An Anonymous

If you are a sexually active young woman it is extremely vital to protect yourself from unwanted pregnancies. While some couples wish to conceive, there are a lot of women out there who engage in penetrative sex with their male partners for other reasons and therefore need to use some form of contraception. Now, condoms may just do the trick for you. They have super high efficiency rates and protect you against sexually transmitted diseases and infections. But women in longer term sexual relationships may want to try non-barrier contraceptive methods after knowing that you and your partner are clean. So, you end up wanting to ditch the condoms, but you still want to prevent pregnancy. You naturally… or let’s say hopefully (please don’t use the pull-out method or adopt a ‘risk it’ mentality) decide to switch to another form of contraception. Your first thought probably was the pill. Why not? It’s even more effective than condoms, it’s easy to get a prescription, readily available (depending on where you’re living), and it’s noninvasive compared to its other counterparts like the implant, or intrauterine device and system . It probably seems like the perfect option for you! I certainly thought so. 

Now, I don’t want this to seem all doom and gloom, but “the perfect option” was far from the case for me. There are a multitude of somatic health reasons why the pill may not be suitable for you, but what I experienced was a hit to my mental health. And I am here today to share my story with you. If you are a prospective oral contraceptive user, a past user, a woman, or none of the above, I hope this article inspires you to think deeper about the risks of certain hormonal contraceptives and allows you to holistically weigh the options women are given for contraception. 

Now, let me set the record straight before I continue. I am not claiming that all hormonal birth control, or specifically the pill, is evil and should be banned permanently. The pill works differently for everyone. There is no one size fits all, especially considering the fact that there are different types. My experience detailed below is what happened to me when I started taking the combined oral contraceptive pill (COC). However, you could also take the progesterone only pill (AKA the “mini pill”)  and while COC may not work for you, the mini pill may and vice-versa. I just want to share my story, albeit a negative one, for a multitude of reasons. Primarily an educative one, but also for the purpose of solidarity. I was lucky enough to have studied psychology in my undergrad and was already familiar with the idea that the development of negative mental health symptoms is out of your hands. But for some women, the inability to continue on the pill may seem like a failure along the lines of: “other women handle it, why can’t I”, or even a failure to your partner to give them the intimacy of sex without a condom. I hope through my story I can show women that they are not alone and that discontinuation is not failure, but also encourage more women to come forward with similar stories.  

In my experience, the only time I had heard about the negative mental health effect of the pill was through some scattered personal stories on the internet. When I went to my nurse appointment, they did an excellent job of disclosing physical and somatic side-effects that I may experience, but I heard extremely little about the mental side. It was essentially chalked up to, “You may experience mood disturbances.” To me, that wasn’t a weighted term. I thought mood disturbances meant that I may be a little sensitive or slightly down at times, just like I had experienced on my period. And I could handle those, so surely the COC pill wouldn’t be any worse. I brushed the piece of information off and did not worry about it for a very long time. 

The COC pill really worked wonders for me the first 10 months I was on it. I did not experience any of the physical side effects that were told to me and it was protecting me against pregnancy. I really had thought that I found the perfect contraception. But unfortunately, this honeymoon period ended and what came after was something I had never experienced before in my life. 

I didn’t really struggle that much with mental health beforehand. I of course, like any other human, had a couple feats in the past, such as a period of panic attacks and some generalized anxiety symptoms, but it was never enough to warrant a diagnosis, or for me to feel like I needed to seek professional help. And by the time I had gone on the COC pill, I felt like I was able to deal with anxiety symptoms in a positive and effective way. 

The onset of my mood deterioration came very fast. It felt like I went from a happy individual to someone who was constantly stressed and generally dejected very quickly. The main culprit for my mood disturbances was experiencing obsessive compulsive disorder (OCD) like symptoms. To explain, they were confined to a very cognitive nature; I would think intrusive thoughts that were extremely distressing to me - as in they went against what I wanted to be thinking and who I intrinsically thought I was - and repeat them constantly over and over in my head. It was as if my mind couldn’t stray from the thought no matter how hard I tried or distracted myself. The fact that I was even thinking about these distressing thoughts was already causing me a considerable amount of mental anguish, but the fixation and obsession made me feel like a stranger in my own mind. Like I had absolutely no control in a place that I previously regarded as entirely my own. It also felt that I was never relaxed. My mind kept going on and on and on, racing around constantly. The only time I felt unaffected by it was when I slept. I tried to help myself as much as I could. I talked to family members and people I considered my support system at the time and attempted to live life normally in hopes that it would eventually go away. I would have some fun times, but I never felt as if I was truly happy in those moments. They were tainted by the way I was feeling underneath it all. I started to lose myself a little bit and wasn’t the happy and vivacious person I once was.  I doubt that this is shown to anyone I didn’t explicitly share these feelings with. I realised that I was quite good at hiding it. Despite seeming ‘normal’ on the outside, I still regard this time as one of, if not the, darkest moments in my life. 

