Washington – Use of antidepressant drugs in the United States doubled between 1996 and 2005, probably because of a mix of factors, researchers reported on Monday.
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About 6 percent of people were prescribed an antidepressant in 1996 — 13 million people. This rose to more than 10 percent or 27 million people by 2005, the researchers found.
“Significant increases in antidepressant use were evident across all sociodemographic groups examined, except African Americans,” Dr. Mark Olfson of Columbia University in New York and Steven Marcus of the University of Pennsylvania in Philadelphia wrote in the Archives of General Psychiatry.
“Not only are more U.S. residents being treated with antidepressants, but also those who are being treated are receiving more antidepressant prescriptions,” they added.
More than 164 million prescriptions were written in 2008 for antidepressants, totaling $9.6 billion in U.S. sales, according to IMS Health.
Drugs that affect the brain chemical serotonin like GlaxoSmithKline’s (GSK.L) Paxil, known generically as paroxetine, and Eli Lilly and Co’s (LLY.N) Prozac, known generically as fluoxetine, are the most commonly prescribed class of antidepressant. But the study found the effect in all classes of the drugs.
Olfson and Marcus looked at the Medical Expenditure Panel Surveys done by the U.S. Agency for Healthcare Research and Quality, involving more than 50,000 people in 1996 and 2005.
“During this period, individuals treated with antidepressants became more likely to also receive treatment with antipsychotic medications and less likely to undergo psychotherapy,” they wrote.
SOCIAL ACCEPTANCE
The survey did not look at why, but the researchers made some educated guesses. It may be more socially acceptable to be diagnosed with and treated for depression, they said. The availability of new drugs may also have been a factor.
“Although there was little change in total promotional spending for antidepressants between 1999 ($0.98 billion) and 2005 ($1.02 billion), there was a marked increase in the percentage of this spending that was devoted to direct-to consumer advertising, from 3.3 percent ($32 million) to 12 percent ($122.00 million),” they added.
Dr. Eric Caine of the University of Rochester in New York said he was concerned by the findings. “Antidepressants are only moderately effective on population level,” he said in a telephone interview.
Caine, who was not involved in the research, noted that several studies show therapy is as effective as, if not more effective than, drug use alone.
“There are no data to say that the population is healthier. Indeed, the suicide rate in the middle years of life has been climbing,” he said.
Olfson and Marcus said out-of-pocket costs for psychotherapy and lower insurance coverage for such visits may have driven patients away from seeing therapists in favor of an easy-to-prescribe pill.
The rise in antidepressant prescriptions also is seen despite a series of public health warnings on use of antidepressant drugs beginning in 2003 after clinical trials showed they increased the risk of suicidal thoughts and behaviors in children and teens.
In February 2005, the U.S. Food and Drug Administration added its strongest warning, a so-called black box, on the use of all antidepressants in children and teens.
Number one was reason was mentioned in passing in the article. I think the major reason that more people are on medication and not in therapy is because, a. insurance covers an MD, who diagnoses and writes prescriptions for medicine, while it pays nothing or next to nothing for therapy visits. b. Today everyone wants a quick fix. Therapy is much more useful to live a good life in the long run, and usually the best treatment is a combination of both psychotherapy and drugs.
Medication provides if not instant quicker relief, while therapy is long lasting.
That’s what happens when people go to psychiatrists. Psychiatrists specialize in medication. People need a combo of both sometimes or just plain therapy can help. Or even doing mitzvahs can make people feel good about themselves. But there are people who can be too depressed to do extra mitzvahs.
Can be important to go to a therapist who is Shomrei Torah U’mitzvahs. Because some therapists can lead you in the wrong direction
Nebach Nebach nebach.
I guess that is what has become of the USA.
Counselling is worthless if you have a chemical imbalance. I was treated for depression 10 years ago, I went to sessions week after week and it was a waste of my time and the therapist’s. When my Dr. prescribed medication I felt 100% better!
I changed my name to protect my confidentiality.
I want to share a story with you all. I was depressed right after my wedding and my parents told me not to tell my wife and they will help me. They took me to Dr. Michael L in Manhattan and he put me onto antidepressants. I was taking meds for 6 straight years. Never did he advise me to go for therapy. He never even bothered finding out the underlying problem.
My brother in law that was good friends with me noticed that I’m not the same person I was as a bochur and he begged me to tell him what’s going on.
1 day I broke and I spilled the beans. He took me to a great therapist and after 3 sessions I felt so relieved (which I never did with meds-the meds were a roller coaster-up the prescription, down the prescription different prescription etc…). We figured out the underlying problem and it wasn’t easy to deal with it and it was even harder to change but I managed.
