“Crazy” is in this year.

Over the past 80 years, there has been a constant rise in the prevalence of anxiety and depression and no one really knows what is causing it. Let that permeate your mind and sink in. This year, I have treated about 1,000 patients in primary care/urgent care settings and 30% of them have a history of anxiety or depression. That data is staggering. My school requires me to input data into a server that organizes information for us to see trends and learn about common themes in healthcare. When I adjusted the settings to display the ratio of patients:mental health issues, I felt a surge of intense questioning. The Association of Anxiety and Depression claims that the prevalence of these disorders is significantly lower. Why?

Perhaps people who are feeling depressed or anxious are more likely to seek medical care, thus skewing the data? Regardless, why are we seeing this dramatic increase and why is this not considered a massive public health crisis? Most of my adult life has been dedicated to questioning things and annoying most of the people around me with my theories…BUT THIS IS A BIG DEAL, Y’ALL.

My database has tangible evidence that suggests about 1/3 people deal with anxiety/depression. I believe that number is even higher because of the lack of accurate reporting. A lot of people do not have the self-awareness to even recognize something is off with the mind and psyche, so who is to say 1/2 of people are actually on this mental health train?

I want to play a guessing game with you. Think back to the last time you saw a medical provider. Perhaps it was your annual physical or an episodic meeting. Did your provider ask you about your mood/stress/energy? As a future provider, I recognize that time is of the essence and you can not perform a full blown psychoanalysis on every patient. With that being said, I value the importance of a handful of screening questions. I try to ask my patients, “how is your energy level during the day/how are you handling your stress/what do you do to for self-care?” It takes about 2-3 minutes and opens the door for a emotional connection.

 

When time permits, I love to teach patients about stress management through alternative methods: belly breathing, guided meditation, and yoga. All this is hunky dory, but back to the point…

What is causing the constant rise in anxiety and depression?

Unsolicited advice/theories I developed that probably hold 7% scientific value:

  • technology
    • after a weekend in the woods, my mind and body are in such a calm state. Being off the grid and “disconnected” is therapeutic for my adrenal glands and neurotransmitters
    • social media (I REALLY spend too much time on that crap) is a forum for “look how amazing I am” and drives feelings of inadequacy
  • food
    • our culture sucks at eating, let’s be honest
    • the era of processed food, sugar, add added hormones is essentially destroying our brain’s ability to regulate emotion and stress hormones…no big deal
    • hypoglycemia can mimic feelings of anxiety and that tends to be an issue when we eat such a high sugar diet–leading to fast metabolism of food and a massive blood sugar crash (you should probably apologize to your pancreas)
  • birth control
    • who doesn’t love good old oral contraceptives…ok, ok, too far, I get it.
    • the estrogen component in most OCP is detrimental to the mind
    • my anxiety was drastically reduced when I changed to a very LOW dose of estrogen
    • all the smart brain docs tell me that estrogen negatively impacts serotonin and norepinephrine
  • lack of community
    • although we are the most “social” generation via social media, we are actually the loneliest
    • in the 1930s-1950s, farming was a critical aspect of society and most people lived on land with many family members and spent very little time alone
    • some people believe that a large social circle will buffer the impact of anxiety/depression, thus serving as protective
    • when is the last time you drove to someone’s house to talk to them instead of text them? Exactly.

My commitment to the medical community is to discover trends and determine how I can make a tiny positive impact in the world. Maybe that is through developing more screening guidelines or writing a self-care novela as a free gift with purchase. “Thanks for getting a Pap today, enjoy your free guide on how to take care of your mind and body.” All jokes aside, I have a lot of questions and a lot of energy to figure them out (thanks to the shit ton of green tea I guzzle). I want to solve this dilemma and save the world. All in a day’s work.

Why do you think we are seeing the consistent rise in anxiety and depression? Comment below!

Love and Light.

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Sources: (http://nymag.com/scienceofus/2016/03/for-80-years-young-americans-have-been-getting-more-anxious-and-depressed.html)

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