14 Comments to
Antidepressant Use Up, Psychotherapy Use Down

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  1. In league with the prior posts about the Mothers Act and Doug Bremner’s comments, and watching the growing follies of our government’s pathetic efforts at aiding the health care access problems in this country, I just want to say after reading this post that I KNOW if any health care bill passes, it will further screw up mental health care interventions. When will responsible, knowledgeable, attentive people involved in health care matters wake up and see the bullshit coming from our alleged representatives in Washington DC?

    And you think a government controlled health care plan is going to value and make psychotherapy accessible? From a bunch of self absorbed, greedy, uninvested, narcissistic politicians?

    Scoundrels use people who are naive and trusting to further their evil agenda. Don’t believe me, just look at history.

    It is a shame George Carlin has passed away, I would love to hear his take on this joke of alleged good intentions by Congress and our President. Town hall meetings to educate the public? Just pass out a copy of the bill to registered voters. Oops, I’m sure the postage would increase the federal deficit by another couple of billion dollars, as well as provide not just a Summer reading, but for the Fall as well.

    Wake up people and take a god damn stand against incompetence and ignorance that will harm us in ways you don’t even see coming now.

    Psychotherapy access is down? Mental health care access is down and falling faster! At least I appreciate Dr Grohol documenting the numbers I have been quoting for a couple of years regarding the percentage of scripts written by non-psychiatrists for antidepressants. That statistic alone should scare the hell out of everyone involved in this debate!

  2. My personal view would be to use medications as a last resort or in cases of emergency situations. I would think that the best route would be to at least attempt talk therapy first or use it in combination with medication. I’m sure that each case is different, but it seems a shame that therapy use is down. I think nowadays some folks prefer a “quick and easy fix” when there really is no such thing. Medications, I would think, at least in part, treat the symptoms without treating the cause. Relating with another human being would seem very advantageous to me because it engages the spirit. Obviously I am no expert (or even close) about all of this so maybe I speak in ignorance on this matter. I think whatever methods work best for that patient would be the best course of action to take with treatment. But why not at least try talk therapy?

  3. A couple of points. When a patient sees a psychiatrist, the prescription that is handed him/her has different meaning then when a GP prescribes it.

    Often, a PCP will hand a patient a prescription to a patient who is in pain, or as an alternative to painkillers. The doctor will also hand this rx to a patient whom he doesn’t know what else to do with.

    My point here is, that a prescription written by a PCP is not the same as a prescription taken as a result of it being written.

    I know many patients who tell me that they were either handed a rx for an antidepressant or otherwise something like Neurontin, the latter almost always for pain.

    And, they either only use it for a short time and stop, or they don’t use it at all.

    So, this really changes the picture.

    Actually, I will limit my comment to this one point.

  4. I have a friend who has been prescribed something like ten different antidepressants and mood stabilizers in just this past last year by her PCP.

    She will tell her doc that whatever he prescribed did not work for sleep, and then he will tell her to try something else and then again something else and then again.

    These are all prescriptions that are never really used more than maybe a couple of days, but they count into the equation of the above study.

    Often, the doctor prescribes this for his own sake and not the patients.

  5. PS: And often, when a patient complains of sleep difficulties, she/he will be prescribed something like Trazodone and which is not even related to Depression. (I mean it can be but it isn’t always at all)

    then, there are patients, like those who have estrogen positive breast cancers, and who are treated with hormonal therapy, like Tamoxifen, or Arimidex, or Femara.

    Those drugs have major side effects ranging from Depression to Hot Flashes, and many of these women are prescribed something like Wellbutrin for the Hot Flashes alone.

    I guess my point here is obvious.

  6. The problem with pills is the same thing people like about them: they don’t require you to change. This ultimately disempowers people by teaching them that the solution is outside themselves, when there are very few circumstances where that has to be true.

    Sure, there are plenty of cases where medications can help – but as a sole solution, I think they are completely inappropriate.

  7. John, I am glad you clarified, with regard to psychotherapy, that the study focused ONLY on people taking antidepressants. But, I do wonder if there is an overall decrease in use of psychotherapy in those getting therapy but NOT taking drugs. Do you know of any studies looking at that trend?

