Intersection of Birth Control and Mental Health

In March of 2016, Kate Sloan was interviewed about the way birth control had affected her well-being.

In a word? Badly.

“A lot of the time, I wanted to die, but not enough to actually kill myself,” she says. “Sometimes I’d be out walking, and I’d see a big truck and think, If that hit me right now, I’d be okay with it.”

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A year later, in the spring of 2017, the Karolinska Institutet in Sweden in collaboration with the Stockholm School of Economics dropped what some people considered a bombshell announcement …and what others considered a long-awaited confirmation of what they’d already known for years.

Hormonal birth control can seriously mess with your well-being.

The double-blind study, published in the scientific journal Fertility and Sterility—not exactly the kind of magazine people leaf through while waiting for their flight to board—found that hormonal birth control adversely affected the areas of mood, energy, self-control and well-being. The study also contained a nugget of good news—taking hormonal birth control wasn’t shown to increase depression.

So, what to do now that you’re armed with this knowledge? Is it time to toss out your hormonal birth control and go birth control-less? Should you shrug and continue taking hormonal birth control no matter what? Throw your hands up and figure that there’s nothing you can do?

The answer: none of the above. The best thing you can do is analyze the facts, consider your own condition, and weigh your options. And we’re here to help you do that.ashley-batz-1298-unsplash.jpg

Just The Facts, Ma’am

It’s important to note that the changes observed in this clinical study were relatively small. But one woman’s “relatively small” is another woman’s “life-changingly large.” Or, in the words of the Karolinska Institutet:

In the case of individual women, however, the negative effect on quality of life may be of clinical importance.

Studies are large and anonymized. This particular study dealt with 340 women between the ages of eighteen and thirty-five, and the pills they were given were either a) placebo or b) ethinylestradiol and levonorgestrel. That means that, if you’re outside the age range of the study, or if your particular birth control contains different hormones, your mileage may vary.

Individual Attention

But if you are a) a woman between eighteen and thirty-five and b) you’re taking a combination ethinylestradiol and levonorgestrel pill, it would benefit you to prick up your ears.

Although terms like “well-being” can sound nebulous and abstract, when your well-being is being adversely impacted by hormones, it’s very real. In order to know if you’re being adversely affected by hormonal birth control, we recommend keeping tabs on how you feel. Keep a journal; note down your moods in the Notes app on your phone; send your mom texts. Do whatever needs to be done to keep yourself aware of how you feel.

It’s not navel-gazing; it’s taking care of your health.

Here are some questions you can ask yourself to get a better sense of how your mood/energy/well-being/self-control is faring:

–       Am I fatigued? Do I find it harder to get tasks done or get out of bed?

–       Am I experiencing mood swings? Do I find myself getting angry at things that normally don’t irritate me? Am I getting upset at things that usually wouldn’t faze me?

–       Do I feel worse than usual? Am I cranky, anxious or listless; am I getting the same amount of pleasure out of things that I used to?

It’s important to note that although the Karolinska Institutet reported that the hormonal birth control didn’t contribute to depression, one of the criteria of well-being included “depressed mood.” In other words, reduced well-being could lead to feeling the symptoms of depression without fitting the definition of capital-D depressed.

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Options, Options, Options

If you feel like you’ve been adversely affected by taking hormonal birth control, it’s time to realize a few things.

The first is this: you feelings are valid. In fact, in the realms of mood, energy, self-control and well-being, they’re everything. There’s no blood test that can tell you whether your moods have been swinging; you have to feel it.

The second thing: there are plenty of options when it comes to birth control. Don’t think that just because you’ve been prescribed a certain birth control pill that you have to stick with it. Check out other hormonal combinations of pills. Consider a non-hormonal option, like the IUD.  Inform your doctor that your feel bad—remembering, of course, that “I feel” is a legitimate phrase—and you want options.

It can be difficult to make a change, especially from a place interrupted by the adverse side effects of birth control. But realizing how important your well-being is and working to improve it is invaluable.

Just take it from Kate Sloan:

“It was only after I’d been off birth control for a few months that I began to realize I felt completely different—much happier, more productive and more capable.”

Whether or not you leave hormonal birth control for a non-hormone option, find a new combination of hormones that works for you. And if you’re one of the lucky women who finds themselves unaffected by the ethinylestradiol and levonorgestrel combination, remember: taking care of your feelings is imperative no matter who you are.  

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