Feel Better? Antidepressant Use Rises 400%, White Women Top Lists

Pill popping for pleasure pushes past previous records. Or so says the CDC in their report Antidepressant Use in Persons Aged 12 and Over: United States, 2005–2008. “From 1988–1994 through 2005–2008, the rate of antidepressant use in the United States among all ages increased nearly 400%.”

In 2005–2008, 11% of Americans aged 12 and over took antidepressant medication…About 8% of persons aged 12 and over with no current depressive symptoms took antidepressant medication.

Pause and re-read that last sentence: many who do not suffer from depression are nonetheless taking medicine for depression. Why?

How about the plethora of commercials in which people just-short-of-beautiful are seen cavorting in fields of green (in slow motion, always) while a voice intones, “You deserve more out of life. Don’t take CheerMeUp if you suffer from toe fungus. Call your doctor if you are feeling suicidal, as several people who took CheerMeUp hanged themselves. Ask your doctor is CheerMeUp is right for you!”

Only 6% of men 12 and over were swallowing happy pills, but 15.4% of women were. This shocking disparity—which, according to the ethos of the age we must move mountains to correct, such that men attain the same rate of antidepressant use as women; perhaps a government program where men are given free pills—held regardless of the diagnosed level of depression. The CDC has a picture of this (Fig. 3), but it is here redone to emphasize the disparity.

CDC depression

This glaring one-sidedness holds for all age levels. Here’s another re-plotting of the CDC figures:

CDC depression

It is also that case that women are more likely than men to be prescribed antidepressants in the absence of a diagnosis by a “mental health professional.” In other words, the men who are on happy pills were more likely to have seen a shrink than women, who are getting their pills from other sources (such as their GP).

Whites eat three-and-a-half times as many antidepressants as blacks: 13.6% to 2.9%. Mexican Americans eat the least at 2.7%. (The CDC only presented these three groups.) This means that white women top the list, outstretching all competition.

One in ten—9.8%!—white women over 12 take antidepressants. Only 2.8% Black and 1.9% of Mexican American women do. For white men, just 3.8% take pills, with Black men at 1% and Mexican American men at 0.8%.

What’s happening with all these white women? They take medication at three times the rate of their nearest competitor.

Income you say? After all, white women make more than Blacks and others and so they’re more able to afford all those pills. Maybe so, but antidepressant use was roughly the same across income levels. And white men make more than white women. The explanation must lie elsewhere.

The CDC does not present (here, anyway) statistics by year, so we can’t say whether the increase is smooth or abrupt.

In a USA Today summary of the CDC’s press release, they dug up this quote:

“These drugs can be very helpful for people who need them,” says Elaine Ducharme, a psychologist and public educator in Connecticut for the American Psychological Association. “People should expect to be depressed after a layoff. They should not be put on a drug, though, unless they have an acute problem.”

Being without work cannot be the cause of the increase or disparity, because Blacks and Mexican Americans have much higher unemployment rates than Whites, especially among the men.

It could be that clinical depression really is on the rise, but that wouldn’t explain why so many women are taking medication in the absence of expert advice. Or it could be that the depression rate was always as high but that people are now seeking treatment—and somehow white women are beating them to doctor’s office. Again, that doesn’t explain why women don’t go to the shrink.

Too, antidepressants are often written for non-depressive symptoms, such as eating disorders. But that still doesn’t explain the discrepancy between white and non-white women, nor the large differences between older women and men.

We have a few psychologists who read this blog. It would be interesting to hear their guesses about these statistics.

28 Comments

  1. I am white, married to a white woman, and have worked with a diverse assortment of men and women, including white, black, and Hispanic. it seems to me that white women never know what they want, yet the black women with whom I have worked know exactly what they want, and they dare you to get in their way. Hispanic women are creatures of beauty, and like to be worshiped. Just don’t look at another woman while worshiping that brown eyed beauty.

    White women have no idea what they want. Black women know what they want. Hispanic women think they already have it. That’s why white women take more pills, and Hispanic women take the least.

    All men can do is to react to a woman’s intractable demands as we pass through their spheres of influence. All men should be taking those little pills.

  2. Women tend to be more emotional than men. When there is a “remedy” for unpleasant emotions, those with access to the remedy and influenced by the marketing will pursue it. The marketing was unleashed a couple of decades ago when the pharmaceutics lobby bribed Congress enough to allow relentless TV advertising. All that promotion adds about 30% to prescription drug costs. Rising health care costs are emotionally disconcerting, especially when family income is down and your house is underwater and you no longer can afford living beyond your means. Oh, and don’t forget the influence of potentially disastrous global warming…

  3. Couple of things:
    IBS is frequently treated with SSRI’s (aka Antidepressants) and is both more prevalent in whites and women. Also, serious PMS (PMDD) is also frequently treated with SSRI’s (I don’t know of any men with PMS). Just going on a gut feeling here (pun totally intended) white women are probably more likely to have health insurance, and be less willing to “just live with it” than our counterparts in other races…

  4. Amanda,

    Irritable Bowel? I’ll not touch the men-without-PMS comment. But there’s less evidence of a health insurance effect since the use of meds is much the same across income levels.

