mental health Archives - Hormones Matter

Ditch the Excuses, Try Yoga

Published on March 14, 2024

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The title may be a little aggressive but your body asked me to tell you that. Why? Every day, more and more research comes out about the benefits of yoga. You may have heard yoga is good for depression, lowering stress and anxiety, reducing inflammation, etc., etc., but maybe despite the endless benefits, you’re still hesitant to try yoga.

The first time I tried yoga, I was 22 years old. I took a class with my sister at the community college. During savasana (a resting pose at the end of each class where you just lie on your back), I thought, “This is stupid. Why am I taking an hour long exercise class to just sit here for the last five minutes? What a waste of time.” Clearly, I was missing the point. And so are you if you’ve said any of these things about yoga.

“I’m not flexible enough to do yoga.”

This is like saying you are not in shape enough to go to the gym. Sure, a lot of people who do yoga are flexible, but yoga is more about your mental and emotional flexibility than physical flexibility. No one ever achieved enlightenment by touching their toes or putting their leg behind their head. That’s not where the answers are. The answers lie within and yoga helps us go within. That said, if going within isn’t what you’re ready for right now, of course yoga can help you become more physically flexible. Keep in mind that if flexibility was really the key, Cirque du Soleil performers would be the wisest gurus on the planet.

“It’s too hard.”

I used to play bass guitar and people would ask me, “Oh, is that easy?” (I don’t know why, presumably it seemed easier because it had four strings?) I would always answer, “Not if you want to do it well.” Nothing is easy if you want to do it well. Yoga is the same, but that doesn’t mean it has to be hard. There is yoga for everybody and there is yoga for every BODY. Seriously. Be smart about how and where you start, however. When I began playing the bass, I wasn’t slapping like Les Claypool at my first lesson. So don’t pick a hot, 90-minute, power flow yoga class for your first time. Start with a beginner class or a gentle class.

The temptation when going to your first class is to make sure you’re “doing it right” so you can look like everyone else. More than anything though, you should listen to your body. Not listening to our bodies is how we get hurt. Remember, the instructor is a guide. If a pose doesn’t seem right, modify it. Pay attention to how it feels. It’s your body and it’s your practice.

“I could never wear those little yoga pants.” Or “I’m too intimidated.”

Sure, there are plenty of yoga studios where the teachers look like models and everyone is wearing coordinating $200 yoga outfits, but there are even more where that is not the case. It’s easy to find them. Look at their websites. Find a teacher that says “yoga is for everybody” or something similar. That’s the teacher to try. And wear whatever you damn well please, as long as it’s comfortable. (Incidentally, that’s good rule for life, too.)

“I’m too old.”

There is chair yoga, senior yoga, gentle yoga, restorative yoga. This woman makes your argument invalid.

“But I’m Christian.”

Yoga is not a religion. You do not have to be Hindu or Buddhist or anything else to practice yoga. The practice of yoga can often become very spiritual though, and by deepening your connection to yourself, you may deepen your connection to the divine. If you’re still not convinced, you can find a more in-depth article about Christianity and yoga here.

One of my teacher’s teachers, Erich Schiffmann said this of yoga:

One of the main themes I always want to reiterate is that Yoga is a lifestyle. Yoga is about the way you do your life, not just part of the time, but all the time. The profound working hypothesis for how to do this, and this is the summation sentence at the end of many pages of figuring things out, is this:

THINK LESS and LISTEN MORE

because when you do KNOWING flows in,

and then GIVE EXPRESSION

to what you find yourself Knowing,

whether you can explain it yet or not.

It took having a stroke to slow me down enough to appreciate yoga. A stroke disconnects the mind and the body in such a startling way. One of the hardest things about recovering from my stroke (or probably any major health crisis) was the lack of trust I had in my own body. I was never sure what I was going to be able to do or not do, from putting on a sock to riding my bike. So for a long time, I just didn’t do much. As a result, I became more fearful and less sure of myself.

It’s not just something as dramatic as a stroke that disconnects us from our bodies. Our constant internet access may make us feel more connected to each other but now we’re even less present in our physical reality than ever before. I’m guilty of this myself–texting while I’m walking the dog, talking on the phone while driving (handsfree of course), shoving food in my mouth as I’m running out the door. All of these things are keeping us from really listening to our bodies. So when they don’t work how we expect them to, when they get sick or break down, we feel like they’ve betrayed us. In reality, by constantly ignoring our bodies, we are the ones betraying our bodies.

Try a yoga class. Listen to your body. I promise it will thank you.

