The other week I read in the New York Times about a “glut of antidepressants.” The story was about the loose (and perhaps over-diagnosis) of depression in a community sample of over 5,600 patients.
Most of those patients examined who supposedly had clinical depression turned out to, in fact, not have it — only just over 38 percent met the official criteria after 12 months.
Somehow this got convoluted with the increase in antidepressants over the past two decades. “One in 10 Americans now takes an antidepressant medication; among women in their 40s and 50s, the figure is one in four.”
While we can lament this increase all we want, I also can’t help but say, “So what?”
Do we spend all that much time lamenting how much human beings rely on mood-altering substances to make it through their daily lives?
Look at how many Americans drink alcohol regularly every week — many every day. Do they do it just because they enjoy the taste of it? Or do they also imbibe because it brings some pleasant mood alteration, taking the edge off of a hard day’s work?
Is alcohol a “better” drug to take in any way, shape, manner or form than an antidepressant?
Look at how many people start their day with a cup of caffeine. There’s really no better example of a mood altering substance most of us take regularly, years on end, to help us get through our days. Too much caffeine has well-documented negative health (and mental health) effects.
Yet do we ever hear people decry how much of a caffeine-oriented culture we’ve become, where more than 50 percent of Americans rely on it daily?
So my problem isn’t so much with a study showing how badly primary care physicians misdiagnose depression in their patients (which is of no surprise to any mental health professional). They do so because they don’t see the harm in making the misdiagnosis if they believe the prescription of an antidepressant will ultimately help the patient get through whatever it was that brought them into the doctor’s office that day. A means to an end, if you will.
No, my problem is with society being upset by the use — and perhaps “over” use — of antidepressants. My problem is with the double-standard society has for certain types of mood-altering substances, but not others, a focus on certain types of drugs, while not having any problem with others.
Do we lament how many people are taking insulin because of the insulin? Or do we actually instead look at the root of the problem (Americans’ ghastly diet and eating habits) of the disease (diabetes)?
In the same way, shouldn’t we stop focusing on how many people take antidepressants, and instead look more toward the why so many doctors are prescribing — and willing patients — taking such drugs?
Non-Specialists Prescribing Specialist Drugs
I think the answers are many, but begin with some primary care physicians seeing antidepressants as the placebo they largely may be. “Here’s a fairly harmless drug (depending on which one, of course) that I can prescribe that may actually help lift the patient’s mood a bit.” They diagnose clinical depression so the insurance company will cover the cost of the antidepressant. (There are actually a lot of other conditions antidepressants can be prescribed for, but let’s leave it at that.)
A patient who may be feeling a bit down (but not meet the clinical definition for depression) sees the prescription as a possible ray of hope to help with their mood. They take it because most patients still do what their doctor suggests and recommends for them.
Inherent in articles like this is the suggestion that we have “too many” people taking “too many” drugs. Yet after two decades of such a drastic uptick in antidepressant usage, I have yet to see the overarching negative societal effects.
If you’re one of the opponents of people taking antidepressants, there’s a silver lining for you. Most people who try an antidepressant actually don’t feel any beneficial effects of it (so says the STAR*D researchers), and stop it on their own.
And once you’ve tried an antidepressant and it hasn’t worked for you, how likely are you going to try another one the next time the doctor suggests it?
But we need to stop stigmatizing and discriminating against a certain type of medication — in this case, psychiatric drugs — and acting like they’re some sort of evil that need the brakes put to their prescription.
Read the full article: A Glut of Antidepressants