Q:  Birth Control Pills & Mood Symptoms

Hello Dr. Phelps -

My 18 year old daughter has been taking OrthoCyclen birth control pills for several months and we are concerned that it has caused an increase in depressive episodes and hostility .  Are you aware of any birth control pills that are not detrimental to the moods of a young woman diagnosed with depression or bipolar disorder?

Thank you for your help
 

Dear Kris --
Simple answer: no. Rarely satisfied to stop there, however, I press on: from what I've seen and what little I've read commenting on this (because there isn't much written about this, that I've run across anyway, and I look), there are some women whose mood symptoms will be quite a bit better on birth control pills (this is the dominant view in the literature; it is said to "maintain a constant hormonal environment" -- especially when they are used, as some OB-GYN's will authorize, at least in perimenopausal women, on a constant basis, i.e. omitting the placebo week). However, there are also women who will clearly be worse -- more mood instability especially, sometimes more depression. I saw a woman yesterday (young 20's) who'd figured out that the higher dose of estrogen in one pill was associated with depression, from trying that twice; whereas the lower dose of estrogen in another pill, one that didn't quite block breakthrough bleeding, did not have mood effects at all, as far as she could tell.

Dr. Phelps


Published July, 2004