Your Toxic Workplace May Render Your Antidepressant Useless

The United States leads the world in antidepressant prescriptions, with eleven percent of the population being on some type of antidepressant. That statistic makes antidepressants one of the most commonly prescribed medications in the United States. While that may seem like an unbelievably high number, even more disturbing is the fact that approximately two-thirds of severely depressed people are not on antidepressant medication for myriad reasons — social stigma, lack of insurance, inability to tolerate side effects, or lack of efficacy of the medication — meaning the medication simply does not work for them.

Antidepressants are meant to work by increasing the amount of the neurotransmitters serotonin, dopamine, and norepinephrine in particular areas of the brain, namely the limbic system, which is responsible for mood and emotions. It’s a $50 billion-a-year industry, and one that is directly marketed to our society through television and other media. In fact, twenty percent of women have been prescribed an antidepressant at some point in their lives, usually between the ages of 25 and 44. While antidepressant usage is extremely helpful and has decreased suicidal ideation in many people with true brain chemical imbalances, it’s estimated that a staggering 75 percent of people on antidepressants don’t experience true relief from major depressive disorders while taking them. Some of that may be because of genetic makeup or inconsistent usage, but researchers have found something even more sobering: people who live or work in toxic environments do not experience relief from antidepressants. Put simply, the people who need the most relief from depression are most likely the ones that will not experience it.

Why does a stressful environment counteract the effects of antidepressants? Researchers aren’t certain, but in a study on mice conducted by researchers at the Istituto Superiore di Sanità in Rome, Italy, the result supports previous research in humans that demonstrated that depressed individuals with a high-status occupation are less likely to respond to antidepressant medication than those who do not have high-stress occupations. Many people may consider only high-profile occupations to be stressful, such as law or medicine, but the research is dependent upon the environment of workers — the demands placed upon them, the presence of threat, discrimination in the workplace, and unclear expectations in the workplace, as well as high expectations placed on the employees.

Silvia Poggini, a Ph.D. student, explained that in the study of mice that the effects of fluoxetine, commonly known as Prozac, on inflammatory markers in the hippocampus part of the brain were completely reversed in mice that were placed in a stressful environment, according to Medscape. This was not true of the mice that were not subjected to stress. She made an analogy to a ship at sea.

“Research indicates that simply taking an SSRI [selective serotonin reuptake inhibitor] is probably not enough. To use an analogy, the SSRIs put you in the boat, but a rough sea can determine whether you will enjoy the trip. For an SSRI to work well, you may need to be in a favorable environment.”

This study may lead to further query because this new data may not line up with how scientists originally believed that SSRIs work, although scientists have long stated that they aren’t exactly certain how SSRIs work, only that they do. This study may mean that not only do depressed individuals need medication to get better, they may also need to leave their stressful job behind — something that is seemingly impossible for many people to do in this uncertain economy.

It’s true that your gossipy coworkers, discriminatory supervisor, and unreasonable deadlines may have contributed to your major depressive disorder. It’s also just as likely that they are keeping your antidepressants from working. For a large part of the workforce, this research data is a game changer.

[Photo by Spencer Platt/Getty Images]