I’m anxious, worried and sad. Should I stop taking birth control pills?

The question:
 
I’ve been taking a low dose birth control pill for about a year now and I’m wondering how much of an effect the hormones can have on my mood. I’ve always suffered from mild anxiety, but lately I just don’t feel like myself. I could be fine one minute and the next I feel a rush of anxious energy, worry and sadness. Could it be the pills and should I stop taking them?
 
The answer:
 
Virtually any pharmaceutical – particularly one that is focused specifically on hormonal regulation – has the potential to impact mood. Sadness, anxiety, as well as irritability or sleeplessness are among the most common potential consequences. Speaking to your family doctor about the changes you have noticed is an important first step. There may be a pill that is a better fit for your body, or alternative forms of birth control may be options to consider.
 
It is equally important for you to consider other situational or life events that may be impacting your anxiety. Interestingly, as humans we generally tend to be pretty poor and often inaccurate in our attributions of what factors affect our emotional and physical health. This can be chalked up to a case of being “too close to home” when it comes to factors that affect us.
 
You say you’ve always suffered from mild anxiety – do you have a sense of what factors (situations, scenarios, concerns, people) contribute to the anxiety for you? Putting pen to paper and articulating in writing the personal contributors is a good way to gain some insight.
 
What is going on in your life right now? Pay attention to changes that may be exacerbating your anxiety. Relationship conflict, work stress and financial concerns tend to be the most common culprits. Even positive life events – such as a having a baby, getting a promotion, or moving – tax our physical and emotional resources and can lead to our body feeling “stressed” (our body doesn’t discriminate between good stress and bad stress!).
 
How is your health generally? Have you been exercising? Eating relatively balanced meals? Getting adequate amounts of sleep? Targeting these areas if they have fallen short, and also minimizing alcohol use, is important.
 
The best way to make sense of triggers and contributing factors to your mood is to keep a daily diary for a week or two. Start from when you wake up, and make an hourly (or close to) entry of the following: your mood, what you are doing, and any particular thoughts you are aware you have been having. Review this with your family doctor, and ensure you have had an up to date physical examination as other health issues (e.g., anemia, thyroid dysregulation) could also be playing a role.
 
Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail.