On Your Mind Sex Ed

No Need to (Pill) Panic: Contraceptives + Depression

By Lindsey Lavoie, WHNP Gabi Powell

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Ahhhh, The Pill. The OG. For decades, this little guy’s been making it possible for Betties to prevent pregnancy until they’re ready! Periods more manageable! Overall, upgrading Betties’ lives for the better! But if oral contraceptive pills (OCPs) came at the cost of your mental health, would you risk it?

Several studies have shown an association between OCPs and increased depressive symptoms in teen girls. Quick pause for a few caveats about those findings. First, the OCP + depression evidence is mixed, with other studies detecting no association at all.  And second, the research regarding OCP’s causation of depression has not been compared to other hormonal + non-hormonal types of contraception.

Betties are already at higher risk of depression and while the OCP is assumed to cause depression in teens, the studies, as of now, only show an association between the two.



If you’re having trouble understanding the difference, try this on: It would be fair for me to say there’s an association between rain and people wiping out. However, is the rain fully to blame for the Betty who bit it, running through the rainstorm wearing high heels? Or that somebody juggling too heavy of a load and eats it on the sidewalk? You see, while rain increases the chance of a wipeout, it’s only one factor.




Depression can be linked with reproductive hormones – natural and pharmaceutical – introduced to the body (Think: post-partum depression, PMS + PMDD, and emotional + mood changes that happen during perimenopause). Meaning, depression in Betties is a real chicken-and-egg head-scratcher because these hormones can mimic or exacerbate the symptoms of depression – like fatigue, insomnia, and changes in appetite.


Another problem with making OCP the culprit for emotional stressors is it doesn’t account for the other numerous factors that can influence mental health – A change in relationship status, lifestyle habits like movement + diet + sleep.



Weighing the Benefits of Taking OCPs

Despite the OCP and depression connection, benefits associated with the pill have to come into play, because yes, every drug has risks and benefits.

Betties may be leaning on OCPs to help manage heavy periods, painful menstrual cramps, acne, endometriosis, or premenstrual syndrome (PMS). In fact, more than a third of OCP use in teens is attributed to these types of medical conditions. By expanding the narrative of OCP as only preventing pregnancy to OCP also actively treating, we see how OCP makes whole-self health possible for some Betties!

Weighing the Risks of Not Taking OCPs

And despite the studies, not taking OCP doesn’t exactly guarantee a Betty’s mental wellness. Forgoing the pill can bring on its own set of physical + mental health concerns:

• Increased risk for unplanned pregnancy + the anxiety that can come with this – stress related to abortion access or new parent stressors.

• Heavy or painful periods can lead to serious health problems + missing school/extracurricular activities


Here at Betty’s, we follow evidence-based medicine and put exaggerating fear campaigns on mute until we’ve got the data to legitimize a concern. In the case of OCP + Depression, here’s the TL:DR: we currently don’t have enough evidence to say oral contraceptives cause depression.

Getting on birth control is not a decision made lightly, Betties, which is why consulting your provider is crucial for making a fully-informed decision. Your unique mind + body makeup, family history + reasons for getting on OCP – all of these are elements your provider will take in to help weigh your risk or benefit of taking oral contraceptives.


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