Fear of Antidepressants Leads People To Shun Treatment

Sep 14, 2011

Antidepressants are the second-most-prescribed drug in the U.S., making them seem about as common as Pez candy.

Yet many people won't tell their primary care doctor that they're suffering symptoms of depression because they're afraid they'll be prescribed antidepressants, according to some new research. And the people who are suffering the most are the ones least likely ask for help.

There's long been a stigma about mental illness, and though people are far more upfront about depression than they were in years past, that stigma hasn't gone away. Just ask someone who's been turned down for life insurance because they took antidepressants long ago, or someone who's afraid to tell the boss why they're struggling to make it in to work.

But clinical depression is common, affecting almost 7 percent of adults each year. Given that, and the suffering it causes, you'd think people would be hustling to the doctor's to get help. But you'd be wrong.

Researchers asked more than a thousand Californians if they would tell their primary care doctor about symptoms of depression. Almost half the people said they had their reasons for keeping the symptoms secret. The No. 1 reason: 23 percent said they feared that they would be prescribed antidepressants.

"There's this anxiety about medications in general," Robert Bell, lead author on the study, told Shots. With antidepressants, he said, that anxiety includes worries about side effects as well as stigma.

The findings were published this week in the Annals of Family Medicine.

There were other reasons for not telling. People didn't think that it was a primary care doctor's job to deal with emotional issues. They had fears about confidentiality. They feared being referred to a psychiatrist. And they didn't want to get tagged as a psychiatric patient. The more depressed the people were, the more likely they were to say that these reasons for not seeking care applied to them.

Bell is especially concerned about the notion that people won't seek treatment for depression from a primary care doctor, because that's where care for depression is most readily available.

"Depression is something that the primary care physician is trained to deal with," says Bell, who is a professor of communication and public health at the University of California, Davis. "I think most people assume if you're depressed that you're off to the psychiatrist, and that's not true."

A recent study found that 7 percent of all visits to a primary care doctor include a prescription for antidepressants, but other studies have found that 25 percent of people with depression aren't getting diagnosed or treated in primary care.
