Column: An SSRI might not be the solution

Last year, in the midst of a particularly rough mental health episode, I visited Counseling and Psychological Services at UNC for the first time. After two hours in the waiting room, I met with a counselor who, after only 30 minutes, recommended I see a psychiatrist.

Two weeks later, I finally met with the psychiatrist. At the end of our 45 minute appointment, he diagnosed me with obsessive-compulsive disorder, a panic disorder and depression. His treatment plan? An antidepressant: Zoloft.

This "miracle pill" did not work for me. It actually left me worse off than when I started. 

In the year since this appointment, I’ve met with several other doctors, all of whom had a similar passion for their prescription pads. Not once has a psychiatrist recommended me therapy or any alternative treatment plan. They always go straight to telling me to fill some prescription at my nearest Walgreens and see them again in six months. 

Antidepressant medications are one of the largest revenue sources for the pharmaceutical industry. In 2019, the global antidepressant market alone was worth almost $12 billion. This value will only grow, with The Pharmaceutical Journal reporting that antidepressant prescription rates have increased by 35 percent in the past six years. 

One could argue that the onset of the COVID-19 pandemic contributed to this dramatic increase, but this is a trend we’ve seen taking shape for decades. Between 1998 and 2018, the number of antidepressant prescriptions more than tripled, according to a longitudinal study published by the National Institute of Health.

This trend mimics those of prescription painkillers, including opioids like OxyContin. Overprescription of these medications, and subsequent prescription drug abuse, has risen astronomically in recent years. However — despite drug abuse and high rates of addiction — a lack of ethical care within American medicine and the pharmaceutical industry prioritizes prescribing over consumer safety.

This is not to suggest that antidepressants have the addictive and detrimental potential as opioids, but I’m cautious of the idea that we should trust everything a doctor prescribes us, given epidemics that have ensued as a result of overprescribing. 

In fact, I don't think antidepressants themselves are that harmful.

They serve a useful function for those with mental illness. Selective serotonin reuptake inhibitors, for example, increase the level of serotonin in your brain, which can be used to treat issues like depression and OCD, which can result from a lack of the serotonin. 

The issue arises when medication is the default. Psychiatrists can prescribe pills like they are candy, with little consideration for any other factors that could contribute to a person becoming depressed or seeking treatment.

There’s little inquiring about a person’s diet and other biological metrics to see if anything else could be causing such a severe shift in mood. Anemia, thyroid issues and magnesium deficiencies are all things that can cause an increase in depression or anxiety and can be detected in a blood draw. 

These issues will not be solved with an antidepressant. 

It took a psychiatrist 45 minutes to put me on a drug that has severe withdrawal effects and is incredibly difficult to stop taking. In many cases, these medications are something patients are put on indefinitely. Commitment to a drug for that long should necessitate a much longer consultation.

Drugs are incredibly important in many individuals' treatment plans. However, the long-term purpose of a drug should be to treat an illness in situations where non-pharmaceutical methods have proved unsuccessful or the patient has treatment-resistant disorders. For some, medication is the only effective solution.

But why are psychiatrists prescribing long-term antidepressant and anti-anxiety medication after such short appointments with no real treatment plan in place? In many cases of situational depression, the situation itself isn’t being resolved. Instead, doctors choose to slap a Band-Aid on a gushing, yet invisible, wound. 

Pfizer, the company behind Zoloft, market their drugs to physicians. Ignoring the inherently unethical nature of medical marketing, in a lot of cases, doctors that widely prescribe antidepressants are receiving luxurious dinners and behind-the-scenes benefits from the companies pushing such drugs.

I’m not telling you to stop taking your antidepressant. If it works for you, perfect. 

Still, a doctor should spend longer than an hour working with patients before deciding to put someone on these types of drugs. A year of therapy has done more for me than any medication a psychiatrist ever prescribed me. And while my case is not universal, I am also not alone in this experience.

Doctors are there to help us, but in a vastly flawed healthcare system like ours, it is valid to be weary of someone putting you on an antidepressant when they won’t even remember your name tomorrow.

@dthopinion

opinion@dailytarheel.com