Does the pill make you depressed?

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

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Women are about twice as likely to develop depression as men. Has the pill contributed to the gender imbalance that has so far been neglected?

Hormones are the conductors of the body: They transmit messages from the brain to the organs, control metabolic processes - and influence the psyche. This applies not only to well-known mood-makers such as serotonin and dopamine, but also to the sex hormones. Many women notice that their mood improves shortly before the fertile days and rushes into the basement when menstruation is imminent.

In this respect, it is not surprising that hormonal contraceptives also intervene in the psyche. To what extent, a large Danish study now shows: It reveals that women who take the pill may have a significantly higher risk of developing depression.

Researchers at the University of Copenhagen evaluated the data from more than one million girls and women aged 15 and 34, which came from Danish health registers.

Significantly more depression

Compared to women who did not use hormonal contraception, women who took a combination pill with progestin and estrogen were 20 percent more likely to develop depression. A progestin-only pill increased the risk by 30 percent, and the vaginal ring by as much as 60 percent. And women who used hormonal patches for contraception actually doubled their chances of developing depression.

The greatest risk of depression was six months after starting hormonal contraception - then the additional risk averaged 40 percent. After four to seven years it was only ten percent.

Young women particularly at risk

Particularly worrying: the risk for 15 to 19-year-olds increased the most. With a combination drug they developed up to 80 percent more often depression, with a progestogen-only pill even up to 120 percent. "Women of this age are particularly sensitive to risk factors for depression," says study director Charlotte Wessel Skovlund in an interview with

Adolescents are emotionally vulnerable

There are many mental disorders in particular during puberty. Every tenth adolescent develops an abnormality such as an eating or anxiety disorder, disturbed social behavior or even depression. The latter occur twice as often in girls as in boys. The investigation could partly provide an explanation for this.

In addition to the sex hormones, the main reason for the mental instability during puberty is, above all, remodeling work in the brain, experts speculate. In addition, there are a multitude of emotional challenges: pubescent people have to cope with the changes in their bodies, disconnect from their parents, develop an adult identity and find their place in the social fabric.

Only adolescent or already depressed?

The problem is that the symptoms of depression in adolescents are often misinterpreted as typical puberty behavior - for example, listlessness, irritability, mood swings, social withdrawal or a loss of performance. If such negative emotions solidify or get out of hand, they should be clarified by a specialist to be on the safe side.

Consider the risk of depression

In principle, Skovlund would not advise women against taking the pill: "Women, especially younger ones, should be aware that depression can be a possible side effect of hormonal contraceptives," says the researcher. This knowledge should be taken into account when considering the choice of a method of contraception. Stopping the pill when depression occurs can also be an effective measure against the emotional upset.

Source: Charlotte Wessel Skovlund et al .: Association of Hormonal Contraception With Depression, JAMA Psychiatry. Published online September 28, 2016. doi: 10.1001 / jamapsychiatry.2016.2387

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