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One in Six Adults Takes Psychiatric Meds

2016-12-12

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The news: one in six adults in the United States filled at least one prescription for a psychiatric drug in the year 2013, according to LiveScience clickbait (those daily, or more frequent, stories with exciting titles– that turn out to be poor descriptors for the stories.)

The article continued:

Antidepressants were the most common type of psychiatric drug in the survey, with 12 percent of adults reporting that they filled prescriptions for these drugs, the study said. In addition, 8.3 percent of adults were prescribed drugs from a group that included sedatives, hypnotics and anti-anxiety drugs, and 1.6 percent of adults were given antipsychotics, the researchers found.

One reason for the predominance of antidepressants is that they are not “scheduled” drugs (that is, there are no restrictions on prescribing them other than the need to have an active medical license in the state.)  The estimate that 6.9% of adults have had a depressive episode fits roughly with the 12 percent who filled prescriptions, when one accounts for the fact that antidepressants are not “scheduled.”

The point is that antidepressants can be readily prescribed with minimal restrictions, and depression is one of the most common symptoms or diagnoses that doctors encounter.  Patients with difficult to diagnose symptoms are often suspected of harboring depression without being able to express it or not understanding its presence.

These figures on medication use are in good agreement with the estimates widely disseminated that one in five adults in America “experience mental illness” in the course of any year.  About seven percent of adults suffer from depression, or to put it technically, “had at least one major depressive episode in the past year.”  A “major depressive episode” is defined as:

“[P]rimarily depressed mood for two weeks or more, and a loss of interest or pleasure in everyday activities, accompanied by other symptoms such as feelings of emptiness, hopelessness, anxiety, worthlessness, guilt and/or irritability, changes in appetite, problems concentrating, remembering details or making decisions, and thoughts of or attempts at suicide.”  (Wikipedia.)

Maybe you didn’t want to know that, but I’m including it because it is a very important problem to which enough attention is not paid.  People tend to deny that they are depressed because they are ashamed of it and perceive it as a weakness.  Someone who denies that they are depressed to others tends to become, and feel, more isolated; isolation is a major risk factor for attempted suicide.

The figures for antipsychotic prescriptions also agree with estimates of the prevalence of psychotic disorders (at least the well-known types like schizophrenia.)  According to NAMI, about 1.1% of adults have schizophrenia, close to the scripts for antipsychotic drugs at 1.6%; of course, other types of psychotic disorder that are less-well characterized are not so well represented in prescription numbers.

The estimate that 18% of adults have had an anxiety disorder does not fit so well with the prescription numbers, possibly because anti-anxiety drugs are generally scheduled at least at the lowest level, Schedule Five, and frequently at Schedule Four or above (more restrictions are placed on older anxiety drugs like barbiturates, which are more dangerous and less well tolerated.)

Other estimates that make one pause to think include the following: one in 25 adults experience a serious mental disorder over the course of a year.  Of the 20 million who use or abuse drugs (including prescribed drugs), roughly half suffer from a concomitant mental disorder.  More importantly in relation to prescriptions, only about 41% of adults with mental disorders receive any kind of treatment during a typical year, and about 62% of those with serious mental illness are treated.

That means that roughly 38% of adults (more than a third) in the United States who suffer from a serious mental illness receive no treatment.  Some of this may be blamed on the lack of medical “insurance” or on the lack of specific mental health coverage in typical “insurance” packages.  Another large factor is the stigma associated with recognition and therapy and the aversive nature of severe mental illness which makes victims avoid psychiatrists and drug treatment.

This post is not intended to present suggested treatment options or ways to improve this situation.  It is intended to draw attention to the situation and allow readers to think about options.  In future posts, potential methods of improving the situation will be presented.

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