    Unfortunately we are becoming a society where we are busier and more time crunched than ever. That means people are ‘running around more’ and not taking time to reflect. And, many would argue we are a society that paradoxically puts more walls up between each other (may be even more alienating) even as we connect more (for example: when does our use of technology – the internet, texting, etc., – hurt rather than help our relationships?)

    Both of these trends go against what psychotherapy asks of the person. I don’t think it’s a ‘inner weakness’ on people’s parts, just they are too, like others, being swept up into the rapidly paced time we live in (which is predicted to worsen, btw!)

    When people are ‘over scheduled’ and stressed (include here too the economic climate), it is natural to reach for what works quickly and, the least expensively. And, yes, it’s natural to reach for what requires less courage and work! 😉

    I think you can liken this ‘sea change’ to the one with regards to religion. Many more people are without a religion or spiritual practice today.

    But, I think there is also always a ‘thesis, antithesis’ thing going on. Yes, mental health parity should make an impact. Also – I think we’ll see other negative affects of this broad use of meds over time arise as well. I think we’ll see the cons of not ‘slowing down’ and really reflecting on what one is doing, where their life is going, etc. and that may increase an interest again in talk therapy. We may also see more of the dangers of long term use of these drugs come out…

    There are still plenty who have experienced the positive results of psychotherapy value what psychotherapy can provide and these stories do spread.

    I’ve been a mental health professional over 20 years now. It’ll be interesting to see where the field goes in the next 20 years…

  8. I think it is important to remember that clinical depression is an illness, and to ignore the physical aspects of this serious disease is a huge mistake. Talk therapy is very often NOT ENOUGH in the battle over this mood disorder. As a psychotherapist, I strongly feel that medical intervention is often an important part of recovery. Nutrition, diet and exercise are also crucial for recovery. Talk therapy is rarely sufficient for seriously depressed patients; especially those with suicidal ideation. Feel free to contact me for any further discussion on this important topic. I wish you all the best.

  9. Thank you John Newmark for your post.

    For my severe, treatment resistant depression, taking medication is anything BUT an easy way out. It is a crucial component to my treatment, and it was hard work to find a combination that has worked for the long haul.

    Talk therapy was useless until, after many, many trials, I found medication that worked and brought the depression under control. Even now, after having worked with and benefited from wonderful therapists, my depression returns if I am not on medication.

    It does a terrible disservice to those with serious mood disorders to imply that taking medication is somehow a cop-out or a poor choice. For some of us, it’s a matter of being able to live a functional, normal life.

  10. Where is it being said that antidepressants should not be offered to those who NEED them? So many of you miss the point to what are the interventionSSS in mental health care, and I see and hear it every god damn day, today no exception. People show up in my office, at inpatient hospitals, referred by other health care professionals, state it at blogs like this and other media sources, and at the end of the day, this culture is losing it more and more and has no interest as a whole in responsibly problem solving. And now I have to listen to this stupid dialogue from our politicians how they are going to save health care and make it right, make it better. The clueless leading the clueless. America, what a wonderful country! You all do not see the freakin’ cliff up ahead, do you? Well, I am not with this crowd.

    I have to take a break from this nonsense so I can avoid this addictive process. Vacations do not change things, this I know, but I can’t stand this ridiculousness. How many times do we as a species have to make the same mistakes before we learn and change to better adapt and improve? You know what I have learned? Great leaders don’t lead because they want to, but they have to, because it is right, and it involves self sacrifice and risks and little true appreciation from the general masses; leading is not for convenience or self serving or seeking accolades. Do you really see our alleged leaders in Washington there because they genuinely embrace leading and helping others? It is a tainted process, this alleged democracy of America, and people have truly lost their way. Again, just looking for the quick outs. Hey folks, rocks at the bottom of the cliff, and gravity will not be avoided!

    “If you want to get better, take a pill, but if you want to get it right, face the truth”. What a wonderful adage wasted on a culture that can’t figure it out!

    August recess, I am dismissed! Breaking away from the pack and breathing at least a short sigh of relief, I hope! Good luck and be well to those who can find it and appreciate it.

  11. skillsnotpills, I really don’t know, or understand what you mean by your comment. I also understand that I am supposed to know what you mean, but I don’t.

    You are disgusted by our comments, right?
    But could you just briefly say, or give an example, about what exactly it is that is bothering you?

