Tag Archives: hormones

Unwanted pregnancy far outweighs any side effects of contraception? How dare you say it’s that simple!

Women on hormonal contraception are more likely to be treated for depression

fullsizerender-1Recent research has shown that women taking hormonal contraception are more likely to be treated for depression. And we already know that those with pre-existing depression may have their symptoms worsened by the pill.

Tell us something we don’t know.

I’ve avoided hormonal contraception completely since a devastating experience in my teens. Mood changes are the top reason why people discontinue using the pill.

But some of the responses to this research have made me pretty angry. I’ve been trying to make sense of why for the last couple of days. Maybe this is really obvious stuff. But maybe it needs to be said again and again until people start to listen.

Unwanted pregnancy far outweighs ALL side effects?

The worst comment I‘ve seen is “avoiding an unwanted pregnancy far outweighs all the other side effects that could occur from a contraceptive”. That’s the sort of thing someone who hasn’t experienced depression might say. I wonder if an equally debilitating (and potentially life threatening) physical health problem would be treated so casually.

I was prescribed the combined pill in my teens with no guidance, no discussion of side effects and without being offered alternative options (I wrote about it in an old blog post here).

The causes of mental health problems are complex and under-researched – but I’ve always felt that the six months of desperation, confusion and trauma I suffered before realising the pill was to blame was the start of long term problems with depression and anxiety. I still occasionally have nightmares where I’m trapped in that time and those feelings.

I had an abortion in my twenties. Unwanted pregnancy can be awful (and can be associated with an increased risk of mental health problems too). But the mental health consequences of getting medication like hormonal contraception wrong can also be devastating – and can last a very long time.

When I posted these thoughts online, others immediately agreed – “Yes, yes, yes! I’ve had both an unwanted pregnancy and a termination and long-term mental health problems aggravated/caused by the pill. And it wasn’t the first one that was more traumatic and terrifying”.

I feel the need to clarify that I’m not suggesting people have terminations instead of taking the pill – but that I need to do this at all just shows how reductive the discourse on this topic tends to be.
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We need to talk about mental health and trying to conceive #takeoffthetape

Find out more about Mind's campaign here: http://www.mind.org.uk/get-involved/take-off-the-tape/

Find out more about Mind’s campaign here: http://www.mind.org.uk/get-involved/take-off-the-tape/

Mind has been asking people to #TakeOffTheTape and share something that makes them anxious. Something they haven’t spoken about before.

I thought I would use the opportunity to write about something that’s hardly spoken about at all.

I’m finding it incredibly hard to balance trying to conceive with managing my mental health.

We don’t talk about this. We don’t even talk about the first twelve weeks of pregnancy much (as I’m well aware from my work with the Miscarriage Association). Trying to conceive often happens in almost complete secrecy. I didn’t realise how it would interact with my fluctuating mental health and I wasn’t prepared.

It’s taken a while to get to this stage. The doctor who removed my coil last year strongly implied that it would be best to continue with my efforts to come off my Citalopram. She moved me to Sertraline (it’s considered safer in pregnancy) and told me to try and reduce my dose completely over the next month.

Coming off medication

In fact it took me three more months. I’ve been trying to come off anti depressants for a while anyway (after a muddled fifteen year relationship with them) and trying to conceive gave me the strength to make it through a hideous withdrawal period. It was probably the hardest thing I have ever done. Alex didn’t have much fun either. I’ve written about it here.

I’m more vulnerable to hormonal changes now. I still have very dark times when everything seems hopeless and I can’t see a way through the next ten minutes let alone the rest of my life. Difficult images and ideas jostle with an endless repetition of fears and doubts. Sometimes the same phrase over and over again. They whisper just below the surface of my consciousness. They’re loud enough to wear me down and shrink my focus to a single point of constant worry – but not quite conscious enough for me to recognise what’s happening in a way that helps me stop.

One these days I’m separated from the world by thick glass that bounces every negative thought straight back at me, infinitely magnified. My attention is forced inwards but my mind is everywhere but present, infecting all it can with worst case scenarios. I can’t look up and out, can’t see the variety of the world and my place in it, can’t take a long deep breath. My chest physically hurts and I feel constantly sick with the fight or flight chemicals flooding my poisoned body as it tries to deal with the powerful threat of my mind.

The inevitable uncertainty and lack of control

These times are getting further apart and each one adds detail to our understanding of the best way to manage them. But trying to conceive has made my anxiety worse. It’s given it another peg to hang its hat on. Issues with eating and body image are often about control (with an emphasis on control over your body) – and anxiety hates uncertainty. But trying to conceive is a very uncertain time. What my body does – and doesn’t do – isn’t completely under my control.

I was managing my mental health to the extent I felt I was in a position to come off medication – in order to do something that has made the problem worse again. The irony isn’t lost on me – although on bad days it just makes me  want to cry.
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PMT, hormones and withdrawal – treading on mood eggshells

Mood eggshellsIt’s fair to say I’m not compleeetely on top of things today.

