Can Birth Control Help With Depression and Anxiety
Dingding Hu
If y'all think your contraception is making you anxious or depressed, you're not imagining things. Evolutionary psychologist Sarah E. Hill explains what happens to your brain on nascency command.
Most women know at to the lowest degree one or 2 other women who have had a bad reaction to the pill. In fact, the question that many of us have almost the pill: "Why does the pill make me crazy?"
Earlier I go into what the inquiry says about all this, let me simply address the elephant in the room — the whole thing most women'due south sex activity hormones influencing mood. Which they do. This might be the world'due south oldest platitude virtually women, just that doesn't make it any less true. Women'southward sexual practice hormones influence women'southward moods. Men's sex hormones affect men's moods. It would exist impossible for them not to.
Back to the question. To offset with, all of united states feel a piffling crazy sometimes. Life is hard and can make anyone feel anxious and overwhelmed at times. For some women, existence on the pill can magnify these feelings, leading to anxiety disorders and depression. Merely if these things happen to you, it doesn't mean yous're crazy; it just means y'all're on the wrong pill.
Mood-related issues like anxiety and depression are super-mutual among women on the pill. Almost half of all women who go on the pill end using it inside the beginning year considering of intolerable side effects, and the one most often cited is unpleasant changes in mood. Sometimes it's intolerable anxiety; other times, it's intolerable depression; or perhaps both simultaneously. And even though some women's doctors may tell them that those mood changes aren't real or of import, a growing torso of research suggests otherwise.
The Scandinavian nation of Kingdom of denmark is home to a number of nationwide registers, collections of data from its citizens on different health and social issues. Because all Danish citizens take a unique personal identification number, researchers have been able to link individual people'southward data across different registers, giving them access to tons of data about patterns of health and social behavior in a whole population.
From these registers, we've learned valuable lessons about the powerful effects that the birth control pill can have on mood. In the offset of these studies, the researchers looked at the records of all the healthy, nondepressed women living in Denmark between the ages of 15 and 34. They then followed the prescription and mental health records of these women (more a one thousand thousand of them) for 14 years to come across whether going on hormonal contraceptives influenced the likelihood of later being diagnosed with depression or being prescribed antidepressants.
The researchers constitute that women on hormonal contraceptives were l percent more likely to be diagnosed with depression half-dozen months later, compared with women who were not prescribed hormonal contraceptives during this fourth dimension. They also constitute the women on hormonal contraceptives were xl per centum more than probable to exist prescribed an antidepressant than were women who weren't prescribed hormonal contraceptives during this time. The results of this study, equally well equally others, suggest the pill can increase some women's take a chance of depression. This seemed particularly true for non-oral products (such as a patch, vaginal ring or hormonal IUD) and for young women (ages fifteen to 19), whose brains are not all the same washed developing and may exist more prone to the influence of hormonal signaling.
As a scientist, I'k obliged to point out nosotros don't know for certain that the pills acquired this increment. Correlation doesn't equal causation. Information technology's possible the researchers found pill taking and depression to be related considering they were each related to some other third variable. For case, women who seek medical interventions to forbid pregnancy might be more likely to seek medical interventions for depression. Or, getting into a new sexual relationship (which can prompt a pill prescription) could be what's increasing women's low risk.
However, the researchers statistically tested for the influence of a number of 3rd variables, and each of these tests found that hormonal contraceptives predicted low risk even afterward statistically controlling for these 3rd variables. Even though this wasn't a double-blind, placebo-controlled experiment, the researchers took great care with their study design and data analysis and the results were published in the New England Journal of Medicine, the top medical journal in the US.
More recently, the same team looked at whether hormonal contraceptives might increase women's run a risk of suicide. Researchers tracked hormonal contraceptive usage and suicide attempts and deaths in all Danish women who'd turned fifteen between 1996 and 2013. (As in their prior study, they did non include any women who had previously diagnosed psychological problems or who had used antidepressants. They also didn't include women already on hormonal contraceptives when they entered the report.) They followed the women for an average of eight years and then compared the likelihood of having attempted or successfully committed suicide amid the women who were prescribed hormonal contraceptives and those who were not.
