Q: “Can Hormonal Birth Control Cause Depression?”
Our study found that women with ADHD are at increased risk for developing depression following oral birth control use, and the reason why might surprise you.
Q: “I heard that women with ADHD who take hormonal birth control are at greater risk for depression. Is this true? I’m exploring birth control options and want to make sure I understand the risks and possible side effects of hormonal birth control.”
Yes, our research group found that women with ADHD were five times more likely to develop depression following use of combined hormonal oral contraceptives (i.e., pills that contain both estrogen and progesterone) than were women without ADHD who were not on these pills.1 We came to these findings after comparing Swedish national register data of roughly 30,000 girls and young women with ADHD to more than 760,000 neurotypical peers in a control group.
More highlights from this study:
- Women with ADHD who used combined oral hormonal contraceptives (HC) or progestogen-only pills had more than five times the risk for depression compared to women without ADHD who did not use hormonal contraceptives of any kind.
- Women with and without ADHD who used non-oral preparations, such as the implant or hormonal IUD, had similar risk for developing depression, meaning that having ADHD did not change the association between the non-oral HC and the risk for depression.
- Irrespective of hormonal contraception use, women with ADHD had a 3-fold higher risk of developing depression compared to women without ADHD.
[Get This Free Download: Hormones & ADHD in Women]
What could explain the increased risk for depression among women with ADHD who take birth control? The way we see it, it’s probably not the hormones in oral contraceptives, per se, that place women with ADHD at greater risk. After all, there was no difference between combined pills (with estrogen and progesterone) and progestogen-only pills in this group.
What we think may be happening is this: When taking oral birth control, women with ADHD, due to their ADHD, might be extra susceptible to forget to take their birth control pills or may take them irregularly, causing hormonal fluctuations that may destabilize mood. Also, a woman’s hormonal levels will fluctuate during assumed pill-free intervals. As we know from the few studies on this, as well as anecdotal evidence, women with ADHD may be especially sensitive to changing hormonal levels.
In addition, poor adherence to birth control pills is also known to increase the risk of experiencing side effects like irregular bleeding, mood changes, and unplanned pregnancy, which may further increase anxiety and place susceptible women at increased risk for depression. If this is the case, women with ADHD may be better off using long-acting non-oral products like IUDs and contraceptive implants, which take working memory out of the equation and make for a more stable experience.
As you continue to find a birth control method that works for you, be sure to talk to a doctor who is knowledgeable about ADHD in women, especially one who understands the role hormonal fluctuations play in ADHD symptoms and overall mental health.
Hormones, Depression, and ADHD: Next Steps
- Read: Hormonal Changes & ADHD — A Lifelong Tug-of-War
- Read: What’s Behind the “Depression Gap” Impacting Women?
- Watch: Hormonal Fluctuations and ADHD — How Estrogen May Impact Symptoms Throughout Life
The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “The Emotional Lives of Girls with ADHD” [Video Replay & Podcast #488] with Lotta Borg Skoglund, M.D., Ph.D., which was broadcast on January 23, 2024.
ADDitude readers: Sign up to access LetterLife, an app by Dr. Lotta Borg Skoglund that provides users with personalized insights — on hormonal cycles, ADHD symptoms, and lifestyle factors — to better manage ADHD.
Use the discount code ADDWEB20 to get 20% off Dr. Skoglund’s book, ADHD Girls to Women, when purchased via uk.jkp.com.
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View Article Sources
1Lundin, C., Wikman, A., Wikman, P., Kallner, H. K., Sundström-Poromaa, I., & Skoglund, C. (2023). Hormonal Contraceptive Use and Risk of Depression Among Young Women With Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 62(6), 665–674. https://doi.org/10.1016/j.jaac.2022.07.847
