“I thought my world was crumbling around me when my parents told me their plans of divorce the summer before my senior year. Senior year was hard enough but I made it through and left for college. The transition felt impossible, but I met a really nice boy in the first week and we started dating soon after. He was the only thing keeping me going through this difficult time, until he broke up with me a year later.  Classes started to become impossible, and I flunked out of all of my pre-med courses, crushing my dreams of Med School and becoming a doctor.”

If this hypothetical patient walked into a doctor’s office today she would be 40% more likely to be prescribed a psychotropic drug than she was 10 years ago. Any one of these three life events is likely to cause loneliness, sadness, loss of sleep and a sense of depression. However, none of these could actually cause a chemical imbalance and therefore a mental disorder. The line between everyday unhappiness and clinical depression is being blurred.

The question is: Are more Americans suffering from depression than in the past, or are doctors in America trying to solve everyday unhappiness by writing a prescription?  There is no reason to believe that there are more Americans today with chemical imbalances. For example, in the period between 1978-1987 the amount of office visits resulting in a psychotropic drug prescription remained stable. However, in the last decade the amount of office visits resulting in these prescriptions increased from 32 million to 45 million. So, if more Americans do not have chemical imbalances, why is it that we are seeing such a drastic increase in medicalization?

One possible reason could be that as medical costs have increased and the use of managed care has become more prevalent, the medical community is cutting costs wherever possible. Under managed care, we have lost the personal attention patients were once given by their family physicians.  Doctors often rush through their diagnosis and rarely have a personal history with the patient. In order to cut corners, medication is being prescribed rather than suggesting an indefinite amount of costly counseling sessions.

With such easy access to medical information via websites such as webMd,  patients seem to be increasingly self diagnosing. They are able to research the symptoms most likely to result in a prescription of a mood-altering drug. As a result of this, it seems that the patients with the strongest voice about their unhappiness are the ones receiving medication, instead of the patients with the most severe cases.

Another factor contributing to increase in prescriptions is the Diagnostic and Statistical Manual of Mental Disorders (DSM). This is the tool most commonly used to diagnose mental disorders and was originally designed to be used by psychiatric professionals, but is now frequently used by lesser trained, primary care physicians. Their limited experience with this tool results in confusion between diagnosing true clinical depression and every day unhappiness.  Another disadvantage of this tool is that it is very outdated.

Prescribing these psychotropic drugs such as Zoloft, Prozac, and Paxil can help to cure the chemical imbalance for patients truly suffering from depression and a chemical imbalance. On the other hand, for those patients suffering from everyday unhappiness, taking these mood-altering drugs only medicates them into thinking they are happy and prevents them from changing the factors in their life that caused the unhappiness in the first place.  However, we cannot place all of the blame on the doctors.  I believe that we are a nation looking for an easy fix.  When given the option between 6 months of weekly visits with a psychiatrist, or a prescription that can be filled on the way home, most would choose the pills. This issue of over-medicalization is not only prevalent in the field of psychotropic drugs, but is common in many other areas as well. One example of this is the diagnosis of Attention Deficit Disorder and Attention-deficit Hyperactivity Disorder.  In 2002 almost 4 million children in America were diagnosed with ADHD.  In some school districts as many as 60% of the students have been diagnosed with ADHD.  Also, although ADHD and ADD are seen as problems all over the world, in no other country are children diagnosed with this disorder as often as in the United States.  So we ask ourselves the same question, are more kids struggling with ADD and ADHD now, or are we just prescribing more?  Some other examples of Americans looking for a fast fix are the use of weight loss pills, sleeping pills, liposuction, and pain killers (instead of getting surgery or going through rehabilitation).

In my opinion, in order to fix this issue of over-medicalization we need to change how we treat our relationship with our medical health. We should focus more on making healthy lifestyle changes instead of turning to prescriptions to solve our problems.  Making changes such as addressing the sources of unhappiness, eating healthier, or developing focusing/studying techniques, would result in long-term solutions and a better quality of life.  I feel that Americans could truly benefit from using less medication and taking a more active approach to solving health problems.

“I thought my world was crumbling around me when my parents told me their plans of divorce the summer before my senior year. Senior year was hard enough but I made it through and left for college. The transition felt impossible, but I met a really nice boy in the first week and we started dating soon after. He was the only thing keeping me going through this difficult time, until he broke up with me a year later.  Classes started to become impossible, and I flunked out of all of my pre-med courses, crushing my dreams of Med School and becoming a doctor.”

