The State of Mental Health in Canada
Zoltan P. Rona, MD, MSc
Mental illness is definitely on the rise.
Mental illness is definitely on the rise. But do pharmaceutical drugs really help, or just mask symptoms while costing Canadians millions?
Are we all going crazy? Or is it that we are all being over-diagnosed? According to Health Canada, at least 20 per cent of Canadians will experience mental illness; the remaining 80 per cent will be affected by mental illness in family members, friends, or colleagues. Four thousand people commit suicide in Canada each year. The Canadian Psychiatric Association (February 24, 2003) goes even further and maintains that at least two-thirds of all Canadians are touched by anxiety and depression. This figure, no doubt, also applies to two- thirds of psychiatrists.
Mental illness affects people of all ages, education and income levels, and cultures. With rare exceptions, the onset of most mental illness occurs during adolescence and young adulthood. Most authorities acknowledge that the causes are a complex blend of stress, genetic, biological, personality, and environmental factors. Some, like the renegade psychiatrist, Dr. Thomas Szasz, argues that psychiatric illness does not really exist and is simply a myth to be found only in the eye of the beholder (see his landmark book, The Myth of Mental Illness). Yet what most of us refer to as mental illness has a deep impact on all Canadians on many levels: the estimated economic cost (health-care costs and loss of work productivity) of mental illness in Canada was at least $7.3 billion in 1993. This figure has ballooned in the past decade to more than $33 billion. By the year 2020, depression will be the single most expensive cause of lost workplace productivity due to disability.
Drug Use Horrors
In 2000, there were more than 3 billion prescriptions filled for psychiatric drugs in the United States and Canada. According to recent research, psychiatric drug use is reaching epidemic proportions. The most alarming aspect of this is that the drugging is starting at a very early age. A recent study of 200,000 preschool children reported that the number of two-to four-year-olds on psychiatric drugs including Ritalin and Prozac soared by 50 per cent between 1991 and 1995 (Journal of the American Medical Association, February 23, 2000; 283:1025-1030,1059-1060). The drugs were prescribed for symptoms such as pain relief, anxiety associated with medical, presurgery and dental procedures, bed wetting, and attention deficit-hyperactivity disorder. The latter is a diagnosis very much in vogue in both preschool and grade school children.
Another published study reports the number of children taking drugs like Ritalin, Prozac, and Risperdal tripled from 1987 to 1996 and continued to increase through 2000 (Archives of Pediatric and Adolescent Medicine, January 2003; 157(1):17 25). At one point in 1996, there was such a surge in the prescription of Ritalin that the drug manufacturer could not make enough of the drug to meet the skyrocketing demand.
Prescriptions for selective serotonin reuptake inhibitors (SSRIs) like Prozac, Paxil, Zoloft, Luvox, and others used to treat depression and anxiety increased by 62 per cent in older children and teenagers (Ambulatory Pediatrics, March/April 2002; 2).
The really scary thing about these statistics is that the effects of such drugs in children so young are largely unknown. What are the long-term effects on brain development, growth, and general health? No one knows or even seems to care. The cost to parents, aside from the obvious potential harm to their children, runs on the order of $150 to $200 a month to fix symptoms that these preschoolers will likely eventually outgrow without the drugs.
The estimated economic cost (health-care costs and loss of work productivity) of mental illnesses in Canada was at least $7.3 billion in 1993. This figure has ballooned in the past decade to more than $33 billion. By the year 2020, depression will be the single most expensive cause of lost workplace productivity due to disability.
Psychiatric Drugs Create New Diseases
While we may not know about the long-term effects of psychiatric drugs in children, we do know a great deal about the harmful side-effects to adults of some commonly used psychiatric drugs. In fact, very few people realize that some of the drugs commonly prescribed by psychiatrists and general practitioners can create new diseases in those unfortunate enough to be “treated” for both bipolar disease and schizophrenia.
One example is Zyprexa, which has been linked to a greater risk of developing sugar diabetes (British Medical Journal, August 3, 2002; 325 (7358): 243). One cannot, of course, blame psychiatric drugs entirely for this side-effect because schizophrenics and bipolar disorder victims suffer more diabetes and heart disease than the general population. Such people tend to have a typically poor lifestyle and tend to smoke more, eat unhealthy foods, and get less exercise. The average individuals receiving strong psychiatric drugs like Zyprexa usually are obese at an above-average rate, yet these diet and lifestyle factors are rarely, if ever, addressed by conventional medical or psychiatric interventions.
No drug is a cure for either schizophrenia or bipolar disorder. All the drugs do is control symptoms well enough to keep such individuals out of the hospital. As soon as the user stops the drug, the symptoms return with full force and the patient is forced back onto the drug. The price of this control is a high one if the eventual outcome is full-blown diabetes.
To the average person, this way of treating mental illness makes no sense. However, some of the more cynical among us would say that it makes both dollars and cents for the drug companies profiting from sales of these chemical marvels.
Prozac for PMS
PMS (premenstrual syndrome) is a very common problem that can easily be controlled in nearly 100 per cent of cases with a healthy diet, exercise, and natural food supplements such as vitamin B6, vitamin E, evening primrose oil, magnesium, and/or the amino acid tryptophan. But leave it to the drug companies to find a drug equivalent to treat PMS. What they call Sarafem is identical to Prozac. If Prozac has some negative stigma appended to its use, the name change means no one will object to taking it as a way of controlling a fairly natural and common life event. How clever and profitable is that? Prozac sales reached $2.6 billion in 2000 and, at $4 a pill, Sarafem is projected to make its manufacturer billions more.
What to Do
Knowledge is the most important tool we have in overcoming the use of dangerous pharmaceuticals for mental illness. Many long-time readers of alive already know that there are excellent alternatives to conventional drug therapies that suppress symptoms and produce side-effects. Those not aware of natural alternatives can educate themselves with the basics of real healing by reading The Encyclopedia of Natural Healing (alive Books) and continuing to read this magazine. Perhaps together we can change the sad state of mental illness in Canada.
The number of children taking drugs like Ritalin, Prozac, and Risperdal tripled from 1987 to 1996 and continued to increase through 2000.