Depression on the pill? Is there anything to that?

Introduction

Depression is a mental illness characterized by the three main symptoms of “depressed mood”, loss of interest and lack of drive. It can be caused both from within the body itself, as well as by external factors such as taking medication. Depending on the severity of the change in mood and character, a distinction is made between mild, moderate and severe depression.

What influence does the pill have on depression?

The contraceptive pill is a hormone preparation which women have been using for a long time as a method of contraception. The aim of the small tablet is to prevent the woman’s ovulation so that no egg can be fertilised. To achieve this, however, it is necessary to intervene in the woman’s own regulated hormone balance.

The artificial supply of the female sex hormones oestrogen and progesterone causes hormone levels to rise which do not correspond to the natural cycle-dependent values. It is precisely the increased oestrogen levels that could explain the increased occurrence of depression when taking the contraceptive pill. The hormone oestrogen can reduce the release of our happiness hormone serotonin.

The serotonin deficiency caused by this can in turn manifest itself in a depressed mood or lack of drive. In women who take the contraceptive pill, the development of depression is observed particularly at the beginning of taking the pill. Over time the body gets used to the artificial intake of female sex hormones and can adapt.

During the first six months, however, depression is a common side effect, occurring in one to ten out of every hundred women and is therefore a “common side effect” according to the package insert. It is important to make it clear in this context that the most frequent first prescriptions are made during puberty. During this period, the hormone balance of every adolescent woman is in a process of change.

As the female sexual characteristics mature and the first bleeding begins, the female body is metaphorically flooded with hormones. Until the release of the hormones has returned to normal, the condition is seen as constantly changing. If young women therefore take the contraceptive pill relatively quickly after the first menstruation has begun, they are in a developmental phase which is naturally characterised by severe mood swings.

If additional external hormones are then given through the pill, the effect of the hormones increases. In addition to changing emotional sensations, there may also be changes in weight, for example. Depression is therefore rarely caused solely by taking the pill. On the contrary, genetic predispositions and additional external factors such as stress can promote the development of depression.

Depression by stopping the pill?

Stopping the pill does not usually cause depression. It is wrong to assume that there is a hormone deficiency when the pill is taken off. It usually only takes a few days for the female sex hormones to reach their cycle-dependent levels again.

In fact, the artificial intake of the contraceptive pill has only manipulated the maturation of the egg cell and ovulation while taking it by suppressing the actual control hormones. If no more hormones are artificially supplied, the control hormones recognise the drop in hormone concentration and cause the body’s own production to increase. However, this is then adapted to the woman’s cycle and finally causes ovulation to occur again.

However, the body’s own fluctuations in hormone levels do not have an effect on the psyche in the form of depression, but more physically on the mucous membrane of the uterus and the breast. Psychological changes in the form of mood swings before menstruation are more likely to be compared with irritability than deep depression. If depression nevertheless occurs after stopping the pill, the reasons for stopping the contraceptive should be questioned above all. If the desire for a child is not fulfilled and reactively leads to a depressive episode, the pill is not the cause of the depression. Personal motives must therefore always be questioned.