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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!

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.

Photo source


About the Author

Amy Corbett Storch


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

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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  • Stephanie

    February 24, 2010 at 10:47 am

    I used the Copper T IUD and HIGHLY recommend it. It is 99.9% effective (no breaking, missing doses, using it incorrectly) and 100% hormone free!!! When I was ready for a second child I had it removed and become pregnant the next month. The most effective birth control method out there (except abstinence of course) and NO HORMONES!!

  • Someone Being Me

    February 24, 2010 at 11:18 am

    I had the exact same issue with my low dose birth control. After having my second son I was fine for the first six weeks then started taking the mini pill after my 6 week post partum checkup. Within a week or so I noticed I was a lot more emotional and started waking up angry every day. I got to the point where I was angry all day every day. So within 6 weeks of starting the pill I quit taking it. Not the ideal solution but it works until I stop breastfeeding. Then I will try going back to my regular pills which I never had any problems with. It could have been a combo of the pill and post partum depression but the pills definitely seemed to make things worse. After having my 1st son (whom I did not breastfeed) I had no problems going back on my regular pill immediately so who knows.

  • christina

    February 24, 2010 at 11:49 am

    Please repeat this to your doctor…print it out and bring it in if you don’t have the energy to rehash it or try to articulate what’s going on. This could be totally unrelated to the pill…regardless, it’s time to get some medical care here. You — and your baby — deserve it.

  • Bitts

    February 24, 2010 at 11:57 am

    Just wanted to chime in with some affirmation for C — YES YES YES! Hormonal birth control made me CUH-RAAAZY after having kids, even though (like you) I used the pill for 10 years before getting pregnant with no problems. Anxiety, depression, insomnia … it was awful. I used both the mini pill (which does not work — I have more than 1 friend who got pg on it even with correct use) and the Mirena. Both caused the same symptoms almost immediately. It took 2-4 weeks for the symptoms to wear off after I quit them but the difference was NIGHT AND DAY. Hormonal is NOT the benign, harmless, convenient cure-all we’re led to believe it is.
    Seriously, C — bag the hormonal birth control if it’s making you nuts. NOT WORTH IT. We are super-fertile, too, but we used a non-latex diaphragm for a while and it was great. I also used a thing called the Lea’s Shield for a while — also cool. Hell, ANYTHING is better than having to bury your screams in a pillow in the garage. I’ve BEEN THERE. It’s NOT NECESSARY.
    Having a tiny baby is super hard, don’t get me wrong … but it’s not supposed to feel that awful. This is not who you have to be just to avoid getting pregnant right away!

  • Olivia

    February 24, 2010 at 12:42 pm

    We are using condoms since I didn’t like the mini-pill. It might have contributed to decreasing milk supply, and it also seems silly to use hormonal bc when we are only have sex once a week or so (baby + breastfeeding hormones). We also aren’t confident enough with Fertility Awareness methods.
    I’m chuckling at the 45% of men who buy the wrong size condoms.

  • Kate

    February 24, 2010 at 12:50 pm

    We switched to the diaphragm after horrendous experience on multiple different HBCs. We now use it in some slight conjuction with the beginning of FAM – except neither I nor my husband can actually wrap my head around the concept of unprotected se when we aren’t willing to try to get pregnant.
    Quick question – has anyone ever actually been able to get a Lea’s shield? A friend of mine recommended it after hearing positive things about it (as better than a diaphragm) — and my OBGYN and my local Planned Parenthood had never heard of it, and couldn’t help me. In fact, PP didn’t even have diaphragms available either.
    When I went to my gynecologist for a diaphragm, they looked at me like I had two heads – underlined the less effective nature of it as compared to the pill, and made me feel like I was really old school for actually requesting one (IE, the nurse who saw me couldn’t even fit me, and I had to come back). So fair warning – if you don’t want HBC, sometimes you have to fight the doctor!