My yoga practice has brought me back to myself by teaching me how to really be in my own body. It has restored the mind/body connection that I wasn’t sure I’d ever get back. I’m so grateful for yoga that I became a yoga teacher last year. Just like any good teacher, I will forever remain a student. So now when I take a class, during savasana I think, “please, just five more minutes here.”

WARNING!

Doing yoga may cause the following side effects:

Love (of self, of others, of life)
Calm
Happiness
Patience
Being nicer to people
Knowing yourself
More flexibility- mentally, emotionally, and physically
Desire to wear fun pants

Have you experienced the benefits of yoga? How has it affected your life?

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

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Photo by kike vega on Unsplash.

This article was published originally in July 2016.

The Power of Repetition for Improving Brain Function

by Arlyn Smith

Published on April 6, 2022

3428 views

repetitive behaviors, neuroplasticity and stroke recovery

Through personal experience and research, I have gained insight into the power of repetitive thoughts and behaviors in creating new neural pathways and forcing the brain to “rewire” itself. This has occurred within my brain as I recovered both physically and mentally after suffering from a cerebellar stroke. Repetition of activity and repetition of thoughts retrain the brain. I will delve into each subject separately, as they are both similar, yet use different avenues to achieve results

Regaining Physical Capacity After My Stroke

In November 2002, I found myself in a coma following a massive cerebellar stroke. This was after 13 years of other issues. The stroke was precipitated by a suicide attempt, one of many over the course of 13 years of poor mental health, drug and alcohol use, anorexia, and bulimia. Details of my story can be found here. With that stroke, I lost all ability to move. Even swallowing was difficult. At that time, I did not know how to recover and the physicians did not appear to think recovery was possible. In fact, the possibility of the long-term training of my brain’s neuroplasticity was mentioned as a mere afterthought by my neurological team. I will admit that at the time this was not something I was overly concerned with initially either. I was simply trying to survive.

At some point, however, I became aware of the fact that the cans of soup I was lifting for physical therapy seemed incredibly easy to lift. Of course, this was gradual and after months of training. It was then though that I realized that minimal retraining of these neurons could yield such results. Research supports this. Here is some of the science behind the post-stroke improvement of the neural pathways pertaining to motor skills.

Over time, I recognized that many years of consistent repetitive physical activity, in my case weightlifting, has retrained the neurological damage acquired by my brain in ways greater than was remotely expected to be achievable without the use of pharmaceuticals, which given my history, I was none too keen to take. I am happy to say that I have yet to take any drugs to treat my extreme neurological symptoms. Instead, I trained, day in and day out. The simple act of repetition and strength building seems to have re-trained my brain. I am now able to walk, talk, and swallow. This took upwards of 17 years to achieve, an exceedingly long and arduous process, but it was well worth the avoidance of medicinal side effects.

In addition to the physical training, I found that supplementation with certain vitamins, such as thiamine, a strong multivitamin, vitamin C, and vitamin D daily, has allowed me to achieve that which dumbfounds scientists and doctors. Vitamins, supplementation, and strenuous physical activity are looked down on by most professionals. I guess things like proper nutrition and exercise are not considered scientific. They work, though. At least for me, they did.

Hopefully, my medical journey will challenge the current medical perspective, and if not, inspire other similarly afflicted individuals to pursue alternative approaches. I have dealt with a cerebellar stroke, anorexia, bulimia, cyclothymia, substance abuse, dialysis, coma, and spinocerebellar ataxia, to name a few of my physical ailments, but I am doing extremely well, despite it all. This is contrary to what was expected of me by my physicians. Frankly, many still cannot believe what I have achieved. Research supports my success. From Neuroplasticity after Traumatic Brain Injury – Translational Research in Traumatic Brain Injury:

The central nervous system (CNS) retains an innovative ability to recover and adapt secondary compensatory mechanisms to injury. The basis of recovery stems from neuroplasticity. This is defined as the ability of neuronal circuits to make adaptive changes on both a structural and functional level, ranging from molecular, synaptic, and cellular changes to more global network changes. The adult brain was traditionally thought to be stagnant, with neuroplasticity confined to cortical development.

Although traumatic brain injuries differ in some ways from stroke, the principles of neuroplasticity remain. The key to retraining the brain is simple repetition. That, along with other supportive influences like diet, nutrition, and of course, no small degree of mental fortitude, is, in my opinion, far more important than medication.

