Antidepressant use spikes among girls, young women after pandemic

• A University of Michigan study found an increase in antidepressant use among adolescents since the beginning of the pandemic in March 2020, especially among females 
• More adolescents are turning to mental health services, and anxiety and depression diagnoses are higher than ever 
• Psychiatrists and educators say mental health initiatives need more funding and support to address the higher need 

Antidepressant use among females as young 12 has soared since 2016, with the biggest jump occurring during the pandemic, according to a new national study conducted by researchers at the University of Michigan. 

That same study found that young women in the Midwest have the highest rate of antidepressant use in the nation.

The study is the latest warning about both the mental health impact of the pandemic on children, teens and young adults, and how that impact is being borne overwhelmingly by women.

Researchers analyzed data from a national database representing 92% of prescriptions dispensed in U.S. pharmacies. They found that in December 2022, the most recent data available, 4,554 per 100,000 (1 of every 22) middle and high-school girls between the ages of 12-17 were prescribed an antidepressant, a 95% percent increase in seven years. The rates for women between the ages of 18-25 also spiked in the same time period, with 6,951 per 100,000 (1 in 14) taking an antidepressant in December 2022, a 74% increase.

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The rates of antidepressant prescriptions for boys and young men also rose, but at a significantly lower pace. Boys ages 12-17 saw a 35% increase in prescriptions, and young men ages 18-25 had a 53% increase.

Antidepressants can help alleviate the sometimes crippling symptoms of depression, like “being able to get out of bed in the morning. staying up late and sleeping a big chunk of the day, not functioning very well, not being able to shower, not being able to attend to grooming and hygiene,” according to Marianne Huff, president and CEO of the Mental Health Association in Michigan. 

Data revealing an increase in medications to treat depression in youth doesn’t surprise Darby Hoppenstedt, director of community partnerships at Northville Public Schools.  

“That trend was occurring prior to the pandemic,” Hoppenstedt said. “It's only continued to increase post-pandemic and for us, the support that we provide really must be accessible, inclusive and tailored to the needs of the school population.”

Numerous studies have found worsened anxiety and depression among adolescents since the pandemic. One study found that between 2011 and 2021, the rate of high school students who reported persistent sadness or hopelessness increased from 21% to 29% in males, and 36% to 57% in females. 

It’s uncertain why women are more likely to be treated for depression than men. Dr. Robert Ellis, a child psychiatrist near Holland, said this difference might be attributed to how boys tend to deal with external conflict and anger while girls tend to deal with more internal conflicts. 

In the U-M study, Dr. Kao Ping-Chua speculated the increase could be a result of longer waits for psychotherapy during COVID lockdowns, or social isolation during distance learning. 

Chua cautions against attributing the spike entirely to the effects of the pandemic. 

“I think that it's hard to kind of separate the pandemic from everything else,” he said. “The pandemic increased awareness about mental health conditions.”

Compounding the problem, families sometimes couldn’t get mental health appointments during the pandemic.

“As a primary care pediatrician, (I saw that) when people came in for their physicals, and they screened positive for depression and started talking about it during the pandemic, it just became a lot harder to recommend (they) go see a therapist because it's going to take six months for them to get it,” Chua said.

Eric Hoppstock, Superintendent of Berrien Regional Education Service Agency, told Bridge Michigan that the pandemic and social isolation “opened the door for more conversations.” In more than 20 years of teaching, Hoppenstedt told Bridge that the mental health conversation is bigger now than she has ever seen. 

Hoppstock pointed to how social media use by adolescents has increased in recent years. With more time spent scrolling on Instagram feeds and staring at phone screens, the definition of human interaction for adolescents is changing. Hoppstock said social media can detach students from reality, which can contribute to rising depression and anxiety diagnoses. 

“We have a generation that interacts differently, and I think some of those ramifications are just coming to light,” he said. Because of that, “we're much more sensitive” to mental health today. 

Huffman of the state Mental Health Association said social media can contribute to mental health issues.“First of all, our culture is not very kind, and so a lot of these kids and young adults and adolescents are faced with what their lives should be like, look like, what they should look like, how they should dress, how they should do their hair,” she said. 

At Berrien RESA, many faculty take part in the TRAILS Detroit program, a project aimed to provide mental health-focused training for school staff. In the program, teachers focus on social-emotional learning to prioritize students’ mental health. One example: In one Berrien County fourth grade classroom, the teacher asks her students to rate their stress levels after a reading block and do a breathing exercise after a math lesson.. 

“We have a long way to go,” Hoppenstack said. “We're not there yet. You know the world changes around you and then you have to respond. What works, what doesn't?”

Finding treatment for teens and young adults isn’t easy. Michigan has just half the child psychiatrists it needs. In 2017, Michigan was home to 239 child psychiatrists – leaving 11 psychiatrists for every 100,000 children in the state, according to the American Academy of Child & Adolescent Psychiatry.   

Ellis, the child psychiatrist, said the shortage of mental health providers has resulted in his clinic being “pretty much at capacity all the time.”

Dr. Nidhi Atri, a child and adult psychiatrist at Corewell Helen DeVos Children’s Hospital in Grand Rapids, said there are often “wait lists (of) …people trying to get access to care.”

Atri said access to care is the key to addressing the increasing need for mental health care, whether that be through advocacy from citizens or funding physician training. How to address the increasing need for mental health care is “a million, if not billion dollar question. Access to (mental) health care is where it's at,” Atri said. 

Chua, who also works as a pediatrician, said the study “confirms what a lot of pediatricians suspected was happening, because I think a lot of us felt like we became mental health clinicians during the pandemic and really, today, that's still true, given the number of people coming in with mental hurdles.”