Mental Health

There is a new prescription drug epidemic within our modern world, or at least what I have heard and seen. Society has created a generation of children addicted to devices and playing games, making friends in a virtual world, and leaving behind the genuine benefits of going outside, exercising, and interacting with real people. Foregoing this way of life has seen a growing epidemic of reported illness such as ADHD, depression, anxiety, and social isolation. However, this instant gratification with the rise of technology in the 21^st century, leaves people wanting a quick-fix solution for everything, especially with mental recovery, unaware of the long-term impacts. Governments, doctors, patients, and their families need to resist the sugar rush temptation of relying on pharmaceutical quick fixes for complex mental health and social problems.

Firstly, we must recognise how psychotropic drugs can be lifesaving and extremely helpful to an individual, keeping patients and the user safe as well as others around them. Drugs in this capacity cannot cure mental illness, and in many cases should not be the first line of call, especially to the growing extent it is today. Many people who need these drugs are brought up to a bare minimum of functionality and need to work with professionals to further improve their state, not to be increasing the dose until the only other option is to switch over to another drug when it may be one of the causes.

To be a little bit technical and show that I am not just talking from a place of interest alone and not science. A psychiatric medication is a psychoactive drug taken to exert an effect on the chemical makeup of the nervous system and brain, an organ something science only understands around 10% of. Nowadays, many doctors hand medications out like lollies; often far too eager to prescribe pills than to suggest alternative methods, which has been somewhat normalised in our social circles. Sadly, not many people are aware of the inherent dangers and short and long-term impacts these compounded chemicals have on our developing brains and systems, and why this came to be.

Before I go off on tangents which I often do, these reactions should be mentioned. In general, it is assumed that antidepressants are beneficial for many symptoms of depression, importantly including suicidality. However, evidence from online as well as I what I know of within our community and myself, shows that Selective Serotonin Reuptake Inhibitors (SSRIs, the most prescribed antidepressant for moderate to severe depression), can cause worsening of suicidal ideation as well as self-destructive and unsafe behaviour in patients. Let alone stories of children from ages of just 7-year-olds given amphetamines, antidepressants, and/or antipsychotics and wanting to take their own lives. We need to wake up to the fact that evidence-free psychiatric prescribing is normal, especially when medications are often overlooked as a cause for this accelerated regressive behaviour, and that it is just “the patients struggle with their illness.”

It is highly plausible that this failure of government to ensure evidence-based prescribing has contributed significantly to Australia’s epidemic of youth suicide. Yet our political leaders have continued to seek advice from the same failed suicide prevention gurus who obstinately deny the possibility that antidepressant use maybe part of the problem.

Aggressive marketing also has fuelled the off-label prescription of antipsychotic drugs for a growing list of mental health disorders, including dementia, anxiety, depression, and insomnia. One cannot underestimate the immense power that drug companies have in peddling their drugs to GP’s, psychiatrists, and paediatricians across the country. At the end of the day, these enormous pharmaceutical companies are solely interested in making the most possible amount of money.

The shifting of psychiatry toward psychopharmacology is worrying. Not only is there a large financial incentive for psychiatrists to prescribe instead of doing psychotherapy, but health insurance reimbursements are also higher and much easier to obtain for drug treatment than therapy. While Australians do have access to free healthcare with Medicare, there is a shortage of doctors particularly in regional Australia, putting a huge burden in these areas. Before the pandemic 1 in 100 psychologists were unable to take new patients, which has now drastically changed to 1 in 3. The increased demand of the adolescent mental health crisis as well as decrease in availability of therapists, psychologists, and doctors means that largely there is not enough time for therapy with patients due to insufficient time and resources; prescription medications are posing as a quick fix to a potential problem that could’ve benefited from longer consultations and regular therapy, with limited side effects. Doctor’s writing prescriptions to treat mental health disorders is a relatively easy thing to do, but from the point of view as a patient, it can certainly not always be the safest, or more successful way.

However, this is not necessarily to do with the ‘system’, or on the responsibility of doctors. Amongst teenager’s there seems to be misconceptions about medicating mental illnesses. Many patients – who are undeniably suffering enough as it is – want a quick fix but aren’t extremely open to other options, feeling medication would be easier. As stated by Daniel Carlat, an associate American clinical professor of psychiatry, “From the standpoint of consumers and patients, it's very attractive on different levels to take a pill to solve your problems," he says, “medication is not necessarily the best way or the only way.” With, or without medication, the option of psychotherapy is beneficial in the way there is no risk of side effects and lower instances of relapse in the way medication offers where it can interfere with the way neurons send, receive, and process signals in a way that does not agree with the patient. We have not gotten to a point where one, or multiple pills can resolve most people’s depression, anxiety, or other mental health disorders.

I feel some fail to realise a drug is not the road to a perfect life; psychotropic medications are meant to be used in conjunction with cognitive behavioural therapy and other forms of alternate therapies. It is important to remember patients who respond to cognitive therapy are – as I mentioned before – significantly less likely to relapse into another bout of let’s say major depression than patients who responded to their antidepressants and are later withdrawn from the drugs. Often, the withdrawal effects from psychiatric drugs can be worse than initial problems they were treating, as it can be hard for the brain and person to readjust to a life without their medical aid.

Although too often, psychotropic medication is an option quickly offered, if you are not informed of the advantages, limitations, and potential harm of all evidence-based treatments, you should do so. Taking medication is a huge risk; no brain is like one another. One fear of mine is the combination of medications; it is an inexact science, trialling young adults on a combination of drugs supposedly treating each issue, or illness. This can result in negative outcomes effecting both the user, and the people around them. There is not a lot of scientific evidence to the reactions of multiple medications together, let alone any evidence to the specific individual reactions to these drugs as obviously every brain, body and human react to things in different ways.

If we start prescribing drugs to ‘fix’ or ‘aid’ in mental illness recovery, when are we going to learn how to survive without them in the long-term and have those skills in which we can try to overcome or live in a sustainable symbiosis with issues less severe yet inevitable in humankind? No human being is expected to be extremely happy all the time, carefree and never anxious, or always willing to sit down for hours on end and study. When will we all start to realise that it is not possible to live a life with perfect mental health. That there are other ways to treat what negatively impacts your life, without prescribing 4 different medications that are changing the chemistry of a brain still being formed for many children and adolescents.

I agree that in some certain cases, medication is vital for the patient’s safety for a period but cannot be the single factor in which one depends on their recovery. We need to go beyond that reliance and work on skills which will fasten our mental recovery. Things like going outside, meeting up with friends even when you feel you can’t, speaking aloud what is causing you distress, even if just to yourself or in the Notes app of your phone. Serious mental illnesses requiring medication is an incredible tool for the path to good health, but over prescription to many who will benefit from nothing more than a placebo effect is not the answer.

If you have made it this far, first of all thank you because I still need to do all of my assignments and study for exams, but second of all I hope I reach one person reading this and let them know that if they feel they are showing worsening symptoms or feel like they want, or need, psychiatric medication, that it should always be a last resort. If you partake in something like CBT or even the daunting FBT, you are only helping your future self. If you are not willing to put in any effort apart from taking a pill either each morning or several times a day, then your trajectory is not necessarily going forward, you’re merely in a perpetual holding pattern. Lifestyle choices, as little as going outside, are extremely powerful in recovery, and if it does take medication to be a catalyst in your brain chemistry changing, it alone cannot fix the problem.