Rewiring Thoughts and Emotions

The concept of creating new neural pathways in the mental and emotional portion of the brain is the most important aspect of this particular subject for me. I have more experience, personally, with this than my physical situations. In 1990, I began down a path of mental self-destruction. Years of depression turned into bouts of psychosis. I attempted to vanquish the mental torment through heavy drug and alcohol use, which was compounded with severe anorexia and bulimia. I was admitted to countless hospitals, treatment centers, and alcohol and drug rehabilitation centers between 1995-2002. I attempted to commit suicide 5 times between 1995-and 2003. The pain I felt from existence was so unbearable that I could not fathom the thought of mortal existence. I suffer from genetic mental illness. This has been an ailment in my family lineage for as long as there have been historical records. It should be noted that many of the mentally ill members of my family have been or are, incredibly intelligent. There is a commonality with those I have interacted with. During our suffering, we repeatedly told ourselves similar things. A lifetime of imprinting our minds with these statements ultimately led to feelings of futility and attempted or completed suicide. The following was ingrained on our psyche, through years of reiteration and brain imprint: “CAN’T”, “NEVER”, “IMPOSSIBLE”.

I remember the specific day that changed my life. On December 15, 2013, I had enough of it all. I was no longer suicidal yet was hit with this realization that my mental health was taking such an enormous toll on me physically and if I did not completely change, mentally, I would not remain alive for very much longer at all. It should be noted that there are countless people throughout the world who have dealt with or are currently dealing with situations parallel to mine. These people remain in the shadows, but trust that the amount of emotional pain they feel or have felt mimics my own.

As would be imagined, by 2003 regular visits to psychologists and counselors had become a routine part of my existence. On the aforementioned date of that monumental decision, I was in some sort of confused state as to “how” I would retrain my brain like I was retraining my body. I quickly recalled an idea mentioned to me by a psychologist regarding retraining neural pathways. I instantly searched keywords online and was inundated with stories, scientific studies, and articles written by prestigious medical professionals. This was, undoubtedly, an extremely effective tool. As I dug deeper, the concept behind this method seemed attainable. I had spent my life reinforcing negative beliefs and thoughts in my mind. Over the years, the negative self-enforcement had imprinted itself deep within my psyche. I need to reverse this and imprint more positive thoughts.

My entire life, I had plied myself with pharmaceuticals and had found no relief. These medications made matters worse. I had somehow come to rely on and believe that these drugs would “fix” me. In pursuing the medical model, I had turned my life over to medicine, and as consequence, did not understand the concept of responsibility for my own life. If I was to retrain my mind, this had to change. I had become responsible for my own life. I began by doing some intense psychological work.

I upped my counseling session to twice a week and realized that the only way I would truly be able to undergo this retraining would be through honesty. Blatant honesty. Not only with my therapist, but with myself. I had to break down the barriers that had barred my mind from receiving any type of positive self-talk. At some point, my counselor and I created a personal mantra:

“Nothing in my life has been a waste.”

This brought a sense of relief. I repeated this to myself ad nauseum. The underlying reasons for my suffering began to seem less invasive and not quite as severe as once thought. I was able to ascertain meaning in my life. Another enormous thing I began to do was to accept compliments. I had become accustomed to rejecting and deflecting them. Self-deprecation had become my normal. Through acceptance of others’ positive views of myself, I was able to view myself more positively.

I was not prepared for the mental shock of quickly switching my thoughts to positive. I feel it necessary to relay this, everything was worth it. The pain, the tears, the hard internal work, it was a small price to pay. The feeling I have now is worth every moment of strife that I experienced initially. This is the recount of my experience. The following are some articles to back up my personal experience, as it is that. My personal experience. Also searchable are more complex experiments, data, and peer-reviewed articles. I challenge the reader to research “neural pathways,” study the idea, be your own mental health advocate, and, if fitting, discuss the concept with your health provider.

You may be surprised by the results!

Here are some articles to consider to begin your journey.

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

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It’s Not All In Your Head: Mental Health and Hormonal Birth Control

by Kerry Gretchen

Published on August 22, 2017

5656 views

Once upon a time, a 26-year-old woman went to her doctor and asked to be put on the new birth control pill that allowed women to only have four periods a year. She had seen it advertised on television. Four months later, 15 pounds heavier and suffering from mild depression, she returned to the doctor feeling miserable. The doctor told her the weight gain and depression were not from the pill because those were not side effects of hormonal birth control. Wait, does this sound familiar? It’s the same story I told in my article about hormonal birth control and weight gain. Only this time, I’m talking about mental health.

The truth is that I gave my mood changes and my mild depression very little thought. Once the doctor told me they were not a symptom of my new birth control pills, I figured it was my fault I was sad and not dealing with things very well.

