Something startling is going on with antidepressant use around the world

Antidepressants are prescription medicines for depression, anxiety, obsessive-compulsive disorder, and other mental health conditions. There are different kinds of antidepressants, although the most common are selective serotonin reuptake inhibitors (SSRIs). Generally, antidepressants can effectively treat mental health conditions by affecting neurotransmitters involved with serotonin and norepinephrine to better regulate mood and behavior. Of course, each type of medication works differently and affects people individually. [1] But antidepressant use is rising worldwide and experts are struggling to explain why.

The Consistent Rise of Antidepressant Usage Around the World

In 2013, the Organization for Economic Cooperation and Development (OECD) examined antidepressant usage in 25 countries. And even a decade ago, the usage was on the rise. However, the organization noted that this increase does not correlate with depression rates firstly because it’s prescribed for other conditions; secondly, because the popularity of these kinds of medication depends on other factors, like wealth, health coverage, treatment availability, depression rates, and the stigma around mental health. 

For example, only a third of people with severe depression take antidepressants in the U.S. Meanwhile, South Korea had the lowest antidepressant rates in all of the 25 countries examined. However, South Korea also has the highest suicide rate compared to all other developed countries. Plus, Koreans are more likely than Americans to view mental illness as a weakness, so they are less likely to find treatment.

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Similarly, another review found that Iceland has high rates of people using antidepressants compared to other Nordic countries.

These rates may result from people perceiving these drugs as very effective combined with the limited access to psychotherapy and other alternative treatments. Meanwhile, their rising numbers in antidepressant usage did not correlate with any reductions in suicide rates or disabilities that result from depression. The review states that “the increase in antidepressant consumption has spurred an ongoing debate [about] whether antidepressants are overprescribed (medicalization) or underprescribed (poor access to treatment).”

In that vein, less than a third of people in the U.S. on this medication have met with a mental health professional in the last year. This indicates that these drugs may be overprescribed, often by primary care physicians. But at the same time, there’s limited availability of holistic mental health care and regular checkups. [2]

The Stigma Surrounding Mental Health

In 2023, antidepressant rates are still on the rise. “Antidepressants are an effective evidence-based treatment and these figures need to be interpreted carefully as antidepressants can be prescribed for a range of health conditions,” says a spokesperson for the Royal College of Psychiatrists. “There are complex reasons why prescriptions for antidepressants are rising, which include progress on diagnosis and support for people with depression, changes in dosages, and the range of conditions they are prescribed for.”

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These conditions include bipolar, depression, depressive disorders, bulimia, anxiety, OCD, PTSD, social anxiety, and panic disorders. [3]

In fact, the rates increased during the first year of the pandemic, when there was an extreme increase in anxiety and depression. [4] Of course, that’s a simple explanation, but these numbers could also indicate other details, such as progress in reducing the stigma around mental health. 

Thirty-five-year-old Fiona Robertson started taking antidepressants in 2013, and she states they were a “lifesaver” and “instrumental” in her recovery. However, she felt the brunt of the stigma around taking medication for these issues. “People are made to feel shamed, to feel like they are not resilient enough or lazy and want a quick fix,” she says. “I’ve seen people giving advice to exercise or eat healthily instead of taking these drugs, and I think this can put people off going to the doctor about it.” She encourages people to seek help when they need it and see if medication is a good choice for them.

Other Mental Health Treatments

However, medication is usually not the first line of defense against a mental health issue. The National Institute for Health and Care Excellence (NICE) recommends people with mild depression should try therapy and behavior changes such as exercise and meditation first. “The fallout from the pandemic and the cost-of-living crisis means we should undoubtedly be concerned about the current pressures on people’s mental health,” says Alexa Knight. She is in charge of policy at the charity Rethink Mental Illness. “But the rising number of antidepressant prescriptions could also be a welcome indicator that people feel more comfortable seeking support when they need it.” [5]

However, she adds that different treatments should be available to people depending on their type of depression. In general, a combination of psychotherapy and medication often results in the largest improvement in depression symptoms. 

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