THE ACADEMIC - Abnormal Psych Discussion Post

The following is this week's discussion question, and my subsequent response, for my Abnormal Psych class:


Why is depression, and its treatment, so popular in American society?  It is very easy to acquire anti-depressants.  Are Americans more depressed today or seeking a quick fixes?


There are so many pieces of the puzzle working together to make this trend happen, in my opinion.  As others have said, people "don't want to take the time" to get therapy from a psychologist ... but I believe that there is much more at play than people just "not feeling like it".  For example, as much as awareness about depression has increased in the past few decades, and there is less stigma surrounding the disease, it is still there.  Many people in my generation grew up believing that depression meant weakness, danger, or "crazy"/unpredictable.  Even if you weren't brough up to feel that way, chances are you were not in a family where one of your parents or elders was going to therapy, and if they were, they were not open about it.  Much of the mental health culture in the United States is about hiding mental illness because it is perceived as weakness.  So, even if you have an open mind about mental illness, if you never had an example of someone seeking mental health care in your family, it still might be hard for you to accept that 1. you should go or 2. that you even need it.

I think another factor that is at work has to do with the pharmeceutical industry itself, and how it works in congruence with society's perception of mental health.  Taking medication on a daily basis is something that you can hide from friends, family, and co-workers much more easily than having to go to therapy once every week or two.  Americans also have to worry about how time taken off to seek mental health care will negatively affect their employer's perception of them.  Admitting to a mental illness or needing therapy could cause some employers to think that you aren't capable of performing your job properly, or that you are perhaps not capable of a promotion that may come up.  There is the possibility of social consequence when you disclose that you are seeking treatment for a mental illness, even though there really shouldn't be.  Because of these feelings, patients are more likely to accept medication-only treatment.  Yes, it's "easy" but it's also the socially "safer" option, which I believe plays a greater role in patient's decision-making about their mental health treatment.  Doctors hand out medication like it is candy.  You can literally schedule an appointment with a new doctor who has never seen you before, have a 15-minute appointment, and then walk out with an anti-depressant prescription.  I know, because I did it when I was 18 and I had a major depressive episode the first time I went to college.  And because, as a culture, we are not well-versed in mental illness, potential treatment, or most effective types of treatment, most patients accept the words of their doctors as being "good enough" for their care.  If a doctor gives you a prescription for anti-depressants and sends you on your way ... if that's good enough for them, it should be good enough for you, right?  I think that's the stance that many Americans take.  And, let's face it, there is no money to be made by big pharma if we actually made it public knowledge that medication-only treatment is basically the most bare-bones means of treatment along with a laundry list of side-effects which may include making you feel worse, or even suicidal.

I don't think that more Americans are depressed than they have been in the past, though I do think that more Americans, in general, know that depression exists.  I think that we've gotten enough awareness to know that, but we don't have enough education to treat it as the public health crisis that it really is.

Our healthcare system is also another obstacle that gets in the way of Americans seeking proper mental health care.  Many people can barely keep up with their medical bills for just their physical health, let alone their mental health.  And many healthcare plans provided through employers have limitations of coverage on mental health services, being typically either a percentage covered, only a limited amount of sessions covered, or even a costly deductible before any benefit is received.  Even after you pay into it with every paycheck ... you have to pay more to receive the benefit.  What sense does that make?  Even with NYS Medicaid, which is arguably one of the best health care plans you can get in NYS in terms of coverage, only offers 10 visits for mental health care annually.  The American health care system is reactive instead of proactive -- and when problems inevitably arise, we cover incomplete solutions and treatment, but not complete ones.