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The Surprising Health Benefits of Sadness

Dina S.* had already been on antidepressants for a few months when she got the most devastating news of her life: Her beloved husband of 10 years had been killed on impact when the small plane he'd been piloting crashed. The next days and weeks were a tearful, painful blur, but even as she grieved, the 50-year-old was dismayed by her own response to the tragedy--it felt hollow somehow, as if she weren't able to access the full depth of her anguish. So after 2 months, she made a decision that was squarely against her doctor's advice: She gradually weaned herself off the antidepressants.

As the effects wore off, her emotional agony became profound. "I was tortured by the fact that I did not get a chance to say good-bye to my husband," Dina says. She took a leave from work and let her raw emotions take over, aware that this meant she would have to confront the pain of her husband's death as well as the anxiety issues that prompted her to start taking the drugs to begin with. "I felt I had a choice--to take antidepressants to just get through the day, or to stop and potentially grow and learn," she says. "I chose the latter."

Dina's decision to part ways with a pharmaceutical solution puts her in an ever-growing minority. Antidepressants have become the most commonly prescribed drugs in America for adults under age 60. At any given moment, about 10% of the adult population is taking them, double the percentage just 10 years ago, and about twice as many of them are women as men. And at the same time, talk therapy as treatment for depression is becoming increasingly uncommon. An American Journal of Psychiatry study published last year found that among people being treated for a mental health issue, 57% used medication only, while just 11% used psychotherapy alone and about one-third used the two treatments together.

"There are lots of reasons why drugs are so popular," says Mark Olfson, MD, an author of the study and a professor of clinical psychiatry at Columbia University School of Medicine. One of them is the widespread attitude that the easiest way to deal with whatever ails you is by swallowing a pill. "People hear about antidepressants in TV ads and ask for them by name," he says. The way insurance companies reimburse for services only supports this easy-fix expectation. "Insurers tend to be much more generous with coverage for antidepressants than for psychotherapy, which means patients who don't want drugs often have to pay a lot more out of pocket for it," adds Dr. Olfson. The financial incentives work both ways: Because psychiatrists can make more money doling out meds in 15-minute office visits than seeing patients for 45-minute talk sessions, more and more of them no longer even provide talk therapy as a service. "The decline in psychotherapy is a huge loss, in my opinion," says Dr. Olfson.



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