I recently found out that a distant cousin of mine is in psych hospital for severe depression. This is not totally out of the blue, but the psychiatrist apparently thinks it was at least partially caused by her combined oral contraceptive pill.
Our minds and our bodies are closely linked. Science is gradually providing fragments of stories about how closely linked they really are.
As the public conversation about mental health is growing, and we are not so scared of revealing our own or our loved ones' suffering with mental illness, (thanks to the tireless individual campaigners and mental health organisations over the last 30 years). I have chatted with a number of people about this idea before posting it, and most had personal stories. My friends and colleagues talked about their bipolar or schitzophrenic siblings, their mother's postnatal depression, their own past mental breakdown, agoraphobia, trychotillomania (hair pulling), bulimia, paranoia, or basic depression, A websearch brings up a range of figures - most of them probably without much evidence - that somewhere around 30% to 50% of people will suffer diagnosable mental illness over their lifetime.
The physical effects of psychiatric medications are well known to those who take them, and to their loved ones. The link takes you to a book review. The story is appaling. I am going to read the book and look at Robert Whitaker's evidence and get back to you later maybe. But this post isn't about that.
Evidence is assembling about the relationship between prescription drugs and mental illness, that heart and cholesterol and NSAID medication can cause depression, anxiety, aggression, anorexia, memory loss, and a bunch of other things in about 1% of users.
Except did you notice this bit?
The MIND article says that the baldness medication Propecia can cause depression in 10% of users, via a suspected hormonal mechanism (suppression of testosterone).
Given that a websearch produces about a hundred thousand hits saying the combined oral contraceptive pill causes depression, plus forums full of heartbreaking stories,
Why did Scientific American not mention the pill? Are they worried that their readers might be sensitive to lady problems? Hardly. It's because there's a gaping chasm in the literature about psych effects ofCOCP for lady problems. Maybe a dozen, maybe twenty solid studies. After hunting very hard, I found three that I think are worth quoting.
Here's a paper from a 2009 pilot study from a psychiatrist at an Australian public hospital saying that depression is the most commonly cited reason for going off the pill, and depression related to contraceptive pill use is probably significant and there's not enough research and it should be investigated.
Here's a paper from a 2012 lit review by 4 people who seem not to have ever written anything else about gynecology, saying that despite not enough evidence and confounding variables, a few large studies say that women on the pill are probably not more depressed than those off the pill. And if you get depressed, you should stop taking it.
And another 2007 paper about a large number of women, written by clinical epidemiologists (folks who look very hard at stats about lots of sick people) saying that after removing confounding variables young Australian women on the pill aren't any more depressed than those not on the pill. And the longer you take the pill the less likely you are that you will be depressed.
Here are a few of the confounding variables
1) Women everywhere are more often diagnosed as depressed than men, apparently 23% against 11%. After women go through menopause it's 11% for both genders.
2) Some of that may be because of the menstrual cycle. There is a recently invented?discovered? psych illness called Premenstrual Dysphoric Disorder (PMDD) which basically means life sucks for the week or so before your period and you can't help but take it out on yourself & everyone else. A few pills have been marketed to dampen the hormonal oscillations and reduce PMDD. Lots of other things can help too. Pay particular attention to the diet & exercise notes because if it's supposed to be a serotonin depression mechanism, exercise is fabulous for lifting & maintaining serotonin.
3) It's not contraindicated for those already with depression or anxiety, ie women who are depressed anyway are prescribed the pill just as often as those who aren't. If a woman is already depressed when she starts the pill and she's still depressed on it - but differently depressed than she was before - how does the epidemiologist cope with the data? Remember that this can confound up to a quarter of subjects!
4) Women who get really depressed generally stop taking a pill, thus self-excluding themselves from any longitudinal studies. (What, are you going to tell a suffering woman that she should stay on it, make her & her family's life hell for the duration of a 5-year study just to give epidemiologists a statistically significant result?)
So anyway,
there's my distant cousin in the psych ward in some Perth hospital,
her 2 young kids are living at her mum's this week,
her fly-in fly-out husband is back at the mine for a fortnight,
and her psychiatrist has taken her off the combined oral contraceptive pill and substituted some juicy antidepressant. The gynecological issue she was taking it for is still around, if she can't be on the pill she may be looking at surgical sterilisation.
And Scholar only has a dozen mostly inconclusive studies since 2000.
If web-available stats on pill use are remotely accurate, about 100 million women are on the pill worldwide at any point in time. Up to a billion women may have tried it during their lives.
If 10% have mood disorders, anxiety, or depression, as a consequence of taking it (seems a reasonable guess given the testosterone-dropping hair medication above)
that's 10 million women!
some with stories like my cousin, some not so bad, some worse,
and one very fat profit margin for the usual pharmaceutical bad guys
And not enough research!
Not enough attention!
