400% Rise in Anti-Depressant Pill Use: Americans Are Disempowered -- Can the OWS Uprising Shake Us Out of Our Depression?

The U.S. Centers for Disease Control and Prevention (CDC) recently reported that antidepressant use in the United States has increased nearly 400 percent in the last two decades, making antidepressants the most frequently used class of medications by Americans ages 18-44. Among Americans 12 years and older, 11 percent were taking antidepressants by 2005-2008 (the most recently reported study period), and 23 percent of women ages 40–59 years were taking them.

Why has U.S. antidepressant use skyrocketed? Are the symptoms of what is commonly called depression—helplessness, hopelessness, and immobilization—always evidence of a medical condition? Or is it time to repoliticize a great deal of our despair, and reconsider the old-fashioned antidepressant of political activism?

Common Explanations for Soaring Antidepressant Use

Nowhere in the CDC report is there any explanation for the 400 percent increase of antidepressant use from 1988 to 2008, however, there are several common explanations offered by mental health professionals and journalists.  

Money is a large factor. It has become more lucrative for psychiatrists and other physicians to prescribe medication than to provide talk therapy. This was detailed in the New York TimesMarch 2011 investigative report “Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy” which reported, “A 2005 government survey found that just 11 percent of psychiatrists provided talk therapy to all patients.” Actually, most antidepressant prescriptions are written by physicians other than psychiatrists and, according to the recent CDC report, among Americans taking one antidepressant, less than one-third of them  have seen a mental health professional in the past year.  

Antidepressant use has also skyrocketed because of the increased practice of prescribing antidepressants for many conditions other than severe depression, and prescribing them for longer periods of time. Among the 2005-2008 antidepressant user group (no data offered on earlier study periods), only 33.9 percent had severe symptoms of depression; 28.4 percent of antidepressant users had moderate symptoms; and 19.2 percent had mild symptoms; while 7.6 percent had no depression symptoms. And, according to the CDC report, more than 60 percent of Americans who are taking antidepressants have taken them for 2 years or longer, with 14 percent having taken them for 10 years or more. 

According to antidepressant manufacturers, the increase in antidepressant use has been caused by their creation of more effective antidepressants, including the so-called selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, and Zoloft which came on the market in the late 1980s and early 1990s. However, by the late 1990s, psychiatry textbooks had already rejected the idea of increased effectiveness of SSRIs (for example, Robert Julien’s A Primer of Drug Action (1998) states, “The newer antidepressants [SSRIs] are not necessarily more effective than the older TCAs [tricyclics] ).”  

Rather than SSRIs’ greater effectiveness, it was their greater publicity that stimulated public acceptance. One publicity coup commenced in 1997 when U.S. government agencies changed the rules for broadcast advertising, no longer requiring full information about side effects (which had previously made it problematic for drug companies to run a thirty-second spot). TV advertising dramatically increased patient requests for antidepressants from their physicians. A study reported in 2005 by the Journal of the American Medical Association, “Influence of Patients’ Requests for Direct-to-Consumer Advertised Antidepressants,” concluded, “Patients’ requests have a profound effect on physician prescribing.”