This Throwback was originally posted in January 2014
The second most lucrative drugs sold in the United States are those used to treat depression. (Drugs to prevent heart disease are first.) Abilify, an antipsychotic and antidepressant, is the 4th largest selling drug in the U.S. with 5.2 billion in sales. I regularly take Abilify, but was surprised when I went to pick up my prescription last week and was told the cost was over $500. Not realizing my insurance no longer covered the entire cost, I laughed because I thought it was a joke. When I was told that the price was already discounted $500, I knew it was not a laughing matter. Wha – wha – wha? $500 is the discounted price? And I was expected to pay that? Is it any wonder that people believe that the pharmaceutical companies have physicians in their back pockets? I had to walk away without this important med in the hopes my pdoc could find a good alternative. Finding the right mix of medications that would help stabilize my bipolar disorder took over 3 years. And that was not fun. Now I have to hope an alternative can be easily found without going through the trial and error period again. I’m optimistic that an alternative can be easily found, however, that small feeling that maybe it won’t be easy is creating more anxiety than I feel like dealing with right now.
After my experience, you can only imagine my indignation when I read a study which shows that Americans are over-diagnosed and over-treated for depression. Apparently others were getting their meds unnecessarily while I was not able to receive mine. “Depression over-diagnosis and over-treatment is common in the U.S. and frankly the numbers are staggering,” said Ramin J. Mojtabai, PhD, author of a study and an associate professor with the Bloomberg School’s Department of Mental Health. “Previous evidence has highlighted the under-diagnosis and under-treatment of major depression in community settings. The new data suggest that the under-diagnosis and under-treatment of many who are in need of treatment occurs in conjunction with the over-diagnosis and over-treatment of others who do not need such treatment. There is a need for improved targeting of diagnosis and treatment of depression and other mental disorders in these settings.”
Please don’t mind if I repeat the last sentence, “There is a need for improved targeting of diagnosis and treatment of depression and other mental disorders in these settings.” Yes, indeed, there is a need.. It sickens me that I had to be homeless and dumped at the doorsteps of Cedar Sinai Hospital before I could get the help I needed, yet, others are getting medicated when they only feel sad or have the blues. I don’t blame the patients, in this world of instant gratification, who wouldn’t want a magic pill to help them feel better or perhaps not feel at all. It is the physicians who are to blame.
The study involved 5,369 participants and examined adults with clinician-identified depression and individuals who experienced major depressive episodes within a 12-month period. It found that when assessed for major depressive episodes using a structured interview, only 38.4 percent of adults with clinician-identified depression met the 12-month criteria for depression, despite the majority of participants being prescribed and using psychiatric medications.
We live in a country that does not have respect for the mentally ill. Public opinion seems to be that too many are seeking a quick fix to help overcome their depression. Apparently they are correct. Public opinion is that doctors are giving out medicine like candy, rather than seeking more appropriate means of therapy. For many that seems to be true as well.
The problem is that the term “depression” is used too flippantly. Here’s the definition of depression:
a condition of general emotional dejection and withdrawal; sadness greater and more prolonged than that warranted by any objective reason
If you’ll take note of that definition, nowhere is the word “sad” used. Nowhere is the word “unhappy” used. If your car is stolen, you are unhappy. If your dog dies you are sad. True, clinical depression just is…it does not occur because you are unhappy, it does not occur because you are sad. Depression occurs for no damn reason. That’s the part that the public doesn’t understand. It saddens me that the medical field doesn’t understand that either. It looks like it’s going to take a while for the stigma of being mentally ill goes away. It’s so depressing.
*** Update ***
Since this article was originally posted, the generic version of Abilify has been released. I now pay only $3.20/month
I’m glad your med costs are significantly reduced. It’s nice knowing people can afford the meds they need.
I do think a lot of non-depressed, but unhappy people are taking anti-depressants. I think a lot of them wonder why they don’t work so well, too. I think it’s similar with anxiety, that way. For some people, there are non-medicinal ways to change their lifestyles and lessen their unhappiness or angst, but they don’t see that, or talk therapy isn’t as easy, or whatever. For other people, for the ones with chronically depressed brains, those meds are between them and living a nightmare.
It is not uncommon for people to experience periods of heightened anxiety or depression and so meds can help get a person through — war, job loss, grief.
Given the short supply of satisfied, well-adjusted people around me, I’d venture to say everyone has coping mechanisms, regardless of their mental health.
Sometimes I get frustrated because people will read my anxiety thoughts and comment on how they worry a lot, too. I suppose those people don’t get it. Too many people don’t understand the real struggle of dealing with mental health issues. Compassion pills might help them. It’s hard to say. I’m not a psychiatrist or a chemist, and I’ve over generalized quite a bit here, but I feel like you’ll understand. I know my brain is sick and sometimes, especially in the middle of the night, the only help is a pill.
