I’m an undergrad at a state university in Ohio. Last night I got a phone call from a close friend from high school going to school several states away. She was in tears and expressed the fear the birth control pills were making her depressed.
We throw around the word “depression” a lot, but in this case what she told me about were several symptoms of what sounds like real depression, and they are very clearly connected to when she began taking oral contraceptive. I’m using this forum to ask for advice on how to approach this situation for a number of reasons. I’m not a counselor, and I’m also a long distance away, but I’m worried about my friend and want to make sure she’s ok.
The reason my friend thinks that her symptoms come from the pill are that they started when she started taking the pill and they tend to be a monthly cycle. Mostly, we’re talking about a strong feeling of disconnectedness and occasional urges to harm herself. This morning I found this article, which reinforces the point: http://www.aphroditewomenshealth.com/news/hormones_depression.shtml I told her to get rid of her pills. She said if she went to the doctor asking for new pills they would just prescribe the next generic on a list without really asking what kinds of problems she was having. She said she was afraid her boyfriend wouldn’t use a condom.
Both of these things worry me. I would like to insist she break up with her bf if he cares more about slightly less enjoyable sex than her mental health, but there’s more at play here than that. And I find it really said that someone so close to me is afraid to insist on something like that. Of course, depression makes all the things that cause that worse.
And I don’t know what to tell her about the doctor. Maybe she should ask about alternatives to hormonal contraceptives? Do you guys have any recommendations for dealing with doctors who just want to give you the next pill? I was thinking about telling her to specifically ask about nonhormonal contraceptives. Have any of you experienced mental health problems because of the pill or known someone who has? Do you have general advice for me?
9 Comments
Is there a planned parenthood clinic in her area? If so, they are generally excellent with patient care and respect as well as affordability. If her doctor will not discuss alternative birth control methods, this would be a good place for her to find a health care professional that will. She could consider lower dose pills, or go with an non-hormonal alternative like a diaphram, sponge, or IUD. Tell her to be clear about her symptoms from the pill as well when she discusses her reasons for looking for alternatives.
I agree that the thing with the boyfriend is troubling, but I do not think you insisting she break up with him will help matters here.
If this site can be trusted, depression may be a side effect. If she does not trust her doctor to listen to her, encourage her to find a new doctor.
Unfortunately I cannot offer any authoritative advice about alternatives, but you can learn about about barrier and implantable methods here, as those list non-hormonal non-surgical options.
And yeah, if the guy isn’t willing to wear a condom, she shouldn’t have sex with him. This is not just a matter of pregnancy — while the pill and other forms of contraception may be effective on that front, only a synthetic condom (not lambskin) offers protection against most STIs/STDs. Female condoms should work on this front, but there would likely be “comfort” issues here just as with male condoms. Her best approach is combine a condom (either male or female, not both) with some other form of protection to provide her one layer of protection against STIs/STDs and two layers of protection against pregnancy. She should consult a (trusted) doctor for more information to help her figure out which combination works best for her (maybe even adding a third layer).
Someone else here may have more/better information, though.
I wish your friend the best of luck. I think the advice above is great and have no expert qualifications, just wanted to say depression sucks, and I hope your friend gets the help she deserves (and the relationship she deserves).
Your friend is lucky to have someone who cares about her the way that you do.
Urges to harm yourself are absolutely not OK. Any reasonable doctor would be very, very concerned about that side effect. If your friend does not feel comfortable with her doctor, she should try to see someone else–at Planned Parenthood, a community clinic, or elsewhere–who she feels comfortable with and who listens to her.
Just to let you know, the most likely recommendation of any doctor in this situation will be to try a different hormonal method. That isn’t necessarily a bad idea. Every pill is different, and different in each person. Side effects are common, and many people need to try a few different kinds before finding one that works. If your friend were my patient (I’m a medical student), I might recommend trying the NuvaRing. Because it delivers hormones vaginally, the dose to the rest of your body is lower, and it tends to cause fewer side effects. I use it myself, having had some negative experiences with pills in the past. There are also, as Cathy has mentioned, some lower dose pills, as well as nonhormonal alternatives such as the diaphragm or IUD if she’d rather just avoid hormones at this point. A good doctor or nurse practitioner will talk through the possibilities and find a method that works for her.
I think the most important thing right now is to help your friend to regain control of her mental health and her reproductive health. I do hope that she one day is able to demand the respect she deserves in her relationship, but those sound like the most urgent things to help her to tackle first.
Has the relationship between the Nuvaring and yeast infections been positively linked?
That’s a good question. Many hormonal contraceptives, especially the higher dose ones, slightly increase the chances of developing a yeast infection. NuvaRing lists vaginitis (inflammation–this would include inflammation caused by yeast infection) among its most commonly reported side effects, so yes, I’m sure it is linked. But I’m not sure how the NuvaRing compares with other hormonal methods.
I experienced depressed mood when I first started taking birth control. Although I would already describe myself as an emotional person who cries a lot, during the first few months on the pill it was unbearable and out of control. I pretty much cried all the time, and not just a little silent tear here and there, but loud heaving sobs – and in public too. It was completely miserable, and the things I was crying about got completely irrational too. Like I had a fight with my boyfriend, okay it’s reasonable to cry about that, but then when we made up and he was really nice about it, I still couldn’t stop crying, and that made me cry even more because I thought he would be upset to know that I was crying.
I’m on the lowest hormone form of birth control: ortho tri cyclen lo. So when I went back to my doctor and told her about this, she said, well you’re already on the lowest dose possible so there’s not much that can be done in that respect. But she had originally prescribed me something like 12 months and she took that back and prescribed fewer months so I would have to follow up in a shorter period. She also said that only I can really know whether to stay on it or go off it, if it’s really that bad it may not be worth it, etc. I don’t know how helpful that is, it was just my experience.
And for the record, while I still cry a fair amount, I do think it has tapered off significantly now that I’ve been on the pill for a while (I started in November I think). Side effects do improve as your body adjusts. I personally set myself a time limit (that my boyfriend accepted and knew about), that if I was still feeling horrible X months in, I would stop taking it and we would have to go back to condoms. But it really has decreased significantly and I now enjoy some of the benefits beyond the no babies part – the lighter period, better regulated, etc.
Hiya! A friend of mine went through the same thing in High School, only she wasn’t able to connect it to her birth control for almost 6 months. When the connection was finally made, she went through a few months experimenting with different brands and hormone levels. Every woman’s body is different, and birth control pills come in all different doses, hormone ratios, forms, and everything!
Your friend is lucky she’s been able to pinpoint the source of her depression so quickly!
Just try to experiment with different pills: marvelon, yaz, and mercilon all have lower doses, and it’s the exact same dose every day (as opposed to different dose and ratio for each day of the cycle). She might also want to try skipping her periods to every-other month. If she’s finding that the depression comes with menstruation, she can simply reduce her exposure to that to maybe 6 or 7 times per year. Yaz has a great system of leaving you off for just 4 days, and in my experience it’s really REALLY successful with younger women.
Likewise, if she has health insurance the Minerva IUD is just amazing. If she’s worried about her partner using condoms diaphragms, sponges, and cervical caps might be a bit too risky in the pregnancy department.
I was one of the lucky people who found an oral contraceptive that worked almost perfectly for me the first time I tried one- but I’ve had a lot of friends and family members who didn’t have the same experience. My mom, when I was in high school, tried three or four different types of Pill before she found one that worked for her- I remember one of the ones she didn’t like caused dramatic mood swings. I also had a friend who had problems with depression on one of the types of Pill she used. It’s a relatively common side effect.
Your friend may be underestimating her doctor’s willingness to listen to her problems- I think the typical thing most doctors do IS go to the next pill on the list, because there’s really no way to know how any one pill will affect any one woman until she tries it, and that may well be the best way to find a prescription that works for her. Trial and error is often the most effective way to find BC that works for you. That said, if she distrusts her doctor for whatever reason, it might be good to encourage her to seek out another doctor, or to go to a clinic like Planned Parenthood if one is accessible to her. Even if they’re not going to do anything different, it might help if she felt more listened to.
I agree with you that the comment about her boyfriend is really troubling. While you probably shouldn’t outright tell her to break up with him – that tends to not have the effect you’re looking for – you could definitely open up a dialogue with her. Consider asking her, for instance, why she wants to stay with someone who doesn’t respect her reproductive health/choices. You might also suggest that she talk with her boyfriend about using condoms – it’s possible, since depression, at least in my experience, can sometimes make you feel very fatalistic and assume the worst, that she’s assuming her BF won’t be open to the idea without having actually talked about it with him. If that’s the case, it’s possible she’ll be pleasantly surprised. If she’s already talked with him, though, or if she goes ahead and does so and finds out that he’ll refuse to use condoms, it would definitely be a good idea to talk with her, like I said, about why she wants to stay with someone who doesn’t have her health and best interests at heart. You can’t make someone break up with a partner who’s bad news- but you can offer support- and gently plant the idea that your friend deserves better.
If there are dating/domestic violence resources in her area, you might want to point her in that direction. Men who engage in reproductive coercion (which is what refusing to wear a condom is) are very likely to be controlling (and potentially abusive) in other ways as well. Even if she doesn’t feel that she’s in an abusive relationship, these resources might be able to point out the warning signs that are present in her relationship, and might be able to help her find strategies for asserting herself.