Can birth control mess with the mind? Navigating pregnancy with mental disorders

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 consequences, shares her journey into exploring the effects of oral contraception on mental health.  “I actually spent my early career studying the way our sex hormones can affect psychological states and motivation…and the desire to attract romantic partners.” It wasn’t until Hill went off oral contraception herself that she began to connect the dots. “I started to feel so differently, that I started to really wonder what we did not know and about the way the pill affects the brain and the way that women experience the world.”

Hill recounts  her personal experience and the research she conducted on the Pill’s effects, highlighting a range of impact on physical and mental wellbeing. Everything from “having less energy” to “being at a greater risk for depression and anxiety,” and how “it can reduce sexual desire and sexual functioning.”

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

Dossetts points out  that society tends to attach  immense  joy to pregnancy and the celebration of pregnancy that women feel ashamed, even stigmatized, if they mention or complain about how they feel. “We're just realizing how common some of these challenges are in terms of mental health because we're just now at a point where we're allowing women to actually speak up about it.” Roughly “one out of every four to five women” suffer from some kind of mental disorder, Dossett says, with depression and  anxiety being most common.   

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

So, what options are available for  women who require medication and aspire to conceive? “The question is not really whether or not these medications are safe but it's more of a risk, risk analysis for each individual person,” Dossett says.  

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

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