  5. The “health insurance effect” is probably not as strong in that many people at the lower end of the income spectrum are enrolled in state-sponsored health insurance programs.

  6. Okay, the Health insurance thing was, as I said, simply a gut feeling…nothing to back it up.

    And yes, Mr. Briggs, Irritable Bowel… 🙂

    Also, at least around here (Northern Virginia) and with my health insurance, it was very hard finding a Psychiatrist willing to see patients on an outpatient basis (I’ve no idea why). The only one that I found was simply working a clinic a few afternoons a week in addition to his work at the hospital. He’s since had heart problems and hasn’t come back to practice in over 5 months.

  7. Why more depressed people? Because society is falling apart in some very key ways that induce mental illness & stress — extreme emphasis on self-centeredness, reinforcement of narcissism, etc. all combine to reinforce superficial/shallow relationships, values, etc. (aka “symbolism over substance” that invariably leaves a person feeling empty & with the sense of missing something substantial, which is entirely true….unless they have a personality disorder–and those are on the rise for the same reasons).

    “Eddy (2008, pp. 32-34) cites 6 reasons personality disorders are on the rise in modern urban cultures, some of which other authors have also noted:

    – Instability in early childhood
    – Diminishing social glue
    – Loss of personal behavior role models
    – A society of individuals
    – Teaching self-centeredness
    – Openness to social complaint (i.e., our frivolous law suit society)

    That (excerpted from the following link) & much more are discussed at:
    http://shrink4men.wordpress.com/2010/09/20/why-narcissism-and-other-high-conflict-personalities-are-on-the-rise/

    While that website has a very clear orientation that, for many, will seem counterintuitive, the perspective presented is equally applicable with genders reversed. What is very clear, however, that certain groups are held to very different stereotypes: its ok for women to cry, men do not….etc. Consistent with such stereotypes (including the one the above website strive to rationalize) women will naturally be more inclined to get mental health-related counseling or treatments than men. Ditto for the patterns in the other ethnic groups presented, which are similarly predictable consistent with group identity stereotypes.

  8. Here’s another telling summary of how superficial & insubstantial people can be. The article describes incredibly shallow women, but clearly implied is that they must be attached to similarly superficial guys.

    Really, how happy can such people be if their entire identity is based on props & things — from outside oneself than from within? Especially when their ability to deflect any accountability for anything is so easy. Humans are social creatures and need meaningful relationships. Things cannot comfort, share, etc. and when things substitute for reality & meaninful life experiences — of course they’ll be depressed….and our society & its values reinforce this superficiality as a value for women…and for white women especially (e.g. Cosmopolitan magazine, which strives for the lowest, basest, common denominator under the guise of glitz & glamour).

    See: http://shrink4men.wordpress.com/2009/01/28/gold-digger-entitled-wall-street-wives-bailing-on-their-husbands/

  9. Kids are different today, I hear ev’ry mother say
    Mother needs something today to calm her down
    And though she’s not really ill, there’s a little yellow pill
    She goes running for the shelter of a mother’s little helper
    And it helps her on her way, gets her through her busy day

    And if you take more of those
    you will get an overdose
    No more running for the shelter of a mother’s little helper
    They just helped you on your way
    through your busy dying day

    Mick Jagger
    Keith Richards
    1965
    Lyrics from Wikipedia

  10. I think the answer is really simple: more people are aware of them and their effectiveness.

    They’re not exactly old technology; it’s really only been since the 1990s (1988+) that they have been available. While Doctors may have been reluctant to prescribe them early on, 20 years of usage ‘in the wild’ have made them a generally safe option for your average patient.

  11. There are two problems here:
    1. overall increase in the use of antidepressants
    2. the gender difference.

    In “Anatomy of Melancholy” the author states that he writes about melancholy because he wants to be busy enough to avoid it.
    There is also a gradual cultural shift re perception of suffering and the ways to deal with it. What was addressed in the past by the dictum of personal development is replaced by the expectation of instantaneous improvement.

  12. On the gender/race difference, I am going to speculate that white women are more likely to seek treatments for all maladies than other members of their gender but not their race and members of the opposite gender.

