Millions of women who feel despondent or depressed when on the pill can finally take comfort in a new study that confirms what they might have suspected all along. The research, published in JAMA Psychiatry, is the first ever to draw a connection between birth control and depression in women—particularly adolescent women. Scientists from the University of Copenhagen tracked one million Danish women between the ages of 15 and 34 over the course of 13 years. What they found was that birth control is associated with higher rates of depression. In particular, women between the ages of 15 and 19 who took oral contraceptives were 80% more likely to end up depressed.

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Here’s Katie Mettler, reporting for The Washington Post:

Women who used the combined birth control pill, a mix of estrogen and progestin, were 23 percent more likely to be prescribed anti-depressants than nonusers, and progestin-only pills raised the likelihood by 34 percent. With the patch, antidepressant use doubled; risk increased by 60 percent for vaginal rings and 40 percent for hormonal IUDs. And for teens age 15 to 19 taking combined oral contraceptives, the use of anti-depressants spiked 80 percent. Although those percentages may seem shocking, the absolute change is a small but significant spike. Among women who did not use hormonal birth control, an average of 1.7 out of 100 began taking anti-depressants in a given year. That rate increased to 2.2 out of 100 if the women took birth control.

Still, many experts in the scientific community are challenging the research. They say that a sample size of one million lends some doubt to the study’s claims—many other factors are at play, including the diversity of developmental stages represented.

But the study’s authors stand by their work, noting that it presents the first high statistical correlation between birth control and depression. The inclusion of adolescent girls in this study is yet another reason to take this research seriously—we feign understanding of the teenager’s inner world, but each new scientific revelation shows us just how little we actually know. A recent study published in the journal Pediatrics suggests that early puberty in girls might be linked to depression. And in some cases, depression might be triggered by an immune response . Perhaps adding to the importance of this study is this: doctors are unlikely to prescribe the pill to women who are already susceptible to depression because the pill worsens their symptoms . That means this study may underestimate the effects of contraceptives on mental health. Women are already twice as likely to experience depression as men. So while this research is complicated, the stakes are high. There are still many legitimate reasons to use birth control, but experts say that women should be aware of both the benefits and the risks.

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