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Kylie Thomason

Professor Adrienne Cassel

ENG 1201-B51

26 April 2020

Antipsychotics: Do They Help or Hurt?

Mental health is finally getting the attention it deserves. Stigma has surrounded the

mental health topic and has degraded those who suffer from these illnesses. It’s shocking

how some people are actually scared of others and judge them just because they have a

diagnosis of depression or schizophrenia. People need to become more educated about

mental health and learn about not just the emotional state but the physiological effects mental

illness can have on someone’s body. For a long time, people who had mental health

symptoms were treated poorly and often called degrading names. There wasn’t further

research to understand why those with mental illness may behave in a different way than

others. People were not interested in having the knowledge about certain mental health

disorders; such as depression, anxiety, and personality disorders. There wasn’t proper

research to determine if certain disorders lead to actual medical risks and diseases. Finally,

some medication was available but they had adverse effects that were very extreme and led

people to avoid taking them. Today, there are hundreds of studies to understand the depth of

mental illness. These studies elaborate the effects mental health has on someone’s mind,

body, and overall well being. After further research I have found that having a history of
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depression can lead to heart disease and a lower life expectancy due to physiological effects

and long use of antipsychotic drugs.

Mental health has a long and tragic history. The treatment varied from patient to

patient in asylums based on if they were wealthy or poor. Dr. Ellen Hotlzman elaborates that

if someone was poor they were sent to public hospitals which, “...were overcrowded and

dirty, with bars on the windows.” She also explains how the nurses were very underpaid so

they would take their anger out on the patients and treat them harshly. Dr. Holtzman

reiterates back then it was very important to make sure the patients were catered to and

pampered because it helped them get cured from the mental illness. This was only necessary

if they were wealthy. It was said that if the patient was pampered and properly taken care of,

the mental illness would go away and their mental state would improve. Those who suffered

from these disorders were neglected and treated very poorly by the rest of the population. It

was noted that mental illness was kept as a secret if you were wealthy. If someone was poor

and could not get the proper treatment they were called “crazy” and a “maniac.” These words

are still used today due to the stigma that is surrounded by mental illness.

Communities started to change a little bit in the 1970s and 1980s. Mental health still

didn’t have set regulations and conditions worsened. According to David Mechanic,

“Massive deinstitutionalization in the 1970s and 1980s, well before communities had

organized reasonable community services, contributed to neglect of people with mental

illnesses and homelessness.” Deinstitutionalization found many people disregarding their

medication and consumed their time with street drugs and alcohol. Mechanic explains how
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there were antipsychotic medications but, “they had many serious side effects, patients

found them aversive, and nonadherence to medication was rampant.” Lastly, since people

weren’t taking their medication and starting using drugs or alcohol, there was a heavy

increase in addiction disorders. Mechanic elaborates by stating there was a “substantial

increase in psychiatric and substance abuse comorbidities.” Mechanic explains how those

with comorbidities needed serious treatment and were constantly getting arrested, which led

them to be put in jail and not getting the proper treatment. Their illnesses were not being

managed correctly while they were locked up in jail. In this case, taking the antipsychotic

drugs helped and hurt the mental health population. Those who were not taking their

medications were developing comorbidities and those who were taking their medication had

harsh side effects. It was like a lose, lose situation for those who were suffering before new

medications developed.

Cardiac disease has been linked to a history of depression by multiple research

studies. One research study conducted by Michael Blumenfield asked a group of respondents

if they were aware of this known link. Blumenfield found that, “Respondents’ awareness of

the three links between depression and cardiac disease presented in this survey ranged from

29.8% to 31.6%” The 29.8% had some awareness of the link between depression and heart

disease. The 31.6% had awareness that depression has been seen to be linked to causing

someone to possibly have another heart attack if they have already had a heart attack in the

past. This study suggests that a very low percent of the indicated sample were aware of the

links between depression and heart disease. When patients come in to get depression
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screenings, they should also be informed of the possible health risks it can have on the body

if left unmanaged.