    GT, does advertising increase drug costs? Certainly we can say that GigaPhama spends $30 million adverising Damitol and Damitol generates $100 in revenues per year. However, drigs have massive R&D and FDA costs. The first pill cost GigaPhama $500 million to bring to market. The second pill cost $5. Additional sales will bring down the average cost per dose sold.

  13. Cultures and sexes have different ways of handling complaints. Placebo effects in Clinical SSRI trials have increased.

  14. There’s a quote, which I’m too lazy to find, to this effect: The act of observing a thing has an effect on the thing, thereby potentially skewing the observation.

    Given this, I surely hope no white women read this post. The stats could add to their depression, causing them to “need” more, better, stronger antidepressants, which, in three years time, would lead to another post with stats, which could add to their depression…

  15. Contraception?

    Abortion?

    Biological clock?

    In other words, having kids, (and grandkids), produces lots of happy hormones in mums.

    And/or looking after one and only child till they’re thirty-three and still haven’t left the nest, got married and produced a grandchild or two is stressful on poor old mum.

  16. Did anyone look at family income instead of women or men income? If a man makes more than his wife, she will still get the pill. As for men vs women, everybody knows that men don’t take care of themselves like women do. One easy test: guys, when was the last time you had your prostate checked? Girls, when was your last PAP test?

  17. bob, I’m not going to even qualify your ignorant post with a rebuttal.

    David, to get the pill, you have to have a PAP test – every year. If they weren’t ransoming my pills, I would not get one. My guess is that they assume women on the pill will automatically be more promiscuous. Monogamy heavily lowers the risk of cervical cancer.

    And as someone who’s been on the pill for most of her adult life, I can say that it smooths everything out and relieves you of the ups and downs that occur when you are not on it. The downside of this is that one thing it also smooths out is your libido. I know when I’m not on it, there are days when I’m dying for some fun. When I’m on it… nothing.

    Another thing to consider is that doctors with poor diagnostic skills will hand out happy pills to patients when the original medicines they prescribed aren’t working. I’ve certainly had this happen to me. Efficacy of medication relies upon proper diagnosis. Needless to say, I dropped that guy like a hot potato. That jerk also denied my request to see a specialist appropriate to my test results and symptoms.

  18. Could it be that at least some antidepressants suppress sex drive in men? At least that is what I heard from male friends who had taken them. They where happy to be able to stop taking them after a while. I don’t know how it works for women; maybe men just tend to see this type of side effect as a more serious problem. I’m not an expert at all, maybe someone with a medical background can say something sensible about it.

  19. Matt, Amanda has a good point in that the SSRIs are used off-label to treat a bunch of other things now: irritable bowel syndrome, migraine, premature ejaculation, diabetic neuropathy, PMS (and I’ve been accused of male PMS — just since I never have menses, it’s been prolonged), neurocardiogenic syncope, and other things. That would lead to some increase.

    Also, it’s a mistake to call SSRIs “happy pills”. In depressed people, they make the patient “happy” because they stop being depressed. In patients who aren’t depressed. they don’t do anything to speak of (except for side effects.)

  20. Depression is not that difficult to diagnose, any GP should be competent to diagnose and treat most cases of depression. The only real justification to go to a psychiatrist would be intractable cases of depression that do not respond to anti-depressants or where several different anti-depressants have been tried, with all having bad side effects. There is a fair bit of evidence that once you have had three or more depressive episodes you are best off taking anti-depressants for life. That would account for the higher rates in older age groups. Also, depression is more common in the aged population.

    I don’t know what the reasons for higher rates of anti-depressant taking among women are, but there are two obvious candidates: women may have higher rates of depression (quite possible, given that depression is somewhat associated with low status, low power occupations), or men may have equal rates of depression but be less likely to consult a GP about it, and probably more likely to self medicate – alcohol abuse being the most likely path here.

    The real answer is probably a mix of both, with a few other minor factors I haven’t thought of thrown into the mix. (Another one I’ve just thought of: women live longer than men. Combine that with higher incidence of depression in the elderly, you have another reason.)

  21. PS, as a sufferer from depression who takes SSRIs long term, I have to say I don’t like you characterizing the increase in anti-depressant usage as “Pill popping for pleasure”. Unnecessarily pejorative.

  22. PPS, the quote from the CDS “About 8% of persons aged 12 and over with no current depressive symptoms took antidepressant medication” is weird. The whole point of taking antidepressant medication is so that you don’t have “current depressive symptoms”. It’s like saying that people taking blood pressure medication have normal range blood pressure – of course they do, that’s the point.

  23. Yes there is a lot more to be depressed about these days, but honestly I believe it’s less of an increase in depression and more about how we were brainwashed by Tipper Gore’s crusade to save us all from being unhappy. Most people probably didn’t think they had a problem with depression until they were told they did. Now try and take away those pills. Like trying to take a bone from a dog.

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