I was really hoping my first post-intro entry in this blog would be filled with great news about how shockingly easy it is to succeed as a freelancer. Unfortunately, that won’t be the case. I’ve made not a single penny freelancing yet. For the past two weeks, I have been struggling with the nightmarish side-effects of a birth control pill called Ortho-Cyclen.
My severe anxiety, bouts of depression and repeated panic attacks reached a climax Friday, when I stopped taking the pill. Then the symptoms subsided almost entirely.
For those who have never struggled with these symptoms or seen someone close struggle with them, I will later explain in vivid detail their truly crippling nature. This blog entry is meant to expose the widespread ignorance of the birth control pill’s potentially serious psychological impacts, which can include permanent structural changes in your brain and neurotic symptoms that are widely dismissed as “increased moodiness.”
Admittedly, starting birth control pills at such a huge turning point in my life was not the smartest thing I’ve ever done. People close to me know I am good at dealing with challenges. I thrive on uncertainty; I crave obstacles. However, because of the Ortho-Cyclen, my unstable circumstances served as fuel for an acute stress disorder, colloquially known as a “nervous breakdown.” And this in spite of the fact that I specifically asked the Planned Parenthood doctor to put me on the safest, lowest-dose birth control pills possible.
Apparently, there is no such thing as a gentle birth control pill.
Since I can’t be of any use providing career advice yet, I’ll recount my experience with birth-control-induced madness, with the hope that it will spare other women. My consolation right now is that conflict makes for interesting content. Just fyi: I’m not a scientist, but I have a minor in neuroscience which, coupled with my journalism background, I hope qualifies me to speak somewhat authoritatively about what happened. Before I proceed, I must acknowledge that for the great majority of women in the world, the pros of birth control pills far outweigh the cons. I am not here to deny their benefits. But I think women need to do more careful, independent research and rely less on doctors who, for some reason, promote this stuff like it’s pregnancy-preventing wheatgrass.
I avoided taking birth control pills for as long as possible. My mother is an award-winning internist and has always put medicine on a pedestal. She believes legal drugs are the answer to everything. When I was little, any worrisome sniffle or cough motivated her to reach for the antibiotics. Meanwhile, my father is an absolute hippie who despises pharmaceuticals. When he is sick, he concocts herbal remedies and improves his diet. In my early 20s, I became convinced I had an incurable yeast infection as a result of the millions of antibiotics I had taken over the course of my life, and my father mailed me a cardboard box filled with grass. Inside the grass I uncovered several unlabeled glass vials filled with dark, multi-colored liquids and a piece of paper with typed, detailed instructions on how much of what to take when. The mysterious concoctions did little for me; soon, I would find out that there was nothing wrong with me at all except the damage I had done to myself taking doctor-prescribed fungicidal bombs I didn’t need.
It’s no surprise I have inherited more of my father’s skepticism than my mother’s appreciation for modern medicine. The idea of preventing pregnancy by altering my hormonal cycle has always seemed horrendously violent to me. The two times I took birth control pills in my past, one kind transformed me into an emotionally abusive, constantly enraged bitch, and the other completely wiped out my libido. I decided never to take birth control pills again.
After living with my boyfriend for several months and trying a variety of non-hormonal options, however, I came to the conclusion that maybe I should give birth control pills another try. After quitting my job and heading to the U.S. to visit family for a few days, I made an appointment at a Planned Parenthood in San Diego.
“Have you ever taken birth control pills before?” the doctor asked me.
“Yes, when I was 19 or so, I tried two different kinds of birth control pills whose names I don’t remember. One made me really angry, and the other made me never want to have sex. Can you prescribe me the safest, lowest-dose pill you have? A second-generation pill?”
First mistake: not remembering the names of my past birth control pills. Second mistake: depending 100% on the doctor for information.
Thus began my downward spiral into insanity. I took my first Ortho-Cyclen pill on Friday, March 22, and by April 5 I was face-down on my bed, hyperventilating in the throes of an excruciating panic attack, convinced that my life was over despite the tiny voice of logic that told me, from a far-off irrelevant place, that what I was feeling was the result of the Ortho-Cyclen and had nothing to do with reality.
