Even if you were the most even-keeled girl out there before you started taking BC, the onslaught of synthetic hormones found in most birth control methods can wreak havoc with your moods, says Elizabeth Reynoso, M.D., an ob-gyn with Drs. Goodman and Partridge in Arizona. All hormonal options contain some amount of a lab-formulated version of estrogen and progesterone, the two hormones that, along with testosterone, control your cycles. Reynoso says that occasionally traditional hormonal birth control can exacerbate depression and anxiety because of the effect hormones have on the intricate balance of serotonin, dopamine, GABA, and norepinephrine, all “feel-good” neurotransmitters in the brain. Estrogen in particular plays a role in depression, with too little causing a dip in serotonin—and once this happens, the ovaries produce less estrogen, starting a vicious cycle of feeling bad. On the other hand, too little progesterone is associated with anxiety since the hormone has a calming effect.
Who’s at risk? Women who have a personal or family history of depression or anxiety.
The worst offenders: While any hormonal birth control has the potential to make you depressed or anxious, the Norplant (an implant in your upper arm) has the worst track record, possibly because it is a progesterone-only device and further encourages an imbalance of hormones.
Consider switching to: Reynoso recommends first trying a method with no hormones or fewer hormones, such as the ParaGard IUD (intrauterine device) or Mirena IUD, respectively.