What They Knew in 1970

I remembered the connection between my birth control pills and that bout of depression when I began reading the Nelson Pill Hearings. One of the first doctors to testify pointed out that there had been a suicide during the original pill trials in Puerto Rico. Neither the suicide, nor the other three sudden deaths (of five total deaths during the experiments) were investigated. But what really got my attention was that the page after the mention of the suicide was the only one missing in the nearly 1500 pages of testimony. I have since been able to get a copy of that page and while the testimony doesn’t seem that damning given the laundry lists of risks, concerns, and dangers with hormonal contraceptives that are examined at the hearings, it does bring up an interesting point.

Doctor Edmond Kassouf’s testimony answers questions from Mr. James Duffy, minority counsel at the hearings (page 6112):

Mr. Duffy: One of the five deaths was suicide.
Dr. Kassouf: Yes.
Mr. Duffy: So what I would like to understand is how does one take a suicide and link the case of death to the pill?
Dr. Kassouf: Very simply. It has been of current concern. Many physicians and psychiatrists are concerned about depression and the pill. If this is true, suicide may well be the end result of that combination and, therefore, a reasonable suspect, a reasonable link.

Suicide Attempts While on the Pill

“I’ve really got to look into this more,” I thought. Well, I had to look no further than page 6447 and the testimony of Dr. Francis Kane, Jr., Associate Professor of Psychiatry at the University of North Carolina. To sum up his testimony about the studies conducted with regard to mental health and oral contraceptives, he says this (page 6457):

“There is considerable incidence of mild to moderate psychiatric morbidity [disease] associated with the use of combination oral contraceptive agents… In three of the four studies, there seems to be agreement that those who have required psychiatric care in the past will be more at risk for the development of morbidity, including psychosis. One study also suggests that there may be some increase in the depth of illness the longer the medication is taken.”

Dr. Kane describes a study conducted in England of 50 women on oral contraceptives who were compared to a control group of 50 women who had not used hormonal contraception. There were no differences in socioeconomic status, age, or history of past depressive episodes. But in the group taking the pill, 14 women “had depression of mild to moderate proportions, while only three of the control group reported this.” The pill users also reported greater depression as well as particularly high scores for “guilt, self-absorption, and loss of energy.”

He goes on to say, “Two suicidal attempts in the pill sample were found, which had not been disclosed to the general practitioner. Since completing the study, another depressed pill-taker had made a serious suicidal attempt.” Three suicide attempts in a study of 50 women? That seems incredibly high to me. Ludicrously high. Especially given that there are other methods of contraception.

But Wait, There’s More!

But that’s just one doctor testifying about a few studies, right? Sure. But the next person to testify was Dr. John McCain (not the senator). One of the first things the doctor points out is (page 6471):

“The contraceptive pills are potent steroid hormones. Alterations of the anterior pituitary function are produced by them… the potential endocrine and systemic disturbances are almost unlimited. The effects produced through the anterior pituitary may be so indirect that years may elapse before a correlation is established between the abnormality and the administration of the contraceptive pills.”

You know what else is a hormonal medicine? Anabolic steroids. “Roid rage” is pretty well documented. Is it really such a leap to think that hormones in birth control can also cause changes in mental health?

Dr. McCain spent years documenting the patients in his practice who suffered serious side effects from hormonal contraception. In that time, he recorded episodes from 52 patients. And per his own testimony, his largest concern was mental health (page 6473).

“The emotional or psychiatric problems are the complications which seem to me to have the most serious potential danger. Three patients have stated that they were desperately afraid that they were going to kill themselves… After the pills were omitted, the depression and suicidal fears of the three patients disappeared, as did the depression of the other patients.”

He also points out (page 6473):

“It is disturbing to consider the patients on the pills whose depression may have ended in suicide and/or homicide with no recognition of any association with the contraceptive pills… Personality changes could be a factor in other conditions such as automobile accidents and divorces.”

Is it really so much of stretch to think that a potent steroid could cause personality changes that could lead to the damaging of personal relationships that are beyond repair? Plenty of other potent substances can and do.

What They Say Now

Dr. Kane and Dr. McCain, as well as every other expert who testified at the Nelson Pill Hearings, agreed on one thing. More research was needed.

So what does the research say now?

Medscape published an article from the American Journal of Epidemiology with the claim that “Hormonal contraception may reduce levels of depressive symptoms among young women.” Yet when you read further into their conclusions, they say that nearly one-third of women discontinue hormonal contraceptives within the first year, many because of mood changes, and those women are unlikely to restart hormones. Therefore, “hormonal contraceptive users at any time point may be overselected for less depression than nonusers.”

