The pill and depression: what we know

A link between hormonal contraceptives and depression has been confirmed for the first time, following a new study published in September from the University of Copenhagen, which has contributed definitively to this long-running global debate. The research arrived just before World Mental Health Day on the 10th of October, having tracked one million Danish women between the ages of 15 – 34 for over 13 years, becoming the largest study of its kind.

Women taking the combined oral contraceptive were found to be 23 per cent more likely to be diagnosed with depression, and those using progestin-only pills—also known as “the mini-pill”—were 34 per cent more likely. Adolescent women are at the greatest risk of developing depression, with an 80 per cent increase seen in those taking the combined pill—the risk is doubled for those taking the progestin-only pill. More worryingly, alternative hormone-based contraceptives often offered to women—such as the hormonal coil or IUS, the ring, or the patch—could increase depression at a much higher rate than either type of oral contraceptive. 

This calls into question the NHS’ emphasis on providing these ‘pill alternatives’, to young women in particular, over recent years. The principle is that they eliminate the risk of pregnancy as there is no need to remember to take a pill every day, but it could well be that the increased risk of depression outweighs this need. However, it is important to note that the study does not show that hormonal contraception directly causes depression, but only indicates an association.

The pill has been commonly linked to other problems such as: higher risks of deep vein thrombosis; weight gain; loss of libido; acne (both an increase or decrease), and nausea. Otherwise, it has not previously been usually linked to depression. Despite this, most pill brands do include depression and anxiety in their ‘potential side effects’ list.

A local female GP describes how in medical school, she was taught to be aware of the association between depression and the pill. She went on to explain that in a “historically male dominated field, depression was ‘dismissed’ as minor issue to deal with in comparison to unwanted pregnancy”. However, in this day and age, understanding the side effects —both mental and physical—is becoming increasingly important, particularly when it comes to communicating these to the general public so they are fully aware and can make decisions themselves.

One student spoke to The Mancunion about her experiences, after she was on the pill for over a year. She says she found herself “incredibly down all the time; the smallest thing could make me burst into tears. I didn’t see it until I came off the pill altogether.” She went on to explain how it influenced both her social and work life: “My housemates were worried about me and thought someone had died. I struggled concentrating on school work, and ended up having to resit two exams in my first year of university.”

Since coming off the pill, her moods are “much more stable and predictable”. She advises: “Talk to your doctor about anything that could possibly indicate depression. If you don’t feel like yourself after you start a new pill just change it. There are so many options and you don’t have to stick to something that makes your life miserable.”

According to The Guardian, one of the study’s authors, Øjvind Lidegaard, plans to next study the possible “association between taking hormonal birth control and attempting or committing suicide”.

In light of this latest research between the pill and women’s health, it is important to always read the package leaflet that comes with your prescriptions to fully understand the potential side effects yourself. If you are in any doubt, ask your doctor or refer to sexual health websites.