Antidepressants: Why the ‘Overmedicated America’ Narrative Is Harmful
We're in an epidemic of mental illness and in an epidemic of misinformation about mental illness. The myth that America is "overmedicated" regarding antidepressants only furthers the stigma that stops people from seeking help.
Dr. Drew Ramsey is a psychiatrist, author, and farmer. He is one of psychiatry’s leading proponents of using dietary change to help balance moods, sharpen brain function and improve mental health. He is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons and in active clinical practice in New York City where his work focuses on the clinical treatment of depression and anxiety. Using the latest brain science and nutritional research, modern treatments, and an array of delicious food he aims to help people live to their happiest, healthiest lives.
He is the co-creator of The Brain Food Scale, co-founder of National Kale Day 501(c)3, and a member of the medical review team at Dr. Oz’s webportal ShareCare. He frequently speaks and conducts workshops nationally, including two recent TEDx talks BrainFork and Brain Farmacy on food and brain health. His work and writing have been featured by The New York Times, The Wall Street Journal, The Huffington Post, Atlantic.com, Prevention, Lancet Psychiatry, and NPR, which named him a “kale evangelist.” His recent bestseller 50 Shades of Kale has made this superfood accessible to thousands. His first book, The Happiness Diet: A Nutritional Prescription for a Sharp Brain, Balanced Mood and Lean, Energized Body explored the impact of modern diets on brain health.
Dr. Ramsey teaches and supervises Psychiatric Evaluation and in the Columbia University Adult Psychiatry Residency Program. He serves as a thesis mentor for graduate students at the Columbia University Institute of Human Nutrition where is also lectures on nutrition and the brain. From 2005 to 2008, he directed the Audubon Continuing Day Treatment Program, a bilingual service for the severely mentally ill located in the Washington Heights. He is a faculty member at the Center for Mind-Body Medicine. Dr. Ramsey is a diplomate of the American Board of Psychiatry and Neurology. He completed his specialty training in adult psychiatry at Columbia University and the New York State Psychiatric Institute, received an M.D. from Indiana University School of Medicine and is a Phi Beta Kappa graduate of Earlham College.
Drew Ramsey: I think the big question in people's minds is who can they trust for their information about mental health? On the one hand we have big pharma, and there have been some incredible breakthroughs. I'm a psychiatrist. I prescribe medications and I find some people really it saves their lives. And you don't hear that in the media. This week I've heard a number of antidepressants called a miracle drug, a miracle cure and I don't take any money from big pharma I've just used these medications for over a decade now. For some people they're lifesavers. Then there's the supplement industry. And the supplement industry is really largely unregulated. They make a number of claims that really aren't supported by the evidence and it gets people into a notion, this happens a lot where instead of taking a medicine that's been closely studied and brought to market and closely monitored, they'll be taking five, ten, 15 different supplements. It's hard to know as a physician whether that's safe or not and whether that's really warranted. There's a lot of delay in terms of people getting appropriate treatment. Then, of course, we have talk therapies, which tend to take a longer time and cost more money.
So this is where I think food comes into the picture. One is we all can agree we trust. For the most part if it's a whole food it grows on a farm. There are concerns about big pharma out but I've never heard a concern about little farmers so that's where I try to direct people. And I also like it as a psychiatrist that it's one of my interventions that is absolutely delicious, that people like, that people can do for themselves. We're in an epidemic of mental illness and we're also in an epidemic of misinformation about mental illness. The amount of stigma that we see still and the embarrassment that my patients have for a victory over some of the most debilitating and disabling illnesses and deadly illnesses in the world, it's concerning as a doctor. I see people just profoundly ashamed by how they're feeling and the illness that they have. So I think we have a long way to go. I think we're getting there. I think more and more - I've been a psychiatrist for 16 years, there's a change in the conversation. People talk about having bipolar illness. People talk about being treated for depression. Men talk about being treated for depression really for the first time in history in a way that it gives me some hope that if we can have a more open conversation we can make a bigger dent. Now it's what more than 40,000 suicides a year in America. We have 600,000 veterans with severe traumatic brain injuries. We have a lot of work to be done.
And on the front lines of mental health I think I just try to remind myself to sit with my patients, to do no harm and to give them a menu of options. I think that's one of the things that's gotten missed in this whole discussion about mental health. People talk about how many people are kind of overmedicated in America and I always like to point out that ten percent of Americans that take antidepressants in the morning, they do that voluntarily because it's something that helps them. And I think that when we talk about an overmedicated society sometimes we miss the point. I would say that we're a mis-medicated society. I've seen a lot of people in my practice who are just on the wrong meds for the wrong reasons and I've met even more people who've never ever had a trial of even something natural like St. John's wort that has incredible evidence that it's a very, very good antidepressant. And I think that's the part, the folks who aren't getting any help that's the most concerning part to me because that's when people end up in real, real trouble.
