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Birth Control & Postpartum Depression

By Amalah

smackdown_pill.jpgHi Amy!

I have been a long time reader and seem to recall you had issues with birth control and anxiety, depression? I have a 4 month old, and recently went back on the mini-pill to prevent another pregnancy so soon after my little boy was born. However, I feel awful. I was dealing with being a mommy pretty well I thought before I went on these, except for the obvious exhaustion with nighttime feedings and all of that. But I felt like a human, like I wanted to wake up each morning. Now though, even though my little boy is smiling and laughing and rolling over (yay!) I find no joy in waking up in the mornings, in fact my husband gets up with the baby every morning so I can get my extra rest, but really I just lay there mustering up the courage to get up and do it all over again. My little boy hardly ever cries but when he does, I feel like losing it. I have to sometimes put in him in the crib and just scream into pillows in the garage so he won’t hear me. I resent my husband every time he isn’t home to save me. I HATE feeling this way, especially since I am getting more sleep now, and my baby is way more fun than when he was a newborn. I think this is related to going back on the pill because the effects were almost immediate. I felt anxious 2 days after starting up again, and now it has just spiraled. I am stopping taking them tonight, but I wanted to know, is this common? I am breastfeeding, does this hormonal therapy add to the hormones of a bf mommy and make you crazy? I feel crazy. I have always been an optimist, someone who loves life, I wanted this baby more than anything, and I am lucky enough to be home with him! It’s everything I wanted, so it’s awful to not want to get out of bed in the morning.


So…..clearly I am stopping the pill, once I realized that might be it (yesterday while staring out the window). But, other than condoms are there other forms of “birth control” that work? We never did any sort of family planning, we basically had sex after I stopped taking the regular pill, which I did for 10 years with no issues, and I got pregnant, 20 days later. It was great! But now I am thinking I never want to take hormonal birth control, ever, again. I just want to be human again, and I don’t want to get pregnant right away either but would love to keep my marriage intact, intimacy-wise ;-). Please help!!

Thanks a bunch!
C

Yes, hormonal birth control — even low-dosage varieties — are known to aggravate symptoms of depression and anxiety, and perhaps even more so for postpartum depression (PPD). Pretty much every handout and info sheet out there cautions against hormonal birth control for women currently being treated for PPD.

Your case, however, sounds a tad bit different, since you didn’t have any symptoms of PPD until you started the mini-pill. So…sure. It definitely could be from the pill alone, and good for you for connecting those dots and stopping it. Pregnancy and birth and breastfeeding have your hormones already out of whack, so I can definitely buy that you could suddenly start having bad reactions to something you’ve taken in the past.

OR. It could seriously just be a coincidental case of Crap Timing. Regular ol’ garden variety PPD can actually start any time in the first year: three to four months is actually a pretty common starting point. So please, keep on top of your symptoms. Don’t automatically assume that you’re cured and it was all the pill’s fault and you just need to give yourself a few weeks to get it out of your system. And then a few weeks turns into a couple months and you still don’t feel like yourself. I certainly hope that the pill is what did it and you’ll be back to your old self in no time, but please please don’t rule out the chance that this is actual genuine PPD and will need to be addressed by your doctor.

As for non-hormonal birth control (NHBC) options, our commenters pretty much addressed every option out there on a recent question about IUDs and depression. Let’s round them up:

Over-the-Counter NHBC
* Condoms (latex, non-latex, lambskin)
* Contraceptive sponges
* Spermicide

Prescription NHBC
* Diaphragms
* Cervical caps
* Lea’s Shield
* Some IUDs

Other NHBC
* The Fertility Awareness Method (FAM)
* The Withdrawal (pull-out) Method

My! What a motley line-up we have here. The efficacy rate on some of these options may sound a bit depressing at first, but most couples end up doubling or tripling up (i.e. she gets a diaphragm or cap, he wears a condom, they both use spermicidal lube). And they may combine these with one of the methods from the “other” category, using the barriers only during her likely fertile times of the month.

Personally, I don’t have any experience with any of the prescription options. Or the sponge. We use a hodgepodge of the natural family planning methods (one thing infertility will give you is an almost painfully detailed awareness of what your body is and isn’t doing) and condoms. But we’re not the get-pregnant-within-the-first-20-days-of-trying couple. Or first 20 MONTHS, even.

A lot of couples mention latex sensitivities as the top reason condoms are a no-go, but non-latex versions are available (Durex Avanti and Trojan Supra) and are quite thin-looking, but are actually stronger than latex. And if your partner complains that condoms just “don’t fit” or “are uncomfortable,” take note! It’s probably not his penis. It’s his ego. A recent study found that 45% of men surveyed buy the WRONG SIZE condom, mostly because they dislike buying anything labeled “medium” or “small,” even if that’s what will fit them properly. Proper fit means better protection AND better sex, so maybe add condoms to your shopping list and actually consult the size guidelines. Then bring them home and toss the box, then ask him to go out and buy you some super-absorbancy tampons.

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About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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