How long should anxiety be treated with medication?
Dr. Mattu answered a common question about how long people should take their medication when being treated for anxiety or depression.
For Tamaryn Paredes, 43, an addiction counselor at a methadone clinic in Portland, Oregon, the coronavirus pandemic became a breaking point. She was living in California at the time and working at a group home for severely emotionally disturbed children, which she said was a demanding job, especially when the children became abusive. .
Helping people with mental health issues is close to home for Paredes. She had lived with depression and suicidal thoughts for years, but the hormonal side effects from her ovary removal surgery in 2019 made things worse for her.
“I felt like my life was falling apart,” she said.
After moving to Oregon for a new job in October 2021, she decided to prioritize her mental health and see a doctor. She was diagnosed with ADHD and prescribed medication, which she said changed her life.
Paredes currently takes three types of medication to manage her mental health. Her sleep quality has improved. She now has more control over her own emotions. Focusing on her job has become easier, especially after she was fired from her previous job due to performance issues.
“I can’t go back to being drug-free,” she says.
More people are seeking mental health treatment and medication as the pandemic forces people into isolation and disrupts support systems, according to a USA TODAY analysis of Medicaid data for the 60 most used psychiatric drugs. It has been shown.
The analysis also revealed the lingering effects of the pandemic. Mental health-related prescriptions will further increase in 2022, increasing by 12% from 2019, outpacing the less than 1% growth in overall prescriptions. This includes generic prescriptions for Zoloft, the most common antidepressant, which increased by 17% over the same period.
Prescriptions for more than half of these drugs have increased since 2019, with Concerta and generic Adderall seeing the fastest increases among ADHD drugs.
Related: Adderall shortage causes ADHD drug prices to rise as patients struggle to fill prescriptions
Even before the pandemic, mental health drug use was on the rise due to more affordable drug options and greater acceptance of mental health treatment. The increase accelerated as the pandemic deepened the country’s mental health crisis following widespread loss and adversity.
The upending of the normal structure caused by the novel coronavirus is likely contributing to an increase in prescriptions for mental health drugs, in addition to heightened awareness of mental health and the spread of diagnosed symptoms, the U.S. says. Amy Wohllemeyer, president of the Society of Psychiatric Pharmacists, said: told USA TODAY.
According to the Census Bureau’s January 2024 survey, the percentage of people experiencing anxiety and depression remains double the pre-pandemic level.
Across all age groups, more than a fifth of adults and a third of people under 30 reported feeling anxious or depressed. The problem is even worse among transgender and bisexual people, with 57% of transgender people and 44% of bisexual people saying they experience anxiety or depression.
“For many people, this has gotten to the point where it’s gotten out of hand,” said Dr. Smita Das, chair of the American Psychiatric Association’s Council on Addictions.
One of the silver linings of the pandemic, Das said, is that “we’ve all started talking more about mental health and bringing it to the forefront.”
Other data confirms the growing toll the mental health crisis is taking on this country. For example, lives lost to suicide and drug overdose are at record levels.
Policymakers and government officials are taking steps to strengthen mental health programs and strengthen social support systems, including creating mobile crisis response teams, establishing a national suicide prevention hotline, and implementing paid family leave laws. Actions are noted and recommended.
Last year, US Surgeon General Vivek Murthy issued recommendations highlighting the urgency to address the “public health crisis of loneliness, isolation, and lack of connection.”
“There’s a growing recognition that we shouldn’t think about mental health any differently than we think about physical health,” Weyermeyer says.
“But for some reason in the past, we’ve blamed people for having to take medication for depression or medication for substance use disorders,” she says.
Economic barriers, such as limited insurance coverage for mental health treatment and high costs for uninsured patients, also make it difficult for some people to obtain drugs, Wellmeyer said. Stated.
Expanding mental health drug market
Arthur Wong, managing director of healthcare at rating agency S&P Global Ratings, said the use of mental health drugs has increased over the past 20 years, partly due to the introduction of lower-cost generic drugs. It is said that this is the cause.
Wong said the field is in high demand as pharmaceutical companies develop new alternative drugs and explore new approaches to treating depression and anxiety.
Of all the generic drugs available this century, sertraline, the generic version of Zoloft, is the most widely used drug for mental health, according to a USA TODAY analysis of federal drug use data. Fifteen years after the brand name hit the market in 1991, this lower-priced alternative was released.
As of early February, generic Zoloft is 300 times cheaper than the brand name, based on the average price pharmacies pay per pill. That means, while the average retail price for generic alternatives hovers around $20, according to GoodRx, supplying a patient with a month’s worth of Zoloft without insurance can cost more than $400. Thing.
