When Your Birth Control Drives You Crazy

dear amalah,

so… birth control, eh? know anything about it? i’ve been breastfeeding or pregnant continuously for the past THREE YEARS and after baby number 2 was born back in january i grabbed my midwife by the shirt and all but screamed, “NO MOAR BABBY!” now, i don’t want to cut off all hope of ever having kids again as the husband and i BOTH are open to more children in the future… like, 4 or more years from now. so the logical answer was to get an IUD or IUC seeing as i am HORRIBLE at taking pills and i wanted the most effective birth control option out there.

herein lies the issue, i’ve had the mirena for 8 months now and seriously? it is teh AWESOME. i can’t feel it, i don’t have to remember anything, and you know what? i’m totally not pregnant! success! however, i might as well be pregnant. my acne (which, btw, i’ve always had the acne that pops up like cysts under the skin, YAY! SCARRING!) which wasn’t really that bad even when i was pregnant is horrific, i had lost 40 pounds postpartum only to gain it ALL BACK over the course of 8 months, insomnia and exhaustion stemming from said insomnia, and i have no drive for anything. no sex. no life. no motivation. unless i absolutely have to, i don’t get out of my pajamas to leave the house. i’ve had a history of GAD (generalized anxiety disorder) and depression all of my adult life and spent both pregnancies on some sort of anti-depressant, and now i seriously feel as if i’m not on anything and i’m having panic attacks every other day.

so there’s the background, here’s the serious issue playing tug of war in my brain: for 8 months i’ve hoped and prayed that this is all just coincidence, just going through a rut, whatever to keep from thinking that perhaps it is the mirena after all. my primary care physician suggested i make a daily log of all medications for 2 months before he toys around with my crazy pills just to make sure i actually take them like i’m supposed to and when i reached out to my friends to see what other reactions they’re having and it’s pretty much the same story from 75% of them (the other 25% have NO side effects whatsoever… bitches…) my midwife responded to my pleas of “should it stay or should it go?” with the message that yes, it can cause depression/anxiety to worsen and asked if i wanted it removed.

so do i keep it in or take it out? i know this sounds stupid, because seriously? a normal person would have had it removed, like, 6 months ago. it’s just that i’ve researched all my birth control options and the mirena WAS my best option. the copper IUD would have been even better, but you know what doesn’t mix well with copper in the cooch? a metal allergy. some of my friends are suffering in silence and some are taking 3 pills on TOP of having the mirena just to battle the side effects (mainly an anti-depressent, sleep aid and then adderall to combat the lack of motivation and scatterbrained behavior.) neither of those responses to the side effects sound like any way to live and yet the thought of constantly biting my nails while watching days pass if my period is 3 days late. before the 3 year pregnancy/breastfeeding stretch i could set my clocks off my periods, i could tell you the exact minute they would start every month. until we decided to have kids, we relied on that ancient natural family planning method (using the calender based off my periods) to have sex. have i mentioned i haven’t had a period in over 3 years? HAVEN’T HAD A PERIOD.

ok, so feel really awful at how poorly this was written and how AWESOME my thought processes are. YAY, MIRENA! YAY, TWO KIDS IN DIAPERS!

please halp before i remove the mirena myself and practice abstinence for the next 4 years.

supahmama 

The Down Side of Birth Control

Oh, dear. And here is where I completely send you over the edge with my incredibly less-than-helpful personal experience with birth control:

You wanna know the big reason I’ve gone and managed to have not one, but TWO pregnancy scares in under a year? Why I’ve not just sacked up and gone on the Pill or an IUD or like, anything vaguely reliable at all? Because hormonal birth control and I do not mix. DO NOT MIX.

Back in college, I opted for Depo Provera (the shot) and spent the next year regretting it, as it made me 1) gain weight, 2) break out, and 3) not ever want to have sex EVER. Like, yeah, I sure didn’t want to get pregnant, but I got the shot because I wanted to have sex occasionally. You know. With my new husband and all. The shot (ONE SHOT!) pretty much ruined things in that department for quite some time and I could not run away screaming from it fast enough.

So I switched to back to the Pill (which I’d been on since high school to regulate my ridiculously irregular and painful periods) and spent the next few years bouncing from brand to brand, trying to find one with the most tolerable side effects. Which, for me, included crippling anxiety coupled with crushing seasonal bouts of depression. FUN!

For awhile I tried balancing out the side effects with more medication. And then more medication to balance out THOSE side effects. Things improved when I went off the Pill to try to get pregnant, then cratered when I tried progesterone and Clomid for a few months. Once again my doctor started medicating the side effects of side effects and I seriously ended up practically suicidal. (Well, without the “practically” bit.) It was bad, and I swore that I would never again underestimate the effect that hormonal medications had on my mind and body. After a fortune in therapy, I got off of everything — from the Pill to my antidepressants and anti-anxiety meds — and seriously felt better than I had in over a decade.

Don’t Ignore Depression

Now, this is MY PERSONAL EXPERIENCE. My personal brain chemistry. I am not a doctor or a psychiatrist or even someone who has done extensive research on the subject. But since you did ask little ol’ me for advice, I have to say…please don’t underestimate the side effects you’re describing. Depression tends to move in one general direction: downward, worse, etc. I already do not like what I’m reading here, and so I’m having trouble grasping the whole “Mirena is awesome!” thing, because DUDE. You don’t have to live like that. You shouldn’t have to live like that. If your IUD is even SLIGHTLY POSSIBLY to blame for near-daily panic attacks and no sex drive and can’t-get-out-of-my-pajamas funks…TAKE IT THE HELL OUT.

If things don’t improve, well, get on the correct medications and then get an IUD put back in. I do get the whole “paralyzed into inaction by indecision” thing, because I’ve had it — it’s yet another classic symptom of anxiety and depression. You’re asking for help, which is yay! Very good! Very important first step! But now it’s time to DO SOMETHING and help yourself.

As for other birth control options: Personally, I’d shift responsibility to your husband for a little while, say…six months or so while you work out the hormones, re-establish a cycle and work with your physician to get your mental health back where it should be. I know condoms are like, frustratingly old-school but again — when your birth control is killing your sex drive, what’s the damn point? I can’t speak for men in general, but I’m pretty sure my husband would probably choose “sex with a condom” over “no sex at all.”

Once you get yourself back on track — either by determining that the Mirena was not the primary cause or by determining that it was, and waiting out the after-effects — perhaps look into some other options. The patch? Nuva-ring? While not as long-term as an IUD, they are at least a non-daily option that will last for a few months. OR if remembering to take a Pill really is the only obstacle, once again, INVOLVE YOUR HUSBAND. This affects BOTH OF YOU. Have HIM remind you to take the pill. Have HIM put it on your nightstand every night with a glass of water. Keep the bottle next to the coffeepot, have him scribble a Post-It note and stick it to the carafe before he leaves for work. Buy a dedicated “take your Pill” alarm clock. (And yes, if you have an iPhone, there are currently THREE pill-reminder apps available.)

Birth control is a team effort — not just the sole responsibility of the one with the womb. You made the joint decision to keep everyone’s bits intact for potential babies down the road (which is where we are too), but keeping everybody’s brains intact is pretty important too.