As I approached the two month mark of feeling this way, I was starting to become defeated, as nothing I did helped me get out of the funk I was going through. It especially didn’t help that my negative mental health symptoms came when I had assignments due for university. I figured if I got past this time and went home for Christmas I would get better. Unfortunately, I was wrong. During the break, I was starting to notice signs of depression in me. I was constantly feeling sad, or almost numb at times, and was quick to cry or feel like I was always on the verge of tears. Nothing seemed pleasurable to me anymore as I knew that it wouldn’t distract me from my obsessive thoughts. It was harder to conceal the way I was feeling around my family now that my depressed mood kicked in. They took notice of it pretty quickly, and sat me down for a talk. I disclosed everything I was enduring and asked about seeking professional help once I went back to university. They were extremely receptive and instantly supported my decision. While letting all of it out to others was cathartic, I still thought that I would have to live with my symptoms until I went to a psychologist. It wasn’t until my mother suggested that the COC pill may be making me feel this way that I even considered its implications. 

Once I had lengthy discussion with just her, I realized that it would be within my best interest for my health to come off the COC pill and test to see what happens. I figured that if there wasn’t any change, I could start taking it again and continue looking for therapeutic options, but if there was then I would be able to remove the stimulus and get a better understanding of how my body reacts to the COC pill.

My road to recovery wasn’t magical in terms of it happening instantly. But approximately 2 weeks after l decided to stop taking the COC pill, I started to slowly feel like my normal self again and was experiencing my mental health symptoms less and less. It continued on like this until they essentially disappeared. About 2 years on, I can say that I don’t really have intrusive thoughts and intense ruminative thinking anymore, and if I do, I feel very way more equipped to deal with them than I ever was when on the COC pill.

Now something I have to discuss as someone who did their undergrad in psychology, is the power of placebo. It is not impossible that my recovery may have had something to do with some implicit bias in me that believed I would get better when I stopped taking the COC pill. I am not going to entirely deny that this may have implicated it. But based on the fact that I haven’t experienced a relapse in my symptoms since and how quickly I got better once I stopped, I think it is a strong contender for implicating and exacerbating my negative mental health symptoms. Additionally, talking to other women post my less than favourable experience and learning that they went through something similar further supports my theory. 

Even though my story comes off as a cautionary tale, I don’t want it to read as a campaign to ‘ban the pill’. While my experience with it was negative, there are tons of women who take the pill and do not experience any adverse mental health side effects. Additionally, it is important to consider the wonders easily available contraceptive methods have done for women’s reproductive rights. But I do believe that you can recognise this and still call for better prescribing practices and education. What I mean by this is having your nurse or doctor take time to go through the potential mental health problems you can face, especially if you already suffer from them. Also, to take extra care to remind you that you are in an open and safe place to freely discuss any mental health issues you experience while taking the pill. And lastly to make it very clear that if you are unhappy with the pill you are currently on you can discuss switching to an alternative one or using another form of birth control entirely. I would also like to add, please do not be afraid to ask your doctor questions and do not feel silly for bringing up things you have read on the internet or heard in person when doing your own research. If this decision may have an impact on your health, you have the right to access and understand all possible bits of information. 

As I’m coming to a close on this article, I just wanted to take the time to say that I hope that my story helped out whoever is reading in some way, shape, or form. Be it that you were thinking of starting the pill and wanted to educate yourself on the potential side-effects, you wanted to read about another woman’s experience that resembled yours, or you simply clicked because you were interested. Whatever the reason, I am glad that you decided to engage with my piece of writing and wanted to say thank you!