Are We in Danger of Over-Diagnosing and Over-Medicating on Mental Health Issues?

Are We in Danger of Over-Diagnosing and Over-Medicating on Mental Health Issues?

With one of every six Americans receiving medication for mental illness, are we at risk of an epidemic similar to the opioid crisis in the future?

A tweet has recently gone viral, about a woman e-mailing in to work saying she wanted to take a few sick days to focus on her mental health, for a couple of reasons.  First, the remarkable courage the woman has for admitting she suffers from mental illness, given the shame that most people feel about someone with the disease, and secondly, for her boss’s reply.

Madalyn Parker requested the use of her sick days to try to return to work “refreshed and back to 100%,” according to news reports.  The CEO of her company, Ben Congleton, praised her as example to all and thanked her for her candid request, calling it a reminder of the importance of taking advantage of sick days for mental health, as well as physical health.

We all must applaud them both for recognizing that mental health is a serious matter and not to be taken lightly.  I became particularly concerned after I read that one of every six Americans are being medicated for mental illness.  That means that, if I go to my local Walmart, one of the next five people I meet is taking medication for mental illness issues, on average.

I am not saying that they haven’t been properly diagnosed and are taking medication because it is necessary, I’m just surprised that so many are being medicated.  It makes me wonder if our definition of mental illness is too broad, and if perhaps we, and I mean physicians, are a little too quick to pull the take-a-pill trigger.

Mental illness is difficult to accurately diagnose, and I don’t pretend to comprehend the criteria for the prescribing doctors.  One of the articles quoted a survey by the American Psychological Association that revealed one of three Americans said they felt “chronically stressed” on their jobs.  That is not at all a surprising statistic to me, since increased responsibility and stress to perform at a higher level at work kind of go hand-in-hand.  But, just because you feel stressed at work, is that a valid reason to take medication?  Full disclosure, the article made no claim that the survey participants and taking medication were linked.

I once went to my primary physician several years ago for my annual physical, and in the course of the conversation I mentioned I was having trouble sleeping and found myself awakening at around 4 AM quite often and unable to get back to sleep.  My doctor said that could be a sign of depression, and offered to write me a prescription for some medication.  I decided against it.  I wonder if I had taken the medication, would it have led to even more medication later on, as often seems the case.

My point is not to indict either the physicians, the patients, or the pharmaceutical companies.  I just have concerns that the prescribing of medications for symptoms of mental illness can soon spiral out of control, and may even lead to an epidemic similar to the opioid problems we are seeing on the news today.

I am not qualified to make that decision.  I would like for the various medical associations and physician groups to take a deep breath and re-examine the criteria for medication for treatment of mental illness.  Surely there are alternative methods that can be tried first in many cases.  And for all I know, that may be the first step.

It would be much easier to prevent over-medicating now than dealing with those who are being over-medicated later.  We just need to be sure that medication is the correct decision and not just the easiest.

Kudos to Ms. Parker and to Mr. Congleton for their courageous acts in recognizing the impact mental illness has on the business world, and for taking steps to bring it out of the shadows.

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