Birth Control

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Dear Psyched,
I read that The Pill causes depression. I don’t want to go off my birth control. Now I am freaking out.
What should I do?
Not Trying to Be a Mom

Dear Better to Be Safe Than Sad,

I hate to hate on journalists, but when it comes to deciphering study results, they don’t have a great track record of getting the story straight. It’s not their fault though. Medical journals are basically written in greek and journalists often don’t have time or skill set to interpret the results based on the controls, methods, statistical power, limitations, etc.

Lucky for you, I do. Here’s the real deal: Two weeks ago, a landmark article was published in a top-notch medical journal, JAMA Psychiatry. The researchers found that of all women who were in the study (more than one million women total), .3% of women using hormonal birth control (including pills, patches, shots, IUDs) were diagnosed with depression. That is .02% more than women who were diagnosed with depression and not using birth control. So, if birth control was causing depression, it was only causing depression in .02% more women, which is not very convincing. Keep in mind that depression is a super common diagnosis that affects about 20% of women.

Because the study compared women on birth control to women not on birth control (instead of breaking down the different types), the researchers made a big assumption that they all had equal access to health care. Even in Denmark where the study was done, 2% opt-out.. It makes sense that a woman who is already using health care for her family planning needs would also visit a mental health professional. The opposite is also true.

Finally, the researchers made a big deal out of the fact that women start taking birth control before they have a positive diagnosis of depression. Women often begin taking birth control as teens, even if they aren’t sexually active. Depression typically begins to take shape once a person is in their 20s. Following this logic you could also say birthday cake candles lead to depression.

Here’s the bottom line: Keep taking the pill. If you start to have symptoms of depression, talk to your doctor. If the pill is to blame, you can easily switch to other methods of birth control.

XO, Psyched

P.S. Need Some Real Talk? E-Mail me and I’ll give it to you straight.