COVID-19 Triggers Increased Use of Antidepressants

With financial experts predicting the COVID-19 pandemic response will result in an economic crash worse than the Great Depression of the 1930s,¹ it’s no wonder that depression and suicide statistics are ticking upward.

According to a Kaiser Family Foundation poll,² between March 25 and March 30, 45% of respondents said the pandemic has disrupted their lives “a lot,” with women (49%) being disproportionally affected than men (40%); 27% say their lives have been impacted to “some” degree.

Most also say there’s “no end in sight,” and 74% of respondents believe “the worst is yet to come.” Only 13% believe the height of the pandemic has already passed.

Fifty-nine percent worry their investments will be negatively impacted for a long time, and 52% worry they will lose their job. A nearly identical number — 53% — worry they or a family member will contract COVID-19.

Already, 39% of adults report having either lost their job or lost income due to working fewer hours. A clear majority — 85% — worry local businesses will permanently close due to loss of revenue.

Compared to the week of March 11 through 15, a larger proportion of Americans also reported negative mental health impacts the week of March 25 through 30 — 45% compared to 32% the week before.

Antidepressant Use Skyrockets

According to an April 16, 2020, report^3,4,5 by Express Scripts, an employer-based pharmacy benefit management company, prescriptions for anti-anxiety rose 34.1% between mid-February and mid-March, by which time stay-at-home orders had been issued for many parts of the U.S.

Combined, drugs for anxiety, depression, and insomnia rose by 21%. Mirroring poll results, far more women have turned to antidepressants than men, with women increasing use by 40% compared to men, who had a 22.7% rise in prescriptions.⁶ As reported by Newsweek:⁷

“Anxiety is the most common type of mental illnesses in the country, according to the Anxiety and Depression Association of America, with over 40 million adults suffering from some form of disorder.

Although medication can be an effective treatment, some of the drugs used can come with serious side effects and a potential for abuse and addiction. Insomnia drugs share many of the same caveats.

[Senior vice president of Express Scripts, Dr. Glen] Stettin insisted that a majority of people experiencing anxiety or insomnia issues during the pandemic should first seek drug-free treatments like cognitive behavioral therapy or practicing good sleep. ‘If you think about anxiety and you think about sleep issues, for most people medicine is not the answer,’ said Stettin.”

Suicide Rates Are Starting to Spike

As one would expect, we are also starting to see a rise in suicides. Suicide statistics reliably follow economic trends, with financial downturns triggering higher rates of depression and despair. According to a March 25, 2020, report by The Sacramento Bee:⁸

“FirstLink, a company that answers both 211 helplines and the National Suicide Prevention Lifeline for North Dakota and parts of Minnesota said this week that call volume in some of its call centers is up 300%.”

According to a spokeswoman for the national Crisis Text Line, text conversations were double that of the normal volume during the week of March 15.⁹ It seems clear the current pandemic has delivered a perfect storm of challenges that is sure to bring many to a breaking point.

According to reports by The Federalist¹⁰ and Red State,¹¹ suicides exceeded COVID-19 deaths in Tennessee the week of April 20. The Regional Forensic Center in Tennessee was investigating nine suicides as of March 27, eight of which took place in Knox County — one of the few areas in Tennessee where nonessential businesses were ordered to close.

The suicides, which occurred within a 48-hour period, account for 10% of the 2019 suicide rate for the region.¹² Meanwhile, only six patients died from COVID-19 in the entire state that week. In a statement, Knoxville, Tennessee, Mayor Glenn Jacobs said:¹³

“That number is completely shocking and makes me wonder if what we are doing now is really the best approach. We have to determine how we can respond to COVID-19 in a way that keeps our economy intact, keeps people employed and empowers them with a feeling of hope and optimism — not desperation and despair.”

Similar warning signs are starting to be noted in other states as well, including Oregon. In a March 24 local news report,¹⁴ Portland police chief Jami Resch said suicide threats or attempts are 41% higher now than this time last year, and there’s been a 23% increase since the 10 days before a state of emergency was declared in Portland.

Carefully Evaluate Your Coping Strategy

The fact that so many are turning to antidepressants at this time is unfortunate, as these drugs have repeatedly been shown to be ineffective at best, and can actually make matters worse. Antidepressants come with a long list of potential side effects, which include but are not limited to ^15,16

• Worsening depression, self-harm, violence, and suicide
• Increased risk of developing Type 2 diabetes,¹⁷ even after adjusting for risk factors such as body mass index¹⁸
• An increased risk for heart attack¹⁹ and stroke²⁰
• An increased risk of dementia²¹
• Depletion of various nutrients, including coenzyme Q10 and vitamin B12 — in the case of tricyclic antidepressants — which are needed for proper mitochondrial function. SSRIs have been linked to iodine and folate depletion²²

In a March 2019 Full Measure report (below), award-winning investigative journalist Sharyl Attkisson interviewed psychiatrist and director of the International Center for Patient-Oriented Psychiatry, Dr. Peter Breggin. I interviewed Breggin earlier this year but have not yet released his fascinating video because of the pandemic.

He is known to many as “the conscience of psychiatry,” as he was instrumental in preventing the return of lobotomy as a psychiatric treatment in the early 1970s. Breggin is also the author of “Medication Madness,” in which he details the many hazards of psychiatric drugs.

When asked what he thinks people don’t know about psychiatric treatment, and ought to, Breggin responds, “They don’t know that all psychiatric drugs are neurotoxins. They don't know that they aren't correcting biochemical imbalances, they are causing biochemical imbalances.”

In Breggin’s view, “There is no promising medical treatment and probably there never can be,” for the simple reason that depression is primarily rooted in the complexity of human emotions and experiences.