It started subtly and intensified rapidly. On Saturday, March 30, the day before my birthday, I burst into tears, 100% certain that my boyfriend had no intention of doing anything for me for my special day. A few days earlier, he had offered to throw me a party; I said no, I didn’t want to have to clean up the mess. “I’ll clean up for you,” he said. “No, I don’t want to socialize,” I responded. Later, he offered to organize a barbecue or something more low key. “No,” I said. “I don’t want to see anybody at all.”
He said no more. Now, on the night before my birthday, I was certain he didn’t care enough about me to plan something for me and that he had simply dropped the ball.
I trembled with rage. “How dare you do this to me?”
“What? We can do whatever you want on your birthday.”
“No,” I said, shaking my head hatefully. “I don’t want to do anything with you. You expect me to plan everything. All because you’re lazy.”
Then I burst into tears. He approached me, but I was inconsolable. I continued hurling insults at him.
“You don’t appreciate me! You don’t use your brain!”
Later, I realized how insane I was acting, and apologized. At midnight, he spent his last few pesos on a slice of cake for me and a candle, and spent the whole next day with me.
The following afternoon, while walking together in our neighborhood, he made a good-natured joke. Sobbing, I threw myself on the floor, accusing him of being an insensitive asshole.
On April 2, Leo left for work as an extra in a commercial around 7 a.m. He kissed me on the forehead and told me he would be returning at 9 p.m. At 10 p.m., while out for dinner with my friends, I started worrying. He hadn’t replied to a text of mine asking him where he had put Season 6 of the TV series “Lost.” I tried calling him, and the call wouldn’t go through. I wondered if something had happened to him.
By midnight, I was convinced he was dead. I literally believed that I could see the outline of his ghost at my window, begging me to help him return to the world of the living. I paced hysterically, hyperventilating, filled with panic. I would never get to apologize to him for acting so irrational, so insane over the past few days. I checked the Mexican papers online for news of a murdered Argentine actor. I asked my roommates, who work with the same agency, to give me a contact. “Surely the filming just ran late,” they assured me. “Here’s a number, but nobody will answer until morning.” I called my mother, sobbing hysterically on the phone to her. I was convinced his kiss earlier that morning was his way of saying goodbye forever. I couldn’t sleep, I tossed and turned in bed, crying like crazy, until he arrived at 3 a.m. Greeted by a hysterical me with mascara staining my entire face, Leo informed me his phone had run out of credit early on in the day and he couldn’t make or receive calls. He apologized, promising it wouldn’t happen again.
On April 4, I wept uncontrollably all day. Every email I was getting from editors said some version of, “Promising story, but it’s not for us,” in reply to my pitches. I was convinced that I was a failure as a journalist and that I would never be able to support myself again. I spent all day in bed, fighting suicidal thoughts. Leo tried in vain to console me. Knowing that I was no longer acting like myself and that my behavior/thoughts were unjustified and that it had reached an unacceptable level of intensity, I decided not to take another pill that night. Screw this shit, I thought, and literally threw the pack of pills out the bathroom window.
The next day was Friday, April 5. Leo got up early for work again, and he locked the bedroom door from the outside and threw the key under the door. The forceful manner in which the key slid along the floor convinced me that he hated me. I stayed in bed, trying to make the feeling go away. “Surely, the hormones are still making you crazy,” I thought. Then I sat up to check my emails. I took a deep breath, scared of myself, my hands shaking. “Don’t worry, Jean,” I said to myself. “If you still don’t have any emails from editors interested in your stories, don’t worry. You’re just starting out.”
