The Pill for anxiety?
April 28, 2015 8:00 AM   Subscribe

Would taking birth control help with my (hormonally-driven) anxiety?

So, I was on birth control for close to 10 years due to heinous cramps as a teenager/young adult. I stopped 2 years ago due to wanting to see if I really needed to continue taking hormones every day, or whether I had "grown out" of the cramping. Turns out I have - yay!

The only issue is that for the past year or so, I have been experiencing increased anxiety right before I start my period. We are talking, wake up in the middle of the night, heart pounding panic attacks, type anxiety. I do have an anxiety disorder and take an SSRI for it, which normally works well. I also have an emergency benzo prescription, which also works well.

But it is very clear that these sorts of midnight panic attacks only happen the few days or so before I start my period, and it is getting to be unmanageable. So I have been considering going on birth control again.

1) Will this actually do anything? I know that many women take birth control to help with PMS symptoms, but this anxiety feels so little like what I have read about PMS that I am skeptical that I will get any benefit from going back on the pill. Have any women experienced a reduction in period-related anxiety symptoms while on the pill?

2) If this is something that will help me, which brand of pill seems to work best, in your experience?
posted by chainsofreedom to Health & Fitness (8 answers total)
Best answer: Rather than thinking of it as PMS - look into Premenstrual Dysphoric Disorder (PMDD). This will probably seem much more on target. Yes, OCPs can help!
posted by treehorn+bunny at 8:07 AM on April 28, 2015 [1 favorite]

Since birth control is free and it sounds like you did not experience negative symptoms during 10 yeras of being on it, why not give it a try and see how it goes? Obviously if you are trying to get pregnant right now this is a no go, but since you did not mention that I assume it's not a major concern right now.
posted by rainbowbrite at 8:14 AM on April 28, 2015

For some women, hormonal contraceptives reduce symptoms of PMS/PMDD; for others, they exacerbate symptoms, especially during the initial couple of months of use. For many women, myself included, continuous usage – i.e., skipping the placebo week or keeping a Nuvaring in for four weeks without a break – provides the best results, by further reducing the rollercoaster that is the monthly hormonal cycle.

Whatever you try, the general wisdom seems to be that you'll need at minimum three months on a medication to fully understand its effects. Since starting a new pill can result in a lot of hormonal wackiness, be sure to practice regular self-care in order to reduce the severity of side effects involved with a new prescription.

As for pill brand effectiveness, it's completely unique to each woman's body and hormonal balance. Personally, I'd try the medication you took for ten years without incident.
posted by theraflu at 8:37 AM on April 28, 2015 [1 favorite]

Yes, my brand of HBC helps a lot with the anxiety left behind by an older, more unstable type of HBC that wrecked my body's hormonal balance. Unfortunately I have to take this new HBC (Zovia) all the time because when I go off it for the placebo week or accidentally get too much soy my PMDD symptoms go through the roof. I take Xanax to help with the intervals where the HBC isn't covering all my symptoms.
posted by Hermione Granger at 9:22 AM on April 28, 2015

Nthing that if you did not experience any bad symptoms on your previous birth control, that might be the best place to start. Anecdotally, I have experienced the anxiety you are describing ON certain types of birth control, which in my case was Yasmin (not Yaz), and Loestrin 21...this is just to say that everyone reacts differently to every type of birth control, and that you should talk to your OB/GYN if you can about the symptoms you are trying to alleviate. I found that when I told my doctor that my anxiety was so bad on those brands that it made me feel like a different person, they took that more seriously than complaints about spotting, cramps, etc. We had to try a few things, and yes, typically you need to give it 3-6 months before changing BC up. I've personally found the Nexplanon implant to work best for me; the release of hormones at a slower, steadier rate means that I don't have days where my anxiety or mood fluctuates wildly. YMMV.
posted by gollie at 9:48 AM on April 28, 2015

This definitely varies from person to person, but yes, for me, HBC (taken all the time with no placebo week) has been totally vital in managing symptoms of depression and anxiety.
posted by goodbyewaffles at 9:57 AM on April 28, 2015

Why don't you just go back on whatever pill you were taking before? It seems like it must have been a good fit for you, since you stayed on it for ten years.
posted by kinddieserzeit at 10:00 AM on April 28, 2015

Response by poster: Ahhhh, I keep forgetting that that stuff is free now! Great, thanks! I'll bring it up with my doctor next visit, and be sure to stick it out for a few months.
posted by chainsofreedom at 5:32 PM on April 28, 2015

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