Respecting the Hormonal Side of Mental Health

Please note that we talk about mental health in this letter. Read it when you’re ready. In the meantime, know that we love you.

Cassidy: Dear Higher Self,

If I am honest, this week was fucking hard.

I don’t feel as though I’ve earned the right to say that, because there was nothing in particular that made it this way. I just got lost in the mantra that I do not have the time or energy to prioritize my mental health. It can wait. It can wait. It can wait.

Unfortunately for me, I didn’t have the energy for much else either, so instead of being depressed with a purpose, I installed myself in a vicious cycle of being unproductive and then hating myself more for it.

To admit this–especially to our Chica family (to whom we always advocate self care)–is difficult. How can I tell our customers that they are worthy of love when I cannot believe the same for myself? That’s not particularly on-brand.

When I reconfigure my approach to mental health, however, I realize that there is nothing that could be more relevant. We promised to be real with our customers when we started writing these letters. Beyond that, what is the one thing that I have never considered as a step towards taking better care of my mental and emotional health? Breaking up with my IUD. In spite of the research that “strongly suggests that there is an increased risk of depression associated with all types of hormonal contraception,” and the repeated affirmations from my mama that it’s something I can and should do (Harvard Health Publishing).

I don’t think we, collectively, talk about the hormonal side of mental health enough. When we address period pain, we mostly reference the physical. If anything, we mention ‘depression’ as a symptom of an unhealthy cycle–but a more holistic understanding of the manner in which hormonal health and mental health are inexorably intertwined is somewhat lacking.

According to Chinese medicine, depression is mainly affected by the liver–the same organ that is essential in breaking down and removing excess hormones from the body. Within its role as the body’s filter, the liver processes emotions in much the same way that it processes hormones. A liver overworked by external factors and emotional stressors is, then, at the root of both problems; this is why the formula Chica is derived from is often prescribed to alleviate depression as well.

To be clear, I’m not advocating that everyone quit their birth control. I just want to contribute to a space where we can be as educated as possible about our health and as vulnerable as we need to be when shit gets tough.

It may have been a difficult week, but I am still here, and I will count that as a victory.



P.S. This letter is dedicated to my roommates, who let me cry and held me when I needed it; to my parents, who brought me a roast duck as a housewarming present; to my professor, who asked me if I was doing okay when I clearly wasn’t; to my therapist, who knows what’s good and assigned me the homework of making more art; to my doctor, who’s new, but still called to check in that I was vibing with my meds. This is dedicated to you and anyone else reading this who feels that they do not deserve to put themselves first.

Elise: Sweet Cass,

I do not take this letter as being to me, because I am not higher than you in any way. You have sat with me many times through my low points, and I sit with you now.

Before we even touch on the effects of hormonal birth control, I want to mention a conversation I had this weekend when I was blessed with the opportunity of sharing a 3 hour car ride with an older woman I had just met, who wanted to get straight to the point of why I feel insecure. She quickly spoke to the root of it: Women, of all ages, are faced an insane amount of demands to meet. And most of us internalize them all. We need to do well in school, perform highly at our jobs, have a social life, attract partners, be responsible for those relationships being happy, have sex when their partner wants, not bring attention to their bodies on the street, speak a certain way, have a backbone while also ‘understanding’ when to be quiet, work out so that we can have a slim bodies, have clean diets, have clear skin, show up really fucking happy. This list doesn’t even include the expectations that are introduced when we do decide to have babies. I am so tired of these expectations, and I am so tired of the voice in my head that tells me I have never done enough with my day, that I am always failing, that I am always behind. I don’t know how to shut off this voice, but one piece of wisdom passed onto me is that this voice isn’t me. It’s fucking obnoxious and it’s loud but it is not me being a bad person, failing myself yet again, it’s just an interesting statement from my crazy roommate. I can slam my mental door knowing I have done nothing wrong for hearing this criticism.

The mental health of founders is not talked about enough. How could building Chica be difficult? I’m starting a company with my best friend and we get to eat chocolate and talk to people about periods. My favorite things! But, everyone starts a company because they love it, and it can still be so draining. A study conducted by a group of researchers from the UC system showed that entrepreneurs report experiencing depression at double the rate of the general population (Michael A. Freeman, M.D.). Being an entrepreneur is difficult, and it’s something we have to keep talking about, and this is why we don’t run Chica alone. We have each other and the amazing, supportive community around us.

I have one piece to add to your mention of hormonal birth control. When hormonal birth control was first introduced via the pill, doctors and pharmaceutical companies hadn’t actually spent much time researching how the pill would affect our health. They did conduct preliminary research on low-income women in Puerto Rico without their consent, however, they either did not see the long-term effects, or did not deem them important enough. We know now that the initial hormonal pill caused life threatening blood clots and increased risk of cancer, because that version contained around seven times more estrogen than the pill we have today. When Barbara Seaman released The Doctors’ Case Against the Pill (1969), Congress held a trial to question all male doctors on the safety of the pill, yet did not allow a single woman to testify (Repackaging the Pill). The lead researcher of the study you quoted, Angelica Lindén Hirschberg, said that she began her study because, “Despite the fact that an estimated 100 million women around the world use contraceptive pills we know surprisingly little today about the pill’s effect on women’s health.” The institutionalized male-centric medical system still insists on ignoring other bodies.

To end this letter on a happy note, I am excited to share that since removing my IUD, I have just completed my first 100% waste free period. I received a menstrual cup (not encouraged to be used with an IUD) a few months ago, but struggled to feel comfortable with its positioning, and would eventually reach for a pad or tampon during my bleeding cycle. I finally bit the bullet and didn’t allow myself to purchase any more single use period supplies and it was actually so easy! Just had to leave my comfort zone a little bit, but it was so worth it to not create a bloody trash can of doom.

I love you LOTS!