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tinyfaery's avatar

Why are Americans so depressed?

Asked by tinyfaery (41973points) August 2nd, 2008

According to this, antidepressants are the most prescribed drugs in America. Why is this the case? What does this say about the American way of life?

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34 Answers

La_chica_gomela's avatar

I’m no expert, by any means, but I think it means that we are want a quick and easy solution to our problems. I know that many people legitimately need antidepressants, and I dont want to try to sort out who needs what, and who doesn’t but I will say that people have been depressed since the dawn of time, and the human condition has improved so much over the course of time, that it’s really sad that people are still so…sad.

I don’t actually know if any of that is true. Maybe it means that we’re more open about our mental health (is that the correct term?), and that’s a good thing.

Maybe it’s a symptom of our lower maslow’s needs being met, and now we are more focused on the higher ones, and we’re not fulfilling those, so .. heck i don’t even know why i’m answering, i really don’t know either tiny.

joeysefika's avatar

is this anti depressants per populus or in total. If just by total it could be because they have lots if people.

tinyfaery's avatar

This is interesting.

Here’s another one.

Do we need them or don’t we? These sites have conflicting statements. One says the drugs might be over prescribed, but when they are not prescribed suicide rates in teens go up.

Randy's avatar

Yup. Wehave everything in easy access and we have excess of it (other than gas, haha). If youhave everything you need, where is there to go?

AtSeDaEsEpPoAoSnA's avatar

Suicides don’t make the government money. The American people have high standards, they complain when not taken care of. They constantly advertise pills for erectile disfunction, heart medication, anti-depressants, arthiritis, headaches, the list goes on. The people want quick fixes, the government is more than willing to help the “quick fix” solution. Most of the American populus doesn’t want, or doesn’t even know about, natural cures for their ailments and pain. I am not a huge organic person, I enjoy exercise and being as heathy as I can afford(its expensive to eat super heathy for my fiance and I). The People don’t take the time for progressive and moderate cures, they want it to day. I believe there is a organic and natural cure for ALMOST every medical problem. I believe in the preservation of self, you have to help yourself heal before anyone else can heal you. I wish I could produce a link from my present location, but I can’t at the moment.

augustlan's avatar

Well…antidepressants are also prescribed for other ailments (the SSRI class anyway), too. For instance, chronic anxiety. I had been through many, many rounds of therapy trying to deal with anxiety without drugs. Nothing worked…it’s a chemical imbalance that therapy couldn’t touch. When I started having panic attacks while driving with my children in the car, I got medicated – pronto. What a world of difference it made, thought not overnight, so no quickfix. I’ve been on the drugs for 10 years or so, and imagine I’ll be on them for the rest of my life. They are also prescribed for people with Fibromyalgia and other conditions.

Harp's avatar

I suspect that it has partly to do with our heightened expectations of how happy we should be. We’re constantly receiving the message that happiness is the norm, and that there’s a fix for whatever keeps us from being in a state of steady bliss.

That expectation is brand new to the human race. Other times and cultures have taken as a given that life is a very uneven mix of joy and sorrow, and that trying to hold the pendulum on the “joy” side of its swing is futile.

The happiness expectation serves our commercial culture well. Look at all the images in advertising that portray people giddy with joy because of the product that has come into their lives. The message is loud and clear: if you’re not happy, it’s because you don’t have the right stuff. Sadness is now a pathology to be healed rather than the natural counterpart of happiness.

What has been lost in all of this is the principle of contentment, the peace of mind that comes from accepting that sometimes we’re happy, sometimes we’re sad, and that it’s OK to just let that be. But then, contentment is the mortal enemy of consumerism.

I don’t mean to imply that there’s no such thing as serious clinical depession. But aside from that real pathology, I think we have created our own feedback loop of heightaned expections of happiness, followed by dejection at not being able to maintain that happiness.

nikipedia's avatar

The responses to this question are absolutely heartbreaking to me and (I apologize if I offend any of you) show a real lack of understanding of psychopathology. This kind of attitude is incredibly damaging to people who have mental illnesses, who need treatment, and who are embarrassed or think they should be able to just get over it.

To answer the initial questions, Americans are depressed for the same reasons anyone is depressed. Some people are depressed because of abuse, trauma, or other circumstances. Some people are depressed because of genes. Most people who are depressed have some combination of those two factors. As @augustlan correctly points out, one of the reasons antidepressants are prescribed so frequently is that they’re increasingly being used (both on and off-label) for a number of different conditions, mental and physical. What this says to me about “the American way of life” is that we’re learning how to ameliorate some of our suffering. Good for us.

