The Crisis of our Generation

Remember many years ago noticing that an inordinate number of women coming to me for cosmetic or reconstructive surgery were on some medication for anxiety, depression or both. Valium, Xanax, Paxil, Zoloft, Effexor, Lexapro, Celexa and other drugs are now routine among medications my patients list on their health history forms. 

As a practical issue, patients who take these drugs respond differently to the anesthetics and sedatives we use for surgery. They are acclimated to metabolizing their medications and, as a result, require sometimes astonishing levels of sedatives and anesthetics to be properly anesthetized. This can pose a real challenge in surgery. 

But my real concern is why are so many women (most of my patients are women) on medications for depression and anxiety? The numbers are alarming. In 2019 — before the coronavirus pandemic — somewhere around one in 10 people in the U.S. were taking at least one antidepressant or anti-anxiety medication. Two-thirds were women. Twenty-five percent of women over 60 take these. The pandemic just added fuel to this fire due to the social disruption, isolation, masking, school and business closures and general fear-mongering. 

Depression is epidemic among our youth. Suicide is now the second most common cause of death in teens and adolescents, behind injuries. During the pandemic, as many as 25-30 percent of children and adolescents admitted to having suicidal thoughts. In the 2022-’23 school year, nearly one third of college students took mood-altering meds regularly. That is nuts. 

Why are so many people anxious and depressed? There is no simple answer, but it does not take much looking around to see that the world is a mess and the world as we knew it pre-pandemic, pre-internet, and pre-social media is gone, probably forever. 

We live in a time of toxic, hyper-partisan politics, crises like climate change, moral relativism and challenges to our country at every turn. Throw in the threat from China, a nuclear Iran, North Korea, the Russo-Ukraine war, and perhaps the hottest flare-up of the Arab-Israeli conflict in a generation, and you have a toxic brew that would depress even the most optimistic person and raise anxiety to stratospheric levels.

What are we to do? As a physician, of course I think of what medicine might offer. We have a wide variety of drugs to combat depression and anxiety. When properly prescribed and taken, they can be life-saving, but we are in danger of becoming too dependent on pharmaceuticals and this comes with a cost. The cost could be in dollars spent — roughly $13.5 billion on mood-altering meds in 2020. It could be side effects that might threaten not just the patient, but those around them. Although given to prevent suicide, one side effect of these drugs is suicidal ideation. Another is aggressive behavior. 

One of the most popular classes of medications used to treat depression and anxiety are SSRIs, selective serotonin reuptake inhibitors. This group includes many of the most commonly prescribed drugs like Zoloft, Lexapro, Paxil and Prozac. These have been linked to aggressive and violent behavior, especially in young patients. Studies of mass shootings have shown that a significant number of perpetrators, perhaps as high as one-third were, or had been, on SSRIs. Studies examining a connection have yielded concerning but inconclusive results, and have recommended caution in prescribing these meds to young adults. Medications are a double-edged sword — great for some and not so great for others. 

Meanwhile, moral relativism and nihilism have led to a whole generation that so fears the present and future that they live life largely on a screen, interacting primarily in an electronic echo chamber. There is little argument that social media has been largely detrimental to youth and young adults, and especially toxic to girls. The algorithm for TikTok causes the same changes in the brain as seen with cocaine use.  

The answer to depression and anxiety will not be found in a pill bottle, psychiatrist’s couch or online. It just might be found in the natural, as opposed to virtual, world. It may be found in seeking a purposeful life of service to others. It may be found in prayer and meditation. It may be found in a healthy lifestyle. 

The author’s opinions within the content are their own and do not reflect the opinions of the Healthy Living magazine’s staff or advertisers.