I don’t worry a lot, I worry all the time. I panic over literally nothing — I have anxiety disorder. If I worried a lot about things worth worrying about or panicked over things that incite panic in all humans, then it wouldn’t be called a disorder, hm?
I worry all the time and this week has been horrible. Twice I went into full blown panic attacks. For those who can’t figure out why I can’t shake it off, I’d love for them to come over while I’m having an attack. Maybe finding me sitting on the floor, rocking back and forth and crying, will open their eyes a bit. Some, I’m sure, would say I’m being melodramatic.
Again, compassion pills?
I’m sorry it’s been so bad for you. I hate that you suffer.
It infuriates me, the number of people who think that they are depressed. My mother takes anti-depressants but refuses therapy. She assumes she doesn’t need it. She has her pills. Personally, I feel as though people who think they are depressed should have to go to therapy if they are to get the meds. Learning a little more about ourselves is never a bad thing. Being unable to get our meds because of prohibitive costs is.
Awhile ago I wrote a piece called Bipolar Despair, where I basically decided to rename my depression in the hopes of separating it from the more mundane “bummed” that people often call depression. I’m putting a link to it here in case you are interested.
I’m very glad to hear that your medication has become affordable. One of the medications I take is called Deplin and it’s not covered by my insurance. I’m grateful that my pharmacy applied a discount card to it to help with the costs and that it’s not $500. It does seem to be working.
https://normalisoutthere.wordpress.com/2016/04/29/bipolar-despair/
I think there’s a lot of people like your mom. Maybe requiring therapy is a good idea. I look forward to checking out your post.
When I had my first miscarriage years ago, the first thing the OBGYN did was put me on an antidepressant. After five minutes of conversation (none of which centered on any depression), she told me she was writing me a prescription for zoloft. It was awful and I quit it after a few days (after being legitimately prescribed it years later, I find out she gave me a full dose, no starting small and increasing a bit at the time). So I can definitely see how these drugs are overprescribed…even though I did struggle with depression off and on then, why on earth shouldn’t someone who has experience such a loss be expected to be sad over it, ya know? Give the people their medicine — and without it costing an arm and a leg — but be diligent with your prescribing!
I’m shocked that she wrote that out for you with no conversation and to find out she doesn’t even know how to prescribe it correctly. This happens way too often.
I’m glad Ability has gone generic for you and is helping. I wasn’t aware of it going generic and I take it too. My mother suffered from depression in cycles. My cousin, a nurse thinks she had bipolar and I agree. I think she had bipolar 2 and suffered mainly depressions. She wouldn’t get help and raised my sister and I alone. She told me she wanted to commit suicide many times but wouldn’t because she was afraid of what might happen to my sister and I. She was afraid to go for help because she thought she would be institutionalized and again, she feared what might happen to my sister and I. The stigma was even worse back then.
I remember having a panic attack only once and I hope it never happens again. I was in the car driving to an exercise class and it hit me like a ton of bricks. Crying and an overwhelming fear. I still have anxiety from time to time but no longer have panic attacks. I’m sorry you have to go through them and so often.
Abilify went generic at the very beginning of this year. I had to buy it from Canada a few times before they did. Without insurance it’s still over $300/month, so I’m glad my insurance added it to their formulary. I’m sad see how difficult it was for your cousin. The stigma was much worse just a decade or so ago and a lot of people lived in hell out of fear. Many still do. I hope you never experience another panic attack. They are not fun.
Thank you, as always, for your comment, Journey.
I’m so sorry you’ve had a terrible week. Mine has been bad too; please know you’re in my thoughts, and I hope things are already getting better for you, dear Bradley! Sending lots of love ❤️ & (((hugs))) your way.
Your huge fan,
The Captain
Hey Captain, doing a little better today. Met with my therapist. Still really shaky, though. Thank you for the love and hugs.
So glad you’re doing a little better (or you were 10 hours ago and I pray you’re even better now & less shaky)
Today, please, please don’t worry too much about your weigh-in. I weighed myself today, and it was creeping higher, but it’ll change; we both know that. Since we had tough weeks it’s to be expected.
I’m so sorry were still shaky yesterday, & I’m really glad you met with your therapist. I look forward to reading your next update, my friend. Your Captain salutes you!!!!! ??
From $500 to $3.20… That tells you how wrong things are in this world. Add to that ignorance and lack of empathy… So sad!
I hope your week improves 🙂
Hugs <3
The price difference is ridiculous and does say a lot. I think the lack of empathy is the worse of all.
I find the costs of my medications overwhelming. The high cost stretches my budget to the very edge, to the point where it affects the quality of my life.
I understand. It’s sad to live where good health care is not considered a human right. I’m sorry to hear your med costs are affecting you so
Its one of the reasons I didn’t want to see my doc because that means more medications and more cost. But I’ve reached the stage where I just have to