  • Bitts

    February 24, 2010 at 1:16 pm

    @Kate — I got my Lea’s Shield online. I had to get a script from the doc (I was going to a teaching hospital so the resident I saw was well-informed and up-to-date about it), fax it to the manufacturer and they sent the shield directly to me. I filled out all their paperwork online. It was VERY easy, but not covered by insurance. I think I spent maybe $60 on it? The instructions are detailed and they have an 800 number to talk you through inserting it the first few times. It’s hard to hold the phone while jamming a contraceptive device up your hoo-ha, let me just say.
    I preferred my diaphragm because it was easier to put in. BUT the Lea’s Shield is more effective, so it’s a tradeoff.
    FWIW, DH got a vasectomy so we don’t use anything anymore. Highly recommended!!

  • JCF

    February 24, 2010 at 2:20 pm

    I’m so sorry you’re experiencing this! I really hope going off of hormonal birth control solves the problem for you.
    We’ve also had birth control issues–I don’t do well on anything hormonal, and I’m allergic to spermicide, which I found out the hard way (itching, burning, infections!). We now use a combination of LAM (Lactation-Amennorhea Method–you have to be seriously breastfeeding full time with no supplementing for the first 6 months of your baby’s life), FAM, and condoms. It certainly isn’t the most hassle-free combination of methods, but it works better for us than a crazy wife, or one who refuses to have sex because it hurts too much from the spermicide. If you’re interested, definitely read “Taking Charge of Your Fertility” by Toni Weschler.

  • Lisa

    February 24, 2010 at 2:24 pm

    Paraguard. That’s the copper IUD. Hurt SO BAD when they put it in 2 months ago, but love love LOVE IT.
    I also have a 4 month old. 🙂

  • heels

    February 24, 2010 at 2:28 pm

    I, too, couldn’t use the pill after having my first child. It made me crazy, even though I had used it for many, many years before. We now use condoms, which we were not terribly excited about, but have turned out to be a lot better than expected. I would look into an iud of some sort, but we’re finished having kids so he’s just going to get a vasectomy.

  • Erin

    February 24, 2010 at 3:28 pm

    Normally I don’t comment here because Amy pretty much gets it right every time. I just wanted to reaffirm her point about PPD. I felt fine! Great! Wonderful! for the first few months after my son was born. Eventually though, I started to feel the way you describe. I actually went a little crazy and fantasized about killing my cat because he meowed. (Don’t worry, the cat is fine) I thought it couldn’t possibly be PPD because it hadn’t started right away. I just thought I was a bad mother.
    Go see your doctor. PPD is very serious (you know that of course) and its important to not rule it out just beacuse you think its the HBC. At the very least, you can discuss other types of BC with your doctor.
    Best of luck. I hope you feel better soon. Those first few months are a doozy!

  • gizella

    February 24, 2010 at 4:11 pm

    i use the vaginal contraceptive films, for about 10 years now, and we have never had a scare. I can’t take hormonal pills etc due to a health condition, so that is where we are at. You have to wait 15 minutes for them to dissolve, but they last 3 hours. You have to use one every time you have sex, not just one for a marathon (wow, forgot about those actually)…that’s my 2 cents

  • Laura

    February 24, 2010 at 8:23 pm

    I am so sorry you are dealing with this. I understand completely. I could have written this myself as I have the PPD issues and a 4 month old. However, this is my second child. I had all those issues you are experiencing with #1, and I HATED my husband (who truly is wonderful) for being able to work and leaving me with my son. I dreaded life, never left the house, and counted the hours until my husband would come home so I could get a break. I also at the time was on the mini pill.
    Knowing I had this issue, with my second, I went on PPD meds before I gave birth. It’s a generic version of Welbutrin, and it is safe for breastfeeding. It’s like a patience pill, very helpful.
    For birth control, I am on Mirena. It’s extremely effective and also safe for breastfeeding (and most BCs aren’t, so be careful there). They seem to market it to women who have already given birth, and it is easy to take out in case you want to have another child.
    Between these two differences, my life is a 180 over where I was last time. Sure, there are bad moments, but I really think my PPD meds and birth control have helped a ton. Just some food for thought.
    Also, I hated hearing this when I was at your point, so I’m sorry for saying it to you, but this is so true. It WILL get better. I promise. The older he gets, the less you will dread your days. I know that doesn’t help you now, but you will not feel like this for the rest of your life.
    Good luck! And please check back. I’d love to hear how you are doing.

