus, noting she had also used their facilities and found them to be quite helpful. After battling with my pride, I did just that. 

It's difficult to admit you need help - that something might be wrong with you which you cannot control. However, I went into my appointment hopeful I would find answers and a person there willing to give me the help I needed. While I was not particularly fond of my psychologist (he wanted me to lead our conversations, and that's not really how I work), he did refer me to the campus physicians to obtain medication for depression. 

My doctor was quite nice. He was one of those physicians whom you wait quite a while for in the waiting room, but it's always worth it because when he meets with you he gives you all the time you need and makes you feel like a person, not something to check off of his schedule. He was kind enough to work with me on getting the correct dosage of medication (and I believe he might have also put me on birth control again to regulate my periods - I can't quite recall), and I enjoyed seeing him whenever my check-ups came due. It is he who pointed out that depression is not a sign of weakness: it's a trial like anything else. Some people struggle with outward ailments, while my pain was internal. He was the one who gave me the hope and strength I had been searching for. 

September 2012 - A couple days
before giving birth to Sophia Grace.
About 250 pounds.

Now, a couple years later, I still struggle with depression and irregular periods, but I have a new diagnosis: Polycystic Ovary Syndrome. As many of you know, Charles and I have been attempting to conceive our second child for about five months now. As it took us only three months to conceive Sophia, and my periods had been essentially regular since after our marriage, and even the three months we had to abstain for medical reasons, I was surprised to find myself without a period for the last three months.

Understandably, I became frustrated. After waiting a couple of months to see if I would have a period on my own, I broke down and scheduled an appointment with a nurse practitioner at the hospital we hope to have our next child in. Of course, the day we went in, I began to spot (ie: a little blood - not considered a period.) As usual, she did blood tests - which of course came back normal - and wanted me to come back if I hadn't had a cycle in two more weeks. 

Two weeks came and went, but Aunt Flow was no where to be seen. Even my spotting was limited to that one day. When it came time to return, I excitedly did so, hoping to be able to move on in our quest to conceive. I was met with a diagnosis of probable PCOS, of which the symptoms are:

• Few or no menstrual periods, or anovulation (which means you might have a period, but no egg was dropped, which is crucial in conceiving.)
• Heavy, irregular vaginal bleeding.
• Hair loss from the scalp, and hair growth on the face, chest, back, stomach, thumbs, or toes (caused by high levels of male hormones aka androgens.)
• Acne and oily skin (also a result of androgens.)
• Depression or mood swings.
• Weight gain or upper body obesity (androgens.)
• Repeat miscarriages.
• Inability to become pregnant (because of the anovulation.)
• Symptoms of too much insulin and/or insulin resistance.*

My symptoms are in bold. (Sorry for the gruesome pictures you're undoubtedly having in your mind - I swear I'm not a fat, hairy, man-woman beast. There was this one time though, where an acquaintance was being nice and went to remove a long, blond hair from under my chin... except it was attached. I get those every once in a while. Thankfully most of what I would consider excess hair is blond - a lot of people aren't that lucky. I would also like to point out that some of my weight issues are due to poor diet and exercise - I can't blame it all on a medical condition. More on that in a bit.) While it would be optimal to not have anything wrong with me, it's nice to have a name for what I've been struggling with for many years. 

The nurse practitioner prescribed Metformin, a drug used to treat insulin resistance in both diabetics and women with PCOS. *This isn't to say I'm insulin resistant, necessarily, but it's best to treat me as such for the moment. I have been taking the medicine for six days now. More spotting has ensued, which may be a good sign. Charles and I are also to abstain or use contraception for a couple weeks to make sure I haven't recently gotten pregnant, then, if not, I am to take medicine to bring on a period (because not having one for too long can cause cancer and, frankly, you can't have children naturally if your body isn't doing what it takes to conceive them.)

So far I'm feeling alright. I get nauseated at night, but that's a possible side effect of the Metformin. It also recently occurred to me that treating the PCOS could definitely bode well for my depression problems, as it is a symptom of PCOS (which is why I mentioned my depression in the first place, as it is one of the worst things I have struggled and currently continue to struggle with.)

