A new research study links birth control usage, especially in teens, to a significantly higher risk of clinical depression. The September article, published in JAMA Psychiatry, confirms what many women have suspected for years – I’m not crazy and these pills are making me sad! Specifically, researchers studied over one million women from 1995 to 2013 and found that women using all types of hormonal contraception were associated with increased risk of depression and use of anti-depressants.
Interestingly, all forms of birth control hormones increased the risk of depression and the use of anti-depressants. Surprisingly to me, the pill form that is a combination of estrogen and progestin had the lowest risk associated with it, increasing the likelihood of antidepressant use to 23 percent. The pill that is only progestin increased the likelihood 34 percent. Antidepressant use was doubled with the use of the hormone patch and hormone IUDs increased the usage of anti-depressants 40 percent. The highest risk was associated with vaginal rings with an increase of 60 percent. The researchers also found that the use of anti-depressant risk increased 80 percent in teens ages 15-19 taking combined oral contraceptives.
Did you know that one of the commonly listed side effects on birth control inserts is depression? And now, this study seems to show a link to clinical depression for the first time. The research has also recently linked glaucoma and osteoporosis risk, which adds to the risk factors.
Obviously, many opponents came out and disparaged the study. Women’s bodies are very complex and their hormones, especially in the age range studied, are fluctuating. Thus, some felt that depression could be caused by other factors besides birth control hormones. One of the criticisms was that women, ages 15-34 may be under significant pressure to find a mate and may already have a higher rate of depression. The researchers anticipated for this and controlled for women who were sexually active and noted “therefore, sexual activity does not seem to be an important confounder for the association between the use of hormonal contraceptives and depression.”
Women have many choices for contraception. While some use it as a form of birth control, others use it to regulate their cycle, address acne, and even help with mood. Knowing your options and side effects in all these areas is essential before deciding on a method. Hopefully, understanding that clinical depression could be a side effect may cause some women to look into abstinence, natural family planning, or the copper IUD for birth control.
Whatever the method, women are finally getting validation when they say “it’s not in my head” and getting the vindication for experiencing depression from hormonal birth control. For my patients who use hormonal contraception, I recommend a high potency multi-vitamin, as B vitamins appear to be used at a higher rate. Also, fish oils have been shown through research to have a mood stabilizing effect. One to two grams of EPA/DHA taken three times daily is an effective mood-stabilizing dose. Also, monitor vitamin D levels as they can drop after discontinuing birth control and multiple studies indicate mood stabilization with the proper amounts of our sunshine hormone. Whatever you choose, do so with an educated practitioner who can help you navigate the pit falls of hormonal contraception and will help you find the best choice for your life!
Ian Hollaman, DC, MSc, IFMCP