Today young people feel worse psychically and take more medication for every passing year, according to the National Board of Health and Welfare (Socialstyrelsen). Ambitions are set too high and unrealistic expectations on life can partly explain the increase, Ingrid Thernfrid thinks, Chief Medical Officer at the Adult Psychiatry in Lund.
About a year ago Simon* got his first state of panic anxiety attack. He was about 25 years old and at the end of his education. Stress consumed his studies, and the uncertainty about the future made him ill. “There was a time when I couldn’t sleep, and one night I thought that my heart was stopping. So I went to the hospital and had an ECG and some blood tests”, he says.
But there was nothing wrong with his heart. The doctors suspected the problem was psychologically rather than anything else and directed him to the Health Care Centre. There he was offered an anti-depressant medication and therapy. Simon was at the beginning very sceptical to medication, but started going to a psychiatrist regularly.
A distinct increase
Like Simon, many young people are psychically ill, and it seems to increase every year. The increase is related mainly to easier psychical problems, such as stress, anxiety and sleeping problems. According to a rapport from the National Board of Health and Welfare in 2013, 10% of the women in Sweden aged 18-24 years-of-age felt so bad they had to use psycho-pharmacologic drugs and looked for psychiatric help. The corresponding numbers for young men were seven percent. This is a distinct increase compared to previous years. Ingrid Thernfrid, thinks the statistics could partially be explained by how people are raised today.
“We have a society where we tell the children very early that they can be whatever they want to be. Everyone wants to emasculate themselves, become successful and happy. Many times those expectations do not match how life actually turns out”, she says.
She thinks earlier generations were, in a bigger perspective, more realistic in their expectations of life. Today young people are raised with the belief that they are the architects of their own fortune – a failure cannot be blamed on society in the same way as before. Many have ambitions that are sky-high and they are never satisfied.
“We ought to have a diagnosis called ‘good girl’, even if it is not just girls. This is about people who are overachievers with unreasonable demands on themselves, and they are often social and ambitious. Superficially they have everything but their goals are so high and they feel bad when they don’t achieve them, instead of being happy with what they’ve got”, she says.
Maria Bohlin, psychiatrist at the Student Health Centre (Studenthälsan) in Lund, also believes that the development of society plays a role in the increase of mental illnesses in young people.
“For a long time the following generations have received more financial safety than ever. Many reasons have created the situation which is different from the present generation. The standard of living is at a risk of worsen for many and that in turn creates a worry”, she says.
More takes medication
The reasons for Simon’s anxiety are hard to pinpoint. During some period of time he felt better, but this spring he had several panic attacks in short periods of time and his psychiatrist suggested, in addition to the therapy, medication with anti-depressants and sedatives. “The sedative medication makes me drowsy. After I have taken the medication it takes about a day before I feel recovered. I did not like the anti-depressants at all, I did not want to take them from the beginning and stopped quickly”, says Simon.
According to the National Board of Health and Welfare’s statistics, the prescription of anti-depressive agents to young people in Skåne has increased with 59% the last eight years. Corresponding numbers for sedative medications (including sleeping drugs) is 65%.
“Instead I wish that more people had the opportunity to talk to someone about their problems. Some may still need the medication, but not everyone”, says Ingrid Thernfrid.
According to her there is a problem within the psychiatry that many doctors prescribe medication until further notice, without any planned end date. This concerns both anti-depressants and sedative medicines, even if anti-depressants does not have the same negative side-effects as certain sedatives have.
“The treatment for a depression is 3-6 months. It is an illness with a so called natural course of events, which means that if you don’t do anything then it will end by itself”, she says and continues:
“Both anti-depressants and sedative medications can absolutely help a patient during the duration of the disease, but if a doctor prescribes a medication then he or she must take the responsibility to finish the prescription when the patient feels better. I wish that we were better at this within the psychiatry.
Misleading statistics
In the past there were few people who were willing to talk about their psychological problems, which means the statistical increase does not necessarily reflect reality. This leads to that the statistics could be misleading.
“Especially boys are more open with their problems today. In the past it was a taboo to talk about mental illnesses, but that is something that disappears more and more”, says Maria Bohlin.
Ingrid Thernfrid agrees with Maria Bohlin about that the attitude of society is changing in regard to mental illness, but sees at the same time the problems with the development. She believes young people are sometimes diagnosed unnecessarily and prescribed medications, when it might be ruminations everyone goes through.
“It is tough to be young, something I believe always has been the case. Many existential questions rise at that age, which causes some to feel bad. Sometimes this is diagnosed as a depression, but perhaps we treat a certain condition as a sickness when it is not. I think it would be better to create a contact to talk to rather than to prescribe psycho-pharmacologic drugs as it is done now”, says Ingrid Thernfrid and continues:
“At the same time you must not forget that there are young people who really feel bad and absolutely are in need of psycho-pharmacologic drugs.
For Simon it was the talks that helped him the most. Sometimes he takes sedatives if he has an anxiety attack. But they have become more rare and recently he has stopped going to therapy because he feels much better.
*) Simon is not his real name.
Article: Eskil Blohme
Translation: Viktor Jönsson
