Birth control increases rates of depression in teens with ADHD

A recent Sweeden study shows that teens and young adults with ADHD (attention-deficit/hyperactivity disorder) may have an even higher risk of developing depression when using hormonal contraception. The study was published in the Journal of the American Academy of Child and Adolescent Psychiatry and used a large-scale population record. It compared 29,767 girls and young women with ADHD aged 15 to 24 years and 763,146 peers without an ADHD diagnosis. The authors of the study determined if those women used hormonal birth control (HBC). 

The results reported by the authors of the study showed that women with ADHD who used HBC had a 5 times higher risk of depression compared with non-ADHD women who were not using birth control. Also, it is significant that the risk was 6 times higher risk in comparison with non-ADHD women who were on oral combined HBC. The risk of developing depression when using non-oral HC was similarly moderately increased in both groups.

More research is needed to determine the exact mechanism behind the increased risk of depression in HBC users with a diagnosis of ADHD. The authors suggest that “hypothetically, the increased sensitivity to oral HBC in women with ADHD may be due to fluctuating hormonal levels following oral intake or during the pill-free interval. There is a considerable lack of studies on how women with ADHD respond to hormonal fluctuations, but there are several reports on how progesterone (or synthetic progestogen) fluctuations affect mood in women.”

The authors of the study concluded that “information on risks with HCs as well as potential benefits with user-independent long-acting reversible contraception needs to be an integrated part of the shared decision making and contraception counseling for young women with ADHD”. A large prospective cohort study already demonstrated that adolescent users of LARC such as the patch and the levonorgestrel intrauterine system had a higher risk of subsequent use of antidepressants and a first diagnosis of depression.

Young ladies deserve better and safer alternatives to hormonal birth control and LARCs. The fertility cycle is part of a young lady’s development and should not be suppressed by dangerous artificial hormones. Teaching adolescents and young ladies to chart their cycles can protect them not only from depression but also from a host of side effects. Fertility education gives young women tools to learn more about their developing bodies, and monitor symptoms to look for real solutions in health care. Fertility education programs that foster chastity and purity can prevent many unwanted pregnancies.

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