Easy Prescription: Psychiatrists are too quick to medicate depression

Robert Kennedy Jr, the US’ health secretary, has a reputation for both quackery and common sense wis­dom, depending on the health issue being advocated. His latest is in the latter category. His department is making a policy to temper overprescription of antidepressants. It has consequences for the world because what the US does, the rest follows.

India has an unusual equation with depression. A large part of the population is not even aware of the condition. Among those aware, most don’t go to a doctor because they feel shame for contracting a mental issue. A proportion get treatment and as soon as the psychiatrist hears their symptoms, he writes a prescription with multiple medi­cines, sometimes analogous to killing a fly with a hammer. Patients are eventually weaned off to lesser doses.

At least in the US, they get an extensive hearing and the doctor makes copious notes before overprescribing. Here, they would be lucky to get 10 to 15 minutes before the prescription pad comes out. Alternative ap­proaches like behavioural therapies and lifestyle changes are afterthoughts. Medical blitzing might be necessary for patients with severe symptoms. Someone with suicidal tendencies needs the hammer. But there are also many whose depression is milder and amenable to non-medication or minimum doses. That approach how­ever demands time, patience, and active monitoring on the psychiatrist’s part. And why should anyone have an issue if the patient gets well faster? The medications are effective, and for someone suffering from depression, its effectiveness can feel liberating. But many of them come with side effects like weight gain, decrease of sexual libido, etc.

Plus, if the same patient has an episode of depression after a period of time—a likely probability with this ailment—their own first instinct is to take medicines again. Strong evidence that regular exercise can act like an antidepressant is discounted by the reliance on medicine. To fix oneself by living better has greater all-round health benefits. The shortcut of a prescription steers you away from that route. Depression is not an ailment to be taken lightly but the pill is not necessarily the first recourse.