g(sc) TALK: Living in a brave new world: a prescription for (un)happiness…

December 6, 2017

Here’s a piece of Canadian trivia for you: Canada ranks among the highest consumers of antidepressants in the world. Yes, it’s true. Even here at GSC, our data shows that we pay more money in claims for antidepressants than any other type of medication - year after year after year.

Which is somewhat astonishing, right? In a country that consistently ranks as one of the best places in the world to live, are Canadians really so anxious/depressed/unhappy?

We’d like to take a stab at answering that question. But first, we’ve got to go deep…

 

ARE WE OBSESSED WITH HAPPINESS?

If you type the word “happiness” into an Amazon search, you’ll find over 62,000 results. Most are self-help books with titles like The Happiness Project, Stumbling on Happiness, and The Art of Happiness (written by the Dalai Lama himself). Happiness is big business. And increasingly, many professionals are asking themselves whether this obsession with happiness is actually making us less happy.

Think about it. Everyone wants to be happy, right? As a society, we increasingly hold happiness up as a fundamental human right. Whether in our jobs, our marriages, our families and friendships, we are constantly pursuing “happiness” in all aspects of our lives.

But experts worry that this oversimplified outlook on life is setting us up for failure. Despite what that $5.99 bargain-bin self-help book told us, “happiness” isn’t some sort of default setting. Many of these books would have you believe that if you’re not feeling happy in your life 100% of the time, then you’re just not doing it right.

No (just no). Negative and sad emotions are part of what it is to be human. And pretending like we can live without them is pointless. We can't. But even worse is that when these negative emotions appear, we feel like we've failed at "being happy" (and that’s on top of whatever unhappy feelings we had going on in the first place).

For those challenging this existing “happy” model of psychology, there is more harm than good in a perpetual (and let’s be honest, kind of annoying) positive outlook. They would argue we should be focusing on how to learn from those dark, difficult, and insecure periods in our lives – while still considering ourselves successful human beings despite them.

 

WHAT DOES THIS HAVE TO DO WITH PRESCRIPTION ANTIDEPRESSANTS?

Glad you asked (or, maybe you didn’t - but for the sake of this article, we’re going to pretend like you did). 

So let’s get back to that stat we mentioned off the top – Canada is one of the leading consumers of antidepressant medications in the world. At any given time, around 13% of GSC’s nearly 2 million plan members are taking antidepressants.

Many experts believe the increases we have seen in the use of antidepressants are linked to what they call, “cosmetic pharmacology”. The term describes how, in order to deal with our negative feelings, increasingly we are seeking chemical help from psychoactive drugs to feel “happier”.

Now, before we get into this further, it feels like a good time to take a break for a very important clarification. Severe clinical depression is a complicated and challenging condition that can often be treated effectively with a drug. That’s a fact. So, while we want to acknowledge that antidepressant drugs are remarkable (even life-saving) for a group of people, we also want to address the idea that perhaps those same drugs are being over-prescribed for a much (much) larger group of people - many who are not deriving any meaningful benefit from them.

In Canada, the antidepressant drug market is a nearly $2 billion dollar industry. Family doctors do the bulk of prescribing - often with little formal training in doing so. And because the diagnostic criteria for “major depressive disorder’ are so broad and flexible, doctors are offering antidepressants more freely – especially as patients are asking for them.

And with all of this perceived happiness going around, why wouldn’t they ask for them? For those on the spectrum of “unhappiness” (low moods, mild to moderate depression, stress or anxiety), it’s easy to believe that your unhappiness means something is truly wrong with you. Even when, in fact, these feelings are often within the realm of “completely normal”.

So what is the solution here? If drugs aren’t the right way to treat all of this “unhappiness”, then how do we fix this?

You could point the finger at the overprescribing habits of family doctors. And to a certain extent, that would be fair. But, the reality is that family doctors are between a rock and a hard place when it comes to treating patients with mental health concerns. If their first choice is to prescribe some therapy instead of a drug, access (to quality psychotherapy) issues persist all across Canada.  Every patient is unique and mental health can be a complicated puzzle.

LET’S TALK… (TO WHO?)

Every year, Bell launches it’s “Let’s Talk” campaign aimed at reducing stigma and raising funds in support of mental health programs across Canada. And, by all accounts, it has been hugely successful in achieving what it sets out to do.

And that’s great! But… (you knew there was a “but” coming) when we encourage people to speak up and seek help for their mental health, it does set up the expectation that good quality support is available. 

The fact is, prescription drugs are the most easily accessible mental health care available today. But many therapies (like Cognitive Based Therapy, mindfulness, and even exercise) have been shown to work just as well (if not better) than prescription medication at treating the most common mental health concerns. They also do a better job of preventing relapse.

Not a single province covers therapy delivered in private practice by a psychologist, social worker or psychotherapist. Psychiatrists are covered by most provinces. And again, that’s great, but… most psychiatrists are overworked with wait lists over a year long. And in a mental health crisis, that’s not much help.

Even if you can wait a year, a psychiatrist may not have the required time to sit with you for multiple sessions to try and determine the real reasons you are facing depression/stress/anxiety/addiction, or any of the many other mental health issues. What they can do, like a family doctor, is prescribe a medication.

 

MAKING FRIENDS WITH (ALL) OUR FEELINGS

Okay, so we’ve painted a pretty grim picture here. But, it’s not all doom and gloom – there is light at the end of this tunnel (or at least, at the end of this blog post). People are recognizing these issues and doing something about them.

One avenue that aims to tackle barriers to access (like cost and location) is the use of online and virtual mental health services. These programs have shown promising results in their ability to provide effective treatment. And Canada’s provinces are taking notice. The hope is that family doctors will turn to these services first for patients with milder forms of mental illness when face-to-face therapy is not an option.

There’s also an ever-growing number of people calling for better screening and diagnostic criteria for mental health, as well as beefed-up public and private coverage of therapy services (psychology, psychotherapy, and counselling, among others...).

And as experts continue to warn about the negative impact our obsession with happiness is having on our mental health, we’ve seen new narratives starting to emerge in the public conversation about the topic. In particular, that maybe happiness isn’t the goal after all. Maybe the goal is to make friends with all your feelings – good and bad.

The practice of mindfulness is grounded in this goal. In a nutshell, mindfulness teaches you to be accepting and aware of what is happening in your mind at any given time, without passing judgement or getting carried away by those feelings. Because once you’ve accepted your negative feelings as just another, completely normal part of you, you can start to learn how to manage and move past them.

We should also point out that mindfulness isn’t just the newest trend in “wellness”. Every day brings more evidence showing that mindfulness is an effective strategy for maintaining good mental health, as well as for coping with poor mental health. And, because we’re data-loving nerds on a mission to improve access to health care (when we’re not processing your claims, that is), we’ve decided to bring this mental health strategy to our plan members.

This December, we’ll be launching our own mindfulness program via the Change4Life® health portal. This (totally free!) program will guide you through six sessions that teach the fundamentals of mindfulness through video, audio and text.

Wherever you fall on the mental health spectrum, we hope you’ll check out the program and learn what mindfulness can do for you. Keep an eye out for our announcement, coming soon...