“Today in vindication,” wrote a woman on Twitter on Tuesday, summarizing the way many have received a striking new study that found those who use birth control — especially teenage girls — may be at a significantly higher risk of experiencing depression.
The research, published in JAMA Psychiatry, has been heralded as groundbreaking for its depth and breadth, even if it seems to only confirm what some women say they’ve been feeling for years — that their hormonal contraceptives make them sad.
Women who used the combined birth control pill, a mix of estrogen and progestin, were 23 percent more likely to be prescribed anti-depressants than nonusers, and progestin-only pills raised the likelihood by 34 percent. With the patch, antidepressant use doubled; risk increased by 60 percent for vaginal rings and 40 percent for hormonal IUDs.
And for teens age 15 to 19 taking combined oral contraceptives, the use of anti-depressants spiked 80 percent.
Although those percentages may seem shocking, the absolute change is a small but significant spike. Among women who did not use hormonal birth control, an average of 1.7 out of 100 began taking anti-depressants in a given year. That rate increased to 2.2 out of 100 if the women took birth control.
It’s the first study to conclude there might be a link between birth control and depression, author Øjvind Lidegaard told The Washington Post. Mood swings are often listed as a known side effect, but not clinical depression.
“It’s not in your head,” one woman wrote on Twitter, sharing the study results.
“This kinda research/publication is exactly what i was looking for,” said another.
One woman, who stopped taking the pill after it made her feel poorly, said she had wondered for years if that decision was an overreaction. “Feel vindicated now,” she tweeted.
But just as quickly as the study garnered praise, its findings were countered with skepticism from some in the scientific community.
It boiled down to this: The study, which analyzed the medical records of one million Danish women ages 15 to 34, revealed a correlation between depression and birth control, but it didn’t directly explore — or prove — that it was the birth control that explicitly caused that depression.
The study authors say they can come up with no other logical explanation, but in the absence of definitive evidence of causation, other scientific experts proposed counter theories for what might have caused the depression instead — among them, being lovesick and heartbroken.
“With having a million women, there are 101 things that are variable here,” Diana Mansour, vice president for clinical quality at the Faculty for Sexual & Reproductive Healthcare in London, told Metro UK. “There’s other things going on in their life like relationships, relationships breaking down and especially with adolescents — just being in a sexual relationship.”
Catherine Monk, an associate professor in psychiatry, obstetrics and gynecology at Columbia University Medical Center, offered a similar counter-theory.
“The possibility that this link between love, sex (contraception), and feeling depressed is strengthened by the fact that the contraception-depression link was strongest in adolescents, those who are at the developmental stage where trying to find a romantic partner is paramount,” Monk told the Huffington Post.
It did not take long for observations like these, published in stories about the study, to outrage some women online.
In a column for the Guardian, writer and birth control critic Holly Grigg-Spall called this rationalization “pillsplaining.”
“It seems that no study will ever be good enough for the medical community to take women’s experiences seriously,” Grigg-Spall wrote. “As soon as this research dropped, the experts lined up to deliver their usual mix of gaslighting and paternalistic platitudes.”
It’s apparently acceptable to blame women’s depression on the fact that they’re women, but it’s not OK to claim a powerful medication formulated from synthetic hormones could be at fault.
To me, and many other women, these Danish researchers are heroes and criticism of their methods … only highlights the incredible knots the medical establishment will twist itself into in order to deny there’s a problem with the pill.
Grigg-Spall’s column was shared widely online.
— (((Mychal))) (@feminist_doula) October 4, 2016
Lidegaard, co-author of the study and a professor at the University of Copenhagen, told The Post he was unsurprised — and undeterred — by the skepticism some have voiced over the research results. Their conclusion called for further research, although he said he expected women who have long reported mood changes while taking hormonal birth control to view the study as validation.
“It’s the first study which demonstrates high statistical correlation,” he said, explaining that criticism often accompanies any first in the science world but that “it doesn’t change the fact that we believe the results.”
The counter theories are interesting, Lidegaard said, but he emphasized that their research disproves them all.
And, he said, it’s important to note that not all women who use contraceptives are necessarily sexually active — some take birth control to manage acne, regulate periods and even prevent mood swings. All this, he said, makes his team believe is it quite unlikely that the correlation can be explained away by the narrative of a Taylor Swift breakup album.
“It’s not a trivial finding,” he said. “We have to realize that we have a new thing here that we have to be aware of.”
But, Lidegaard said, the intention of the study was not to incite widespread fear, something others in the science community emphasized as well. The average woman need not immediately halt use of all birth control methods — but they should be informed about what they’re putting in their bodies.
Hormonal contraception is just one of many contributors to depression development among women, Lidegaard said, but those who feel their birth control is making them unwell should discuss it with a doctor.
“Whatever you choose, there will be benefits and risks,” he said.
Ben Guarino contributed to this story.
This story has been updated.