Sandra had been to a psychologist for almost two years and was in an extra difficult period of her life. – The psychologist thought that the conversations did not work well enough, and that we did not get anywhere from where we stood. The 20-year-old was therefore prescribed antidepressants. Calculations made by NRK based on figures from the Prescription Register show that the increase from 2012 to 2020 for the age group 15–39 years has been approximately 17 per cent. A larger part of this increase occurred between 2018 and 2020 (approximately 9.7 percentage points). Figures from Farmalogg’s drug statistics, which the Pharmacy Association has obtained for NRK, show that this development also continued in 2021. Sandra thinks there should have been more alternatives. – I wish it was a better offer for talk therapy and that kind of thing instead. They are very good at coming up with alternatives, but there is often a low threshold. I have other friends who struggle with depression that just get rejected after rejection, and that’s stupid. In Norway, the use of antidepressants is most common among those over 40 years of age. Since 2019, use in this age group has only increased by a few percent, while the increase among those under 40 has been more than 10 percent in the last couple of years alone. The largest increase has been in the age group 15–19 years. It is 30 percent. More people need help Trond Velken is chief physician and specialist in child psychiatry at Vestfold Hospital. He believes it is important to look at why there has been an increase on a national basis. – When more people ask for help, one would have to expect that more people also start treatment. Only a small proportion receive medication, but when the total number of patients has become so large, the number who use medication will also increase. Trond Velken, chief physician and specialist in child psychiatry at Vestfold Hospital, emphasizes that this has been a challenge for a long time and that it is important to look at why the problem is increasing. Photo: Privat Velken emphasizes that, as a general rule, one will resort to other treatment methods first. – When it comes to young people, I would argue that there will usually be other forms of treatment than medicine and that are best. Then there may be exceptions, but the main rule is that other treatments will be more effective, and may give the best result in the long run. Velken says that they have noticed the increase in mental health problems in recent years. He mentions pandemic, digital addiction, social media, performance pursuits and sleep deprivation as possible contributors, but says that it can be difficult to find one cause because there are several factors that come into play. – I think, no matter what the reason, that we must deal with the fact that more people need help now. Notices an increase in heavier topics Communication Manager in Mental Health Youth, Line Toft, says that they are concerned that medicines are prescribed where other treatment could have been effective. – We are a little worried that medicines will be prescribed before thorough enough assessments have been made. We assume that the numbers are so high because there has been a lack of other offers, and then medication can be a bit of a quick fix. Line Toft, Head of Communications at Mental Health Youth, says that Mental Health Youth has noticed an increase in heavier topics. Photo: David Gustavsen Toft says that they notice an increase in heavier topics. Many people struggle with anxiety, depression, suicidal thoughts, loneliness and a lot of unrest related to pandemics, war and climate. The organization believes the help should be more accessible. – When you first ask for help, you have probably gone with those thoughts alone for quite some time, so then it is urgent. The waiting times must be reduced, so you get faster help and calls. Did not feel involved Sandra herself thought that talk therapy worked well. She did not feel involved enough in the decision to start taking antidepressants. – I was only told that the psychologist had thought it was a good thing for me to start. Then I had a conversation with a doctor who asked what I was struggling with, and then it was written out then. – High threshold Marte Kvittum Tangen is the leader of the Norwegian Association for General Practice. She can tell that they have noticed the increase on a national basis. The leader of the Norwegian Medical Association, Marte Kvittum Tangen, says that there is a clearly increased incidence of mental disorders in young people compared to before. Photo: Thomas B. Eckhoff / The Norwegian Medical Association Tangen says that the threshold for prescribing antidepressants to children and young people is still high. – We have clear and unambiguous professional recommendations to avoid the use of drugs if other treatment can have just as good an effect. Tangen says that it is not an easy problem to solve. – There is no simple answer to the solution, but we must have increased awareness that we lack capacity. We need more child and adolescent psychiatrists, stabilize the GP scheme we have and think about causes and preventive measures in the future. Working with clearer guidelines In 2017, the Norwegian Directorate of Health was commissioned by the Ministry of Health and Care Services to evaluate measures for more correct use of psychotropic drugs for children and young people. Johan Torgersen is Division Director for Quality and Process in the Norwegian Directorate of Health. He says that a national competence network has been established for psychotropic drugs for children and young people, and that the Norwegian Directorate of Health is working to publish professional advice. Photo: Finn Oluf Nyquist / The Norwegian Directorate of Health Division Director for Quality and Process in the Norwegian Directorate of Health, Johan Torgersen, says that they have acknowledged the situation and are actively working on it. He says that they work with professional advice that will be published during the year. These should clarify the principles of treatment with psychotropic drugs. – We must also acknowledge that there are some who need these drugs, and the important thing now is that you give this to those who actually need it, and not anyone else. Torgersen emphasizes that it is important to focus on the reasons why drug use is increasing in this group. The Norwegian Directorate of Health has commissioned FHI to connect, analyze and interpret data from several sources in order to understand the development features that the Prescription Register shows. Going forward, he believes it will be a lot about capacity both at GPs and in the specialist health service. – When it comes to GPs, it is the municipalities that have the primary responsibility. What we can do is point out the challenges and say something about what the municipalities must prepare for, so that they can plan and scale the offer in line with it. – What could be the consequence for all the young people who are struggling, while we wait for more knowledge and find the reasons why drug use is increasing? – We believe that young people who are diagnosed with depression receive proper treatment and follow-up today. Studies show that almost everyone who was diagnosed with depression by a GP is referred to a specialist. A quarter of those who are diagnosed with depression for the first time are treated with antidepressants, while three quarters receive other treatment, such as cognitive therapy, Torgersen continues. I think it can help to think new In the future, Sandra thinks it is extra important to listen to young people who are having a hard time. – One should perhaps listen a little more to us who actually struggle with it, try to have a type of cooperation so we do not just feel we are rejected. It is often not the struggling people who come forward and tell about it, it is often psychologists and doctors who say what is right in the book. The 20-year-old thinks it can help to think new. – All people are different, no one is the same, so you have to somehow go a little out of that book and try to find some alternatives for those who do not fit into exactly what is written.
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– Wish it was a better offer – NRK Vestfold and Telemark – Local news, TV and radio
