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Are too many Americans taking antidepressants?
Are too many Americans taking antidepressants?. Originally published by The Conversation.
By Andrew McLean, Clinical Professor of Psychiatry and Behavioral Science, University of North Dakota · 2026-09-10T13:33:32.868Z
Rates of anxiety and depression have grown since the COVID 19 pandemic – as have prescriptions for antidepressants. brizmaker/iStock via Getty Images Plus Drugs for treating depression are among the most prescribed category of medications in the U.S. – 1 in 6 American adults take them https://doi.org/10.1136/bmjment 2025 302287 . Some health researchers and advocates have raised concerns that too many patients are using antidepressants https://doi.org/10.1001/jamapsychiatry.2021.0823 and that patients who want to stop taking them struggle to do so https://doi.org/10.1111/hex.13966 . One of the most prominent voices on this point is Health and Human Services Secretary Robert F. Kennedy Jr., who launched an effort in May 2026 https://www.medpagetoday.com/psychiatry/depression/121129 encouraging doctors to find other ways besides antidepressants and other psychiatric drugs to treat depression https://www.statnews.com/2026/07/13/hhs ssri deprescribing experts gather clinical withdrawal guidance/ when possible. As a psychiatrist for over 35 years https://campus.und.edu/directory/andrew.mclean , including a past role as the medical director of North Dakota’s Department of Human Services, I’ve seen both the benefits and the problems with antidepressants. In my view, there are grains of truth to claims that they are overused, but the full picture is much more nuanced. What are antidepressants, and who takes them? Over half of all antidepressant medications prescribed https://www.truveta.com/blog/research/research insights/mental health prescribing trends/ are a type of drug called selective serotonin reuptake inhibitors, or SSRIs. The first SSRI – fluoxetine, better known by its brand name Prozac – was approved in 1987. A handful of other types of SSRIs, which work through different mechanisms, also exists. Antidepressants can be helpful for moderate to severe depression https://theconversation.com/depression too often gets deemed hard to treat when medication falls short 198282 , but they are typically not warranted for mild depression https://www.ncbi.nlm.nih.gov/books/NBK361016/ , as the side effects might outweigh any potential benefits. For mild depression, many effective nonmedication treatments exist. However, the distinction between mild and more severe symptoms https://theconversation.com/when does clinical depression become an emergency 4 questions answered 200231 sometimes gets lost. In everyday language, people use the term “depression” to describe everything from a minor sense of the blahs to a serious clinical condition requiring treatment. Healthcare workers in primary care clinics routinely screen patients for depression using a widely used questionnaire. This tool can be effective in flagging patients who might need further testing or treatment. But in my experience, if used on its own to diagnose, it can be easily misinterpreted https://doi.org/10.1016/j.jclinepi.2020.02.002 . A person having a bad week or two who scores higher on a screening test might be prescribed a medication that was not necessary. But the tool can also fail to flag people who do need care. Over a third of people who die by suicide https://theconversation.com/suicide has reached epidemic proportions in the us yet medical students still dont receive adequate training to treat suicidal patients 216603 have visited a primary care provider in the month https://doi.org/10.7759/cureus.86356 before their death. For those 55 and older, it rises to more than two thirds https://doi.org/10.1176/appi.ajp.159.6.909 . Prescribing in general practice According to a 2026 analysis, most prescriptions for antidepressants in the U.S. are not written by psychiatrists https://healthcostinstitute.org/all hcci reports/primary care providers prescribe the majority of antidepressants and anxiolytics for people with employer sponsored insurance/ . In some cases, these medicines are prescribed by nurse practitioners or physician assistants with psychiatric qualifications, but most are written by primary care providers, who are not specialists in mental health. Clinicians who provide primary care don’t just have less time to evaluate patients’ mental health concerns. They also have less access to ways of treating depression apart from medication, such as talk therapy. Primary clinics that have behavioral health providers and consult with psychiatrists https://aims.uw.edu/evidence base for cocm tend to help patients more effectively and provide more treatment options. These types of collaborative approaches to care are still rare but are becoming more common https://doi.org/10.1097/MD.0000000000032554 . I recall my father, who was a country doctor in general practice, saying that half of his patients’ problems had to do with mental health issues, and he didn’t know how best to help them. Today’s primary care providers do receive more training on mental health issues, and they are often more equipped to recommend lifestyle changes that can be especially helpful for people with less severe depression symptoms. But it’s simply human nature that when given a choice between taking a