I’m a better person with the support of my great wife and therapist.
I’m no longer on meds and can’t forgive the doc who literally stole 6 years of my life by stoning me with meds I never needed!
The message I want to get out is:
Before doping yourself think what changed in your life? What might be causing you to feel depressed?
90% of the time meds are the lazy solution that doesn’t even work.
Good luck out there!
there is nothing wrong with it as long as you have a good productive and with Hashems help a long life.
as you see from numbers 8 and 9 these issues are more complicated than a pill or 3 sessions talking to a “counselor”
perhaps a good friend, spouse, relative, rabbi, or other human being who can listen and offer sage advice is all thats needed. i personally am biased towards a jewish/halachic perspective which can be at odds with “therapy” which is self centered and does not include jewish values/morals.
defining depression is not simple.. as we see in 8 and 9 sometimes its a quick discussion with an understanding human or modification of body neurotransmitter balance. sometimes it is just a kick in the (you know where)…. unfortunately, there are those few with deeper issues who might benefit from doctoral level interventions for a fixed period of time.
Exercise may really help for someone who is on anti-depressents because of depression. Do a Google search – you may find something about this.
Exercise can particularly help when someone is depressed about weight gain.
Also – beware of some anti-depressents can cause G-d forbid suicide. I once read this. I am not sure if it was prozac or some other.one.
So – volunteerism, mitzvahs, exercise – could be helpful!
Maybe even check a health food store for healthy alternatives to anti-depressents. Don’t know if they work though – or could have a placebo effect.
Ari – happy you got help without anti-depressents.
If one has a very good therapist – medications can be totally unnecessary (always check though with a doctor before taking my advice here!)
And if someone is on medication – I don’t know if you can stop cold turkey. Might have to ease off it slowly.
Seems with psychiatrists in particular – medication is the only answer with them. That’s why maybe psychiatrists need to be avoided by most – depending of course on the severity.
Um, Ari – I don’t know if you are allowed to say the name of the therapist here – but maybe it would be helpful if vos iz neis allows it. Don’t know.
Boruch Hashem I don’t need that person for myself – but every now and then I come across people who need to see someone – or someone better.
Anyhow – thank you vos iz neis for publishing my previous comments. Yosher koach .
I totally agree that therapy is not the solution for everything. I’ve been to therapists myself for depression and I know several others in my situation. Some therapists just tell you to talk talk talk until you feel better. My friend went to someone like that and just sank deeper until she realized it was ruining her life. Some keep interrupting with stupid comments every second or keep on asking in a patronizing voice “how did you FEEL when that happened?” Once I begged a therapist to help me cope with my day to day life and she said we first need to discuss my past for a few months. I can go on and on but basically I feel there are very few effective therapists. What helped me most was discussing my issues with a rov, areal tzaddik with a lot of insight. I felt he really cared. I also found a good psychiatrist on my fourth try who found the right meds which help a lot
I have had people who have been depressed from time to time call me up to talk to me. Many times after, they said they felt better. i am not a therapist or professional, but many of us are capable of this. I am sure there are many out there who have had a friend, familly member or acquaintance that has said to you after you lending an hear and giving advice – that they feel much better since talking to you.
So many have this capability of helping others who are depressed.
However, for those with severe depression – this might not help – but can help somewhat.
I do believe though some people out there are in very bad shape and may need the medication as well.
This great news! I just bought stock in Pfizer, Merck, and Bristol Meyers.
On a more serious note. If you want to feel good about yourself, do a very good deed and then don’t tell anybody about it. Know someone who needs money? slip a envelope with a few hundreds under their door. They need a job? Tell a friend to hire them and then give your friend the money to pay them. There are non financial options as well. Wanton acts of kindess and random acts of charity go a long way.
Medication without therapy is a poor approach and medication by a non-psychiatrist is risky. Depression is a recognized condition (but it a catch-all phrase for about a half-dozen major types and even more sub-types). If “feeling down” lasts for more than a few days or is impacting your ability to function, see a doctor.
The best approach is—
(1) medical–make sure there are no medical conditions causing depression
(2) therapy–identifying the exact type of depression is essential. Over the past 30 years, research has shown that short course, CBT (cognitive behavioral therapy) has the best outcomes [in response to #10 (Robert) while “me” centered, remember you are the patient. Also, rather than psychoanalytic, CBT actually requires that you DO things and change your behavior)].
(3) Medication–drugs are indicated for some people some times. Better if done through a psychiatrist who is a specialist and really knows the meds. Also, a good psychiatrist will consult with the psychologist so that a comprehensive care plan is put in place.