2007-ish... Back when I was dying my hair.

Another significant symptom of PCOS in my life is the weight gain. As previously mentioned, I have always been at least a little chubby. In middle school (when this all started) my solution was to give my all during P.E. class... and it worked. I lost some weight, but I still didn't feel confident about my body just because the other kids didn't approve of me (yeah - I was not one of the "popular" kids. Big shock, I know.) If I could go back and tell my younger self she was beautiful just the way she was and Susie Q's opinion didn't matter in the slightest, I definitely would. I really could have benefited from even a tenth of the confidence I have now.

In high school, I slowly gained a little more and a little more weight, until I got to a point where I no longer weighed myself because I knew it would only depress me further. I felt stuck and hopeless, and any attempt at reducing the pounds seemed fruitless. The photo to the right is of me with my Desert Harmony (Barbershop) section my last day at school in Las Vegas, Nevada. While I treasure the memory, every time I see this picture I am ashamed of how large I was.

November 2009 - Nearly 280 pounds.

Finally, my family moved to Missouri, where I can't say I was doing more exercising, but somehow I ended up losing around 20-30 pounds. I only know this because my family had started a new diet (we were chronic yo-yo'ers) shortly after I graduated, and we were required to weigh ourselves weekly.

Surprisingly, this diet worked... but my health declined and I was miserable. We had fallen prey to the HCG diet - 1000 calories a day (made up of essentially nothing), and a spray which was supposed to suppress our appetites. I remember being at work one day, and I started balling uncontrollably (it doesn't help that I was not on anti-depressants at the time) because I was so hungry that I couldn't think. We ended up going to get some real food which completely blew the diet but took me out of starvation mode. Many months later, I was still struggling with the after-effects, the worst of which being chronic, painful constipation. (If any of my former roommates are reading this, I'm sorry I clogged the toilet so much... I couldn't help it and I was really, really embarrassed!)

April 2011 - I was around 220 pounds here.

The human body requires, at a minimum, 1200 calories a day. If you're really, really active or a man, that won't be nearly enough. Additionally, "healthy" weight loss is about 1-2 pounds a week, while I was loosing that much each day. People, if a diet is so severe that you're losing that much weight and starving, it's not worth it and it's almost definitely not good for your body! Don't succumb to the temptation.

My second (and final) semester at school, I was a part of the Biggest Winner program, a Biggest Loser spin-off held at my college. I loved it. I ate about 1500 calories a day for the majority of it, then 1200 near the end. I also worked out about five times a week with my team. It was great! I think my team ended up in second place, which we shouldn't have gotten, but that's a story for another time. I felt great, I was looking great, and my depression was pretty well under control as long as I was constant with my exercising and eating habits. I went from about 250 pounds to 215 pounds. None of my pants fit, and I was loving it.

September 2012 - Just after giving birth. About 250 pounds.

Then the semester ended, I abandoned my precious gym and the pressures of being readily accountable for my health. At first, not much happened. I didn't eat everything in sight, but I certainly wasn't as careful as I had been before. Then I met and married Charles, all while having managed to keep the weight off whilst not prohibiting new weight to creep on.

And creep it did. Little by little, I gained here and there. Then I got pregnant, and while I attempted to eat healthily for the baby, that motivation was dashed when I learned she would not survive no matter what I did. Several especially difficult months ensued, and I was again about 250 or so pounds by the time I gave birth. I felt huge, and the awful emptiness of my arms didn't make it any easier.

Three months later, Charles and I were permitted to begin trying for another baby, although I'd been advised that losing a significant amount of weight would be very beneficial. As always, I knew the doctor was right, and was glad to inform him we'd joined a gym and were enjoying our benefits there. Then we moved thirty minutes away from said gym and couldn't afford to attend anymore.

Until about a month ago, I had done very little to improve my health. First, I tried making our meals from scratch so they would be more nutritious and I wouldn't have to worry about hidden causes of weight gain. Of course, that only works if the meals you make are actually healthy. Baked chicken chimichangas, though delicious, are not nutritious when you take into account all the cheese, butter, and sour cream it takes to make them and the fact that it's nearly impossible to have just one.

