“Birth control pills cause depression.”
Most people who take birth control pills do not become depressed because of them; trials show no average worsening of mood.
If you are on the pill or thinking about it, you do not need to expect depression; most users have no change in mood. If your mood clearly drops after starting or switching, that is worth acting on, because another pill or method may suit you better.
If you start or switch a pill, pay attention to your mood for the first few months, and talk to your prescriber if low mood shows up.
Safety note: Pills that contain estrogen raise the risk of blood clots and stroke and are not advised for people who have migraine with aura, a past blood clot, or who smoke and are 35 or older.
Talk to a healthcare professional if: you notice low mood, loss of interest or anxiety that starts or gets worse after beginning or switching a pill, especially if you are a teen or have had depression before. If you have thoughts of harming yourself, get help right away.
Randomized trials do not show that hormonal birth control worsens depressive symptoms on average, while large observational studies find a small rise in antidepressant use among users, especially teens, that may reflect other differences between users and non-users. Confidence is moderate because the trials are short and include few first-time or young users.
Most people who take birth control pills do not become depressed because of them; trials show no average worsening of mood. In a Danish study of more than 1 million women, those using hormonal birth control started an antidepressant slightly more often, about 2.2 versus 1.7 women per 100 each year, but that kind of study cannot prove the pill was the cause.
In a review of 12 randomized trials with 5,833 women, hormonal birth control did not worsen depressive symptoms compared with placebo over about three cycles, but first-time and young users were underrepresented. In the Danish study, combined pill users had a 23% higher rate of starting an antidepressant than non-users, and the link was stronger in teens aged 15 to 19 and in the first six months of use. A 2024 review of 43 studies found a slight increase in depression risk in women without past mental health problems and a slight protective effect in women who had them. Mood also depends on past mental health, menstrual symptoms and life events, so one person's response can differ from the average.
- de Wit AE, de Vries YA, de Boer MK, Scheper C, Fokkema AA, Schoevers RA, Giltay EJ. Hormonal contraceptive use and depressive symptoms: systematic review and network meta-analysis of randomised trials. BJPsych Open. 2021;7(4):e110. DOI: 10.1192/bjo.2021.64. PMID: 34099098. PMCID: PMC8220855
- Skovlund CW, Mørch LS, Kessing LV, Lidegaard Ø. Association of hormonal contraception with depression. JAMA Psychiatry. 2016;73(11):1154-1162. DOI: 10.1001/jamapsychiatry.2016.2387. PMID: 27680324
- Jahanfar S, Mortazavi J, Lapidow A, et al. Assessing the impact of contraceptive use on mental health among women of reproductive age: a systematic review. BMC Pregnancy and Childbirth. 2024;24(1):396. DOI: 10.1186/s12884-024-06587-9. PMID: 38816797. PMCID: PMC11137968
- US Centers for Disease Control and Prevention. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. Appendix D: Classifications for Combined Hormonal Contraceptives