The study also points out that:

“Existing literature on hormonal contraception and depression has been primarily confined to small, unrepresentative samples. Among these smaller studies, few cohesive findings have emerged.”

And:

“Little research has examined the role of exogenous hormone use in suicidality, and existing research has focused on mortality from suicide rather than suicide attempts.”

And according to WebMD, there are a laundry list of medications that can cause depression. What is not included on this list? Birth control pills. The only hormonal contraception included is Norplant. Interestingly enough, the active ingredient in Norplant is levonorgestrel, a progestin found in many birth control pills as well as hormonal IUDs. So am I supposed to believe that when injected into my arm, synthetic hormones can cause me depression but when taken daily as a pill or sitting in my uterus for 5 years, they won’t? Does that make any sense at all?

It doesn’t make sense to Dr. Kelly Brogan. That’s why when she has patients that complain of depression, anxiety, low libido, mood changes, weight gain, etc. she recommends they stop using hormonal contraception.

What Have We Learned?

Hormonal contraceptives can cause mental health issues
Women who suffer from mental health issues are much more likely to suffer from increased symptoms when on hormonal contraception
Often the longer hormonal contraception is used, the greater the symptoms
Discontinuation of hormonal contraception can usually alleviate mental health symptoms
The research promised from the Nelson Pill Hearings has never materialized

Why, if they knew in 1970 that hormonal contraception was deeply connected not only to depression but also to suicide, has it not been further researched? It’s been nearly 50 years since Dr. Philip Ball (page 6493), a specialist in internal medicine, testified before congress. Which makes what he says all the more chilling.

“It is not considered reasonable that there be any mortality or morbidity in a pill used purely for contraception purposes. Medical research has got to offer something better than this. Physicians will probably look back on the contraceptive pill era of the past 5 years with some embarrassment.”

Exactly.

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This post was published originally on Hormones Matter on June 22, 2016.

Why Medicate When You Can Meditate?

by Kerry Gretchen

Published on October 24, 2016

3625 views

When the subject of meditation comes up, I often hear, “I could never do that my mind is always racing.” Mine too! That’s why I meditate. To be honest though, many days it goes something like this:

Okay, good. I feel comfortable. This is going to be good. Just ten minutes. Wait, did I set the timer? Does it matter if you set the timer? Shouldn’t you meditate without a timer and just “know” that you are done? Maybe I’m not that good at meditating. Obviously, I’m not that good at meditating. I’m not good at a lot of things. Hey, wait, aren’t I supposed to stop with the negative self-talk? Yes, okay. I love myself. I am good at many things. Has it been ten minutes? I’m totally going to have a sandwich after this…

Saying you can’t meditate because your mind is too busy is like saying you can’t work out because you’re not strong enough. That’s exactly why you should work out. Quieting the mind is a practice. You aren’t going to get better at it if you don’t try. “Okay,” you may say at this point, “but why do I need to quiet the mind?” Well, I’m glad you asked. Let’s look at the science.

The Science of Meditation

What does it do?

When it comes to the brain, bigger is better and meditation is fertilizer. It has been shown to increase the volume of gray matter in the left hippocampus. What does that mean? It means an increase in “learning and memory processes, emotion regulation, self-referential processing, and perspective taking.”

The growth doesn’t stop there. Another study found that “meditators showed significantly larger volumes of the right hippocampus… larger volumes in these regions might account for meditators’ singular abilities and habits to cultivate positive emotions, retain emotional stability, and engage in mindful behavior.”

It also makes your brain thicker in the prefrontal cortex and right anterior insula. These regions are important for sensory, cognitive, and emotional processing. In addition, the research indicates that meditation may help slow age-related decline in these areas.

Meditation doesn’t just make your brain bigger, it also makes your telomeres longer. What the heck are telomeres? Telomeres are the caps at the end of each strand of DNA that protect our chromosomes, like the plastic tips at the end of shoelaces. “Shorter telomeres are associated with accelerated aging and related diseases… long-term meditators have a significantly younger biological age.” So maybe next time you’re fretting over getting older instead of reaching for the wrinkle cream, sit down and don’t think about it.

How does it work?

“Meditation enables us to move from higher frequency brain waves to lower frequency, which activates different centers in the brain. Slower wavelengths = more time between thoughts = more opportunity to skillfully choose which thoughts you invest in and what actions you take.”

What are the benefits?

