The use of antidepressants doubles after five years

But is it a problem or an encouraging sign that people are getting much-needed help?

Figures from the Health Insurance Organization (HIO) show that the number of patients taking antidepressants has almost doubled in Cyprus in the last five years: from 33,470 in 2019 to 64,611 in 2023 .

On the other hand, there is a simple explanation. March 2020 was when antidepressants became available in Gesy – some can be prescribed by individual doctors – and 2020 was indeed when the biggest increase took place, a 51% year-on-year increase and a year in 50,461 patients.

Again, the number has grown even more since then – and the HIO figures reflect the state system and Gesy, in any case. Private doctors are not included – and many people choose to go private, as a certain stigma still clings to mental health even now.

Clinical psychologist Anna Papetta estimates that the actual number taking antidepressants may be twice the number of HIOs. His colleague Evangelos Orphanides said Cyprus Mail that “as a ballpark figure… about 5-10 percent of the Cypriot population may be using antidepressants”. No official figures are given, and that sounds ridiculous.

What is causing this growing problem? And is that, in fact, a problem — or an encouraging sign of people getting much-needed help?

In the first question, the increase in numbers is because antidepressants are now being prescribed for all kinds of mental health problems, not just depression.

Papetta mentions PTSD, ADHD, bipolar disorder, eating disorders, sleep disorders, and even Alzheimer’s — not because they treat the condition, of course, but to reduce anger and improve mood — as those conditions. medicine that can be used. Then there is depression, not depression per se but a close cousin. “Many people are motivated to take medicine just to feel better,” he says.

That’s the bottom line: a society-wide increase in stress and anxiety, caused – perhaps – by a lack of interaction and interpersonal relationships.

Covid has played a role here, not only in making people more aware but also in promoting fear of contact. “If you touch, this will happen. If you talk, you will be infected,” Papetta recalled. “People turned away from them.”

But the problem is bigger than Covid. For some reason – technology being the main suspect – we have forgotten how to communicate. Papetta hears about families, for example, where a parent texts their child to come over for dinner, instead of going up to their room to tell them in person. “Everything happens through the screen.”

Thirty-year-old Ioanna (not her real name) admits: “We don’t get along that much,” she told Cyprus Mail. “The way of communication has changed.” If you like someone, maybe leave a message on their Instagram, don’t approach them face to face.

Ioanna represents the same group with experience of antidepressants, as a personality type – she describes herself as anxious, prone to feelings of guilt, worried about losing control and “naturally almost as bad as a person” – who has years of experience in mental- health issues, and works hard to achieve a kind of stability. She had anorexia as a teenager, and later suffered from binge eating and panic attacks.

An even more extreme example is 67-year-old Xenofon Ioannidis who runs Omilos Elpidoforos, a support group for people with chronic intellectual disabilities. He himself was diagnosed with “recurrent depression with anxiety disorder” and was put on antidepressants back in 2006, although he managed to reduce the dose over the years.

These are people with chronic problems – unlike the (larger) number of patients who are given short-term medication after a traumatic event such as the death of a parent, or just to ‘feel good’ ‘ when life becomes too difficult. see.

Is the increasing prescription of antidepressants a problem? Doctors seem convinced that the new generation of drugs is not addictive (except for Xanax, says Papetta) and side effects – especially sexual dysfunction that was a symptom of earlier drugs – are significantly reduced .

Most importantly, everyone seems to agree that they help, at least in most cases — about 35 percent of patients have TRD, or treatment-resistant depression — and at least to relieve those crippling feelings of fear and hopelessness.

That said, “it’s not a magic pill,” says Ioanna – who, despite her problems, has been trying to change her life (not living alone, spreading her work to do not burden yourself with any work. ) instead of relying on medicine.

He explains: “The pills help at first. “When you’re not working at all, they slow down your system a little bit, so you can work better and solve your problem.”

The problem is, it’s easy for antidepressants to become a necessity, or an easy fix – and for people to rely on the calm they bring without solving their problems. Combining medication and psychotherapy is an obvious solution, but it doesn’t always happen – mainly because of the professional divide between psychiatrists (who are medical doctors, and prescribe medication) and psychologists ( which focus on treatment).

Ioanna took fluoxetine for six months under the age of 20; it didn’t solve anything, and it made him sleepy. Later, when she started having panic attacks, another doctor put her on paroxetine. That helped more, and she took it for about two years, working her way down to a small dose before stopping altogether — “and a small dose is good,” she adds. more, “because it allows you to feel things”.

That’s another thing, what drugs do to emotions. Xenophon says: “Antidepressants work by suppressing the world of a person’s emotions, so that they do not have strong emotions. The danger – if the patient takes it too long – is that “it is like a vegetable, almost like a zombie”.

The prospect of ending up with large numbers of people living in a state of complacency – feeling ‘good’, but not feeling anything – is a real worry. Unfortunately, HIO figures show that 64,993 patients (the vast majority) were on medication for more than a year in the period 2019-2023. Most courses last several years at least.

‘Nearly half of Brits using antidepressants could quit now, research finds’ was the headline. Independent on June 26. Long-term use is a big risk here, especially when it acts as a deterrent to other fundamental changes.

Unsurprisingly, many doctors try to offer alternative treatments. Orphanides uses virtual therapy to help patients manage their anxiety. Nicosia psychiatrist Dr. George Mikellides offers magnetic resonance imaging, an FDA-approved treatment that uses magnetic fields to stimulate nerve cells in the brain.

Papetta takes another approach, asking patients to take a blood test before starting, to check what he calls the “magic five”. These five indicators are thyroid, iron, ferritin, hemoglobin and vitamin D – any of them, if they are not working, can affect the mood and cause depression as a symptom. Sometimes it’s a simple matter of body chemistry.

Ultimately, the story here is that 1 in 10 Cypriots have mental health problems that require medication. Were these people always part of the population, but unable to get help in the past? Or is it instead a case of the mental health industry creating new problems for mental health (and consumers)?

“The apparent increase in mental health problems may not necessarily mean that more people are developing these conditions now than in the past,” Mikellides said. Cyprus Mail. “It may reflect better awareness, reduced stigma, and improved access to mental health services…

“However, there is a reasonable concern about the overtreatment of normal life stress,” he admits, and adds: “It is important to distinguish between clinical conditions and normal responses of feelings in the problems of life”.

Meanwhile, the use of antidepressants is increasing.