daily medication and engaging in activities that require commitment and intention, many will choose medication. The opposing forces of stigma and access Stigma has been a long standing barrier https://theconversation.com/psychologists are starting to talk publicly about their own mental illnesses and patients can benefit 177716 in seeking mental healthcare. Since the COVID 19 pandemic, anxiety and depression have become more prevalent. That’s particularly true among adolescents and young adults https://doi.org/10.1542/peds.2023 064245 – especially young women, who tend to experience less stigma https://doi.org/10.1542/peds.2023 064245 around mental health issues. New rules during the pandemic https://www.kff.org/medicare/what to know about medicare coverage of telehealth/ also made it significantly easier for people to access https://theconversation.com/online therapy having its moment bringing insights on how to expand mental health services going forward 136374 mental health treatment – both therapy and medications – remotely, via telehealth. Such access continues to grow. Before the pandemic, only 1% to 2% of antidepressant medications https://doi.org/10.1097/MD.0000000000042305 were prescribed via telehealth. By 2022, it was roughly one third https://doi.org/10.1001/jamanetworkopen.2024.33334 . Given these trends, and the fact that clinicians often turn to medication for treating depression regardless of the severity, the uptick in antidepressant prescriptions since 2020 https://doi.org/10.1016/S2215 0366 24 00245 1 should come as no surprise. Virtual visits allow people to navigate more easily around stigma and find increased and convenient access to care. And many people feel more comfortable https://doi.org/10.1017/S1463423618000403 getting such care in a primary care clinic rather than a mental health clinic. Systemic issues drive prescribing For all these reasons, I would say that antidepressant medications are likely overused in some cases. Undoubtedly, some people who take them either don’t benefit from them or could address their symptoms in other ways. On the other hand, expanded access to mental healthcare – including medication – has also enabled people who need treatment to receive it. Even now, many Americans with serious depression receive no or limited treatment https://www.samhsa.gov/blog/release 2024 nsduh leveraging latest substance use mental health data make america healthy again .
For people with mild depression, medication may not be the best option, but the distinction between mild and more severe symptoms sometimes gets lost. Dimensions/E+ via Getty Images What’s more, in my view, this imbalance reflects systemic problems in the U.S. healthcare system at least as much as physicians’ prescribing habits or patients’ requests. For example, primary care clinics are a great place to screen for mental health issues, but getting proper treatment may involve more specialized care – which many patients can’t access. And on the business side, clinicians get little support https://doi.org/10.1186/s12875 024 02321 8 in helping patients with lifestyle changes and nonmedication treatments – rather than prescribing drugs. Difficulties in ditching antidepressants Kennedy has claimed that for some people, stopping antidepressants can be harder than quitting heroin https://theconversation.com/robert f kennedy jr says antidepressants are harder to quit than heroin is he right 248937 . Research suggests such extreme effects of discontinuing medication are rare, though not unheard of. Any time a person is on a medication for a significant period of time, the brain and body adapt to establish a new balance https://www.verywellhealth.com/drug tolerance 5271896 . This happens with other substances, too – as any regular coffee drinker who has tried abruptly quitting knows. People who want to stop taking antidepressants after being on them for a long time generally do best when they gradually taper their dose over weeks to months, unless they have a specific reason for stopping more quickly. For antidepressants, clinicians watch for withdrawal symptoms https://my.clevelandclinic.org/health/diseases/25218 antidepressant discontinuation syndrome including sleep problems, flu like symptoms, headaches and an electrical buzzing sensation in the head. A 2024 review of dozens of rigorous studies that compared the experiences of people taking antidepressants with those taking a sugar pill found that roughly a quarter of people stopping antidepressants https://doi.org/10.1016/S2215 0366 24 00133 0 experienced some withdrawal symptoms, and for 3%, they were severe. While certain antidepressants might be more likely to cause withdrawal symptoms, it’s tough to tell who might have the most difficulty. And for some patients, depression is a chronic illness for which they must take medication indefinitely. However, most people working with an experienced clinician are able to successfully discontinue these drugs https://doi.org/10.1016/S2215 0366 24 00133 0 . Ultimately, what’s most important is that patients are able to consult with a knowledgeable provider in making that decision.
Andrew McLean has taken part in projects that have included government funded grants related to mental health and substance misuse and holds an Endowed Chair in Neuroscience funded in part by the Neuropsychiatric Research Institute through the UND Alumni Association and Foundation.