Depression can be hand in hand with another mental illness. Some illnesses that have

been linked with depression are bipolar disorder, anxiety, and schizophrenia. The drugs used

to treat these illnesses are called antipsychotics. What exactly are Antipsychotic drugs?

Smitha Bhandari defines antipsychotic drugs as, “Antipsychotic medications are used as

short or long-term treatments… such as hallucinated, delusions, or mania symptoms.” These

symptoms are shown in those who have bipolar disorder and various different types of

schizophrenia. There are first and second generation antipsychotics that are used to treat a

variety of mental health disorders. First generation​ manages psychosis but causes undesirable

side effects. Second generation treats psychosis and withdrawal.​ Smitha also explains that the

side effects of these drugs tardive dyskinesia, muscle spasms, drowsiness, and tremors.

Smitha also mentions a side effect of a certain medication is a fatal skin reaction but does not

indicate the name of the skin reaction that is caused. Clozaril is also stated in the article and

explained that it needs blood testing every two weeks to make sure the levels are not fatal in

the blood system. These medications have helped the mental illness population in so many

ways but there are always consequences to them and some consequences may even be fatal.

Antipsychotic medications have also been noted to lead to heart disease and heart

attacks. The CDC states, “The use of some antipsychotic medications has been associated

with obesity, insulin resistance, diabetes, heart attacks, atrial fibrillation, stroke, and death.”

Atrial fibrillation is also known as afib and is an irregular heartbeat that can lead to stroke if
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not treated. Heart attacks and strokes can also lead to death at a young age. This relates to

Fadi Khasawneh when she explains that “Antipsychotic medications can cause various types

of cardiovascular complications.” These cardiovascular complications may include

conditions such as arrhythmias, hypertension, myocarditis, and orthostatic hypotension. All

of these associations stated by the CDC and Khasawneh are a hazard to the body and can

lead to death at a younger age. Khasawneh concludes that pharmacists and doctors need to be

more aware when prescribing antipsychotic drugs due to the hazardness side effects they

could have if someone has an underlying condition. If someone has an underlying condition,

the medication can cause an exacerbation of the underlying illness and make the symptoms

or condition worse. Moreover, if the patient has a heart condition and the doctor knows the

antipsychotic drugs also lead to certain heart conditions, the patient could potentially have a

lower life expectancy from the double risk factors involving heart conditions.

Depression involves so much more physiological factors that people do not think

about. When someone mentions depression, people often just think that person is very, very

sad. What others do not realize is depression can increase cardiac activity. Someone who is

depressed may experience anxiety as a symptom. During an anxiety attack, it is common that

their heart rate will speed up and their blood pressure will increase. Having anxiety is

traumatizing in itself. Someone’s heart rate increases, then they start to sweat, next comes the

increased breathing all while the thought of dying overpowers every other thought they might

have. When I have an anxiety attack, both of my arms lock up and they start to tingle and my

hands feel like they are paralyzed, while they are stuck clenched together. Feeling like I’m
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never going to be able to move my hands because they are paralyzed is causes even more

anxiety. The day after an anxiety attack, my heart literally feels sore. It feels like my heart is

swollen and it’s almost like it’s so swollen I can feel it in my back. These are only personal

physiological factors that I experience and there are so many more that others don’t talk

about.

