Can Birth Control Disrupt the Mind? Navigating Pregnancy with Mental Illness

Sarah Hill, professor of social psychology at Texas Christian University and author of This Is Your Brain on Birth Control: The Surprising Science of Sex, Women, Hormones, and the Law of Unintended Consequencesshares her journey exploring the effects of oral contraception on mental health. “I spent my early career studying how our sex hormones can influence psychological states and motivation… and the desire to attract romantic partners.” It wasn’t until Hill herself went off oral contraception that she started to connect the dots. “I started feeling so different, that I really started to question what we didn’t know and how the pill affected the brain and the way women experience the world.”

Hill talks about her personal experience and the research she has done into the effects of the pill, highlighting a range of effects on physical and mental well-being. Everything from “having less energy” to “being at greater risk of depression and anxiety”, and how “it can reduce sexual desire and sexual function”.

Emily Dossett, a clinical associate professor of Psychiatry & Behavioral Sciences at the Keck School of Medicine of USC, discusses another often overlooked aspect of women’s health: the prevalence of mental health disorders before, during, and after pregnancy. Dossett points out that “pregnancy is a time of tremendous and rapid physiological change,” and that “if a woman is susceptible to anything, really; diabetes, hypertension, heart disease,” then pregnancies with those disorders “are more likely to come to the forefront or even come to the forefront for the first time. The same is true for mental health disorders.”

Dossett points out that society tends to place immense joy in pregnancy and the celebration of pregnancy, which can make women feel ashamed or even stigmatized for mentioning or complaining about their feelings. “We’re only realizing how prevalent these mental health challenges are because we’re now at a point where we’re allowing women to actually talk about them.” About “one in four to five women” suffer from some form of mental health disorder, Dossett says, with depression and anxiety being the most common.

Because there is little research on women’s mental health and pregnancy, Dossestt explains that there is a general “lack of understanding and comprehension and naming of these disorders in the mental health world.” And when it comes to medications, “the FDA, which approves all medications, does not allow pregnant or lactating people to be included in drug trials.”

So what options are available for women who need medication and want to get pregnant? “The question is not so much whether these medications are safe, but more of a risk assessment for each individual person,” says Dossett.

“I believe passionately that everyone has the right to have a child. Everyone has the right not to have a child, and everyone has the right to raise a child in a safe and healthy environment. Those are the principles of what we call reproductive justice. And I believe they apply to people with mental illness just as much as anyone else.”

In her book This Is Your Brain on Birth Control: The Surprising Science of Sex, Women, Hormones, and the Law of Unintended ConsequencesAuthor Sarah Hill admits she never connected the dots. “I had to find a blind spot with it, as I think a lot of us do… I really started to wonder what we didn’t know about the way the pill affects the brain and the way women experience the world.”

Sarah Hill, pictured here, says: “It wasn’t until I stopped (the pill) after being on it for so long that I started to feel so different.” Photo courtesy of Sarah Hill

Emily Dossett, pictured here, says pregnancy is a time of tremendous and rapid physiological change. Underlying health conditions are more likely to manifest or worsen. The same is true for mental illnesses.” Photo courtesy of the Keck School of Medicine at USC.

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