The Age of Distracti-pression – The New York Times

If you’re wondering which pills and how many of them Americans have relied upon to make ourselves feel better since Covid-19 arrived, the answer, in short, is yes.

“I should have gone back on medication sooner in the pandemic than I did,” said Leah Bellow-Handelman, 36, matter-of-factly. Ms. Bellow-Handelman, a nurse who lives in Brooklyn with two small children, has been on and off Prozac for anxiety since her 20s. Shortly before the pandemic, she had weaned herself off in time for her first pregnancy.

So, she wasn’t taking anything when the pandemic struck, even though her life was operating in full crisis mode: She worked at the urgent care center at Memorial Sloan Kettering in Manhattan, a cancer hospital. The emergency room is dedicated to current and former cancer patients, and many of the patients admitted to the urgent care had especially severe cases of Covid and needed oxygen or intubation right away.

“We just put our heads down and did what we had to do,” she said. “We were in such autopilot disaster mode in the spring, that by the summer, that was when we really realized how intense that spring really had been.” Ms. Bellow-Handelman also felt isolated; many friends had left the city, and of those who remained some were hesitant to see her because she worked in health care.

By August 2020, her husband encouraged her to go back into therapy.

After a complicated second birth, she decided she needed more than just talk. Her therapist, she said, “was never opposed to me going back on medication, but she was trying to get me to do mindfulness and meditation — stuff that I just don’t do.”

She turned to Prozac again. Now, she said, “I’m a different person.”

The reasons behind the decision to start or restart psychiatric medication are often not reducible to simple cause and effect.

“I’m definitely medicated because of Covid, but I’m also medicated because I’m a woman who was a nurse who had babies in the middle of Covid, and a traumatic birth,” Ms. Bellow-Handelman said.

She is one of millions of Americans who started or restarted psychiatric medication during Covid’s long and dreary run. Tracking exactly which pills Americans are swallowing these days is difficult because much of this information is privately held.

But, from companies that provided data to The New York Times and from other existing research, it is possible to begin to assemble a picture of our medicine cabinets and, by extension, our mental health.

First, the broad strokes: In 2019, the Centers for Disease Control and Prevention estimated that 15.8 percent of American adults took prescription pills for mental health. During the pandemic, the National Center for Health Statistics teamed up with the Census Bureau to carry out quick online “pulse” surveys and tracked mental health prescription pill use.

The numbers they turned up echo what we already sense: We are depressed, anxious, tired and distracted. What’s new is this: Almost a quarter of Americans over the age of 18 are now medicated for one or more of these conditions.

More specifically, according to data provided to The Times by Express Scripts, a pharmacy benefits manager, prescriptions across three categories of mental health medications — depression, anxiety and A.D.H.D. — have all risen since the pandemic began. But they have done so unevenly, telling a different story for each age group and each class of medication.

Antidepressants continue to be the most commonly prescribed of these medications in the United States, and their use has become only more widespread since the pandemic began, with an 8.7 percent rate of increase from 2019 to 2021, compared with 7.9 percent from 2017 to 2019, according to Express Scripts.

IQVIA, a global health technology and clinical research firm, found that in 2021, a total of 337,054,544 prescriptions were written for antidepressants in the United States through the course of the year, representing a steady annual increase since 2017, when that number had been 313,665,918.

But for some age groups, that change has been more pronounced. Since 2017, there has been a 41 percent increase in antidepressant use for the teenagers included in the Express Scripts data (which consists of roughly 19 million people.) For this same 13- to 19-year-old bracket, in the first two years of the pandemic, there was a 17.3 percent change in anxiety medications. It had been a 9.3 percent rate of change between 2017 and 2019.

One 13-year-old rising eighth grader in Colorado currently takes the antidepressant Paxil and the stimulant Adderall. (She also takes melatonin, a nonprescription supplement, to help her sleep.)

Before the pandemic, she had started taking Adderall to help her with her A.D.H.D., but when her school switched to remote learning, she struggled. “It just felt like one of those days where you sit at home and you don’t do anything. It felt like that was every day, like I was stuck in some endless cycle…