A Great Depression Goes Off Its Meds

As the economic downturn worsens, America faces a new and more immediate crisis: Crazy people are going off their meds. Whether they were being treated for psychosis, paranoia, or believing their dog is the re-incarnation of Genghis Khan, millions of patients are no longer able to afford the drugs that help alleviate their symptoms. Dispensed prescriptions for antidepressants have recently dropped by 29 percent. Depressed people aren't the only ones being made crazier by the new depression. Speaking at an investor conference recently, Walgreens CEO Jeffrey Rein said that the U.S. is experiencing the "tightest prescription market" in his 27-year career, as more cash-strapped patients skip their pills. His company has gotten so desperate for business that they're calling customers, who have neglected to fill prescriptions for everything from Amoxicillin to Zoloft, to ask, "Do you want to be around long enough to watch your kids grow up? And also, if you wind up dying, who are we going to sell all these drugs to?" You know times are hard when your drug dealer starts calling to threaten you with death. But apparently they're not the only ones hassling depressed consumers. A recent NPR poll found that one in four people in Ohio say they have collection agencies chasing them. The most common reason given for this was unpaid health bills. As millions more are added to the rolls of the unemployed and uninsured, these problems are likely to get much screwier, with increasing numbers of people preferring to buy food and be depressed, rather than to buy their happy pills and starve. During the Internet bubble of the 90s and the housing bubble of recent years, there has also been what may turn out to be a huge bubble in the use of drugs to treat depression. In 1993, U.S. sales of antidepressants were about $2 billion. By 2007, sales had increased to almost $12 billion. 237 million prescriptions for antidepressants were dispensed last year alone -- more than for drugs of any other type. The huge increase in the use of antidepressants may have helped cause the financial bubbles. Many "irrationally exuberant" stockbrokers, bankers, and Ponzi-fund investors may have just been high on (legally prescribed) drugs. The natural market balance between greed and fear may have been knocked out of whack when stressed out Wall Street traders began popping Prozac and other popular psych meds and suddenly became fearless financial Supermen. Faster than a speeding derivative. More powerful than a credit-default swap. Able to drink tall double-caf espressos in a single gulp! There are a number of evolutionary theories about depression that help explain why it is so prevalent across all age groups. Evolutionary psychologists believe that depression is an adaptation that helps us in many ways. For example, it may be a good thing that you get depressed after getting your ass kicked by the bigger, stronger leader of your tribe. While you're depressed, you're unlikely to want to go and challenge him again, which keeps you from repeated ass-kickings. Depression may also be a useful social adaptation that enables your friends and loved ones to recognize when you really need help. Some people always act needy, and you learn to ignore them. "If I helped my annoying brother fix his crappy car every time he asked me to, I might as well never take off my grease monkey suit." But evidence of depression can change your attitude. "Something must really be wrong with my brother. He doesn't want to go anywhere, anymore. He hasn't even asked me to help him fix his crappy car in a month." As millions of Americans go off their meds, there's no telling what might happen. Will there be a rash of suicides, or just a bunch of people wandering the streets, talking into cell phones that have been disconnected from the network due to lack of payment? Will crazy Uncle Willy come to live in your attic or will he take his sleeping bag down to Public Square and begin preaching to passersby about the Alien Invasion of 2012? It's bad enough that you're stressed out because you lost half your retirement fund, and the boss keeps commenting on your meager outbox every time he walks by. But what happens when previously well-medicated relatives suddenly show up at the door after midnight complaining that you're broadcasting secrets about them on the TV? Hopefully this will all be useful to our psychological evolution because we have the makings of a Really Great Depression.