The Pill: The unspoken reality about its effect on mental health

Molly Pace explores the evidence around the pills effect on mental health, alongside her own experiences. 

There are roughly 100 million women worldwide taking the contraceptive pill, with about a fifth of these experiencing a heightened level of depression. This year, research confirmed the association between the pill and depression, providing much-needed recognition of women’s experiences with the pill. Shortly following this, the male contraceptive pill trials were terminated due to the identification of depressive side effects. Such effects, which a fifth of women live with every day, and often in the absence of appropriate support, were considered serious enough to stop male pill advancement. Is this just another example of underlying societal patriarchal views, or are the side-effects women experience minute in comparison to the effects of falling pregnant? 

I am someone who has lived with an eating disorder, anxiety and minor depressive tendencies for multiple years. The fact that the pill was handed to me with no serious warning about the extent to which it could change my weight, heighten anxiety and lower my mood is rather shocking. The hormonal changes it caused sent me on a downward spiral of anxiety, depression, self hate, and strain on my relationship, all caused by my repulsion to the idea that someone could love me in that state. Fortunately, my boyfriend recognized the changes I was experiencing as detrimental to my health, and made a link between the onset of my heightened anxiety and depression to the time I started the pill; he convinced me to stop taking it. 

After starting the pill, I went from being someone who gets anxious when attending social events or having days of low self-esteem, to being someone who had anxiety attacks that rendered me struggling to breathe, even when I was on runs (my usual safe-haven from my mind). My attitude towards myself worsened, leaving me feeling unbearably “done” with everything and, on few occasions, in a state so low that sadly I resorted to self-harm. This not only left me in an emotionally unstable, unmotivated state, but additionally brought strain upon my usually-rather-perfect relationship. 

Far too many days called for my boyfriend to calm me down from states of extreme anxiety, or coax me out the house and convince me that life was worth living. Often, my internal hatred would express itself outwardly as external bitterness, and would make me angry with my boyfriend for loving me. I would continuously attempt to convince him not to. My declining self-worth would not allow me to comprehend or accept love or happiness, because I felt so undeserving of them. I got to a place where I knew exactly what could make me happier, and purposefully avoided it in a self-deprecating cycle. 

My mental health history, and the fact that my boyfriend is aware of it, became my saving grace in this situation. I appreciate how lucky I am to have someone able to recognize my mean streaks as an unfortunate expression of my mental state rather than intentional acts of cruelty. Not experiencing pressure from my partner to stay on the pill also played a major role in providing me with relief. I can imagine an alternative situation in which a man might trivialise mood changes to be “just PMS” and request their girlfriend to stay on the pill because “sex doesn’t feel as good with a condom.” Whilst better sex is a considerable pro for taking the pill, mental health undoubtedly comes first. 

The recent release of the news that the male contraceptive pill trial was halted due to depressive side effects, which many of my friends and I have experienced, leads me to question whether my mental health is of less worth than a man’s. In no way am I suggesting that the male-pill trials should have continued, as I would not wish the emotional trauma of depression or anxiety on anyone. However, I do think it is vital that a deeper understanding of the crucial difference between manageable PMS symptoms and clinical depression is instilled in society. 

Women often ignore concerning character changes for the sake of better sex, fear of pregnancy or relationship pressure. The conversation about contraceptive methods should be had more frequently in relationships, and both partners should be aware of the possible side-effects contraceptive methods can have. In many cases, the responsibility of long term contraception is placed on women (fertile only 2-3 days a month) rather than males (fertile every single day) - a pressure that is overlooked by the majority of people. For now, we can hope that an ideal contraceptive pill with no side-effects is developed, and meanwhile, recognize when hormonal sideeffects become too large to endure.