Depression is a serious and legitimate mental illness, and it is not the same thing as simply being sad. Antidepressants are not a “quick and easy solution”. Some people with depression struggle for years to find the right balance of medications (if they ever do—for some people no treatment is really effective). Antidepressant medications are expensive and often have unpleasant side effects. No competent physician would prescribe them for a bad mood or for an inflated expectation of happiness.

And “the government” is actively researching naturopathic medications for a variety of illnesses. A quick google scholar search turns up this article:
“The published evidence suggests that ginkgo is of questionable use for memory loss and tinnitus but has some effect on dementia and intermittent claudication. St. John’s wort is efficacious for mild to moderate depression, but serious concerns exist about its interactions with several conventional drugs. Well-conducted clinical trials do not support the efficacy of ginseng to treat any condition. Echinacea may be helpful in the treatment or prevention of upper respiratory tract infections, but trial data are not fully convincing. Saw palmetto has been shown in short-term trials to be efficacious in reducing the symptoms of benign prostatic hyperplasia. Kava is an efficacious short-term treatment for anxiety.”
(http://annals.highwire.org/cgi/content/abstract/136/1/42)

and this article:

“From the existing literature, St. John’s wort appears to be a safe and effective alternative in the treatment of depression. ”
(http://www.ncbi.nlm.nih.gov/pubmed/10190758)

and this article:

“Hypericum perforatum was more effective than placebo and similar in effectiveness to low-dose TCAs in the short-term treatment of mild to moderately severe depression.”
(http://www.jonmd.com/pt/re/jnmd/abstract.00005053–199909000-00002.htm;jsessionid=LJrWvl0t9pSw09N8F7Gv90RzrJxp5K6BtDLPYFrWsPYC2JqNGvgv!982088527!181195629!8091!-1)

And so on.

AtSeDaEsEpPoAoSnA's avatar

I wasn’t implying that people who take medication are mentally weak individuals, I just saying that more americans try harder for there health. I glad it worked for you Augustain

PupnTaco's avatar

@niki: there are legitimate uses where meds are life-saving, and it’s impossible for someone who doesn’t suffer depression/mania/other disorders to say they understand.

But the relationships between Big Pharm, doctors, reps, patients, and the media are so out of whack. Meds are way overprescribed. For many I’ve known, it’s a way to mask the problem instead of dealing with its source.

marinelife's avatar

Hurray, nikipedia. This thread had taken on an odd tone and turn. I know so many people whose lives have been changed by the new medications that help with chemical imbalances. A bright, talented man whose ADHD had kept him from successfully holding any job for very long, but who is now a productive and fulfilled professional. A woman who suffered for years until her children’s heredity issues caused her to seek treatment when they were successfully treated. I could go on.

I attribute the medication backlash to a Puritan hangover in our culture.

I do think there are some interesting and valid points in this thread about our lifestyle (overworking, overconsuming, underexercising, too much sugar) and how that impacts otherwise healthy people’s perceptions regarding happiness, but I think it needs to be in a separate thread from a discussion of clinical depression.

@AtSeDaEsEpPoAoSnA I am completely nonplussed regarding the references to the government. Health care and health insurance are private for the most part, so what has the government to do with any of it?

nikipedia's avatar

@PupnTaco: I agree that the relationship between doctors and the pharmaceutical industry is really incestuous and foul, but I think the general trend is that this relationship usually takes the form of a doctor prescribing one antidepressant over another (e.g., Celexa over Prozac) rather than deciding to medicate a patient who doesn’t really need medication. I am sure there are exceptions to this trend.

Also, I certainly don’t know anything about the people you’re referencing, but for most people mental health and treatment are incredibly private matters—is it possible you don’t know their entire situation? I hate to pull this card, but I have personally interviewed over 500 people with depression about their mental health histories, and literally almost none of them have sought treatment exclusively in the form of medication. I would estimate the prevalence of that situation at less than 5% in the population I’ve interviewed. Maybe it’s a sampling error; I don’t know, but my experience is very different from yours in this regard.

Harp's avatar

@Marina & Niki
I don’t know that this discussion is necessarily just about clinical depression. In her second link above the question is raised about sadness being treated as clinical depression. It seems likely that some of this occurs.

Most of the respondents here have acknowledged that clinical depression is real, and I’m not hearing anyone advocate not treating it pharmaceutically (I’m certainly not).

allengreen's avatar

@AtSeDaEsEpPoAoSnA—the opinion of men are not welcome here….