And depression is not because they are “devoid of G-d” (but, IMO, some people have gone off the derech because they were depressed, not vice versa) or helped with a “good kick in the ****”
If you haven’t “been there” or worked with people who are depressed (I’ve been in healthcare for almost 30 years) it’s hard to understand or relate.
I have had people who have been depressed from time to time call me up to talk to me.
that is not depression, everybody gets depressed every now and then and that is healthy. If one suffers from depression one is depressed most of the time no matter what his or her surroundings are, even if the surroundings are great they still can be depressed.
I too would like to chime in against therapists.I niavely believed all the hype about them in many frum publications and spent tremendous amounts of money and effort on nothing. Some therapist simply fooled THEMSELVES into thinking that they are Gods gift to the world and the all knowing solution to all problems.I confronted my former therapists and two of them acknowledged they KNEW they were doing next to nothing for me but ‘even next to nothing is better then nothing’
That said I don’t mean to discourage all therapy.Apparently some people are helped but please be proactive when dealing with a therapists, and don’t trust them.If you feel you getting nowhere let them now.Give them a hard time.For the sake of her other clients if you a bad therapist go back and talk to her like I did.
I wonder if there are as many depressed people in countries with socialized medicine. We love out health care but there is no doubt much pressure is added when people don’t have a safety net. In Canada it is illegal for phamacutical companies to market directly to consumers.
Seperately, ECHO, a frum organiztion offers referral to therapists and other medical professionals. Some therapists are more expert than others. And some theriapists specialize with certain issues. In general a speacilist might be better than ‘A jack of all trades’.
While pills have their place, and there are some people who genuinely need them, they are way overprescribed. I have a friend who lost her father as a teenager and was prescribed meds. They didn’t do anything in terms of helping her get her life back together. Gee, I wonder why she could have been depressed… Could it possibly be because… her father died??? What she needed was grief counseling, NOT pills. On the other hand, I know people who were clinically depressed (as in, they had a chemical inbalance, rather than depressing life circumstances) and medication worked wonders for them- but these people who truly need them are very much in the minority.
As far as frumkeit and therapy go, maybe if we actually allowed college and graduate/professional school, we would have more frum therapists out there who could counsel with a Torah perspective. Sorry, Rabbi Dr. Twerski is only one person, and that’s not enough for every frum yid who requires the services he offers.
hi i have panick attacks during driving, i have tryed meds and therapy,i cant seem to rid my self during driving does any one have any suggestions? please write them if you do. thank you.
Having been in therapy I think part of the reason they are so ineffective is because the high esteem they are held in keeps them off their toes..
Now here are a few words from a mental health professional.
The current antidepressant medications have multiple uses besides “depression”. They help for anxiety, OCD, impulsivity, and several other symptoms within the psychiatric realm. They also have many applications for general medical issues, such as chronic pain. There is a percentage of these prescriptions that are written for these other uses.
There probably is an increase in depression. Our society tells us that so many things are “necessities” when they are actually luxuries. Read the advertisements in any publication, even the kosher ones. And that is only one tiny source of depressed feelings.
The newer class of antidepressants has a much more limited profile of side effects. Thus, the risk-to-benefit balance is much more favorable than the older antidepressants. It is easier to dispense them. Often, the individual who takes them even without benefit won’t care much, since it basically has no effect for them but otherwise doesn’t hurt. Many non-psychiatrist physicians have limited training in prescribing these meds, and are comfortable in doing this in cases they feel are not complicated.
There probably is an increase in the “chemical imbalance” aspect of depression. There are many reasons for this. I am not convinced this accounts for the numbers quoted in the article.
There is a long standing debate about medication versus therapy. Here’s my take (based on many years of extensive experience). Both have their roles. Not everyone who is depressed will benefit from medication, and not everyone will benefit from therapy. There are too many specifics to each. The most important thing is to be evaluated properly, and to work with the appropriate professional who will maintain good professional ethics throughout. Trading recommendations to friends at the checkout counter is not a good idea.
As for referral organizations, there is also Relief that specializes in mental health referrals with good connections to hard-to-reach specialists. The office is in Boro Park, and is listed in the heimishe phone directories.
I would recommend being proactive with therapists, but not to give them a hard time. They are doing their best to carry out their profession, and they no more deserve to be tortured than anyone else. Most are not charlatans, and most are qualified much more than a good trusted friend (though that may really be all someone needs). But one would be smart to be proactive. Know in advance an estimate of the length of treatment, the cost, and there should be an agenda of what the goals are and how to achieve them. One would do much the same when having renovations done on your home.
