Thursday, January 5, 2012

Professional Spotlight - The Development and Evolution of a PCOS Mental Health Professional

In an earlier post for Power Up for PCOS, I wrote about my personal PCOS story.  It’s a saga that spans four decades, 22 surgeries, and an unbelievable number of tests, diagnoses, prescriptions, exercise plans, dietary approaches, supplements, and mental health practices.  If you missed it, you can read it here.

In addition to addressing all the medical issues, many of which were quite pressing, I had to do a lot of adapting, coping with stress, and changing of my mindset.  Back in the early days, I was stubborn and uneducated, not to mention inadequately supported.  Neither I nor my caregivers clearly understood the complexity of my condition, nor the tremendous sadness and grief associated with having a body that doesn’t look or perform like a normal female body, in spite of my concerted efforts.

There was a long, slow process of accepting the complete reality of the diagnosis, really learning about it, and applying what I know to help my body function better.  Although I’ve done a lot of this “processing” work, it’s an ever-changing state of mindfulness that I utilize to keep up with the complexities of my condition.  I’m hyper-sensitive to foods, changes in exercise, too much caffeine, alcohol or sugar, getting inadequate sleep, or missing my meditation time.  I know my body and my brain really well at this point, but it took a lot of misguided attempts to get me to the place I am today.

In the last few years, I’ve spent far too much time in doctor’s offices.  A lot of that time has resulted in fear, rage, frustration, and sadness.  I’ve had to accept that the western medical world has limited offerings, alternative health care is useful in some ways, but typically rather slow, and that almost no one gets why my condition frequently makes me so sad and angry.  Being a health psychologist, and a certified bereavement facilitator, with a deep and abiding fascination for our complex endocrine systems (I specialize in treating the psychological aspects of endocrine disorders such as PCOS, diabetes, thyroid cancer, and infertility), I realized that there are two things missing in the treatment of PCOS.

One is an attention to the mental health issues.  Women with PCOS commonly have depression, dysthymia (a milder form of depression), anxiety, and even bipolar disorder.  Doctors are usually so focused on the physical symptoms that this part of the woman gets overlooked.  The other thing I realized is that an inter-disciplinary approach is not just useful but absolutely necessary.  You need an endocrinologist and a gynecologist, as well as a dietician and a psychologist, at the very least.  Ideally, you’ll have an internist as well.  And possibly a dermatologist, a reproductive endocrinologist, and a yoga instructor or meditation teacher.  That’s a big team, and you, the woman with PCOS, are right in the middle of it, managing that team. 

But it’s stressful to be making decisions about who to see, and how often.  Juggling exercise schedules and special dietary needs, worrying about infertility or dealing with infertility, addressing acne, hair, and weight issues – all of that is hugely stressful psychological, financially, and time-wise.  Our work lives, friendships, family time, and love lives are subject to the disruptions and demands of PCOS.

When I found Monika Woolsey, RD, of inCYST, I immediately decided to take the inCYST training so that I could solidify my understanding of the nutritional, physiological, and emotional issues of PCOS.  The inCYST training confirmed that I was on the right track in thinking about this condition as one that requires a team approach.  For us, the standard answers don’t apply.  We CAN exercise too much.  We CAN eat too little.  We DO have a lower stress tolerance than average.  We DO become depressed or even suicidal for seemingly no reason at all.  I wanted to be able to speak authoritatively, and not just anecdotally, about the complexities of PCOS.  I also wanted to be able to offer some solutions, as well as explanations, for what goes on psychologically for the PCOS patient.   

Awareness is key.  Knowledge is power.  Yet motivation is still sometimes difficult to muster, especially when you have a lot of information, and you’re not sure what’s accurate or appropriate or relevant to your own situation.  When you work with me, I look at you as a whole person, not just a woman with a specific mental health issue.  We look at motivation, blocks to success, things that trigger unproductive behaviors, and also process the grief issues about our imperfect bodies.  We talk about the right ways to get informed, implement a program of healthy changes, and create a workable stress management program.  I offer suggestions for further education and referrals to other PCOS-sensitive practitioners.  I keep an eye out for symptoms and side effects that develop as a result of other treatments (mood shifts from birth control pills, for example). 

You can find out more about the psychological impacts of PCOS, and how to cope with them, by reading my “Mental Health Monday” blog on, listening to my radio interviews with Monika Woolsey of and Sasha Ottey of (both archived on, purchasing my educational CD from PCOSChallenge, or by scheduling an in-person, phone, or Skype consultation with me.  I’m also available for public speaking and radio interviews that highlight issues of concern to women with PCOS.  And next year, you can look for my book on PCOS mental health issues, which explains a multi-pronged approach to successfully managing PCOS in much greater detail.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California.   She has completed the inCYST training.  She specializes in counseling women and couples who are coping with infertility, PCOS, diabetes, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. Gretchen or her practice, or obtain referrals in the Los Angeles area, please visit her website at, or e-mail her at  You can also follow her on Twitter @askdrgretchen. 

1 comment:

  1. We are soooooooo lucky to have Dr. Gretchen on our team!!!! and for those of you who feel connected to her she writes for us at inCYST every Monday. she also does Skype counseling. don't deny yourself the opportunity to work individually with her if your mental health pieces of PCOS are interfering with your intentions to take care of yourself.