A prominent female psychiatrist questions whether women are overprescribed

The New York Times edition for Sunday, March 1, 2015 includes an interesting commentary by a psychiatrist, Julie Holland, M.D., which is critical of how mental health medications are prescribed for many women. She is described as a “psychopharmacologist, psychiatrist, and author.” She is the author of “Weekends at Bellevue: Nine Years on the Night Shift at the Psych ER,” which received positive reviews. She is also the editor of “The Pot Book,” quote which supports the use of marijuana for medical purposes. Her CV indicates that she has a history of researching the use of hallucinogenic drugs in experimental psychiatric research. She clearly has a unique background.

Her commentary in the New York Times, “Medicating Women’s Feelings,” argues that women are, due to biology, more moody than men and the male-dominated mental health industry tends to pathologize some aspects of what she advocates to be normal female behavior. She notes that more women than ever are currently prescribed mental health medications, and a significantly higher percentage of women are prescribed than men. I was surprised to learn that, according to Dr. Holland, at least one in four women in the US take a mental health medication, compared with one and seven men.

Dr. Holland is particularly concerned about the most common antidepressant medications, SSRIs, which she advocates tend to leave people feeling numb, both physically and emotionally. She is particularly concerned about the impact of this types of medication on female emotional functioning, and reports that they tend to leave patients with less empathy, less irritation and sadness which obviously would be potential benefits for a depressed person, but also less erotic dreaming, creativity, anger, expression of feelings, and the ability to mourn.

She notes that the “emotional blunting” resulting from being on this class of medications may result in women who tend to take on behaviors that are typically approved by men, such as appeared to be less vulnerable. While this type of behavior may help women in the business world, she advocates that it is costly for women and goes against their natural biology. She also notes that this class of medications can “promote apathy and indifference,” and advocates that this goes against traits that women offer to relationships, family, and society, such as empathy and sensitivity. She concludes, “when we are overmedicated, our emotions become synthetic. For personal growth, for satisfying marriage and him for a more peaceful world, what we need is more empathy, compassion, receptivity, emotionality and vulnerability, not less.”

My take on this article: I’ve had many patients who have found antidepressant medication to be helpful in the short run, as it may take the edge off of their mood symptoms and may give them more energy, but have had many complain that it makes them feel “numb,” “apathetic,” and “unable to care about things.” I think that Dr. Holland makes some interesting points that are particularly relevant to women, but not necessarily limited to them.  Readers have posted a large number of comments about her article on the NYT website, so she obviously has touched a nerve or two with her article.

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