These physiological factors have been brought up in many research studies and by

national associations. According to the Centers for Disease Control and Prevention (CDC)

and Haomiao Jia, PTSD, depression, and anxiety all can lead to heart disease and a lower life

expectancy. The CDC emphasizes, “People experiencing depression, anxiety, stress, and

even PTSD over a long period of time may experience certain physiologic effects on the

body, such as increased cardiac reactivity, reduced blood flow to the heart, and heightened

levels of cortisol.” Cardiac reactivity involves high blood pressure and an increased heart

rate. The high blood pressure can lead to the reduced blood flow to the heart. The reduced

blood flow to the heart can lead to the heightened levels of cortisol in the blood. Meanwhile

these physiological effects can be detrimental on the body. The CDC elaborates that all of

this can lead to increased levels of calcium in the blood vessels and this leads to metabolic

and heart disease. All of these physiological factors can lead to a lower life expectancy if not

treated correctly. Jia emphasizes, “...previous studies have shown a dramatic decrease in life

expectancy for those with serious mental illnesses.” He finishes his research study by

explaining how much of an effect serious mental illnesses have on the heart. These high heart

rates and high blood pressures can lead to a lower life expectancy if left untreated.
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Someone might argue and say the reason depression leads to a lower life expectancy

is due to personal choices. A person may be so depressed, they may choose to end their life.

Kirsten Weir explains the depression rates in the United States as a sharp increase since the

beginning of the year of 2006. In her words, “Suicide ranks as the fourth leading cause of

death for people ages 35 to 54, and the second for 10 to 34 year olds. It remains the 10th

leading cause of death overall.” One would argue the heart disease and effects of

antipsychotic drugs is not the reason for this lower life expectancy if they read this research

study. Especially since it notes suicide is the second leading cause of death are those who

have an age range of 10 to 34 years old. Stating that suicide is the 10th leading cause of death

overall, no matter what age or gender, in the United States is also a big deal. There are many

reasons why someone might want to commit suicide. For example, someone might be

stressed, depressed, or be in trouble with the law and doesn’t want to deal with the

consequences. Depression is not the only reason why someone might want to kill themselves.

Therefore, this would not be a relevant argument because the data does not suggest how

many people killed themselves because they were depressed.

Another aspect someone might argue from is that depression doesn’t cause heart

disease but that heart disease leads to depression. Researchers have conducted studies to

determine how many people are experiencing depression when they have heart disease. One

researcher, Torkil Berge, discovered that “A total of 57 of 232 patients reported symptoms of

depression or anxiety when screened.” This study determines that of the 232 with heart

disease, approximately 25% of patients in the hospital have depression. This could be biased
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because the screening took place in a hospital and could have been right before they were

about to be taken down for a test. The patient could also have answered yes to the depression

screening because they just got negative results from a test or is waiting for the results from a

previous test.The research study does not follow up with further questions asking why they

have depression or if they have depression because of the heart disease. Moreover, many

times people are depressed because they are admitted into the hospital in general. The

argument that depression is caused by cardiac disease is not a reliable argument based on this

research study due to the setting being at the hospital.

Another argument someone may have is that people aren’t actually depressed, it's the

stress they encounter that leads to a lower life expectancy. Mark Levin produced the

documentary, ​One Nation Under Stress​ that noted, “In the United States, suicide has gone up

30% over the last 17 years.” This whole documentary explains what stress has on the body

and the brain. Stress can be a reason someone is depressed or in a slump. Stress alone has a

great amount of physiological effects and this could be the reason why there is a lower life

expectancy in those with depression. ​One Nation Under Stress a​ lso mentions that high

amounts of stress has been linked to shrinking certain parts of the brain. Stress could be a

logical reason why someone is majorly depressed about life. Stress has various long term

effects that could cause anxiety and could lead to depression. Stress can also have long term

effects on the cardiac reactivity, just like anxiety. Although someone can argue that stress is

actually the reason someone may have a lower life expectancy, it doesn’t technically explain

how or why this is.