The women on hormonal contraceptives were twice as likely to have attempted suicide during this time than the women not on hormonal contraceptives. Just the risk of successful suicide attempts was really higher: It was triple that of women not on hormonal contraceptives. As with low risk, the biggest negative impact of hormonal contraceptives on suicide gamble was constitute for young women (ages 15 to xix) on non-oral products.
When it comes to why the pill can mess with your mood, the ii systems that shoulder most of the blame are the HPA centrality and some of our neurotransmitter systems. Start, the HPA centrality (or hypothalamic-pituitary-adrenal axis). It's made up of 3 systems working together — the hypothalamus, the pituitary gland, the adrenal glands — and plays a cardinal role in the body's stress response. The type of blunting of the HPA axis nosotros tend to run into in pill-taking women is a known contributor to mental wellness problems, including the types of mood disturbances feature of PTSD. Because lacking the biological tools necessary to deal with stress literally harms your ability to cope, having a broken stress response might be a key player in the development of anxiety and depression. Information technology could besides harm emotional well-being in indirect ways through its negative impact on our ability to blot emotionally meaningful events from our environments.
The 2nd slice is the function that neurotransmitter systems play in making women feel lousy on the pill. Before I explain, I demand you to know three quick things.
Quick Thing ane: Neurotransmitters are chemicals that the brain uses to communicate with itself and the remainder of the body.
Quick Thing two: Excitatory neurotransmitters tell your encephalon cells to get ready for action, making them more likely to fire off messages to other brain cells.
Quick Thing iii: Inhibitory neurotransmitters tell your encephalon cells to slow their roll, making them less likely to fire off messages to other cells in the brain.
The almost prevalent and frequently used inhibitory neurotransmitter in the brain is GABA. It'south often on the scene in a large way when your brain is trying to tiresome itself downward. GABA gets released when you're relaxing in your PJ pants, and it's also released when doing things like meditation and yoga.
Interestingly, you tin get a relaxed GABA-rific experience from other things that stimulate GABA receptors, such as alcohol and benzodiazepines like Xanax. And our bodies actually produce compounds that work much like booze and Xanax. 1 of the about powerful is allopregnanolone, a neurosteroid. Information technology gets synthesized when progesterone is broken downward in the body and has the event of kicking-starting action by your GABA receptors.
Unfortunately for women on the pill, the bogus progestins in the pill don't seem to offer this same benefit. In fact, inquiry suggests that women on the pill may have lower levels of these natural sedatives relative to what's observed in its absence, regardless of the bespeak in the cycle.
This can mean bad news for women'southward mental health. When GABA receptors aren't properly stimulated, information technology'due south known to make people experience anxious, overwhelmed and depressed. A number of mental-health-related issues, including panic disorder, low, bipolar disorder and the mood-related symptoms of PMS, are characterized by lower-than-average levels of GABAergic activity. Lack of such activity can also increase a person'due south adventure of alcohol dependence.
Research suggests that changes in dopamine and serotonin signaling may also play a role in mood-related changes seen on the pill. Dopamine and serotonin, like GABA, are neurotransmitters. These chemicals come on the scene when we're spending time with people we love, eating hot fudge sundaes, falling in love, having sex and having orgasms.
Not surprisingly, these neurotransmitter systems modify what they do in response to women's cyclically changing sex hormones. In particular, the inquiry finds that estrogen makes rewarding things feel even more rewarding than they do in its absence and that progesterone attenuates these furnishings. Estrogen makes sex experience sexier, chocolate taste yummier, and getting status boosts feel heave-ier.
