“When we are over-medicated, our emotions become synthetic. For personal growth, for a satisfying marriage and for a more peaceful world, what we need is more empathy, compassion, receptivity, emotionality and vulnerability, not less. We need to stop labeling our sadness and anxiety as uncomfortable symptoms, and to appreciate them as a healthy, adaptive part of our biology.”
Do you agree? This was the concluding paragraph from an article written by psychiatrist Julie Holland, who suggests that women, who tend by nature to be more emotional, sensitive, empathetic and yes, moody, are often thus likely to be over-medicated. Why? Because, as Holland notes, although “women’s emotionality is a sign of health, not disease…we are under constant pressure to restrain our emotional lives. We have been taught to apologize for our tears, to suppress our anger and to fear being called hysterical.”
I was curious about her hypothesis that women may be over-medicated for mental health issues, so investigated further. If you look at prescription drug claims in the United States, women indeed utilize more prescriptions for anti-depressant, anti-psychotic and anti-anxiety medications than men. Overall, 25% of women (vs 15% of men) take a drug to treat a mental health condition, with women ages 45 and older showing the greatest use of these drugs. And over time, psychotropic prescriptions to women have increased at a greater rate than men. Specifically, anti-depressants, the most commonly used mental health medication, are utilized by roughly 2.5 times as many women as men. Now, women are almost twice as likely as men to be diagnosed with major depression and/or generalized anxiety as well, so drug use trends appear to match diagnoses. But one wonders whether Holland’s point is a good one– that the gender gap in medication use is in part a social construct rather than a true biological or psychological gender difference in mental health.
Medication use itself is not necessarily a bad thing. For example, there is controversy in the medical practice as to whether children with Attention Deficit Hyperactivity Disorder (A.D.H.D) are over-diagnosed and over-medicated. But recent mortality data indicate that 32,000+ Danish children diagnosed with A.D.H.D. had roughly twice the increase in mortality over children without a diagnosis of the disorder. One hypothesis is that A.D.H.D. contributes to other detrimental behaviors during the teen years, such as antisocial behavior, substance use, and anxiety, that ultimately increase mortality risk. Thus, treating A.D.H.D. during a critical period of child development may be valuable for health and longevity. However, Holland’s point- that gender differences in female emotional reactivity may bias clinicians to over-prescribing medication– raises the larger issue of just how we define an emotional and psychological state of “normal” when our social context both defines and directs us.