Big Pharma has got itself a bad, bad name. Many people become nervous at the mention of pharmaceutical intervention for mental illness, but there's another solution that may bring ease to some: it's called little farmer, quips psychiatrist Drew Ramsey. For how food can control conditions like anxiety and depression, look through Ramsey's previous videos on Big Think. But here, Ramsey wants to address the popular notion that America is overprescribed. "I always like to point out that the ten percent of Americans who take antidepressants in the morning, they do that voluntarily because it's something that helps them." In his 16 years of psychiatric practice, Ramsey has more often seen mis-prescription rather than overprescription. But at least mis-prescribed people are on the path to finding the right treatment – much worse is the people who aren't getting any help at all whether it be diet, or therapy, or pharmaceuticals. Psychiatric medication isn't right for everyone, but in many cases it truly saves lives, says Ramsey. If we continue to propagate the over-prescription myth for this kind of medication (opiates are another issue), it may alienate those who need help from seeking it at all. Stigma doesn't help in the effort to reduce severe life disruption and suicide, which for the latter totaled 42,773 Americans in 2014, a steep rise from 29,199 people in 1999. Drew Ramsey's book is Eat Complete: The 21 Nutrients That Fuel Brainpower, Boost Weight Loss, and Transform Your Health.
Drew Ramsey's book is Eat Complete.
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What does sports fandom look like in the new normal?
- With the masses huddled at home and glued to our screens, the last several months of frozen competition provided an opportunity for sports franchises to experiment with creative modes of fan engagement, often involving multiple media channels.
- On another level, this is a challenge that wasn't prompted by COVID-19 and won't go away when COVID-19 does.
- Franchise marketers are accelerating their digital transformation processes, finding innovative ways to connect with fans online, with VR, community building and repackaging classic content.
Head back to the stadium – virtually<p>After months of deprivation, fans are panting to see their favorite teams. For the moment, they are so eager to return to live sports that they are ecstatic over any live game broadcast. On July 5, some 5.7 million people tuned in to the Southampton v. Manchester City match, making it the Premier League's most-watched match ever. </p><p>But as time goes by, the shine of live sports will wear off. An empty stadium is disappointing both for viewers at home and for players. The NFL's "virtual draft" event in April drew a larger audience (15.6 million) than Monday Night Football did last weekend (14 million), even though the former was little more than a televised Zoom call while the latter was a marquee matchup between two of the hottest teams in the league, the Chiefs and the Ravens.</p><p>The time has come for the sports industry to find creative ways to harness technology for the next generation of fan engagement. What can we learn about the future based on what worked best during the pandemic?</p>
Breathe new life into regurgitated content<p>Filling up gaps in the programming schedule with reruns of classic games worked well at first, but returns are diminishing. Success requires networks to put more work into their content choices.</p><p>Tommy Stimson, managing director at Qualitative Insights, <a href="https://marumatchbox.com/4-actions-fan-engagement-sports-covid-19/" target="_blank" rel="noopener noreferrer">points out</a> that fans aren't very interested in games from the last 10-12 years. Footage from these games is already widely available online, plus "The known outcome and familiarity with the content makes the reruns less-than-satisfying." Instead, Stimson recommends showing iconic, historical sports moments that most of today's fans haven't seen or experienced. </p><p>Fans appreciate reruns far more when the footage is interspersed with new analysis and commentary, either from current players or from the athletes who were playing at the time. One of the darlings of Netflix's pandemic-era programming lineup, Michael Jordan's <em>The Last Dance </em>documentary, which followed the 1997-98 Chicago Bulls on their title run, drew an average of 5.6 million viewers for each of its ten episodes.</p><p>Many teams hosted social media-integrated "watch parties," where former players shared their personal memories and fielded questions from fans while streaming classic games, and fans were delighted with the multi-screen experience, which dovetailed perfectly with game rerun telecasts. <a href="https://www.prnewswire.com/news-releases/survey-sports-with-empty-stadiums-means-millions-of-americans-will-be-engaging-from-home-301094037.html" target="_blank" rel="noopener noreferrer">One poll</a> found that 76 percent of U.S. fans want more watch party-style viewing options moving forward.</p>
Screenshot of New England Patriots re-watch party ad
