Can the pill really make you crazy/anxious/bitchy/depressed? We spoke with two experts to find out more about this link.
Everyone knows someone who swears that birth control made them depressed, anxious, crazy, jealous, or just a general monster.
Or maybe you were one of those people! It's a side effect that seems to have a lot of anecdotal support, but not much conclusive science behind it. Why do some people notice weird mood changes while on birth control and others don't? Why might one formulation affect you more than another? And most importantly, how do we know it's the birth control and not some other factor at play?
To find out more, BuzzFeed Life took a look at the research and reached out to two experts: Dr. Alyssa Dweck, board-certified OB-GYN and coauthor of V is For Vagina, and Nicole Petersen, Ph.D., a neuroscientist specializing in how hormones affect brain and behavior at the Semel Institute for Neuroscience & Human Behavior at UCLA School of Medicine.
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Overall, there is not strong evidence that birth control causes mood changes or mental health disorders.
There have been a lot of studies on this, but nothing has found a conclusive link between the two, Dweck tells BuzzFeed Life. In the past 15 years, there have been four major studies to look at this link. Here's a little bit more on those:
Two of the studies were inconclusive and didn't find any significant positive or negative mood effects from birth control. The first was a 2003 study that looked at 658 women taking birth control pills. They found that some women felt their premenstrual mood was worse on the pill while others thought it was better, and the only predictor of a worse mood was a history of depression. The next was a 2007 population-based study in Australia that looked at over 9,000 young women. They found that women taking birth control pills were no more likely to experience depressive symptoms than women not taking the pill, after adjusting for other factors. They also found that the likelihood of experiencing depressive symptoms while on the pill decreased as time went on.
The other two studies actually found positive mood effects associated with hormonal birth control. A 2011 population-based study in Finland looked at psychological effects while using birth control pills or the IUD. They found that any mental health effects were modest and mostly positive. And the most recent one was a 2013 population-based study in the U.S., which found that birth control users had lower levels of depressive symptoms on average compared to other women, and they were less likely to report a suicide attempt in the last year. They concluded that hormonal birth control may reduce depressive symptoms.
But these studies all come with limitations, and it's possible that they're not telling the whole story.
One major limitation is that it's hard to prove that any self-reported changes in mood or mental health (which are so individual and hard to pin down in the first place) are actually a result of taking hormonal birth control and not a result of a million other factors going on in each person's life, says Dweck. Not to mention that many people already have a preconceived notion that hormonal medications may alter your mood, so that could lead to a self-fulfilling prophecy or just cause you to attribute your strange symptoms to the pill rather than something else (like that you're severely stressed, overtired, sick, whatever).
Another issue is that people who have bad side effects on birth control may stop taking it, so the huge studies that compare people on and off birth control wouldn't necessarily account for those who already went off of it because it made them anxious or emotional.
Or it could be that these findings show the average experience most people have on birth control, which is great and helpful for most people, but it doesn't mean that there aren't some outliers who might react negatively. If some people experience positive mood changes and some experience negative mood changes and some stay the same, the average finding may look like there's no real change, says Petersen.
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What the research does tell us is that for the vast majority of people, hormonal birth control is well tolerated and does not influence your mood.
For lots of people, birth control can help with heavy periods, painful cramps, horrible acne, irregular cycles, and even conditions like PCOS and endometriosis, says Dweck. And hey, an improved mood wouldn't be too far off if you're getting benefits like this.
Of course, that doesn't mean that everyone will react to every medicine in the same way — just like allergy medicine might make you pass out while it makes your best friend twitchy and hyper. We're all different.