Two recent news items highlight the role of so-called “antidepressants” in our national epidemic of suicide.
On July 24, a meta-analysis of randomized control trial (RCT) data for fourteen antidepressants showed that these drugs caused a near-tripling of completed suicides compared to placebo.1 In the world of clinical medicine, an odds ratio of almost three hundred percent normally would be considered huge. If, for some perverse reason, the drug companies wanted to tout their wares as suicide enhancers, these data would be considered overwhelming evidence that these nostrums are effective at doing just that.
The other item, just nine days later, was the death of Saoirse Kennedy Hill, twenty-two years of age, who was pronounced dead of an apparent drug overdose after being found unresponsive at the Kennedy family compound in Hyannis Port, Massachusetts.2 A headline noted that she had “battled depression.”3
Indeed. Three years earlier, Hill authored an essay about her struggle with “mental illness” at the posh Deerfield Academy,4 where tuition and fees can run in excess of sixty thousand dollars a year.5
What are we to make of all this? I’ve been to Africa. I’ve met people who live in mud huts and don’t always get enough to eat. I’ve met girls who don’t go to school at all because their parents can’t afford school fees. What do you think they might have to say about this affluent young woman’s obsessive concern with her own internal emotional state?
But this commentary is not an attack on a young woman whose life ended far too soon — although no doubt it will be received by some as such. It’s an attack on the garbage pit our culture has descended into.
I have listened to people who began taking psychiatric drugs, often for the most banal reasons you could imagine — their girlfriend broke up with them, they were worried about their upcoming exams — and who had bad reactions which were well-known toxic effects of those drugs. Instead of taking them off the drugs, their doctors responded with new diagnoses, more drugs, stronger drugs, and higher doses, until someone who started out with nothing more than the everyday problems of living ended up with a crippling disability. Is that what happened here?
The problems Hill described in her essay sound like nothing more than standard-issue teenage angst — at least before she came under the care of the psychiatric profession. And, just as appalling as the death of a young woman at the very beginning of her adult life is the media’s stunning lack of curiosity regarding the kind of treatment she received — even though psychiatric “treatment” for depression these days almost always means “drugging.”6
We no longer teach young people wisdom, temperance, fortitude, and justice. Instead we encourage them to see themselves as fragile creatures whose brains can go haywire for any reason, or no reason at all. Then we tell them they have the “disease” of depression and ply them with drugs with a known link to worsening depression and suicidality going back for decades.7
One out of eight Americans aged twelve or older have taken antidepressants within the last twelve months, including a staggering one out of four prime-age women.8 Sixty-eight percent of those consuming antidepressants had been taking them for two years or more.9 Worldwide spending on these drugs topped $14 billion in 2014 and is expected to reach nearly $17 billion by 2020.10 Our rivers contain not just measurable amounts of Prozac but enough to alter the behavior of fish living in these waters.11
And where is all this relentless drugging getting us? As prescriptions for antidepressants have skyrocketed, outcomes have gotten worse. What was once a rare and usually self-limiting condition has become chronic, debilitating, and frighteningly common.12 Depression is now the leading cause of disability worldwide.13
In the United States alone, the economic cost of depression rose from $83 billion in 2000 to $173 billion in 2005 to $210 billion in 2010. That figure includes $27 billion in direct medical costs, $53 billion in workplace costs, and $5.4 billion in suicide-related costs.14 The suicide rate has also soared, and by 2017 was higher than it had been at any time since the Second World War.15
This is not what happens when treatments work. And yet, no doubt Hill’s death will be held up as evidence for the need for even more “mental health awareness.” How many more will have to die before this changes?
- Michael P. Hengartner and Martin Plöderl, “Newer-Generation Antidepressants and Suicide Risk in Randomized Controlled Trials: A Re-analysis of the FDA Database,” Psychotherapy and Psychosomatics, July 24, 2019, https://doi.org/10.1159/000501215. ↩
- Kathryne Q. Seeley and Jonathan Martin, “Granddaughter of Robert F. Kennedy Dies After Overdose at Family’s Compound,” New York Times, August 1, 2019. ↩
- Corky Siemaszko, “Saoirse Kennedy Hill, Found Dead at Her Family’s Cape Cod Compound, Battled Depression,” NBC News, August 2, 2019, https://www.nbcnews.com/news/us-news/saoirse-kennedy-hill-found-dead-her-family-s-cape-cod-n1038716. ↩
- Saoirse Kennedy Hill, “Mental Illness at Deerfield,” Deerfield Scroll, February 3, 2016, http://deerfieldscroll.com/2016/02/mental-illness-at-deerfield/?fbclid=IwAR3MCKhSTxY–vcPjVVfuUUhyxf-iz0DrQn8MdzY3VvYaV1mnY1HHPdksyk. ↩
- Deerfield Academy, “Fast Facts,” retrieved August 3, 2019, https://deerfield.edu/apply/fast-facts/. ↩
- Mark Olfson et al., “Treatment of Adult Depression in the United States,” JAMA Internal Medicine 176, No. 10 (August 29, 2016): 1482-1491, https://doi.org/10.1001/jamainternmed.2016.5057. ↩
- David Healy, Let Them Eat Prozac, (New York: New York University Press, 2004). ↩
- CDC, “Antidepressant Use Among Persons Aged 12 and Over: United States, 2011-2014,” August 2017, https://www.cdc.gov/nchs/data/databriefs/db283.pdf. ↩
- Ibid. ↩
- Market Research Store, “Global Depression Drug Market Poised to Surge from USD $14.51 Billion in 2014 to USD $16.80 Billion by 2020,” May 10, 2016, https://globenewswire.com/news-release/2016/05/10/838292/0/en/Global-Depression-Drug-Market-Poised-to-Surge-from-USD-14-51-Billion-in-2014-to-USD-16-80-Billion-by-2020-MarketResearchStore-Com.html. ↩
- M.M. Painter et al., “Antidepressants at Environmentally Relevant Concentrations Affect Predator Avoidance Behavior of Larval Fathead Minnows (Pimephales promelas),” Environmental Toxicology and Chemistry 28, no. 12 (December 2009): 2677-2684. https://www.doi.org10.1897/08-556.1. ↩
- Robert Whitaker, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (New York: Broadway Books, 2010). ↩
- World Health Organization, “Depression,” March 22, 2018, https://www.who.int/news-room/fact-sheets/detail/depression. ↩
- Paul E. Greenberg et al., “The Economic Burden of Adults With Major Depressive Disorder in the United States (2005 and 2010),” Journal of Clinical Psychiatry 76, no. 2 (February 2015): 155-162, https://doi.org/10.4088//JCP.14m09298. ↩
- Chelsea Whyte, “US Suicide Rate at its Highest Since the End of the Second World War,” New Scientist, June 19, 2019, https://www.newscientist.com/article/2207007-us-suicide-rate-at-its-highest-since-the-end-of-the-second-world-war/. ↩
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.