  • Jenny

    February 25, 2010 at 10:47 am

    I agree with Amy’s advice, and want to reiterate the need to not only stop the pill right away, but get yourself to the doctor for a PPD assessment. As Amy said, PPD can develop any time within the first year — certainly your depression could have been solely caused by the pill, but taking the pill could have exacerbated the situation as well. Your doctor will be able to help you identify other contraceptive options as well as help you determine if your depression is something more serious. Good luck to you, and I hope you are feeling better soon!

  • NGS

    February 25, 2010 at 12:33 pm

    Why are people such condom haters? It’s easy, it’s clean (no more wet spot!), and it avoids hormonal BC. I don’t notice a difference “in feeling” or comfort with a condom or without and my husband says he doesn’t either (he could be lying to me to make me feel better, but, hey, what a guy, right?). Sure, there’s a bit of awkwardness as we have to stop in the middle of foreplay to break the condom out of its little pouch, but it seems like a small price to pay.
    Count me in on the condom bandwagon!! Please join me!!

  • JennyMooMeow

    February 25, 2010 at 3:02 pm

    Bottom line. STOP. TAKING. THE. PILL. There are other ways to prevent pregnancy and get you back to normal.

  • anon

    February 25, 2010 at 3:22 pm

    The sponge alone will NOT prevent pregnancy.
    I know

  • Momof3

    February 25, 2010 at 10:35 pm

    I had the same experience after having my 3rd – SUPER depressed and CRAZY after starting the pill. We are super fertile too (3 kids in 2.5 years), but we now chart my cycle, use condoms and have a diaphragm and spermicide on hand as well. You can never be TOO safe, right?? I completely agree with the comment above about how the Dr will fight you not to get the diaphragm – you just have to stay tough. I reccomend reading Taking Charge of Your Fertility – fantastic book that really lets you know the ins and out of your cycle and makes it all make sense! Going off hormones does not equal an unplanned pregnancy! If you normally don’t like condoms shop for some on or somewhere similar where you can find different brands, ribbed, studded, etc. that you may like more than the average lubricated sold at grocery stores. Charting is fantastic, can’t say it enough, I bought a cute notebook, printed charts on cardstock and bought pretty marker pens, makes it a little less boring! If you don’t start to feel better in the next couple days definitely see a Dr, I felt better almost immediately after quitting the pill! GOOD LUCK!!

  • Trish

    February 26, 2010 at 11:02 pm

    Anyone heard of Cycle Beads and used them? They are a very simple fertility awareness method developed by Georgetown U. There’s some (well-designed) research to back up that they are 95% effective at preventing unplanned pregnancy when used correctly (that’s better than condoms but worse than the pill). Basically it’s a little circle of beads that have a small rubber ring which you move from bead to bead – there are dark brown beads for all your “low likelihood of pregnancy days” and glow-in-the-dark white (fun!) beads for days when you are likely to become pregnant. They developed this method based on women whose periods are regularly 26-32 days apart (I think, but don’t quote me on that). So if your periods are further apart or closer together, apparently they don’t work so well and you need a second method. However, something like 80% of all women have cycles that fall within that range. Just another option, and easier than charting and taking your temp and all that. I have not used them personally to prevent pregnancy (no probs with HBC so far), but I DID use them to help my husband and I know when I was likely to get pregnant. They were helpful in that regard. If anyone has used them for pregnancy prevention I would love to hear how they worked out. Otherwise, you might want to check them out for those of you who cannot or do not want to use another method. They were about $20.

  • Amy

    February 13, 2015 at 7:28 am

    Definitely try the standard coil (not the one with the hormone in). I have had trouble with the pill for years. Some left me feeling like I was going crazy. Eventually found one which minimised my emotional roller coaster, however I discovered the coil, had one fitted and indifference was almost immediat and dramatic. after years ofstruggling with my emotions, I felt human again. My husband noticed the difference to.
    Doctors main concern is to deal with unwanted pregnancy and ensure the pill is safe physiologically, but I believe they need to do far more extensive research on how it affects womens hormones which trigger psychological problems. I think is huge concern which is not being addressed. I for one will never go on the pill again.