bcpillWhen I was a 19-year-old in college, I decided to try the Pill. It soon became apparent that I’d made a big mistake: With every tiny disc I popped daily, my mood went further and further south and I was headed into very dark territory. I was also experiencing extreme mood swings and bouts of anger I’d never had before.

After about two months of that emotional disintegration, I stopped taking the pills–and within a few weeks, my moods improved and became more stable.

Thing is, at the time I started taking the Pill, I was already struggling with depression. It was obvious to me that the Pill was making the condition far worse than it had ever been. And that’s what I want to talk to you about today.

NEW STUDY FINDS DEPRESSION LINK

A new study of more than one million Danish women published in JAMA Psychiatry found that women who use hormone contraceptives–including the combined Pill (with synthetic estrogen and progesterone), “mini” Pill (with synthetic progesterone only), hormone IUD, patch and ring–are more likely to be diagnosed with depression and prescribed antidepressants for the first time than women who don’t use hormone birth control. And this risk is far higher for females between 15 and 19 years of age.

However, it may be that this increased likelihood of hormone birth control-related depression is true only for certain at-risk segments of women: Those who have a predisposition for depression or are currently battling depression as I was.

Here’s why: Past research has gone back and forth about hormone birth control’s role in depression–some studies claim to have found a link while others haven’t. Similarly, many women report mood changes on hormone birth control, while many others don’t. Then you have this study that claims that women using hormone contraception actually have a lower risk of depression. But, then the study authors go on to point out that women with depression tend to use hormone birth control less and, when they do try it, like me, they get off it pretty quickly, which may have impacted the study’s outcome. Which leaves us just as confused as before.

While this new study was unusually large–over one million women, making it more reliable–unfortunately, it didn’t compare the depression risk in women who use hormone birth control with the depression risk in women using hormone-free forms of birth control, which would be the best way to solidify the link. However, it did add one intriguing clue: It showed that teens had the highest risk of getting depressed while on hormone birth control.

Since teen females are already at a higher risk of depression than women who are older, this suggests that a predisposition for depression could be making the risk of experiencing depression from hormone birth control greater.

WHY THE LINK

Researchers believe the key culprit behind the increased depression risk is the synthetic progesterone. In hormone birth control, it helps prevent pregnancy by blocking ovulation as well as thickening cervical mucus, which helps stop sperm from joining the egg, and triggering changes the lining of the uterus to thwart implantation of a fertilized egg.

However, any natural cycling gal knows that once their Week 3 rolls around (the week right after ovulation), rising progesterone can also affect mood, triggering the blues, crying jags and even depression. Scientists believe it’s because progesterone reduces levels of mood-moderating brain chemicals, such as GABA and serotonin. So, if you’re sensitive to progesterone or are already dealing with down moods, taking the synthetic version of progesterone for three weeks or longer in a row could mean day after day of sadness caused by it.

Research suggests that the cycle-long lower level of estrogen in some hormone contraceptives may also play a role in initiating or exacerbating depression in some women since estrogen is a hormone that helps increase mood-lifting brain chemicals.

The sudden drop in estrogen during non-active hormone days may also be too severe for some birth control users since it doesn’t mimic the gradual estrogen drop-off that occurs in the premenstrual week of a natural cycle, leading to more intense premenstrual symptoms.

WHERE TO GO FROM HERE

I’m happy to say that my depression has been “in remission” for the past 21 years. But, since I know I’m at risk of recurrence, I do everything I can to increase my likelihood of staying depression-free, which includes sticking to a regular sleep routine, exercising, eating nutritious foods, taking multivitamins and extra vitamin D and avoiding depressants, like alcohol–and synthetic hormones.

If you struggle with depression or are at risk due to a past bout of depression and you’re considering hormone birth control, keep in mind that synthetic hormones can potentially impact your mood. So, talk with your health care provider about what effects it may have on you first.

If you’re a parent or guardian of a teen girl who wants to try hormone birth control, talk with her doctor about her mental health history. And, if she starts using hormone birth control, monitor her moods so you can detect any changes that may be related to the contraceptive she’s using.

I eventually opted for a hormone-free, but rather permanent, form of birth control–a tubal ligation–because that was the only reliable form of hormone-free birth control available years ago. Now there’s the hormone-free IUD, Paragard, which is a non-permanent form of hormone-free birth control that claims to be 99% effective. Like most birth control, it still has some risks, so talk to your gynecologist to see if it’s right for you.

Are you going through perimenopause or have other conditions that you heard over-the-counter progesterone may treat? The same advice applies to you: Before you take any kind of hormone–over-the-counter or prescription–talk with your doctor first since all hormones come with certain health risks. And if you’ve struggled with depression in the past or are currently dealing with it, bring it up to your doctor during your visit.