New Zealanders are taking medications at soaring rates. Marika Hill asks whether the nation is addicted to a quick-fix.
"I was dark, really dark. I completely lost focus on reality. I couldn't see past doom or gloom and had a very self absorbed attitude," Rebecca says.
The 29-year-old is among the increasing number of people treated for depression and anxiety.
Anti-depressants helped her climb to safer grounds, out of reach from the choking tug of depression during her teenage years and again after a break-up in her mid-20s.
But, she despairs at the ease with which little pills are now dished out.
Eight million prescriptions for pills to treat these complaints were dispensed in 2011-12, pushing the nation further into drug-induced state, according to Pharmac figures.
"The pills mask the symptoms of a deeper cause. They have their place and definitely help, but they're not fixing the cause of the problem. They helped get me to the point I could fix the problems," she says.
Anti-depressants have become the first point of call for health professionals, she says. Especially now that "depression" marks her medical file. A midwife asked her to go on anti-depressants while she was pregnant - just because she had a history, regardless of her healthy state.
The health system needs to provide greater support and therapy, she says.
Rebecca is not her real name. She hides her identity because there's still a stigma attached to mental illness, despite the huge campaigns such as Like Minds.
Prescriptions for depression, anxiety, insomnia and pain jumped by 60 per cent over the past five years.
This amounted to an extra 800,000 patients swallowing 3 million more bottles of prescription pills over the five-year period.
New Zealand is at the high end of the world spectrum of mental illness, according to one the country's leading voices on mental health.
AUT psychology professor Max Abbott said some of those prescribed anti-depressants are probably not clinically depressed. However, there is no doubt an increasing number of people are seeking treatment for mental illness.
So why is New Zealand, and so many other developed nations, seeing this trend?
"There is quite a strong relationship between the prevalence of mental disorders in a society and the degree of social inequality," he says.
As the gap between rich and poor increases, so does the rate of people needing support.
Women are twice as likely to be diagnosed with mental illness - one in five woman compared to one in 10 men.
Mental health patient advocate Sue Ricketts relies on her anti-depressant pills to live a normal life.
"For a tiny pill to keep me on a really good path, that's what I need. I'm going to actually enjoy my life and live to my potential."
Medication is not for everyone, but for some people it's a lifeline, she says.
"For many people, taking medication for anxiety or depression is like people with diabetes needing insulin. They need to be on it and they need to be on it indefinitely because of their body-makeup."
Ricketts runs Mental Health Advocacy and Peer Support in Christchurch.
The rates of mental illness for women are higher because they are more likely to discuss their feelings, she says. Doctors in the past have also been more likely to view a woman's symptoms, such as heart palpitations, as a mental health issue, while men are sent for health checks.
"There's still a huge amount of shame attached to people with high anxiety and depression, particularly with men.
"As a nation we don't want it, but let's accept the people who have got it."
The nation is not just struggling with depression and anxiety - and it's not just adults.
The Sunday Star-Times revealed last week that the number of diagnosed mental health conditions in New Zealand's children has sky-rocketed. About 25,000 children have been diagnosed with behavioural and emotional problems, with anxiety driving rising numbers.
Insomnia is also on the increase among adults. About 237,000 people were prescribed sleeping pills in 2011-12, up 77 per cent from five years ago.
The number of people prescribed painkillers leapt from 1.2 million to 1.9 million over the same period.
The sometimes dangerous love affair with painkillers and sleeping pills has been no better illustrated than in the world of celebrities.
Painkillers were implicated in the death of popstar Michael Jackson and rising actor Heath Ledger.
Sleep therapist Dr Alex Bartle says his more severe patients have been popping a pill for shut-eye for more than 30 years.
"We do see people who are pretty hooked on them and escalating dosages. It is a quick-fix."
Often the patient has become so desperate for sleep they demand sleeping tablets from their GP.
"The problem is the patient gets hooked into it and starts thinking unless they put that pill in their mouth at night they won't sleep."
However, researchers in Britain and America last month questioned how much a placebo effect came into play. The analysis of more than a dozen clinical trials of common sleeping medications found the placebo effect accounted for half of the effectiveness of the pills.
"There is a huge component of that and you see it all the time when you try and withdraw people from one zopiclone [sleeping tablet]," Bartle says.
Going from a quarter of a pill to none is very difficult because the person is no longer putting anything in their mouth.
"That's clearly a placebo effect because there is bugger-all medication in a quarter of a tablet."
Capri Hospital in Auckland also deals with prescription medication detox and mental health patients.
Psychiatrist Dr Siale Foliaki says there has been a dramatic increase in demand for services.
Modern society is provoking more anxiety in the population, he says.
"The simplest thing you can do to reduce their distress is throw a tablet at them. It's the path of least resistance and it is the reason we are seeing a dramatic rise in Pharmac figures.
"If you want to get them into good shape, throwing a tablet isn't going to do the trick."
There is no quick-fix when it comes to mental health problems, he says.
"If a GP can give you some Prozac in a 15-minute consultation . . . it's a really cheap option. It's much cheaper than sorting out someone's marriage. Let's be honest. Mental health treatment is time consuming and time is money."
Judi Clements from the Mental Health Foundation said some doctors are beginning to offer counselling, but it's by no means universal.
"Prescribing may be the option and for some people it may be effective, but it shouldn't be the only option."
This was the case for Essential Mums blogger Jane Yee.
She fronted up on a mental health awareness campaign after suffering depression in 2005 and 2007.
At her lowest point she was sleeping on her parents' couch with her mother force-feeding her yoghurt and bananas.
"There was nothing to look forward to in my life and no joy and would go to bed hoping I wouldn't wake up in the morning.
"I basically wasn't a functioning member of society."
She tried anti-depressants, but found she could get through with just the support of family and counselling.
"That's what worked for me, but I know a lot of other people had huge success from medication so I'm certainly not discrediting [anti-depressants].
"I do think it's a combination. Medication alone is not the answer."
- © Fairfax NZ News
Pals and playmates (pictures)
Reacting to a sudden cancellation
New Zealand's best deck built yesterday
Appreciating Tony Allen
The meaning of blogging