The benefits of meditation are many and varied. An article from Dr. Hari Sharma compiles many of the highlights in the following paragraph:

“Research has confirmed a myriad of health benefits associated with the practice of meditation. These include stress reduction, decreased anxiety, decreased depression, reduction in pain (both physical and psychological), improved memory, and increased efficiency. Physiological benefits include reduced blood pressure, heart rate, lactate, cortisol, and epinephrine; decreased metabolism, breathing pattern, oxygen utilization, and carbon dioxide elimination; and increased melatonin, dehydroepiandrosterone sulfate (DHEA-S), skin resistance, and relative blood flow to the brain.”

Reductions in stress, anxiety, depression, pain, and blood pressure—what else do you need to know? How about that meditation can also help with insomnia and appears to be effective for treating post-traumatic stress disorder (PTSD).

How to Meditate

If they could bottle and sell the benefits of meditation, you’d probably pay top dollar for it. Especially given the lack of side effects. Yet like diet and exercise, knowing something will make us healthier doesn’t always get us do it.

Some people think the only way to meditate is to sit in lotus position on a yoga mat with a stick- straight spine. Not true! You also don’t have to meditate for long periods of time. There are many different meditation techniques and you really can’t do it wrong. When does anyone ever say that to you about anything? I’ll say it again. You really can’t do it wrong. I often meditate for ten minutes at a time while lying in bed just after I wake up. (Incidentally, a snooze button makes a great timer.) Or, I’ll meditate when I go to bed. Sometimes I just end up falling asleep. Guess what? It doesn’t matter!

You can also meditate while eating, while walking, while dancing, or even just gazing. Perhaps the simplest and easiest way is just to focus on your breath. As explained in the 2 minute video below, Tibetan Buddhist Master Yongey Mingyur Ripoche offers a simple technique for meditating that you can use anywhere. I know it’s helped my “monkey mind.”

Do you have any experience with meditation? What has or hasn’t worked for you?

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Image by 3503898 from Pixabay.

Why Am I Here? Thoughts on Survivor’s Guilt

by Kerry Gretchen

Published on July 25, 2016

2213 views

“I’m so glad to see you. I didn’t think you were going to make it.”

If you’ve read my story, you may remember that is what the emergency room doctor said to me a few weeks after I had a stroke. I had only been out of the hospital for a week when I developed a rash from the seizure medication I was taking. Because it was a Friday night, my neurologist told me I needed to go to the emergency room. I cried as my in-laws drove into the parking lot of the little local hospital. It was the very same hospital that had sent me home twice before finally discovering, days later, that I had blood clots and was bleeding into my brain.

“You’re a miracle.”

One of the advantages of having a stroke at 28 is that when you return to the ER, they finally take you seriously. I was ushered into an examination room within 5 minutes of checking in. As I waited to be seen by the doctor, a nurse came in. She was very excited and a little emotional.

“Hi,” she said. “Don’t you remember me?” I did not. “I sat with you for hours when you were in here a few weeks ago.”

I immediately began to feel very guilty for not remembering this lovely woman who so obviously cared about me. She took my hand in hers. “You’re a miracle,” she said reverently.

Confused about what the appropriate response to that was, I smiled meekly and said, “Thank you?” When she left the room, I could hear her talking to people up and down the hall. “The miracle girl is here!” she said over and over.

Later, I would lay in bed, or sit on the couch, or ride in the car and wonder, “If I’m such a miracle, why am I here?” What was an enthusiastic and loving sentiment from that nurse turned into a real mindf*@k (pardon the language but there was really no phrase that worked as appropriately here) as my poor, broken brain puzzled over why I had survived.

What is Survivor’s Guilt?

Trying to understand your purpose in this world is a tough enough task. Nevermind trying do it while you’re struggling to just tie your shoes and feed yourself. I wanted to put it out of my mind and just take things one day at a time. But it was hard to do that. There is so much uncertainty during and after a health crisis like a stroke. What will my life look like now? Will it ever look like my life before? Do I want it to look like my old life? Of what kind of life am I even capable?

At the time, I wouldn’t have called it survivor’s guilt, but that may have been what I was dealing with. Survivor guilt (or survivor’s guilt; also called survivor syndrome or survivor’s syndrome) is a mental condition that occurs when a person perceives themselves to have done wrong by surviving a traumatic event when others did not.

Though more common, or perhaps more noted, in survivors of combat and natural disasters, it can also occur in patients who have overcome a health crisis (cancer survivors, HIV/AIDs patients, etc.). It was originally identified in the 1960s in survivors of the Holocaust and since been re-categorized as a symptom of Posttraumatic Stress Disorder.