I opened my inbox. I had received absolutely no new emails. I felt myself unraveling, that I had no center, that I was literally coming undone and had no idea what to do next. It was completely unlike me. I took a deep breath again. In half an hour, I had to attend a breakfast with the president of an important agriculture organization in Mexico who wanted to sponsor one of my films with Leo. I needed to go. I dressed myself, dizzy all the while. I rode my motorcycle to the interview and sat down in the restaurant. “You can do this,” I thought. “This is your job.” The official arrived, and I was able to keep it together. We had a pleasant breakfast and a successful exchange of information. However, I felt the entire time that I was fighting a massive hurricane inside my gut. When I returned home, I released my hold on it, and vomited ceaselessly. I had only eaten some fruit at the breakfast, but I could’t stop puking.
Then I read my emails again. I still had not received a single reply from editors.
That’s when it happened. The only other time I have had a full-blown panic attack was when I was drowning at the edge of the Los Tuxtlas jungle when a rip current pulled me out to sea. Panic is a sensation I never understood until I experienced it. I used to hear about people having panic attacks and assumed it meant they were weak humans who let their emotions get out of control. When panic gripped me (“gripped” is such an appropriate word) in the rip current, I knew that it was the panic itself that was going to kill me, and not the rip current, if I didn’t get it under control. I knew that if I could keep calm, my chances of survival would increase significantly. However, panic is uncontrollable, and logic has no power over you once it sets in.
Panic is an animal with teeth that eat you from the inside out. Rationality literally becomes incomprehensible. The most horrible possibility becomes the only reality. In the ocean, I became convinced, 100%, that I was going to die; now, in my bedroom at my desk as panic gripped me again, I was totally certain that quitting my job had been the worst mistake I ever made in my life, and that my future was ruined. I crawled into bed, trying to expel the feeling from my body with facts: I have enough savings to keep me afloat for quite a while, it’s only been two weeks, you just stopped taking birth-control pills that are probably still screwing with your brain. But these facts had no effect on me. The only thing real was my certainty that I was doomed, and my even greater certainty that my uncontrollable emotional reaction to being doomed would doom me further. I couldn’t breathe. My career was ruined, and surely Leo would fall out of love with me now that I was a worthless piece of shit, an emotional wreck. I wanted nothing more than for this feeling to stop, but it was so enormous that I knew I had no power over it. It had permeated my mind and tainted my perception; it would never go away. I tried to imagine the plane ride back home out of Mexico, and couldn’t fathom how I could physically drag myself through the process of moving back to the U.S. now that all my hopes and dreams had disintegrated. My only consolation was the thought that perhaps a mental institution wouldn’t be so bad, after all; maybe the doctors there would take good care of me and make me feel safe. I gripped the sheets, trying in vain to stabilize myself. I, a person who actually prefers wild horses that buck and rear and need to be reined in, had become powerless on the back of this internal monster.
I could feel it growing inside me every second. The only other time I had felt something remotely similar to this was when I took LSD in college and and felt that the devil was taking possession of my body; I once described that experience as “the opposite of giving birth,” feeling that I had to try with all my might to keep an external being from entering me. I felt that I had two options: stay here and go absolutely insane, or hop on my motorcycle and head to my friend Zerina’s house. Zerina is a therapist and I figured she’d know how to help me. Although both options were dangerous, I felt the latter offered me a tiny chance of survival, whereas the former did not. So I shoved my helmet on my head, dragged myself to my motorcycle and sped to Zerina’s house. I made it there in one piece, thanks to the fact that it’s Holy Week in Mexico, and there is hardly a soul on the notoriously dangerous roads of the Mexican capital. I walked into her apartment, my head spinning, feeling faint. Zerina fed me oatmeal and tranquilizing tea and proceeded to speak rationally to me, reassuring me in a million different ways that everything was going to be okay and that what I was feeling was surely a lingering effect of the birth-control pills.
By that evening, the anxiety has released its hold on me and my body ached all over. The levels of cortisol in my bloodstream had been so high all day that my muscles were sore.