There are several professions in the mental health field. The most known are psychiatry (medical degree with specialty training in mental health), psychology, and social work. There are several others. There is much in common in the training, though the approaches are often varied. I would rather a good social worker than a mediocre psychologist or psychiatrist. It is not responsible to make a general comment about any of these fields being better or worse than the others. The most salient difference among these is that only psychiatrists can prescribe medications. The others cannot. This is not a ranking, just a basic difference.
I will also side with the comment about going to a therapist who is a Shomer Torah Umitzvos. There are B”H many, and the competence level is generally high. This is not an endorsement for any specific therpaist. It can be wise to ask.
Lastly, the fact is that health insurance covers medical treatment far better than mental health, no matter what the diagnosis is. This is a shame. There is proposed legislation to require “parity”, but this has not yet become law. Meanwhile, therapy is not covered well under most insurance. For obvious reasons, most therapists who are not based in social service agencies do not accept insurance. If they did, there would be a “big brother” with nearly no training that would manage the payments and authorization for services who is employed to deny this. I would never get involved with that type of control. It would make working in this important field impossible for parnosoh. Would “parity” laws help? I don’t know, but I’m watching to see if this ever happens.
People also need to realize that chemical imbalances can be caused by improper nutrition. Today, many people eat so much processed and junk food and are missing key vitamins, amino acids and other nutrients. Yes, it is much easier to take a pill, rather than learn about nutrition and make the proper changes to lifestyle. Most doctors are not trained, nor do they have the time, to really question patients about various lifestyle factors. So much of chronic disease could be eliminated, including depression, with good nutrition, moderate exercise, adequate sleep, drinking water, and yes, doing mitzvos!
# 32 a quick suggestion ; take a digital recorder in the car & if you feel the panic attack coming on hit the record button & say what your thoughts, fears ,triggers are at that moment ( you may want to pull over) this will help you pinpoint what thought is triggering the attack.
& give dr. steven friedman a call for a consult he is the chief of anxiety disorders in downstate & has a prvt office on pierpont street 718-624-0488 ( take the recorder with you to your appt .)( also take your prescription records ,names & dosages & duration along so you get straight down to business in the first session
for those that know he is a shomer torah umitzvos & a top diagnostician / straight to the point / & will never hold onto a patient if he cant help
whether he is the right therapist is a matter of chemistry . hatzlacha
Thank you, Anonymous at 12:25 p.m., for making a number of important points.
If I didn’t suffer from depression already, the cruelty and ignorance displayed in many of the comments would be enough to set off an episode!
I clearly remember my first “depressive episode” at approximately age 5. The episodes continued despite seeing any number of therapists, counselors, and talking my “problems” to death. You see, I didn’t have any real “problems” — apparently I had something wrong with my brain.
In 1988, I tried what was then a new, virtually unknown medication: Prozac. Voila! Within a few weeks, my regular symptoms had disappeared, and my more serious depressive episodes abated. I’ve since changed to another SSRI drug, but I consider them lifesavers.
I’d be interested if the naysayers decline to take, for example, medication for hypertension. Why don’t they just “will” their blood pressure to lower on its own?
Do they also decline bypass surgery? After all, they could have perhaps avoided it by changing their lifestyles?
Yes, people should take non-medical steps to improve their general health, but denying them efficatious medical help out of some misguided Puritan ethic is just . . . sad.
to # 32/43- personally i have not had to struggle with panic attacks or the like ( take a look at frumsupport.org to blog with other frum sufferers)
however i have bs”d closely coordinated getting people to the right places & many times accompanied them to therapists & docs especially when the patient spoke yiddish – i suggest you do some research there are a number of very good orgs. & yechidim that are very knowledgeable / the tough part is that you will hear many diff. opinions about whos good & where to go or not to go, as a rule these recommendations are honest yet we keep in mind that its based on that individuals experience ( i forgot to mention that dr. steven friedman does not write prescriptions but he will tell you if he feels youll benefit from the meds
hatzlacha & these attacks can be managed
Please do not coment till you have walked in our shoes. Emotional pain from depression is as debilitating as physical pain.
In the past 10 years I have seen 4 different Drs.and many therapists.
Did any of you hear about second opinions? That is what I did. Saw a Dr. Got meds, went to another Dr. for a second opinion. Therapists, basically if you don’t see a difference in a few months, stop going, also if you feel to attached it is a red flag.
B”H my Dr. is frum. first thing he ordered was extensive bloodwork, Bottom line, my thyroids were out of whack, but I was and still am clinically depressed. My Drs approach is to give the minimal amount of meds and make you go for therapy.
Be an informed consumer. Read about depression and anxiety. Read about all the meds out there, a patient that does his/her homework can not be dragged around by an incompetent Dr or therapist.
please write here some orginizations and phone numbers for me an other readers
thanks alot