PupnTaco's avatar

@Allen: nice try.

tinyfaery's avatar

Please do not let allen jack this thread. Please do not address him.

tinyfaery's avatar

Let me weigh in on this a bit. I have worked for too many years, with countless adolescents and young adults, who have been diagnosed with bipolar disorders, OCD, ADHD, borderline personality disorder, etc. There are plenty of legitimate diagnoses, but I also see a tendency for those in the mental health profession to quickly label a child/adult as blank when it simply isn’t true. I can legitimately distinguish between someone with legitimate depression, BPD, OCD, etc. and the others; this is mostly seen in children. Some psychiatrists will label a child with ADHD and prescribe adderall when all the child needs is some discipline, consistency, and nurturing. Many times its the parents pushing doctors to prescribe medication, because they do not want to take the effort to handle their children. So at a young age children are labeled blank and they spend the rest of their lives (not always) on drugs. The label often gives children a free pass to act out, they blame all of their behavior on their disease and take no responsibility for changing their lives.

Of course these diseases and disorders exist, but my experience with these diagnoses has made me question the American tendency to label almost anything a disease, and subsequently throw medicine on it.

AtSeDaEsEpPoAoSnA's avatar

Opinion to me has no gender, just a point of understanding. This thread is a great window to more knowledge about medicine and mental illness. And in no way I feel as if my opinion is being compromised by these women. Maybe if you didn’t make such close-minded statements you would have such a hard time with a womans opinion.

AtSeDaEsEpPoAoSnA's avatar

Sorry tiny, I’m not trying to trying to trash the thread.

nikipedia's avatar

@Harp: Again, this is not something I have seen in my work. That doesn’t mean it doesn’t exist, but I am deeply skeptical of the article and think it represents a very small minority. Most of the people I talk to are embarrassed about their condition and were very reluctant to seek treatment—as with many mental illnesses, they had to wait until they hit absolute rock bottom before being able to admit something was wrong and to ask for help.

I think you’re right that this discussion isn’t necessarily about clinical depression. It seems like the initial question has evolved into several: What constitutes depression versus sadness? Why are people in our society so sad when we have so much? Is it legitimate to treat that kind of sadness with medication? Is that happening? To what extent are people responsible for their own happiness? How much happiness can we reasonably expect? And so on….

@tinyfaery: the American tendency to label almost anything a disease

I guess this is sort of a radical position, but as far as I’m concerned, if something internal is causing significant functional impairment or other extreme distress (obviously pretty blurry guidelines), I think I’d be willing to call that a disease. And if medication helps with that, I don’t see a problem using it.

Of course, these statements don’t apply to every situation you described. I’m sure some doctors have a problem with over-diagnosis and over-medication, but frankly, I prefer that to the opposite, and it also has not been my experience, which is certainly extremely limited. I work in a research setting rather than as a clinician and my diagnoses are validated by two (doctoral level) psychologists and a psychiatrist. We almost never disagree. It has given me a lot of faith our diagnostic system.

tinyfaery's avatar

@niki I see disease as exactly that, dis-ease. I just question the tendency to seek doctors and science, instead of searching within ourselves to find what is causing our dis-ease—stress, over-expectation, diet, apathy, etc. Personally, I have found much more success treating my chronic illnesses by changing my diet, exercising, acupuncture, and therapy, than by seeing doctors and taking medications. I’ve also had a minority of clients (and I do admit it is a minority) be able to stop medicating by making certain lifestyle changes and seeking help outside of traditional, western medicine. I’m sure you’ll throw some numbers at me. But in my experience, drugs are not always the correct answer.

SquirrelEStuff's avatar

@tiny
I really like that last answer.
I think with many things in this country, everyone wants solutions, without actually identifying the true problem.

susanc's avatar

A thread of great integrity, with the obvious exception (well handled).
Real compassion, real information, real expertise, real questioning.
I’m interested in la_chica’s notion that, as our physical well-being is generally so good in this culture, we may have moved up the Maslovian pyramid because we can.
This doesn’t call into question any of what harp, niki or
tiny has said, and it explains our shared view that people used to just suck it up. Maybe they sucked it up because they were so busy surviving/competing. There was nowhere to turn for emotional help except the church – which told people to suck it up!