More than 100 million women take birth control pills worldwide, and many of them have no idea that the intake of these artificial hormones increases their likelihood of succumbing to blood clots and breast cancer, let alone that they can possibly make them go insane. Doctors prescribe the pill without fully informing women of its risks. The World Health Organization states that “the health benefits of any method of contraception are far greater than any risk from the method.” Several gynecologists and general practitioners have scolded me for not being on birth control pills, preaching about their correlation with decreased risk of ovarian cancer, endometrial cancer and colorectal cancer. Nobody has ever mentioned to me the fact that hormonal contraceptive use is “associated with an increased rate in depression, divorce, tranquilizer use, sexual dysfunction, and suicide and other violent and accidental deaths,” according to cohort trials mentioned in one of the few recent studies on psychological impacts. Nor had I ever heard of this study on female cynomolgus monkeys, finding that triphasic oral contraceptives disrupted “social behavior, hypothalamic-pituitary-adrenal axis regulation (in the brain) and the underlying central nervous system function,” according to the researchers.
Few doctors who prescribe birth control bother to mention the difference between second-generation and third-generation pills. Both increase the risk of deadly blood clots per 100,000 users, but second-generation pills increase it to 15 while third-generation pills up the risk to 25. It’s a “small” risk, doctors say. But do the math yourself: the baseline risk of blood clots is 5 per 100,000. If 100 million women take either a second- or third-generation birth control pill, that means between 10,000 and 20,000 women have died of blood clots caused by the pill. And compare it to the risks of taking illegal drugs like Ecstasy, which kills only seven people per million users in the UK and only 1 person per million users in the U.S. What’s going on here?
Ortho-Cyclen contains 0.04 mg of ethinyl estradiol (man-made strogen) and 0.25 mg of norgestimate. If you look up “norgestimate” on Google, the first thing that’ll pop up is a Wikipedia page with a half-assed description about it being a “synthetic progestin,” preceded by a helpful Wikipedia warning:
|This article does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (February 2007)|
Apparently nobody has thought to improve on the article since 2007. This seemed fishy to me, so I did more digging. As I looked through page after page on the Internet, I became increasingly aware of how little information actually exists about norgestimate. According to Dr. Dawn Stacey at About.com, norgestimate is a third-generation progestin. When I read that, alarms went off in my head immediately. The Planned Parenthood doctor had prescribed me Ortho-Cyclen when I asked her specifically for a second-generation birth control pill. Was Ortho-Cyclen actually a third-generation birth control pill? What the hell?
Turns out, it is. But it took way too many Google searches to figure that out. If I, a journalist and seeker of truth by nature, had trouble finding that info, and was misinformed by my Planned Parenthood doctor, what about the millions of other women who take birth control pills?
If few women are aware of the physiological harms that birth control pills can cause, even fewer know that birth control pills can and will alter their brain structure and neural activity. In a 2010 study published in Brain Research, it is shown that the brain’s steroid receptors react to synthetic estrogen and progestin with structural modifications.
“The possibility that an accepted form of chemical contraception has the ability to alter the gross structure of the human brain is a cause for concern, even if the changes seem benign — for the moment,” wrote the neuroscientist Craig H. Kinsley in a Sept. 28, 2010 article in Scientific American. “In any event, women need to have all of the medical and now, neurobiological, information they can use in informing their personal contraceptive decisions. Like the rest of life, and like the steroid choices made by those ballplayers, there are costs and benefits. The benefits are well established; the costs, however, are still coming to light.”