December 2012

My next step was adding more fruit into our diet. I was so, so tired of feeling like I was stuck in rice, pasta, and bread recipes. It was great to just eat an apple or a banana every once in a while, and for a couple weeks we filled bowls with fruits we both enjoy and happily munched away, feeling markedly better about ourselves.

However, it shortly became clear that my period was just not going to come completely unassisted, and the diagnosis I received required more action than just eating some fruit every now and then. So, now, what is the next step? The question of the "best" way to eat has long been in question, and not just for me. 

Since I had had success with calorie-counting before, that's where I started. I found something called "The Best Diet Plan," which outlined how to figure out how much protein, fats, and carbs you require daily, and explained the differences between trans-fat, saturated fat, monounsaturated fat, and unsaturated fat, as well as a little bit about the glycemic index, which is important for someone who may or may not be insulin resistant.

Polycystic Ovary Vs. Normal Ovary
Found here.

But there was no instruction on how to proceed to the next step. I knew how many calories I should be eating, and what they should consist of, but I didn't know what to do next. Complicating the matter, I also have to provide food for my husband, who would require almost a thousand more calories than I do a day.

Fortunately, my aunt had sent me a message the same day in response to an inquiry I had made on Facebook for low-GI recipes with some information on something called the "Slow-Carb Diet." Basically, you end up eating as much as you want of low-GI foods like vegetables, protein, and legumes, make sure to drink lots of water, then have one super awesome eat-anything-you-want day a week, and you're good. You don't count calories or anything, and both Charles and I get our fill without me having to worry about his portion versus mine.

I have personally found this way of eating to be quite enjoyable. I'm having to do more cooking (reconstituting dried beans, cooking meat, etc.) but I eat until I'm satisfied, and I don't feel at all guilty about what I ate, on top of which I love looking into my fridge and seeing a bunch of color. It makes my heart happy... literally!

Today, May 2013, about 270 pounds,
and all my messy-haired,oily-faced me-ness.

Additionally, a lot of my eating unhealthily has been due to laziness - I don't want to cook -insert healthier food option here- so I'd rather get it pre-made, or find anything that is. However, many things can be made to fit a lazy person's needs. For example, I made one or two pounds of pinto beans at once, bagged them up into two-cup baggies, and just grab one and dump it in a bowl when I want some. Done, and done. The same goes for meats and vegetables, although I love that many vegetables are perfectly delicious when raw.

The last couple of days, I have really wanted some sugary things I have in the house, but I know I just have to wait until Saturday and then I can have whatever I want, which is a great motivation. Homemade granola bars (which is what I have been craving) are already on that menu. In the meantime, I don't feel sluggish after eating meals, I sleep more soundly (because my body doesn't have all the extra calories running around, I'm guessing), and I can take honest pride in my nutrition.

As far as exercise is concerned, Charles and I have been getting out a little more, and I have been making an effort to be more active. At the moment, my goal is to get my nutrition under control and medications set, at which point we will move onto more significant exercise. (Getting used to a new medication and attempting to be appropriately active at the same time is actually quite difficult, in case you were wondering.)

Found here.

PCOS has been beating me both physically and emotionally for a good majority of my life, and I think it's time I kicked it in the face. My goal is to handle my symptoms by eating right, taking the appropriate medications, and eventually exercising more.

I may occasionally provide you, my wonderful readers, with updates, though I will try not to make them nearly as long as this post has been. I also want to take a moment to thank all those who have supported me throughout the years. Depression, whether it is brought on by PCOS or something else, is hard. It can really hurt your life. I have had many friends who have stuck by my side no matter how far away we are from each other, or what may be happening. You (my friends,) my Savior, and my family are great buoys of strength, and I wouldn't be here if not for a combination of all three. Thank you.

Oh, and as a treat for those who actually read this monster post, here's a picture of my sister and I when we were really little. Yes, that yellow thing is a bird hanging on to my skirt.

Do you know anyone who has struggled with PCOS, depression, or other unseen medical trials? If you have personally experienced something along these lines, what are the best ways you have been supported or given support to those you love?