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Finally, the last argument someone might make is depression doesn’t lead to a lower

life expectancy, it’s the substance abuse that leads to a lower life expectancy. There is a high

correlation between depression and those who are addicted to drugs or alcohol. ​One Nation

Under Stress​ reiterates that this can lead to premature deaths and notes these deaths as

“deaths by despair.” Anne Deaton partakes in the documentary and explains “whites are

reporting more depression along with an increase in mortality from drugs and suicide.” This

states that there is a large amount of reports from the white population that mortality is

increasing due to drugs and suicide. Someone would argue that drugs are the reason why this

population has been correlated with a lower life expectancy because they might be

overdosing on the street drugs they are using. Alcohol could also be used in an argument due

to excessive alcohol use can lead to alcoholism, which has its own risk factors on someone’s

health. These days nobody knows what kind of drugs they are getting and it's getting more

and more easy to overdose, every day. Anne Deaton also expresses how many people are

using pure fentanyl and have no idea. Drugs and alcohol could be used in an argument to say

they lead to a lower life expectancy or heart disease but it doesn’t explain how depression

correlates with this lower life expectancy. This would not be a valid argument to justify that a

history of depression does not lead to a lower life expectancy or heart disease.

Although mental health conditions and regulations have improved significantly over

the years, it is still a topic that needs more recognition. People who suffer from mental illness

have so many things to be concerned about. The stigma that is surrounded by mental health is

just one of many physical issues they encounter every day. Along with on the streets calling
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someone with mental health mean names, some people with mental illness may also be trying

to sort out voices they hear in their heads. A history of depression can lead to heart disease

and a lower life expectancy due to physiological effects and long use of antipsychotic drugs.

There are many counterarguments someone could bring to the table to change the mind of

others’ away from the physiological facts and antipsychotic medications. Moreover, mental

health can be crippling to anybody and people need to educate themselves on the long term

effects depression has on one’s body, mind, and spirit.

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Work Cited

Berge, Torkil, et al. “Screening for Symptoms of Depression and Anxiety in a Cardiology

Department.” ​Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk

Medicin, Ny Raekke,​ vol. 139, no. 14, Oct. 2019. ​EBSCOhost,​

doi:10.4045/tidsskr.18.0570.

Bhandari, Smitha. “Antipsychotic Medication for Bipolar: Uses & Side Effects.” ​WebMD​,

WebMD, 14 Apr. 2020,

www.webmd.com/bipolar-disorder/guide/antipsychotic-medication.

Blumenfield, Michael, et al. “Public Awareness about the Connection between Depression

and Physical Health: Specifically Heart Disease.” ​The Psychiatric Quarterly​, vol. 83,

no. 3, Sept. 2012, pp. 259–269. ​EBSCOhost,​ doi:10.1007/s11126-011-9199-6.

“Heart Disease and Mental Health Disorders.” ​Centers for Disease Control and Prevention​,

Centers for Disease Control and Prevention, 20 Mar. 2020,

www.cdc.gov/heartdisease/mentalhealth.htm​.

Holtzman, Dr. Ellen. ​Monitor on Psychology,​ American Psychological Association, Mar.

2012, www.apa.org/monitor/2012/03/asylums.

Jia, Haomiao, et al. “Impact of Depression on Quality-Adjusted Life Expectancy (QALE)

Directly as Well as Indirectly through Suicide.” ​Social Psychiatry and Psychiatric

Epidemiology,​ vol. 50, no. 6, June 2015, pp. 939–949. ​EBSCOhost​,

doi:10.1007/s00127-015-1019-0.
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Khasawneh, Fadi. “Minimizing Cardiovascular Adverse Effects of Atypical Antipsychotic

Drugs in Patients with Schizophrenia.” ​Cardiology Research and Practice​, Hindawi,

4 Feb. 2014, www.hindawi.com/journals/crp/2014/273060/.

Mechanic, David. “Mental Health Services Then And Now.” ​Health Affairs​, 1 Nov. 2007,

www.healthaffairs.org/doi/full/10.1377/hlthaff.26.6.1548.

One Nation Under Stress. Directed by Marc Levin, performance by Sanjay Gupta. HBO 25

March 2019. ​https://www.imdb.com/title/tt10350078/

Weir, Kirsten. ​Monitor on Psychology,​ American Psychological Association, Mar. 2019,

www.apa.org/monitor/2019/03/trends-suicide.