Treating the Whole Patient

Because we don’t usually think of health crises as causing PTSD, the guilt and other mental health conditions that accompany these situations are often left untreated. I was treated for my stroke physically, but not really mentally, except in the capacity that it affected my actual cognitive abilities. I was sent home from the hospital with prescriptions for blood thinners, seizure medication, and a whole host of other drugs to counteract the side effect of the other two (despite the fact that I had not exhibited any of those side effects). Yet no one asked how I was dealing with the emotional side of what happened to me.

And it’s not just stroke survivors that have trouble processing what happened to them.

“Depression is 3 times more common in patients after a heart attack than in the general population, with 15% to 20% of heart attack victims qualifying for a diagnosis of major depressive disorder, and a far greater proportion experiencing increased levels of depressive symptoms.”

According to the Lung Cancer Alliance, 63.9% of lung cancer survivors have experienced feelings of survivor guilt.

“While survivorship is often portrayed as an over-the-moon, happy feeling that all people battling cancer set as their goal, many lung cancer survivors feel burdened by it, experiencing emotions of guilt, anxiety and stress.”

Yet it seems that once the physical body is out of danger, many patients, myself included, are left on their own to unravel the emotional impact—to make sense of the new and unfamiliar life in which they find themselves. Often this process can take years.

For example, this project I’m working on is a staggering reminder that I have survived while so many haven’t. Though my stroke was 10 years ago, it is difficult to read the stories and interact with the families of the women who were killed by hormonal birth control. It brings me face to face with questions I thought I had long ago answered. Why me? Why did I live while so many others did not? And am I doing what I’m supposed to with this life?

“I really needed you.”

About a year after my stroke, I told my dear friend Jamie about what the nurse said. I told her how much it weighed on me, about the pressure I was putting on myself. Her response was beautiful and simple and a good reminder for us all. “What if you’re here because I really needed you not to die?” Mind blown. Maybe some survivors are supposed to achieve great things and change the world. Or just maybe our purpose is as subtle and as profound as being there for someone else.

That message was enough for me for a long time. But when I was contacted about working on this project, I knew there was a reason. This work is important. Women need to understand the side effects of hormonal birth control, the symptoms of a blood clot, and that their options are not just the pill or pregnancy. We need to start asking why life-threatening blood clots, emotional issues, loss of libido, weight gain, as well as many other side effects are considered “acceptable.” We need to hold the pharmaceutical companies to a higher standard. We need to value human life above corporate profit. We need to take women seriously when they discuss their medical concerns. We need to fully research women’s health issues. The entire paradigm of women’s health care and contraception needs to change. The conversation has been started. And I think I may be here to add another voice to it. The voice of a survivor.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

5 Surprising Reasons Not to Use Hormonal Birth Control

by Kerry Gretchen

Published on June 29, 2016

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The following is a list of some the health factors that increase your risk of side effects from taking hormonal birth control. It is by no means a complete list of contraindications but you may find some of these surprising. I know I did.

Five Reasons You May Want to Reconsider Hormonal Birth Control

Reason 1: Smoking and Age

You are probably familiar with these warnings. You may have heard them on television commercials or seen them on magazine advertisements. Or maybe you read my article about risk communication and saw them there. The problem with these warnings is that the wording makes it seem like you are only at risk if you are over 35 and a smoker. But the truth is that these two risk factors stand independent of each other. You are at increased risk if you are over 35 years of age. You are at increased risk if you are a smoker of any age. And if you are a smoker who is over 35, you have an exponentially higher risk for blood clots when using hormonal birth control.

Reason 2: Migraines

According to a 2010 article in the Reviews in Obstetrics and Gynecology, 43% of women in the United States suffer from migraines. That’s a huge number of women. Also, according to the same article, 43% of women using birth control are using hormonal contraception (the pill, rings, shots, implants, etc.). I’m not a statistician but I’m guessing there is some overlap between the women that suffer migraines and the ones using hormonal birth control. This is problematic for two reasons:

A great deal of evidence suggests that migraine, particularly migraine with aura, is associated with an increased risk of ischemic stroke, and that this risk may be further elevated with the use of hormonal birth control. But if you don’t believe me, both the American College of Obstetricians and Gynecologists and the World Health Organization advise that women who suffer migraines with aura should not use hormonal contraception.
Reevaluation or discontinuation of combination hormonal contraception is advised for women who develop escalating severity/frequency of headaches, new-onset migraine with aura, or nonmigrainous headaches persisting beyond 3 months of use.