I take a standard dosage of Wellbutrin; at the moment, if I don’t I collapse; I also see a therapist on a regular basis. Trauma and grief force me to depend on these supports. If I’d asked for an antidepressant and a truly competent therapist 45 years ago, my life would have been very different.
The trauma and grief overlie a lot of Stuff I didn’t absolutely have to deal with before.
It makes me feel sad to acknowledge this Stuff, but it lifts my depression to sort it out.
I could do neither without help.

augustlan's avatar

@susanc…hope you find peace :)

GreatEscape's avatar

I believe that we americans are depressed because the powers that be have turned us into compulsive consumers. We are constantly told that what we have sucks and if we don’t buy the newest thing that we will be ridiculed. Everyone is trying to keep up with the jones but they don’t realize the Jones are about to default on their mortgage, spent the kid’s college fund on that new Escalade, and can’t sleep in fear of losing their job to outsourcing to someone oversea’s who is more qualified than them.

drhat77's avatar

I feel that a lot of the antipathy against people who have to use anti-depressants or ADHD medicines comes from the feeling that we are or should be in control of our own mind, that those people should just “snap out of it”, and that fear that if chemicals (like neurotransmitters) control our life, then who am I on the inside, anyway. Like a lot of people in this thread have already pointed out, clinical depression is a disease, and the fact that neurotransmitter abnormalities have been tied to it bolsters that claim.
WITH that all being said, there are a lot of people who feel sad and unfulfilled, and they see all the direct-to-consumer advertising,and feel that they should have happiness in a bottle, and they strong arm some doctor into giving it to them. That gives us the inflated numbers pointed out earlier. But the OTHER thing it does is it attaches a state of ridicule to the ACTUAL sufferers of depression – it lumps them in the same category of “the sad and unfulfilled”, the people who may be able to just “snap out of it”

stratman37's avatar

Maybe we’re fighting over the terms “depressed”, and (what should have been asked) “unhappy/unfulfilled”. I’ve suffered from clinical depression for years and am finally having great success with Effexor. However, I also see the whole “things can’t make you happy” train of thought. Family is the most important healer! Well never regret taking the time to be with our friends and loved ones, even though they’re not on any commercial vying for my money. I often buy somethings that I want/“need” and it sits on a shelf collecting dust, but I NEVER come away from a meaningful time with my family feeling like I’ve wasted my time.

augustlan's avatar

@stratman…Effexor is what finally worked for my Chronic Anxiety/Panic Attacks, too. It has been instrumental to my well being.

nina's avatar

I want to address the word ‘Americans’ in the question.
I can compare Americans to Russians from personal experience, and to Europeans from literature and film.
I believe that Americans, overall, are a lot more cheerful, optimistic and constructive in their approach to life, than the two groups I have mentioned.
I would rather attribute the prominent place of ‘depression’ in the american social consciousness to american positive worldview, and to the inbred american feeling of entitlement to happiness. Come on, we are a nation that has ‘pursuit of happiness’ written into its very foundation: The Declaration of Independence! This is a nation which, as opposed to Oscar the Grouch, cherishes joy and gets truly miserable when unhappy. And what in the world is wrong with that?

whiteowl's avatar

it means not more then just that americans are too much into their health! and if there is justa a little sign og warring they go for drog store!

Chant21's avatar

WARNING: Very long post to complex question:

I think this has to do with several things that can lead to misdiagnosis of depression. I want to state that I am not stating that depression is not a real problem or that people who suffer from depression are to blame. In fact I am stating that it is largely those that are doing the diagnosis that may be mistaken or mislead by the symptoms and lack of details. Again, this not questioning the very real existence of depression and the need to treat it. It is what I believe often leads to mis-diagnosis and prescription of medication in those that are not truly suffering this disease.

1) The mislabeling of depression as “not able to function” in what we have culturally signified as norms. What I mean by this is that if a person displays a resistance in the form of emotions to fitting in with what we believe to be a non-extreme situation, there is a tendency to say some thing must be wrong with the person. This is in no saying that there are not many people that do have a sever reaction that is far more intense then would be warranted. I am simply stating that there seems to be a “lets get the person functioning”, within the constraints set rather then question the setting. One (the individual) is easier to fix than the other (setting). This is very different than people who are truly depressed. As others have stated, or at least hinted at, depression seems to be defined today as a prolonged sense of unhappiness. Even examples of success of the medication are often presented in this way. Such as, Subject A couldn’t hold down a job before the medication, now they can. There seems to be little questioning of the jobs this person had before or the environment they were working in. It’s automatically assumed that the person should not have any problem doing the job or that a “normal person” should be unhappy about the things in life that society imposes on us.

2) Neuroscientists have made many great discoveries in the brain and its chemistry but much of the knowledge is still in discovery and not complete understanding. So although we can see how the brain chemistry is different in a person that is stressed, often times it is just that. We can tell when they are stress. We can’t tell whether that stress is reasonable or not, only how severe it is at the time of the reading. For example, fear could medically be consider a severe abnormality, when looked at from a pure physiological stand point, even if at the time of assessment it is perfectly normal that the subject express fear. As an example, if I were to go to the doctor immediately after an automobile accident but did not share that with the observer my demeanor would likely seem as very anxious. Many psychiatrists/medical personnel pick up on the symptom and prescribe based solely on this.