The doctor moved me from Citalopram to Sertraline last month (slightly better for any potential pregnancies) and suggested I try and reduce the dose a little (again in preparation for the same). I wasn’t sure whether this was a good idea considering I’ve been struggling more recently – but also felt it was worth another go given a) things have started to be a little easier and b) the doctors are always telling me my old dose was sub therapeutic anyway (pah!).

Hormone smash

It was actually going pretty well until my period hit. Then those hormones smashed into me with a force I haven’t experienced for a while. Saturday was a real struggle, slow moving, anxious and crying on the kitchen floor (poor old confused Watson). Sunday was a little better – I felt exhausted and raw but calmer. We went to the Wildlife Photographer of the Year – it was good to get out of the normal routine but the crowds made me anxious and I cried in the bakery afterwards – overwhelmed by food choices for a birthday breakfast today. At least afterwards Al and I could laugh at some of my more ridiculous tearful utterings –  “I just want some nice bread” (sob).

Mood swings

And today I’m struggling with some serious mood swings. One moment I’m feeling calmer. I’m more on top of things and able to see ahead to all the joy in my life. The next it’s really black. My chest feels very tight, there’s no good memories anywhere and I can’t see a way through at all – the mental trickery of depression taken to an extreme. It seems to take almost nothing to trigger the change. I’m treading on mood eggshells and wary of the world. It’s tricky to trust in any individual moment.

It seems that both medication withdrawal and day to day management of my mental health is massively exacerbated by hormones at the moment. The worst weekend in October was a period weekend too. I need to recognise it and ride it out but it’s hard hard hard. Hopefully the worst will be over this month.

Writing, running and cake

Writing things down has helped – but on days like this I only feel myself when running. So I’m going to run and run and breathe deeply and listen to the world and watch Watson chase squirrels and hope I come back calmer – and ready for some birthday cake.

Pills and Pregnancy – when careless journalism damages vulnerable people

Pills panic

Sitting down at my desk this morning, I opened Twitter for my usual pre work browse. My eye was caught by this tweet, which linked to an article by the BBC ‘Antidepressants ‘could be risk to unborn babies”.

Of course, I clicked straight through. My recurrent depression and uneven support and information from mental health services means I have been on varying doses of Citalopram since I was 17 – almost 13 years now. For most of the last seven years I have been attempting to reduce my dose.

I have a range of support and techniques in place – Mindfulness, exercise, writing being the main ones. Despite these, I haven’t managed to get below 20mg. Above 20, all is well. Below 20, things become a slog, a constant joyless fight against endless rumination and negative fog.

I’m also almost 30 and with a long term partner. It won’t be long until I’m thinking more seriously about pregnancy. Future pregnancy is one of the reasons I am trying to cut down. I’ve been told in the past by doctors that they would always recommend a mother continued with appropriate antidepressants during pregnancy if she needs them – that a depressed mother is a much greater risk to a baby than anything else. But, ideally I’d rather not be taking them – especially given the occasional headlines about the risks. These tend to ‘trigger’ increased worry and rumination associated with depression. It’s not always rational – but depressive thoughts aren’t. Continue reading

Mind the gap – GPs, antidepressants and mental health support for young people.

“I’m not going to give you another prescription”
“What… but I need it.. (panics)”
“Don’t worry, I was just testing to see if you really did still need them..and I think you do”
GP in Fenham, Newcastle

“Just take them when you feel you need to”  – to me aged 17.
GP in Cumbria

“So, do you want to kill yourself then?” – on a routine prescription pick up.
GP in Bow, London

“It’s important you stop taking this medication as soon as possible, we have no idea what impact it can have, especially if you start taking it when you are under 18”
GP in Fenham, Newcastle

“It’s fine for you to take it as long as you need to, even for ever”
GP in Tower Hamlets, London

“They’re not addictive”
GP in Cambridge

“You will get withdrawal symptoms”
GP in Byker, Newcastle


The above is a selection of the contradicting information and advice – as well as frankly bizarre approaches and attitudes I have experienced in the twelve years I have been seeing GPs regularly. 

(2016 note – I wrote this piece in 2011 when I was just getting started blogging – but a lot of it is still relevant)

Personal and practical barriers to getting support from a GP

I’ve spent lot of time supporting young people to take the first steps to support. Their GP is usually the gatekeeper for services.  A lot of young people really struggle to get the mental health support they need, facing a number of personal or practical barriers along the way. As well as support in articles, live chat and on discussion boards, one of the projects I was involved in at YouthNet (now The Mix) was crowdsourcing and discussing experiences in order to create community content to help others overcome these barriers. The project really highlighted the frustrating reality of trying to get the support you need from local health services. Continue reading