A 2016 meta-analysis of seven research studies demonstrated “a two- to fourfold increased risk of stroke among women with migraine who use combined oral contraceptives (COCs) compared with nonusers.” But once again, like so many other things about hormonal birth control, the authors of the study report that research is lacking in this area and more studies need to be done.

Reason 3: Family Clotting Disorders

Many people have a clotting disorder and simply don’t know it. When I had my stroke while on birth control pills, I had no idea that I had the fairly common clotting disorder Factor V Leiden (FVL affects between 3-8% of people). But what I did know was that my grandmother had had two strokes. And my aunts and uncle had all had blood clots.

Unfortunately, women are not systematically tested for clotting disorders before they begin using hormonal birth control. This is very dangerous and why it’s so important to give your doctor a thorough family history; something I know I wouldn’t have considered that vital when I was 18 years old.

A lot of health professionals don’t take the time to review your family history, making it even more important that you mention your family history of blood clots and your concerns about hormonal contraception. You might even insist on being tested for clotting disorders before increasing your risk of a dangerous and sometimes deadly blood clot.

Reason 4: Depression and Mental Health

I explore this further in this article but the basics are:

Hormonal contraceptives can cause mental health issues
Women who suffer from mental health issues are much more likely to suffer from increased symptoms when on hormonal contraception
Often the longer hormonal contraception is used, the greater the symptoms
Discontinuation of hormonal contraception can usually alleviate mental health symptoms

Reason 5: Diabetes

Dr. Hugh J. Davis, the first doctor to testify at the Nelson Pill Hearings said the following (page 5930):

“A woman, for example, who has a history of diabetes or even a woman with a strong family history of diabetes is not an ideal candidate for using oral contraceptives… [they] produce changes in carbohydrate metabolism which tends to aggravate existing diabetes and can make it difficult to manage.”

Hormonal birth control elevates blood glucose levels, can increase blood pressure, increases triglycerides and cholesterol, and accelerates the hardening of the arteries, among other things. They knew this in 1970. But what about the research now? Well, if you’ve read any of my other articles it probably won’t surprise you that the current research is… wait for it… you guessed it… INCONCLUSIVE! Here’s a look at what I’ve found:

“Cardiovascular disease is a major concern, and for women with diabetes who have macrovascular or microvascular complications, nonhormonal methods are recommended.
There is little evidence of best practice for the follow-up of women with diabetes prescribed hormonal contraception. It is generally agreed that blood pressure, weight, and body mass index measurements should be ascertained, and blood glucose levels and baseline lipid profiles assessed as relevant. Research on hormonal contraception has been carried out in healthy populations; more studies are needed in women with diabetes and women who have increased risks of cardiovascular disease.”

And:

“The four included randomised controlled trials in this systematic review provided insufficient evidence to assess whether progestogen-only and combined contraceptives differ from non-hormonal contraceptives in diabetes control, lipid metabolism and complications. Three of the four studies were of limited methodological quality, sponsored by pharmaceutical companies and described surrogate outcomes. Ideally, an adequately reported, high-quality randomised controlled trial analysing both intermediate outcomes (i.e. glucose and lipid metabolism) and true clinical endpoints (micro- and macrovascular disease) in users of combined, progestogen-only and non-hormonal contraceptives should be conducted.
Not enough evidence is available to prove that hormonal contraceptives do not influence glucose and fat metabolism in women with diabetes mellitus.”

As a side note, a recent study demonstrated a link between hormonal contraceptives and gestational diabetes.

Contraception is a very personal choice. I believe all women should research the risks associated with using hormonal contraception, but especially if you experience any of the health conditions above. Should you weigh the risks and benefits of using hormonal birth control and decide it’s still the right choice for you, please take a moment to review the symptoms of the blood clot and seek help immediately if you notice any of these.

Real Risk Study: Birth Control and Blood Clots

Lucine Health Sciences and Hormones Matter are conducting research to investigate the relationship between hormonal birth control and blood clots. If you or a loved one have suffered from a blood clot while using hormonal birth control, please consider participating. We are also looking for participants who have been using hormonal birth control for at least one year and have NOT had a blood clot, as well as women who have NEVER used hormonal birth control. For more information or to participate, click here.

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Five Reasons You May Want to Reconsider Hormonal Birth Control

Reason 1: Smoking and Age

Reason 2: Migraines

Reason 3: Family Clotting Disorders

Reason 4: Depression and Mental Health

Reason 5: Diabetes

Real Risk Study: Birth Control and Blood Clots

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