Supporting Mental Health with Psychotherapy for Endometriosis
By Gabrielle McCarthy
BA, BSN (non-practicing RN), MEd (Candidate)Endometriosis is an incredibly painful condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus. This can affect areas such as the ovaries, the lining of the pelvis, and the perineum. However, endometriosis isn’t just about having painful periods; it’s a chronic, inflammatory disease that can cause a variety of physical and emotional challenges. Individuals with endometriosis often experience debilitating symptoms such as body-wide pain, bloating, constipation, IBS, back pain, fatigue, bladder issues, pain during intercourse, and mental health struggles. Infertility is also a common concern, which adds to the emotional toll. It’s estimated that up to 10% of premenopausal individuals with ovaries and a uterus are affected by endometriosis, with about 75% experiencing ongoing pelvic pain. Despite being classified as benign, the tissue implants can spread, causing long-term damage to affected organs.
The Impact of Endometriosis on Mental Health
Endometriosis is not just a physical health issue; it can deeply affect a person’s mental well-being. Chronic pain plays a significant role, but it’s not the only factor that links endometriosis with conditions like depression and anxiety.
Research indicates that women with endometriosis experience significantly higher rates of mental health conditions compared to the general population, with prevalence rates of 86% for depression, 29% for moderate to severe anxiety, and 68% for mood disorders overall.
Additionally, emerging evidence suggests a genetic link between endometriosis and various mental health conditions, including depression, anxiety, and eating disorders. These psychological symptoms often persist even after considering the physical pain associated with the condition.
Common psychological struggles for individuals with endometriosis include:
Depressive mood and feelings of hopelessness
A heightened sense of vigilance regarding the onset or worsening of symptoms
Social isolation and withdrawal from loved ones
Catastrophizing, or anticipating the worst outcome
feelings of grief, loss and anxiety related to infertility
A general sense of unsafety or uncertainty in life
Sadly, many individuals with endometriosis feel dismissed or unheard by their healthcare providers, which can further exacerbate these emotional struggles.
The Role of Psychotherapy in Supporting Individuals with Endometriosis
While there is no cure for endometriosis, psychotherapy can play a crucial role as part of an integrative approach in helping individuals manage the emotional and psychological impacts of endometriosis alongside medical care.
Validation and Empowerment: Psychotherapy helps to validate the experiences of individuals living with endometriosis, empowering them by offering tools for coping and self-care. This can be crucial for regaining a sense of control and agency in their lives.
Mind-Body Interventions: Therapeutic techniques like mindfulness, relaxation, and cognitive-behavioural approaches can reduce stress, manage pain, and minimize hypervigilance around symptoms. By teaching individuals how to reduce their physiological stress response, these methods can help improve their quality of life.
Space for Grief and Processing: Psychotherapy offers a safe space to process the grief and emotional challenges associated with reproductive health issues, such as infertility and living with a chronic health condition. It also provides support for navigating the impact of these challenges on interpersonal relationships, allowing individuals to explore and express their feelings in a supportive environment.
References:
Del Pino-Sedeño, T., Cabrera-Maroto, M., Abrante-Luis, A., González-Hernández, Y., & Ortiz, Herrera, M. C. (2024). Effectiveness of psychological interventions in endometriosis: a systematic review with meta-analysis. Frontiers in Psychology, 15, 1457842-. https://doi.org/10.3389/fpsyg.2024.1457842
van Stein, K., Schubert, K., Ditzen, B., & Weise, C. (2023). Understanding Psychological Symptoms of Endometriosis from a Research Domain Criteria Perspective. Journal of Clinical Medicine, 12(12), 4056-. https://doi.org/10.3390/jcm12124056
Koller D, Pathak GA, Wendt FR, et al. Epidemiologic and Genetic Associations of Endometriosis With Depression, Anxiety, and Eating Disorders. JAMA Netw Open. 2023;6(1):e2251214. doi:10.1001/jamanetworkopen.2022.51214