He believes one needs to avoid numbing and escapist behaviors and implement strategies to support healthy brain function instead, in order to “be able to deal with your issues.”

As noted by Breggin, studies^{23,24,25,26,27,28} have repeatedly shown antidepressants work no better than placebo for mild to moderate depression. Two meta-analyses^29,30 have also demonstrated that when both published and unpublished trials are included, the placebo response accounts for a whopping 82% of the beneficial response to antidepressants.

Most recently, a 2017 systematic review³¹ with meta-analysis and trial sequential analysis of 131 placebo-controlled studies found that “all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantly increase the risk of both serious and non-serious adverse events.

The potential small beneficial effects seem to be outweighed by harmful effects.” None of the trials, even when reporting a positive result, met the threshold for clinical significance of 3 points on the depression score.

Are You Just Scared or Living in Fear?

As explained in my recent article, “You Can Control Fear,” there’s a difference between being scared and being fearful. Right now, the whole world is holding its proverbial breath in anticipation of what might come next. It’s easy to feel fearful, considering the daily barrage of bad news.

However, understanding the difference between being scared and living in fear can be very helpful, as fear has a paralyzing effect while being scared primarily heightens alertness.

Novel threats raise a person's level of anxiety to a greater degree than familiar threats, even when they have the same or similar consequences. This is thought to be related to activity in your amygdala, which processes emotions.

The authors of a 2013 study³² found that activity in the amygdala increased when participants were shown images of unfamiliar flowers and snakes, while images of familiar natural objects did not. Ryan Holiday, author of 10 books, including “The Daily Stoic” and “The Obstacle Is the Way,” writes:³³

“Being afraid? That’s not fight or flight. That’s paralysis. That only makes things worse. Especially right now. Especially in a world that requires solutions to the many problems we face. They’re certainly not going to solve themselves. And inaction (or the wrong action) may make them worse, it might put you in even more danger. An inability to learn, adapt, to embrace change will too.”

Knowledge and Preparation Boost Courage

While fleeting feelings of concern are expected when faced with new experiences, when such feelings are allowed to continuously dominate, paralysis can set in. To thrive in times of great uncertainty and fear, Holiday stresses the importance of training, education, and preparation, which are the foundation of courage.³⁴

The difference between being fearful and being scared is that fear paralyzes your ability to evaluate what's happening and make decisions. But preparation and information help you to make decisions and act, even when you're scared. This is the definition of courage — taking action despite being scared.

Preparation begins with understanding the long-term consequences of fear and panic to your health — and realizing these health conditions are neither inevitable nor necessary to your survival.

There are several strategies you can use to reduce fear and find your courage. It is important, to begin with, the understanding that feelings do not have a life of their own. In other words, feelings are generated. Your feelings change depending upon your circumstances and your thoughts.

Watching a funny movie may trigger laughter and feelings of happiness. Watching a sad movie brings many to tears. Reading the headlines during an epidemic or pandemic can trigger fear. There’s an unknown factor in the situation. You may not have control over the news media, but you do have control over your thoughts and your health. In other words, your thoughts engender feelings.

Consider a Media Diet While You Prepare for the Future

One of the strategies you can use to reduce fear is to change the way you think about things. Yes, we’re dealing with many unknowns right now, but focusing on planning and preparation rather than getting locked into panic mode can go a long way toward safeguarding your mental health. Take the safety precautions you can take, and limit your exposure to the news.

Psychology Today³⁵ recommends reducing anxiety by consuming positive news stories while keeping up with what’s going in the world. Also do your best to apply some critical thinking when reading the news. It’s important to pay careful attention to “vague or loaded terms, cited statistics, and unstated assumptions.” In other words, don’t accept at face value what’s in the news but, rather, consider the information and ask questions about what you’re being told.

Other stresses- and depression-reducing techniques include getting enough exercise, eating whole foods, limiting sugar, and getting quality sleep. When you’re tired and your body doesn’t have adequate nutrition to function, you’re more apt to fall into the trap of fear-based thinking. Additional treatment strategies for depression can be found in “What Does the Best Evidence Say About Antidepressants?”

The Emotional Freedom Techniques

https://youtu.be/H9H7XEQ-WN0

A strategy that can provide more immediate results is the use of Emotional Freedom Techniques or EFT. In the video above, Julie Schiffman demonstrates a tapping strategy to relieve anxiety and other challenging emotions brought on by news and uncertainty about this pandemic and/or self-quarantining.

If you aren’t familiar with EFT you’ll find a library of demonstrations at “Basic Steps to Your Emotional Freedom.”

The NET FAST Technique

Another alternative is the Neuro-Emotional Technique’s First Aid Stress Tool, or NET FAST, demonstrated in the video above. Firstaidstresstool.com also provides an excellent printable summary with visuals of the technique,³⁶ which even a young child can do. Here is a summary of the FAST procedure:

1. While thinking about an issue that is bothering you, place your right wrist, palm up, into your left hand. Place three fingers of your left hand onto the area of your right wrist where you can feel your pulse.
2. Place your open right hand on your forehead. Gently breathe in and out several times while concentrating on feeling the issue that bothers you.
3. Switch hands and repeat steps 1 and 2.

Suicide Prevention Resources

Last but not least, if you feel depressed, anxious, or creeping despair, don’t hesitate to reach out to family, friends, or any of the available suicide prevention services:

• The National Suicide Prevention Lifeline (U.S.) — Call 1-800-273-TALK (8255)
• Crisis Text Line — Text HOME to 741741 to connect with a crisis counselor
• Lifeline Crisis Chat — Chat online with a specialist who can provide emotional support, crisis intervention, and suicide prevention services at www.crisischat.org