Credit: Facebook<p>Networks would also do well to tap into the <a href="https://bigthink.com/culture-religion/money-sports-success" target="_self">deeper reasons</a> why people follow sports, by sharing narratives about how teams come together as a unit, or times when players overcame adversity. Viewers are eager for behind-the-scenes content that reveals how players stay in shape, how managers set strategies, or the motivating factors behind decisions to trade, draft, and otherwise acquire talent.</p><p>As brands collect more viewer data, they can also deliver more personalized content experiences that engage fans more deeply. </p>
Invite fans to vote for in-game elements<p>Giving fans ways to have a real effect on in-game elements is another winner for the sports industry. Juventus has long been a trail-blazer for digital transformation, so it's no big surprise to see the storied soccer franchise leading the way again.</p><p><span></span>Juventus <a href="https://www.socios.com/new-goal-celebration-song-for-juventus-is-revealed/" target="_blank">invited fans to vote</a> for its new in-stadium goal celebration song using Socios, a token-based voting and rewards platform, to ensure that the results wouldn't be sabotaged by rival fans or manipulated by hackers.</p>
Credit: Twitter<p>Fans overwhelmingly chose Blur's "Song 2," and were rewarded by <a href="https://www.dailymail.co.uk/sport/football/article-7868543/Juventus-fans-chose-iconic-Blur-track-goal-anthem-pioneering-blockchain-vote.html" target="_blank" rel="noopener noreferrer">hearing the song four times</a> in the first back-to-business game between Juventus and Cagliari. </p> <p>Socios has been doing some interesting work in the digital fan engagement realm beyond the Juventus example. Its parent company, Chiliz, partners with teams to issue blockchain-based, franchise-branded coins. Apollon Limassol FC decided to put on a head-to-head skills challenge between players, with <a href="https://medium.com/chiliz/apollon-fc-apl-fan-token-sells-out-in-6-minutes-generating-100k-f3bc6a98e75d" target="_blank">fans using tokens to vote</a> on the matchups. In esports, itself a social distancing-friendly concept, fans of Spanish team Heretics were able to vote on which players would go head to head in Fortnite death-matches.</p>
Encourage fans to connect together at home<p>Part of the beauty of sports is that it forges relationships. Season ticket holders connect with neighboring seatmates in the stadium; families bond over a shared love for their teams; friends come together to watch the big match and analyze it ceaselessly during and after the game.</p> <p>It's difficult to translate this to a situation where even private socializing is frowned upon, but it's not impossible. </p> <p>To build hype as the NFL season neared, Pepsi <a href="https://www.marketingdive.com/news/pepsi-delivers-tailgate-in-a-box-to-football-fans-hankering-for-game-day/584016/" target="_blank" rel="noopener noreferrer">tapped into this demand</a> with a "Tailgate-in-a-box" kit that includes an outdoor projector and a range of Pepsi products. The kit is valued at $5,000 and was delivered to sweepstake winners, so it's unclear how this will translate into the general market, but the opportunity is clear. Pepsi is also experimenting with a "tailgate tour" that brings live music and outdoor games to fans viewing from home. </p> <p>The <a href="https://www.sportbusiness.com/2020/09/nba-leverages-microsoft-partnership-to-revolutionize-virtual-fan-experience/" target="_blank" rel="noopener noreferrer">NBA led the way recently</a> by offering 320 fans the opportunity to "attend" games in the Orlando bubble. At-home viewers logged in through Microsoft Teams, and their streamed likenesses were beamed onto 17-foot video boards set up around the courts. The tech made it look like viewers were sitting next to each other, plus participants could interact with each other and see and hear their reactions in real time. The NBA has other plans to allow fans to chat during games, display a real-time statistical overlay, and introduce gaming elements as well. </p>
Credit: Instagram<p>Technological advances, including <a href="https://bigthink.com/what-would-it-take-to-create-a-fully-immersive-virtual-reality" target="_self">virtual reality</a> (VR) and augmented reality (AR), offer teams new ways to offer virtual fan experiences.</p> <p>Another option that could become very popular is <a href="https://losangeles.cbslocal.com/2020/05/27/virtual-reality-sports-fans-broadcasts/" target="_blank" rel="noopener noreferrer">audio AR</a>. Powerful recording equipment picks up the minutiae of sounds that make up the audio backdrop of in-stadium viewing, and then broadcasts it to at-home viewers. AR allows the noise to grow louder or fainter as viewers "move" closer to or further away from the action. Brands can even add crowd sounds, like gasps at a near miss or the shouts of vendors, to enhance the experience. </p> <p>In Japan, an app called Remote Cheerer allowed fans to capture their real-time reactions to on-field action and actually play triggered sounds in the stadium, instead of the canned crowd noise we've hearing in our MLB, NFL and NHL telecasts. This type of solution keeps fans at home more engaged and makes even the passive TV watching experience more authentic.</p>