    Did say something stupid, for example?


  12. I personally have no bias against taking anti-depressants. I don’t think one should wait until they are on the brink of a horrible demise. I know that I was depressed as a child. I did not realize that I have been depressed all my life until I started taking anti-depressants.
    I wonder why so many people suffer from depression. Is it a natural variation in humans? Is it our society? I have not seen any research that addresses why so many people are depressed.
    I am starting to think that, well, the world isn’t a bowl of cherries for anybody. Life is NOT fair, and there is a lot of suffering. People get sychologically damaged at early ages. It’s no one’s fault, really. It’s like a family inheritance of genes, only instead of genes, it’s psychological traits and issues.
    I say, take the pill, and make yourself and everyone around you feel better. Make the world a little better.
    One caveat is that the pharmaceutical companies are making out like bandits. Like I said, life is not fair.

  13. I can see not much changes here, Do any of you, truly know what your talking about?!!.. Or is it just comforting to yourselves to merely paticipate in Psycho Babble,.. Get off the internet and get into the real world.

  14. It must be me, as I again do not follow what
    Lisa Van Syckel is talking about.

    With me, I was responding to the article by saying that I think the ‘research’, (and which shows that prescriptions for antidepressants have gone up by like 75%) may not be as significant as it sounds, because antidepressants are prescribed for not only a lot of people by their PCP’s for depression, but also for all sorts of other reasons, and often repeatedly, when the first or second rx does not do the job. Also, that unlike when patients see a psychiatrist, when they are prescribed an antidepressant by a PCP, they often do not take it, because they were seeking help for another problem, and they really wanted something like pain killers and not antidepressants. So, the needs of the patient and those of the doctor are not the same in a general practice often, and as they are when you go to a psychiatrist.

    Now, I did not learn this from the internet or in psycho-babble school, but in the real world and from real people. pretty much everything I say comes from real experience from self and others. This is why I don’t get what feels like hostile ‘put down’ from the above people who don’t seem to want to bother to explain their points because we are not worth it?

    I am not invested in being ‘right’ but I am not an idiot either, and I do live in the real world.

  15. Um…Lisa…you’re on the Internet too, apparently.

    Besides, it doesn’t follow that because people post on a blog or internet forum that they’re not involved in the real world. I work, have friends, recreational activities, all thanks to effective treatment for my depression.

  16. Sheila, you better pray your antidepressant keeps working because when it ceases to be effective, good luck in tapering off of it and dealing with withdrawal symptoms that Skills’s colleagues falsely claim only last for two weeks.

    Personally, I wish I had never taken a crumb of a psychiatric medication as these meds have destroyed my life and it has been h-ll in trying to get off of them. I have a hearing loss and cognitive issues.

    Heck, dealing with depression would have been a walk in the park compared to the devastation these meds have caused.

  17. Having just read a wonderful oped piece at http://www.americanthinker.com (Obamacare and Me) by Zane Pollard, MD, an opthalmologist who outlines how the CURRENT government programs he is in limits his health care options for the patients he treats, I suggest all interested read it and see the parallels to mental health intrusions.

    Limited access to certain medications. Already done. Limits on the number of psychotherapy visits. Certainly will happen. What diagnosis can be decided to access treatment. Private insurance has laid the groundwork to this being a reality by a government plan.

    Here’s the real harsh one: limit access to mental health care as a whole, as this is a disposable population to the government. Don’t believe me, just look at history.

    I’m trying to light a fire under those who have the need and interest to be invested in what is happening here, folks. But, maintain your bitch sessions if it works for you. Just came across something that I thought would explain it better than I have seemed to have failed at doing.

    Enjoy August!

  18. Skills…says: ‘ But, maintain your bitch sessions if it works for you.’

  19. So much anger… :(

    I thought the goal here was to try and help one another. This is an interesting discussion. I would hope to be respectful of everyone’s opinions while expressing my own. More information is supposed to be advantageous, right?

    I would think the best course of action would depend on each individual. Find what works best for that person. My personal opinion would be to try talk therapy first and then use medication if that doesn’t seem to be alleviating the patient’s difficulties. Just my personal thoughts on the matter. Healing is the goal here and how best to heal? That’s the question to be answered, right?



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