Over the past five years, prices for the 30 most prescribed psychiatric generic drugs have fallen faster than the average decline for all generic drugs. This is based on USA TODAY’s analysis of national average drug acquisition cost data, which includes information on how much retail community pharmacies pay for drugs. .
Search our database to see which pharmacies are paying for your generic or branded drugs..
While generic prices are on the decline, branded product prices are steadily rising, a phenomenon known as the “generic paradox.”
Andrew Mulcahy, senior health economist at Rand, a nonprofit research organization, said it’s not unusual for brand-name manufacturers to raise prices after lower-priced generic equivalents become available.
Less than 10% of prescriptions are branded drugs, but drug companies still make money by selling to “some patients,” Mulcahy said.
Some patients prefer to take brand-name drugs because they believe that alternative generic drugs are inferior or less effective, even though they meet the same Food and Drug Administration standards, because other drugs do not work as effectively. , some patients continue to use more expensive drugs.
Lack of funds and human resources
While the pandemic has facilitated the expansion of telehealth, it has also exacerbated challenges such as behavioral health worker burnout, high turnover rates, and national staffing shortages.
This puts quality of care at risk, especially in underserved communities.
“The toll of trauma can be high because you hear the horror stories,” said Tamaryn Paredes, who counsels people with opioid use disorder.
Paredes is treating 140 patients, three times the original number. The reason is that there are more people in need than healthcare providers.
Rural and remote areas have been particularly hard hit. For example, on many tribal lands, mental health care is “absolutely non-existent,” said Lori Jump, CEO of Strong Hearts Native Helpline, a nonprofit that works with Native communities.
Most nonprofit centers operated under government authority rely on subsidies to serve patients who cannot pay. Some people received a temporary reprieve through the 2021 American Rescue Plan, which allocated more than $3 billion across the country in mental health and substance use grant programs.
Central Plains Center in Plainview, Texas, was one of 40 community behavioral health clinics to receive federal funding. Received over $1 million. Nevertheless, CEO Shelley Bohr said she was concerned about future funding and what would happen after the subsidy expires in August of this year.
Bohr said the facility serves fewer than 4,000 people a year, most of whom are low-income, uninsured or on Medicaid.
Bohr said another concern weighing on her is the lack of certified therapists willing to work in rural clinics. “If you just want a paycheck, you can’t take this job,” she says.
Case in point: The therapist position at Central Plains Center has remained unfilled for three years.
“They don’t have roots here,” said associate CEO Jason Johnson. “They tend to see our small towns as stepping stones.”
overcome the stigma
The increase in people seeking treatment and medication does not fully explain the pandemic’s impact on mental health. Because many people, especially people of color, the LGBTQ+ community, and people with disabilities, are reluctant to seek help.
Das, the Stanford University professor, said it will take time to overcome that hesitation, adding that in some communities it has been labeled a “personal failure.”
The 2022 National Drug Use Survey found that among adults with severe mental illness who did not receive treatment, the majority reported that they could have taken care of their mental health on their own.
Tanisha Malcolm, a Black woman who was diagnosed with bipolar disorder 20 years ago, said her family doesn’t believe in mental illness or psychotherapy. For them, mental health conditions “were not even considered real,” Malcolm said. She said, “No one believed this was happening to me because ‘it doesn’t happen to us.'”
The New York City resident said the underlying message is “you have to be strong, you have to be tough.” There’s no time to be depressed. ”
Malcolm, who lives alone, said he also felt anxious and unsupported during the pandemic. As her mental health worsened as she watched the number of coronavirus infections and deaths continue to rise, she kept turning off the television completely. She said Malcolm was nervous about leaving her home as someone with co-morbidities. She lost her friendships and her community.
To remedy this, she co-founded the Black Minds Matter support group at the National Alliance on Mental Illness in New York City in May 2020 to support Black people like her living with mental health conditions. Now, the support group is thriving, Malcolm said, adding that participants are sharing wisdom on how to navigate all aspects of daily life as a Black person and manage mental health conditions.
They feel “seen, empowered, and valued.” It’s just like a big group hug,” she said.
On the other coast, Tamaryn Paredes, who works with addicts in Oregon, said she finds satisfaction in her demanding job by connecting patients with the resources they need. Her goal is to become a certified clinical social worker, drawing on her experience working in methadone clinics and children’s group homes in California.
“I realized that working with kids gave me street cred,” Paredes said. “People always say, ‘It gets better, it gets better,’ and I’m proof of that.”
