Covid 19: More anti-depressants dispensed in 2020 than year before
'If someone needs an anti-depressant for a year to get them back to where they need to be then that is OK.'
More anti-depressant medication was dispensed every month last year by pharmacists than the year before, and a top pharmacist says this reflects a growing need for help as the pandemic continues.
The Irish Pharmacy Union monitors dispensing across the industry. Figures released to the show a greater need every month.
There was a slight rise in January, even before the pandemic hit and this escalated through the year.
Anti-depressants including selective serotonin re-uptake inhibitors sold as Prozac and Lexapro are typically prescribed by GPs or other mental health specialists and collected from a pharmacist.
In January, 546,621 such prescriptions were filled, which is 2.3% more than January 2019. The difference rose to 5.3% in February.
The panic of the first lockdown in March drove many people to fill extra prescriptions, and this is reflected in a jump of 12% compared to the previous year. A total of 585,847 prescriptions were filled.
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However, the data shows the increases continued every month, although in May the difference was negligible at just 0.4%.
Perhaps surprisingly, as the restrictions were eased in June and July, the numbers of people needing anti-depressants rose again. Numbers dipped slightly in August although remaining higher than the previous summer and have risen steadily since then.
In November, 567,891 prescriptions were dispensed, a rise of 7.2% on November 2019.
Many patients have developed a closer relationship with their pharmacist as other treatments went virtual.
Kathy Maher, spokeswoman for the Irish Pharmacy Union, said she and her colleagues countrywide have similar experiences.
“Definitely anxiety and depression-related symptoms were the biggest number of consultations we had for June, July and August.” However, she stressed this data reflects an increasing comfort with seeking help for mental health issues.
“It does show people are that stressed but they are seeking help. We are becoming better as a nation at doing that.
“If someone needs an anti-depressant for a year to get them back to where they need to be then that is OK,” Ms Maher said.
She has noticed some people fear becoming addicted, but said this is not true of the new generation of pills.
“When you hear of Prozac or Lexapro, they are not addictive,” she said.
The data, collected by Health Market Research for the IPU, shows a 10.1% increase between September 2020 and that month in 2019.
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Ms Maher, a pharmacist in Co Meath, speculated this could be linked to the different effects schools reopening had but it could also have an element of people restocking.
She said: “We saw anti-depressant prescribing increase again in September, we can’t pinpoint particular reasons. It could be unemployment, parents who held it together until then.” The data is anonymised so she could not say if prescriptions for under-18s have risen.
In her experience, unemployment or erratic employment is also having an impact.
"We put them onto the Samaritans,” she said.
She is aware of cases where men who usually work in construction are under-employed, and the mental health burden caused by financial anxiety also falls on wives and partners.
Ms Maher said the absence of face-to-face therapy outlets is a rising problem, compounded by not being able to meet with GPs.
“We always recommend people seek out talk therapy as well. That is really difficult with Covid, there are very few face-to-face appointments now,” she said.
Mental health charity Pieta is urging people who are self-harming to come forward and ask for help, after new data revealed there was a drop in A&E presentations relating to self-harm during the first lockdown.
In mid-December, provisional data from the National Suicide Research Foundation indicated that the amount of people presenting to hospitals with self-harm fell in March and April.
Overall, the number of people presenting to hospitals after self-harming remained the same as last year. However, the researchers could not measure the number of people who were self-harming and not accessing acute hospital services.
*Data Briefing*
— National Suicide Research Foundation (@NSRFIreland) December 15, 2020
The National Self-Harm Registry Ireland Team have prepared an update on hospital-presenting self-harm during the period January-August 2020.
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Sinead Raftery, Pieta House's regional manager for the Munster and south Leinster region, says: "At Pieta, our numbers have remained pretty much the same with regards to presentations of self-harm, but if people are not accessing the acute services they need after self-harm injury, that is hugely worrying."
She says Pieta's services are open to anyone who is engaged in deliberate self-harm, as well as people with suicidal ideation.
