Dr. Henry Paul, MD

Psychiatrist, Author and Educator


August 28th, 2013

A recent article in the New York Times stated that there was an excessive prescribing of antidepressants in the United States and that the reason was probably that there was an over-diagnosis of depression in the first place. Putting aside the many different trends which might lead to excessive prescribing of psychotropic drugs in general I think what the article misses is that the approval of antidepressants by the FDA was for Major Depression, while in most practices patients present with depression problems which might not exactly fit the criteria for a Major Depression but fit what might be called “Minor Depression” or what is referred to by the clinical term Dysthymic Disorder. It has been my experience that the majority of depressed people I see have a minor depression and not the more severe and dramatic form of Major Depression. It has also been my experience that these people respond to antidepressants but the response might seem less dramatic because the original clinical condition was less severe. These patients have depression which might be a bit less severe and not as long lasting but still suffer greatly. Their condition not only affects their mood but the ability to work, love, parent and to enjoy life. Untreated it can also lead to drug and alcohol abuse. While the drug companies could probably only afford the approval of medications for Major Depression or were only willing to spend the amount needed, it does not follow that people are being given meds when not even depressed. If anything it appears to me that there is an under-diagnosis of depressive disorders. But worst of all the recent trend to use medication in the absence of talk therapy-still the golden standard of treatment-seems to go on unabated.

Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.