If this patient walked into a doctor’s office today she would be 40% more likely to be prescribed a psychotropic drug than she was 10 years ago.¹ Any one of these three life events is likely to cause loneliness, sadness, loss of sleep and a sense of depression. However, none of these could actually cause a chemical imbalance and therefore a mental disorder. The line between everyday unhappiness and clinical depression is being blurred.

The question is: Are more Americans suffering from depression than in the past, or are doctors in America trying to solve everyday unhappiness by writing a prescription? I do not think there is any reason to believe that there are more Americans today with chemical imbalances than there was 30 years ago. For example, in the period between 1978-1987 the amount of office visits resulting in a psychotropic drug prescription remained stable.2 However, in the last decade the amount of office visits resulting in these prescriptions increased from 32 million to 45 million.2 So, if more Americans do not have chemical imbalances, why is it that we are seeing such a drastic increase in medicalization?

I am concerned that as medical costs have increased and the use of managed care has become more prevalent, the medical community is cutting costs wherever possible. Under managed care, we have lost the personal attention patients were once given by their family physicians.  Doctors often rush through their diagnosis and rarely have a personal history with the patient. In order to cut corners, medication is being prescribed rather than suggesting an indefinite amount of costly counseling sessions.1

With such easy access to medical information via websites such as webMd, I believe that patients are increasingly self diagnosing. They are able to research the symptoms most likely to result in a prescription of a mood-altering drug. As a result of this, the patients with the strongest voice about their unhappiness are the ones receiving medication, instead of the patients with the most severe cases.

The tool most commonly used to diagnose mental disorders is the Diagnostic and Statistical Manual of Mental Disorders (DSM). This tool was originally designed to be used by psychiatric professionals, but is now frequently used by lesser trained, primary care physicians. Their limited experience with this tool results in confusion between diagnosing true clinical depression and every day unhappiness.

Prescribing these psychotropic drugs such as Zoloft, Prozac, and Paxil can help to cure the chemical imbalance for patients truly suffering from depression. However, in my opinion for those patients suffering from everyday unhappiness, taking these mood-altering drugs only medicates them into thinking they are happy and prevents them from changing the factors in their life that caused the unhappiness in the first place.

“I thought my world was crumbling around me when my parents told me their plans of divorce the summer before my senior year. Senior year was hard enough but I made it through and left for college. The transition felt impossible, but I met a really nice boy in the first week and we started dating soon after. He was the only thing keeping me going through this difficult time, until he broke up with me a year later.  Classes started to become impossible, and I flunked out of all of my pre-med courses, crushing my dreams of Med School and becoming a doctor.”

If this patient walked into a doctor’s office today she would be 40% more likely to be prescribed a psychotropic drug than she was 10 years ago.¹ Any one of these three life events is likely to cause loneliness, sadness, loss of sleep and a sense of depression. However, none of these could actually cause a chemical imbalance and therefore a mental disorder. The line between everyday unhappiness and clinical depression is being blurred.

The question is: Are more Americans suffering from depression than in the past, or are doctors in America trying to solve everyday unhappiness by writing a prescription?  There is no reason to believe that there are more Americans today with chemical imbalances. For example, in the period between 1978-1987 the amount of office visits resulting in a psychotropic drug prescription remained stable.² However, in the last decade the amount of office visits resulting in these prescriptions increased from 32 million to 45 million.² So, if more Americans do not have chemical imbalances, why is it that we are seeing such a drastic increase in medicalization?

As medical costs have increased and the use of managed care has become more prevalent the medical community is cutting costs wherever possible. Under managed care, we have lost the personal attention patients were once given by their family physicians.  Doctors often rush through their diagnosis and rarely have a personal history with the patient. In order to cut corners medication is being prescribed rather than suggesting an indefinite amount of costly counseling sessions.¹

With such easy access to medical information via websites such as webMd,  patients are increasingly self diagnosing. They are able to research the symptoms most likely to result in a prescription of a mood-altering drug. As a result of this, the patients with the strongest voice about their unhappiness are the ones receiving medication, instead of the patients with the most severe cases.

The tool most commonly used to diagnose mental disorders is the Diagnostic and Statistical Manual of Mental Disorders (DSM). This tool was originally designed to be used by psychiatric professionals, but is now frequently used by lesser trained, primary care physicians. Their limited experience with this tool results in confusion between diagnosing true clinical depression and every day unhappiness.

Prescribing these psychotropic drugs such as Zoloft, Prozac, and Paxil can help to cure the chemical imbalance for patients truly suffering from depression. However, for those patients suffering from everyday unhappiness, taking these mood-altering drugs only medicates them into thinking they are happy and prevents them from changing the factors in their life that caused the unhappiness in the first place.