[22F] Experiencing emotional instability with a history of PCOS

Patient Description

A 22-year-old female has been experiencing emotional instability for a few years, often triggered by stress or drama within close relationships. This emotional instability clouds her judgment and leads to actions driven by anger or frustration. She sometimes becomes inconsolable, crying easily, with episodes usually lasting a day but sometimes extending to a couple of days. She has noticed changes in her sleep patterns, with periods of sleeping too much and other times having difficulty staying asleep. She has not experienced changes in appetite or energy levels. She has had thoughts about self-harm but no desire to act on them. Additionally, she has become extremely indecisive and has lost interest or pleasure in activities she used to enjoy. Smoking marijuana helps manage her emotional instability, although she has stopped smoking cigarettes. She has not tried any treatments or therapies for her emotional instability or substance use. She has a family history of depression and was previously told she might be depressed, though it was not a formal diagnosis. She also has PCOS, diagnosed at age 17, and is currently taking birth control called Diane. She used to take metformin but no longer does. She has no known allergies or adverse reactions to medications and is not taking any over-the-counter medications, supplements, or herbal remedies.

Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

Emotional Instability and Related Symptoms

Depression: Given your family history of depression and the symptoms you've described (emotional instability, crying easily, indecisiveness, loss of interest in activities, and thoughts of self-harm), depression is a likely diagnosis. Depression can significantly impact your daily life and relationships, and it often requires professional treatment.
- Typical Treatments: Treatment for depression often includes a combination of therapy (such as cognitive-behavioral therapy or CBT), medication (such as antidepressants), and lifestyle changes. Your healthcare provider may also recommend support groups or other resources.
Anxiety Disorders: Emotional instability, especially when triggered by stress or relationship issues, can also be a sign of an anxiety disorder. Anxiety can manifest in various ways, including excessive worry, irritability, and difficulty concentrating.
- Typical Treatments: Treatment for anxiety disorders may include therapy (such as CBT), medication (such as anti-anxiety medications or antidepressants), and stress management techniques.

Hormonal Influences

Polycystic Ovary Syndrome (PCOS): PCOS can influence your hormones and potentially contribute to mood swings and emotional instability. Hormonal imbalances can affect your mental health and exacerbate symptoms of depression or anxiety.
- Typical Treatments: Managing PCOS often involves lifestyle changes (such as diet and exercise), medications to regulate menstrual cycles and hormones (like birth control pills), and sometimes medications like metformin to manage insulin levels.

What you can do

Emotional Instability and Related Symptoms

Seek Professional Help: Given the severity and duration of your symptoms, it's important to consult a mental health professional. They can provide a formal diagnosis and recommend appropriate treatment options.
- Therapy: Consider starting therapy with a licensed therapist who specializes in mood disorders. Cognitive-behavioral therapy (CBT) can be particularly effective.
- Medication: A psychiatrist can evaluate whether medication might be beneficial for managing your symptoms.
Healthy Coping Mechanisms: While smoking marijuana may provide temporary relief, it's important to find healthier coping mechanisms.
- Mindfulness and Relaxation Techniques: Practices like meditation, deep breathing exercises, and yoga can help manage stress and improve emotional stability.
- Physical Activity: Regular exercise can boost your mood and overall well-being. Aim for at least 150 minutes of moderate aerobic activity each week.
Support System: Lean on your support system, whether it's friends, family, or support groups. Talking about your feelings and experiences can provide emotional relief and perspective.

Hormonal Influences

PCOS Management: Continue managing your PCOS with the help of your healthcare provider. If you haven't already, discuss your emotional symptoms with them, as they may be related to your hormonal balance.
- Regular Check-ups: Keep up with regular medical check-ups to monitor your PCOS and overall health.
- Lifestyle Changes: Maintain a healthy diet and exercise routine to help manage PCOS symptoms.

What you should look out for

Given the complexity of your symptoms, it's important to seek medical care to ensure you receive the appropriate treatment. Reasons to seek care more urgently include:

Worsening Symptoms: If your emotional instability, thoughts of self-harm, or other symptoms worsen, seek immediate help from a mental health professional or go to the emergency department.
Physical Symptoms: If you experience any new or worsening physical symptoms related to PCOS or other health conditions, consult your healthcare provider.

Remember, while I can provide information and suggestions, it's crucial to seek care from real health professionals to receive a formal diagnosis and treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider. If you have more questions or need further assistance, feel free to continue the conversation.

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6 mo ago

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