Declining Mental Health – The New York Times

The pandemic’s true toll on our mental health won’t be known for some time, but we’re beginning to see some of the initial signs in our medicine cabinets.

Since early 2020, millions of Americans have started or restarted psychiatric medication to cope with the pandemic’s ripple effects. Tracking exactly which pills Americans are taking is difficult because much of this information is privately held, but Casey Schwartz, the author of “Attention, a Love Story,” dug into data provided to The New York Times and began to assemble a snapshot of the current state of our mental health.

The gist: In 2019, the C.D.C. estimated that 15.8 percent of American adults took prescription pills for mental health. Now, nearly a quarter do so.

Antidepressants are the most commonly prescribed mental heath medication in the U.S. Their rate of use increased to 8.7 percent from 2019 to 2021, compared with 7.9 percent from 2017 to 2019, according to Express Scripts, a pharmacy benefits manager. Teenagers had a 17.3 percent increase in the use of anxiety medications in the first two years of the pandemic, compared with a 9.3 percent rate of change between 2017 and 2019.

Similar jumps can be seen in the use of stimulants, like Adderall. In 2021, just under 77 million prescriptions were written for A.D.H.D. stimulant medications, nearly six million more than in 2020. Among Americans ages 20 to 44, use of A.D.H.D. medications increased by 16.7 percent from 2019 to 2021, compared with a 7 percent increase from 2017 to 2019.

Across the country, many psychologists and psychiatrists have been witnessing the pandemic’s mental health effects firsthand. They report practices filled to capacity, patients who are in significantly worse shape than before, or patients who had been stable for years, but who are now in need of medication, intensive outpatient treatment or hospitalization.

These rising medication numbers aren’t necessarily caused only by a worsening of mental health in this country, although rates of anxiety and depression have increased. Part of the uptick could be explained by the fact that, stuck at home, people finally had time to seek out the health care they had been delaying.

And emergency legislation, passed in the early days of the pandemic, may have played a role. The new rules lifted the requirement that doctors see patients in person in order to prescribe them certain controlled substances, including Adderall.

Even so, patients seeking help are doing so against a backdrop of isolation, restriction, uncertainty and grief.

“I think what a lot of people are trying to avoid talking about is trauma: People were traumatized by Covid,” said Alex Stratyner, a psychologist in New York. “Millions of people have died. There has not been a processing on a grand scale of what it is we just endured.”

As Indonesia’s government seeks to control the spread of the coronavirus across a vast archipelago, home to some 275 million people with multiple belief systems, inducing people to wear masks is but one challenge.

Perhaps an even bigger one — especially among Indigenous groups that adhere to deep-rooted traditions that can run counter to modern health policy — is vaccinations.

The Baduy tribe live on the slopes of a remote mountain in Banten, the westernmost province on Java. As a general principle, they reject vaccinations. Vaccination efforts among Indigenous groups like the Baduy are also greatly complicated by geography, with many groups living in remote locations and some villages accessible only after walking for several hours.

But despite their stance on vaccinations, the Baduy, who live in one of the provinces hardest hit by Covid, appear to have successfully avoided the worst of the pandemic. There have been no deaths attributed to Covid in the area where the Baduy live. Their first case of Covid was recorded in July of last year, and there have been a total of eight known cases through mid-June, according to a local health official.

Both health officials and the Baduy themselves believe it’s their way of living and their remoteness from congested, urban life that has spared them. Outside visitors are few. The concept of social distancing is incorporated into their beliefs, with their airy homes widely spaced and physical contact limited. They don’t shake hands.

“We still maintain our customs. If we mock our customary laws, or break the customary law, we are afraid of karma. There will always be punishments,” said Jaro Saija, the chief of Kanekes, as the collection of Baduy hamlets are known.

Saija and others, however, have chosen to be vaccinated in order to travel more freely to cities and towns. (Villagers who do get vaccinated are obligated to perform purification rituals.) And he conceded there might be some merit to this mixing of the modern with his ancient faith.

“For me, the most important thing is to protect my community and stay healthy,” he said. “Therefore, I am doing everything: the medical thing and the mantras thing.”

I was on the high end of vigilance throughout the pandemic, until March of this year. Just before the B variants began making big trouble, I was on a ski trip and let down my guard in a crowded lodge. I came home with a scratchy throat and a sense of dread. I am 69, and have had trouble with shortness of breath for a while. Covid exacerbated it, and it’s not better yet. I like to hike in the summer, and all I can do is take walks. No mountains! I can hold my new granddaughter, but I can’t carry her any distance. Suddenly, I feel my age. My retirement years have been spent hiking, gardening, and skiing. I’m scared that may have come to an end.

— Anne Pratt, Beacon, N.Y.

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Thanks for reading. I’ll be back Wednesday — Jonathan

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