Not enough public & scientific care for women's health!
Tonight I am a bit angry. Can you tell?
Our minds and our bodies are closely linked. Science is gradually providing fragments of stories about how closely linked they really are.
As the public conversation about mental health is growing, and we are not so scared of revealing our own or our loved ones' suffering with mental illness, (thanks to the tireless individual campaigners and mental health organisations over the last 30 years). I have chatted with a number of people about this idea before posting it, and most had personal stories. My friends and colleagues talked about their bipolar or schitzophrenic siblings, their mother's postnatal depression, their own past mental breakdown, agoraphobia, trychotillomania (hair pulling), bulimia, paranoia, or basic depression, A websearch brings up a range of figures - most of them probably without much evidence - that somewhere around 30% to 50% of people will suffer diagnosable mental illness over their lifetime.
The physical effects of psychiatric medications are well known to those who take them, and to their loved ones. The link takes you to a book review. The story is appaling. I am going to read the book and look at Robert Whitaker's evidence and get back to you later maybe. But this post isn't about that.
Evidence is assembling about the relationship between prescription drugs and mental illness, that heart and cholesterol and NSAID medication can cause depression, anxiety, aggression, anorexia, memory loss, and a bunch of other things in about 1% of users.
Except did you notice this bit?
The MIND article says that the baldness medication Propecia can cause depression in 10% of users, via a suspected hormonal mechanism (suppression of testosterone).
Given that a websearch produces about a hundred thousand hits saying the combined oral contraceptive pill causes depression, plus forums full of heartbreaking stories,
Why did Scientific American not mention the pill? Are they worried that their readers might be sensitive to lady problems? Hardly. It's because there's a gaping chasm in the literature about psych effects ofCOCP for lady problems. Maybe a dozen, maybe twenty solid studies. After hunting very hard, I found three that I think are worth quoting.
Here's a paper from a 2009 pilot study from a psychiatrist at an Australian public hospital saying that depression is the most commonly cited reason for going off the pill, and depression related to contraceptive pill use is probably significant and there's not enough research and it should be investigated.
Here's a paper from a 2012 lit review by 4 people who seem not to have ever written anything else about gynecology, saying that despite not enough evidence and confounding variables, a few large studies say that women on the pill are probably not more depressed than those off the pill. And if you get depressed, you should stop taking it.
And another 2007 paper about a large number of women, written by clinical epidemiologists (folks who look very hard at stats about lots of sick people) saying that after removing confounding variables young Australian women on the pill aren't any more depressed than those not on the pill. And the longer you take the pill the less likely you are that you will be depressed.
Here are a few of the confounding variables
1) Women everywhere are more often diagnosed as depressed than men, apparently 23% against 11%. After women go through menopause it's 11% for both genders.
2) Some of that may be because of the menstrual cycle. There is a recently invented?discovered? psych illness called Premenstrual Dysphoric Disorder (PMDD) which basically means life sucks for the week or so before your period and you can't help but take it out on yourself & everyone else. A few pills have been marketed to dampen the hormonal oscillations and reduce PMDD. Lots of other things can help too. Pay particular attention to the diet & exercise notes because if it's supposed to be a serotonin depression mechanism, exercise is fabulous for lifting & maintaining serotonin.
3) It's not contraindicated for those already with depression or anxiety, ie women who are depressed anyway are prescribed the pill just as often as those who aren't. If a woman is already depressed when she starts the pill and she's still depressed on it - but differently depressed than she was before - how does the epidemiologist cope with the data? Remember that this can confound up to a quarter of subjects!
4) Women who get really depressed generally stop taking a pill, thus self-excluding themselves from any longitudinal studies. (What, are you going to tell a suffering woman that she should stay on it, make her & her family's life hell for the duration of a 5-year study just to give epidemiologists a statistically significant result?)
So anyway,
there's my distant cousin in the psych ward in some Perth hospital,
her 2 young kids are living at her mum's this week,
her fly-in fly-out husband is back at the mine for a fortnight,
and her psychiatrist has taken her off the combined oral contraceptive pill and substituted some juicy antidepressant. The gynecological issue she was taking it for is still around, if she can't be on the pill she may be looking at surgical sterilisation.
And Scholar only has a dozen mostly inconclusive studies since 2000.
If web-available stats on pill use are remotely accurate, about 100 million women are on the pill worldwide at any point in time. Up to a billion women may have tried it during their lives.
If 10% have mood disorders, anxiety, or depression, as a consequence of taking it (seems a reasonable guess given the testosterone-dropping hair medication above)
that's 10 million women!
some with stories like my cousin, some not so bad, some worse,
and one very fat profit margin for the usual pharmaceutical bad guys
And not enough research!
Not enough attention!
Not enough public & scientific care for women's health!
Tonight I am a bit angry. Can you tell?
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