Given that the pill keeps estrogen levels low beyond the cycle and stimulates progesterone receptors, it's possible the pill might have the event of dampening reward processing in the encephalon. And if the world seems unrewarding, this makes united states feel depressed. One hallmark symptom of depression is that people no longer find pleasance in things that they used to find pleasance in. So it'south besides possible that the pill might increase a person's risk of depression past making pleasance less pleasurable. Consistent with this idea, research finds that pill-taking women — when compared with their naturally cycling counterparts — have a blunted positive emotional response to happy things and don't feel activeness in the reward centers of their brains when looking at pictures of their romantic partners.
Information technology seems pretty clear from the research that the pill can cause some women some pretty serious issues with their mental wellness, simply the science isn't yet at a point where we can make strong predictions about exactly what's going to happen to whom, and on what.
However, co-ordinate to the research, you lot might have a greater risk of experiencing negative mood effects on the pill if:
- You have a history of low or mental disease (although at that place is too testify that the pill can stabilize mood in certain women with mental affliction).
- You take a personal or family unit history of mood-related side effects on the nascence control pill.
- You lot are taking progestin-just pills.
- Y'all are using a non-oral production.
- Yous are taking multi-phasic pills (pills with an increasing dose of hormones across the cycle rather than a abiding dose).
- You are 19 or younger.
These bullet points tin give yous a starting betoken to initiate a conversation with your dr. nigh any mental health concerns. They aren't your fate, though. Fifty-fifty if you're an 18-year-quondam with a family history of low and you lot're on the birth control patch, if yous aren't experiencing signs of troubled mental health, the chances are incredibly low that you're going to suddenly develop mood issues from nativity command. This is especially true if you've been on information technology for a while and seem to be tolerating information technology well.
What's more, while some women feel negative mood changes on the pill, some women experience the contrary reaction. They experience a whole lot better and mentally healthier on the pill than off it. Research also finds that the pill tin offer huge mood-stabilizing benefits to women who take severe PMS.
The almost critical thing well-nigh the pill's effects will come from you lot: How exercise y'all feel on information technology?
Whatsoever time you start a new pill, please allow someone close to you know about information technology. Ask them to make notation and tell you lot if they notice any changes in your behavior that might suggest the onset of depression.
Considering the hormones in the pill influence what the brain does, information technology'due south almost incommunicable to separate out what the hormones are doing from who we are. We feel like the version of reality that is created past our brain on the pill is real. This tin make information technology difficult to find depression creeping in. Rather than feeling like the pill is messing with our mood, it just feels like our life is getting crappier or our job has gotten more stressful. If y'all tell your person that you are trying a new pill, they may be able to help you recognize issues that start to develop and then that you tin wait for a new pill or an alternative means of protecting yourself from pregnancy.
On superlative of this, consider keeping a periodical. If possible, beginning it before going on the pill and then you have a log of how you were feeling before and after. Having hard evidence of your mood prior to the pill can be a skilful manner for you to retrieve about your past more than considerately, making it easier to recognize whatsoever changes. In each entry, brand note of your mood, free energy level and well-being using some sort of scale (ane="I feel sad/anxious" and 10="I feel great"). This will aid y'all go on tabs on how things change for you (or not) when trying out a new pill.
If yous're already on the pill, it'due south not besides late to keep rail of how you're feeling. Make a note of your patterns. If you accept more happy days than pitiful ones, that probably means everything's on the right track. None of us feel happy all the time, but nosotros should feel happier more often than sad when things in our lives are going well. If y'all have fewer happy days than you retrieve yous should, talk to your doctor. It could exist time to endeavor a new pill or address an issue with your mental wellness that you've let go besides long.
Excerpted with permission from the new book This Is Your Brain on Birth Control: The Surprising Science of Women, Hormones, and the Police force of Unintended Consequences past Sarah E. Colina PhD. Published by Avery, an banner of Penguin Random House, LLC. © 2022 by Sarah E. Hill.
Watch her TEDxVienna Talk now:
Source: https://ideas.ted.com/how-the-birth-control-pill-affects-your-mood/
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