3) Normal unhappiness like all emotions can and do snowball and can go untreated until they reach a “fever pitch” or “breaking point”. This ties in with expectation of happiness. Unfortunately many people are told and believe that we should be happy and should be willing to accept things as they are. Often unhappy people are discouraged, from expressing certain feelings too often. Also, growing up we are conditioned to not show our unhappiness and to appear pleasant despite what we are internally feeling. This leads to suppressing these feelings to others as well as to ourselves. As many of us know, those emotions do not just disappear but build and mutate. At the time the outburst happens it appears very extreme and can be diagnosed as abnormal.

4) Often the person themselves just want the quick cure. They rather take the pill and not be unhappy or anxious anymore. Face it, finding the cause and taking steps to correct problems can take a long time. People may be impatient, can’t afford the lengthy sessions, do not have the ability to change their situation to the point needed, or simply rather not have to deal with the cause(s) itself. Medication, while not cheap is very often cheaper than other forms of treatment in time, money and emotional dedication.

5) Those that treat people are often very caring and sympathetic. Often they empathize with the sufferer and want to help. If an easy “fix” is available they will often be tempted to use it, over anything that may cause the sufferer to suffer for longer then the “fix”. Seeing a person in pain is a horrible thing for them and denying anything that could relieve that person from that pain, seems cruel.

The flip side of this is that there are also those that, unfortunately, are just trying to “fix” the people. They don’t really empathize with the suffered but see them more as simply having a problem to be solved. For example, a practitioner that thinks that a kid is too active will simply subscribe something to “calm” them down. They have for some reason or another already decided that medication is the best option at anytime that the symptom arises. Already convince of the legitimate need, in their mind, they search for reasons NOT to prescribe rather then a reason to prescribe.

6) Money and time. As I stated, it is almost always cheaper than other treatments. Not only in money from the sufferer but also in time for both the person(s) treating the sufferer and the person suffering. Like it or not those that prescribe a “medical treatment” make quite a bit more then those that chose more traditionally treatments, in the end. More money and clients. While I don’t think this is at all a major reason, it is a factor. If a psychiatrist can “treat” more clients and feel they help more people (money may just be considered a bonus) then they are much less likely to critically evaluate whether the treatment that allows it, is truly needed.

Chemically, the medication blocks the person from having high levels anxiety/unhappiness and is consider success. This is in essence leading to curing anxiety not the reasons for it. This is very dangerous and I believe should be only used in extreme cases. I often ask people, to make a point, “wouldn’t be great if you could get rid of physical pain?”. The answer is almost always “yes that would be great”. But then, I comment, “what would happen if you where on fire but couldn’t see it? Wouldn’t you damage your body severely?” My point is that our emotions and reactions serve a very good purpose and shouldn’t be “cured”. The main problem is many of the prescribed medications are “blockers”, meaning they block or hide the symptom from cause reactions in the brain by changing the chemicals in certain parts of the brain. Which means once the medication is no longer taken or effective the problem comes back.

My hope is that ,someday, medication for depression is able to be used like medication is when a person goes into surgery. That being that it is only used as a tool to make the sufferer more able to recover from the necessary treatment of the cause. There are those that may have such an abnormal chemistry that they will truly need to be on medication most if not all there life but most people I believe do not nor should not fall in this catagory.

searchwithin's avatar

It would be really helpful once in a while to turn off all the external input like TV, radio, video games, and all other distractions to allow us to hear the sound of our inner voice explain to us why we are so sad.

searchwithin's avatar

People have souls. A soul has needs just like the body does. There is a God who created us and everything we see and don’t see. Many people have not realized this and are now suffering from various kinds of ailments and problems as a result of not developing their connection to their Originator. Many don’t know who they are, where they came from, why they exist, or where they are going. Though they may have every conceivable convenience and material asset at their disposal; nevertheless, their souls are undergoing starvation. So, in order to fill this void, they try to apply all kinds of salves, one of these being anti-depressants. But the key to happiness of the soul, body, mind, and every other part of us is to remember our Creator once again, understand Him, and come to honor and obey Him. We would then have understood our life’s core purpose and would achieve victory and happiness in our lives. A GREAT and powerful talk on this topic is on you-tube called “The Purpose of Life” by Khalid Yasin. Hope you will enjoy it if you decide to watch it. Peace to my human family!

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