"It is so difficult for people to reach out for help anyway, and when you add in the worry of a pandemic, and the public messaging that you should only go to A&E when it's a crisis or an emergency... people may feel they don't want to put an extra 'burden' on the system."
Leigh Kenny, Pieta House's regional manager for the greater Dublin area, says it's important for people to know their services are still open.
Ms Raftery says that some of the things people used as a healthy coping mechanism, such as going to the gym, meeting up with friends or family, or having peer support, are now unavailable to them.
"Not having the same structure in the day can also be difficult for people. A lot of work, school and college went remote, and some have stayed that way.
"We were asked to physically distance, but not emotionally distance. We had to think outside the box to help people connect to each other."
Ms Kenny adds that if people do have a setback, it's okay. "People might find themselves engaging in a behaviour they thought they had overcome... a new way of coping can be learned, and this can involve returning to your therapist. You can get back on track again."
For people worrying about a loved one who is self-harming, Ms Raftery explains that they can avail of key support sessions from Pieta.
"It helps them gain an understanding of self-harm, which can only benefit, as self-harm is often misunderstood."
She adds that people should not be afraid to broach the topic with their friend or family member. "You should ask the question in an open way, so the person feels that they are able to answer honestly. People may also need help or encouragement... with accessing services."
She says you can ring Pieta on someone else's behalf, with their consent, if they feel like they can't make an appointment.
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Ms Kenny says it is important for the person who is self-harming to have someone else acknowledge them.
"That can be pressure for concerned friends or family, they feel like if they open this dialogue, they have to be able to fix it. The only person who can fix it is the person themselves, with the right support. It's about understanding, hearing and supporting them."
Looking to the future, both women believe that the pandemic will have long-term consequences for people's mental health.
Ms Raftery says there will be an economic crisis, which worsens people's mental health and wellbeing. "We saw it in the last economic crisis. There needs to be a focus on having the resources there."
Ms Kenny adds that Pieta will always be there for people in need, thanks to the Irish public donating generously to the organisation. "It's your service, please use it, and know there is hope."
Pieta's free 24/7 helpline is 1800 247 247. The text help number is accessed by texting HELP to 51444.
You can also call 0818 111 126 to make an appointment with a therapist.
In its tenth year, the First Fortnight Mental Health Art & Culture Festival may find itself needed now more than ever.
The event, which started on January 2, will include more than 70 events. These will take place throughout the month in the aim of challenging the stigma surrounding mental health through the medium of the arts.
Due to Covid-19 and the restrictions on social gatherings, the 2021 events will take place online.
Olympian Sonia O’Sullivan, poet Stephen James Smith, comedian Alison Spittle, best-selling author and comedian Colm O’Regan, and musician and writer Jess Kavanagh will all feature in this year’s event.
The past year, due in large to the pandemic, multiple quarantines and high unemployment, has taken a massive toll on many people's mental health.
According to statistics from the CSO, in November 2020, more than one in three (35.6%) survey respondents rated their overall life satisfaction as ‘low’. This compares with 29.6% in April 2020 and 8.7% in 2018.
The percentage of respondents that felt downhearted or depressed ‘all’ or ‘most of the time’ in the four-week period prior to interview doubled between April and November 2020, from 5.5% to 11.5%.
Those aged between 18 and 34 reported the lowest levels of overall life satisfaction with 42.1% having a ‘low’ overall life satisfaction rating.
Edel Doran, First Fortnight Programme Co-ordinator said 2020 has been a year when we have been told to lock ourselves away from other people and to not see our friends and family and in some cases to isolate.
"There has of course been reason for this but the effect has left us lonely, isolated and vulnerable. This is something many people experience when they have a mental health difficulty they feel they can’t share." Ms Doran said.
“They feel powerless. When we challenge mental health stigma, we help create a society that is there to help and to listen to mental health discussion. The arts are a powerful tool for this, the nation turned to the arts during this difficult time for a source of entertainment, escapism or enjoyment."
There will also be a series of events which explore loneliness, isolation and community relatable experiences to many people in these times.
Those interested in attending the events should register firstfortnight.ie
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