Online forums are replete with accounts of birth control pills causing panic, anxiety, and depression. One woman was diagnosed with panic disorder. Another stopped being able to take care of her kids. Countless women have no idea that their sudden anxiety/depression/panic is a result of the pill they just started taking. How many women are wrongly diagnosed with a chronic mental disorder and put on anti-depressants or anti-anxiety medications, when it is their birth control pills causing the problem? If I had not had an inherent distrust of the pill, and possessed the knowledge that I am fundamentally a strong and emotionally resilient person, I might have thought that my sudden mental problems were related to other factors, such as my career change, and an actual inability to deal with them. Some women have been on birth control pills so long, with years of anxiety issues since they were teens, that they can’t remember if they were ever normal. Others develop a physiological dependence on the pill, with an onslaught of mood problems when they try to stop taking it; this is really concerning since women over 35 years old are at a significantly higher risk of breast cancer and blood clots caused by the pill and they should not have to keep taking it. It is almost impossible to find any reliable, authoritative science explaining widespread psychological side-effects of the pill or their long-term repercussions. Doctors and pharmaceutical labels dismiss or minimize their importance by lumping them together into an “increased moodiness” category. Women themselves often fail to recognize the seriousness of the pill’s real psychological impacts, continuing to take a problematic pill for weeks or months in the hope that the “mood swings” will subside eventually. They’re assured, repeatedly, that birth control pills should stabilize their moods. And in some cases, that’s true — they’re sometimes prescribed to treat anxiety disorders and PMS. But in too many other cases, the opposite happens. For a medicine that’s only 53 years old and causes widespread mood alterations, it has made the female population troublesomely confident.
Birth control pills work in part by interacting directly with the brain; they stimulate or inhibit the release of certain hormones from the hypothalamus and other brain structures. As a side-effect, the pills sometimes increase the concentration of a brain enzyme that metabolizes serotonin, a neurotransmitter responsible in part for feelings of well-being. That results in a sudden, sometimes sustained drop in brain serotonin levels. Most likely, that’s what happened to me, the plummeting levels of serotonin causing me to feel extreme anxiety and despair. When my boyfriend hugged or kissed me, the lack of a serotonin response in my brain made me interpret his actions as meaningless or fake rather than reassuring. When rejected by editors, the lack of feel-good neurotransmitters in my brain made it impossible to move forward and see other possibilities. Scientists have also found that serotonin neurons possess receptors for both estrogen and progestin, which means synthetic hormones contained in birth control pills can directly modify gene expression and impact mood, cognition “and other neural circuits,” according to researchers. Another study showed via functional MRI imaging that synthetic progesterone increased activity in the amygdala, a part of the brain that governs fear and anxiety reactions.
Brain levels of serotonin plummet following cocaine, LSD and Ecstasy consumption. It’s often referred to as the “come-down” of these illegal drugs. Scientists cite MDMA’s effects on serotonin as one of the reasons it needs to be banned. Why is there such widespread intentional silence on the mirror impacts resulting from birth control pill use? Why do so many doctors say, “Just try another pill,” encouraging a woman to spend months in hell, without considering the potential long-term damage to her brain?
There is evidence that the neural rewiring that occurs in the female brain as a result of birth control pills can be permanent. Since these pills often cause depression, anxiety, panic attacks and have in some cases led to chronic sexual dysfunction, this should really freak you out.
Lately, there is an increased push to sell birth control pills over the counter, without a prescription. This is highly concerning considering the fact that already, too many women take these pills without having any idea what they do to their brains and bodies.
Clinical trials for reversible inhibition of sperm under guidance, or RISUG, have been slow due to a lack of volunteers in India. Too few men are willing to risk their penile and testicular health to avoid getting a woman pregnant. When I asked my boyfriend if he would be willing to undergo this procedure once it was legalized, he shook his head vigorously. Why are women so willing to endanger their bodies and minds?
There’s no question that the birth control pill has hugely helped the feminist movement and that it has done much in helping to avoid millions of unwanted births, abortions, etc. But now it’s time to take a step back and make sure we don’t get swept up by the current. We should make sure we are making informed decisions, which seems very hard to do as things stand; we should ask ourselves why there is so little reliable information out there, and particularly so few studies investigating the structural and chemical changes these pills cause in our brains. Why are the known risks so often downplayed? Anyone who interacted with me over the past two weeks knows the pill was not making me “moody” but mentally deranged.
If you want to help elaborate on this investigation, go to the Planned Parenthood closest to you and ask them to prescribe/recommend a second-generation birth control pill. Email me at firstname.lastname@example.org letting me know what prescription you receive. I want to know how many people are misinformed. Also, please email me or comment with your experiences on birth control pills if you’ve had similar psychological reactions or completely different ones.