- Mental health prescriptions have increased exponentially since the COVID-19 outbreak.
- Traumatic events cause a similar chemical reaction in the brain as experienced by those with chronic hormonal imbalances.
- Treating depression and anxiety early can result in a quicker recovery and potentially reduce the risk of experiencing a similar episode in the future.
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Depression, anxiety, and insomnia are on the rise, with a recent report finding that prescriptions for the treatment of these conditions increased 25.4 percent between Feb. 16 and March 15.
Anti-anxiety prescriptions alone showed an increase of 37.7 percent. And 78 percent of all antidepressant, anti-anxiety, and anti-insomnia prescriptions filled during that final week (which was the peak week of the report’s findings) were brand-new prescriptions.
The global COVID-19 crisis, and the impact it’s having on life as we know it, is contributing to a concurrent mental health crisis. In response to the mental distress they’re experiencing, people are turning to medications for help — many of them for the first time.
But some still have questions about whether medications can truly help those who have never experienced depression or anxiety before.
Are these medical interventions meant only for those with genuine chemical imbalances? Or can they help those dealing with mental distress as a result of a traumatic event, like this pandemic?
Healthline spoke with experts who gave us answers to common questions such as these, as well as how to recognize the symptoms and manage depression and anxiety in healthy ways during the pandemic.
Dr. Tracy Latz, MS, is a licensed, board certified integrative psychiatrist with more than 30 years of clinical experience treating trauma, anxiety, and depression.
“Anxiety and depression are most often treated with antidepressant medications that work by inhibiting the reuptake of neurotransmitters in the synapse (space between neurons) in the mood centers of the brain,” Latz told Healthline.
These medications target neurotransmitters known to be important in calming the mind and lifting mood.
There are three main classes of antidepressant medications, but Latz points out a fourth that should only be used when needed.
“Many people have also heard of another class of medications that really should only be used short term, if at all,” Latz explained, mentioning benzodiazepines, which she says can be quite addictive.
Latz outlines the three main classes of antidepressants below.
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin is an important neurotransmitter that’s found to often be low in people under significant stress and in people with anxiety disorders, post-traumatic stress disorder, and depression.
When serotonin is low, people often report feeling “blue,” hopeless, and depressed, and may have suicidal or nihilistic thoughts. Concentration becomes more difficult, and people may be irritable or have panic attacks, anxiety attacks, or even compulsive (ritualistic, repetitive) behaviors.
Crying spells, excessive worry, poor appetite, weight loss, and insomnia are also frequently seen when serotonin levels have been low for extended periods.
Norepinephrine-dopamine reuptake inhibitors (NDRIs)
Norepinephrine is a neurotransmitter that’s important for giving us “get up and go.” Dopamine gives us the drive to do daily tasks.
When a person is low in norepinephrine and dopamine, they will have a very low energy level and may feel lethargic. They may sleep too much or have difficulty getting out of bed.
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
When a person reports feeling significantly anxious or depressed, and they report all the symptoms noted in the other two drug classes, then they may respond best to a medication in this class that can address all their symptoms.
It’s a common misconception that medications are only helpful for people who are experiencing chronic chemical imbalances, as opposed to depression or anxiety resulting from a traumatic event.
“Trauma can actually trigger changes to neurotransmitter levels in the brain,” said Dr. Lindsay Israel, a board certified psychiatrist and chief medical officer at Success TMS.
If you’re experiencing depression or anxiety, you’re dealing with a chemical imbalance — even if you’ve never had a similar issue before.
The trauma you’ve been through (and yes, the current COVID-19 pandemic does count as trauma for many, even if you haven’t gotten sick yourself) has the potential to actually change your brain chemistry.
“Therefore, medications can help treat symptoms that were set off by a traumatic life event by modulating those levels properly,” explained Israel, who specializes in depression, anxiety, and obsessive-compulsive disorder (OCD).
But she does caution that when depression or anxiety result from a traumatic event, treatment should always include processing in psychotherapy for the best long-term results.
Latz and Israel say medication can be especially helpful for people who are:
- feeling overwhelmed
- finding their symptoms are interfering with their daily social, academic, or occupational functioning
- experiencing difficulty concentrating
- having sleep disturbances most nights
- experiencing appetite fluctuations
- having a lack of motivation or interest in hobbies or activities
- experiencing frequent panic attacks
- dealing with dark or negative thoughts about death
- experiencing suicidal thoughts
“Every medication varies in the time it takes to reach what is called a ‘steady state,’” Israel said. “This is when the medication has reached an equilibrium in the blood and is distributed evenly so that it is able to begin to take effect with the maximum benefits.”
She says this typically takes 4 to 6 weeks, but that every dose increase can mean an additional 2 weeks before the new steady state is achieved.
In most cases, Latz says you should be experiencing at least some response within 3 weeks.
If you have no response, she says your dose may need to be increased.
“If you have no response in 3 weeks following an increase in the dose, then you may need to consider a switch to another medication,” Latz explained.
Because we all hope our current situation is temporary, it makes sense that someone experiencing depression or anxiety for the first time might be tempted to simply wait it out rather than seek treatment.
But Israel says early intervention is key to the best outlook.
“Depression can worsen over time if there is no intervention to stop it. Seeking help early on, especially if this is a first episode, can not only help you feel better sooner, it can also potentially decrease the chance of another episode occurring in the future,” she said.
For those who may be feeling apprehensive about seeking treatment, Latz also points out there’s no shame in asking for help.
“Just because you have a short-term need for medication does not mean that you will have to continue on it forever,” she said.
Sometimes we all just need a little help getting from one day to the next.