The rates of mental illness in the United States (US) have increased significantly over the past twenty years. In 1999, 10.1 million individuals were treated with depression and in 2009, 17.6 million individuals were treated with depression (Soni, 2012). More recent data estimates that 17.3 million adults in the United States had at least one major depressive episode during 2017, which represents 7.1% of adults in the US (NIH, 2020). Although the rates of depression are alarming, sex differences related to depression exist.
When sex differences are examined, women are treated for depression at higher rates than men. In 1999, 7.3 million women were treated for depression compared to 2.8 million men. The rates of depression for both sexes have increased since 1999. However, the rates of women being treated for depression in 2009, 12.5 million were higher than men (5.1 million). (Soni, 2012). The National Institute for Health (2020) found that adult women (8.7%) experienced a major depressive episode more frequently than adult men (5.3%).
When examining the adult population being treated for mood disorders (i.e., depression) and anxiety disorders, these sex differences continued with 18.0 million women receiving treatment compared to 8.8 million men (Soni, 2007). Moreover, doctors are more likely to prescribe Serotonin Reuptake Inhibitors (SSRI’s) to middle ages women, as one out of four women in their 40’s and 50’s are prescribed SSRI’s (Friedman & Leon, 2007). Women in this age group may experiencing stressful life events including divorce, and providing support for their children, while also taking care of aging parents. Additionally, one must consider the ratio of women being prescribed SSRIs in comparison to female sexual assault (Community works.org). The ration is 1:4. One in four women are victims of sexual assault. The underpinning and causes of depression and anxiety for women specifically must be taken into consideration when providing support for this population.
Serotonin Reuptake Inhibitors are the gold standard for treating mood disorder (e.g., depression) anxiety, and behavioral disorders (Las Cuevas and Sans, 2006) and are the most widely prescribed antidepressant worldwide (Preskorn Stanga, & Ross, 2004). Although SSRI’s are fairly new in comparison to tricyclic medications developed in the 1950’s, they are more effective and well tolerated.
Fifty to sixty percent of individuals being treated with SSRIs because of depression respond quickly (Papakastas et al., 2008; Brent et al., 2008). In addition, After 8 weeks of SSRI treatment, significant improvement of depression symptoms is seen (Tollefson, Holman, Sayler, & Potvin, 1994; Montgomery, 1989). The quick response to SSRI medication is critical because when we examine the importance of alleviating symptoms related to severity of symptoms on a continuum (e.g., mild, moderate, and severe) for our clients and loved ones who are struggling to function, decreasing depressive symptoms is powerful and their ability to function in the major domains of life (e.g., career, school, intimate relationships) improves. Alleviating fatigue, normalizing sleeping and eating patterns, thinking more clearly, engaging in decision making, and decreasing suicidality and thoughts of death is critical.
SSRI’s are used to treat both depression and anxiety and all SSRI’s have the potential for side effects (i.e., nausea, diarrhea, insomnia, drowsiness, dry mouth, nervousness). Individuals prescribed SSRI’s for anxiety have improvements over time, but can experiences an increase of anxiety symptoms within the two weeks of SSRI treatment (Beasley Jr, Dornseif, Pultz, Bosomworth, & Sayler, 1991).
There is conflicting evidence related to SSRI use related to suicidality and violence. While researchers have found an increase in suicidality and violence in a healthy sample of adults (Bielefeldt, Danborg, & Gøtzsche, 2016), other researchers have found no connection between SSRI use and suicidality and violence (Tandt, Audenaert, & van Heeringen, 2009). What we do know is that vulnerabilities may exist in healthy adults and that there is a relationship between age, SSRI’s, suicidality, and violence. Essentially, the younger the individual is, the more vulnerable they are to suicidality and violence (Tandt et al., 2009). Hence, many SSRI’s are blacks listed for children and adolescence including Paxil and Celexa. Other SSRI’s have age restrictions and treatment restrictions. For example, Prozac is recommended for children ages eight and older for the treatment of depression and obsessive compulsive disorder, an anxiety disorder. Prozac is the only approved SSRI approved for children under 12 years of age. For children aged 12 years old and above, Lexepro can be prescribed for depression and Zoloft can only be used to treat OCD for children ages 12-17.
Regardless of age, stress reduction, problem solving, coping skills, and counseling need to be incorporated into an individual’s life when they are experiencing depression and/or anxiety. In addition, for adults experiencing moderate depression and/or anxiety, SSRI’s may be helpful in reducing symptoms. Medication adherence is important. Check in with your doctor, psychiatrist, and mental health provide to ensure you are on the right medication and the dosage is effective. Consequences for long term use of SSRI’s exist and include fatigue, and memory impairment. For individuals who experience an episode of depression, consider tapering off after two years of use. With this said, it is imperative that individuals to engage in the behaviors mentioned above as well as include a healthy diet and exercise into their daily habits.
Tom Bodett surmised, "They say a person needs just three things to be truly happy in this world: Someone to love, something to do, and something to hope for." A counselor is a great resource to personal happiness.
Read my next blog: How to increase serotonin levels naturally
Comments