Endometriosis is a condition that is characterized by tissue resembling the one that normally lines the uterus to grow and form lesions elsewhere in the body. These lesions swell with each menstrual cycle, but because they are located outside the uterus, they cannot leave the body with menstruation and cause local inflammation and pain.
Besides pain, women with endometriosis very often experience fatigue and psychological symptoms, such as anxiety and depression.
What are anxiety and depression?
Anxiety involves extreme feelings of fear and worry. Physical symptoms such as a racing heart, rapid breathing, and sweating also are common in people with anxiety.
Depression is characterized by constant negative thoughts and feelings. It can cause changes in eating and sleeping patterns, problems with concentration, and a loss of confidence. Many people with depression lose interest in things they once loved doing.
Relationship between endometriosis and anxiety, depression
It is not well understood how psychological factors and other endometriosis-related symptoms such as pain are correlated. However, there seems to be a mutual relationship between psychological problems and endometriosis-associated pain. Pain and other symptoms of endometriosis can lead directly to psychological problems, but research has shown that anxiety and depression also can alter the perception of pain.
Factors associated with anxiety and depression in endometriosis
There are several factors that are associated with anxiety and depression in endometriosis.
A diagnosis of endometriosis can take a long time — sometimes several years — and not knowing the cause of the symptoms and how to manage them can be a very frustrating experience.
Frequently, endometriosis symptoms are not taken seriously by friends and family members. Fatigue is confused with tiredness, and many people do not understand that the pain women with endometriosis experience is not comparable to the usual menstrual pain that most women know. The feeling of being misunderstood also may contribute to the development of psychologic problems such as anxiety and depression.
Many women with endometriosis also face fertility problems and struggle to get pregnant, which can cause a lot of stress and lead to anxiety and depression.
Most endometriosis treatments result in only temporary relief and symptoms often recur. Even when they are successful, some treatments such as hormonal therapy can negatively affect mood and emotional well-being. While surgery to treat endometriosis can reduce the level of depression, at least short-term, more drastic surgeries, such as a hysterectomy or oophorectomy, which are irreversible and cause infertility, also may cause anxiety and depression.
Coping with anxiety and depression
For women with endometriosis who are facing anxiety or depression, it is essential to receive adequate psychological support. Patients can ask their doctor if he or she can refer them to a psychologist or counselor, ideally one with interest in endometriosis. An endometriosis support group also can offer good support. Patients can exchange ideas with women who have had similar experiences and learn how they coped with particular challenges. This can be a local or online support group. Most countries have national endometriosis organizations that provide information about the condition and can help patients find a psychologist or support group.
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