Study finds Utah leads nation in antidepressant use; role of women cited

SALT LAKE CITY -- Doctors here have for years talked about the widespread use of antidepressants in the state. But there was no hard evidence until a national study that tracked drug prescriptions came to an unexpected conclusion:

Antidepressant drugs are prescribed in Utah more often than in any other state, at a rate nearly twice the national average.

Utah's high usage was cited by one of the study's authors as the most surprising finding to emerge from the data.

Few here question the veracity of the study -- which was a tabulation of prescription orders, said Dr. Curtis Canning, president of the Utah Psychiatric Association. But trying to understand the "why" has puzzled many, he said.

"The one true answer is we don't know," said Canning, who has a private practice in Logan. "I have some hunches.

"In Mormondom, there is a social expectation -- particularly among the females -- to put on a mask, say 'Yes' to everything that comes at her and hide the misery and pain. I call it the 'Mother of Zion' syndrome. You are supposed to be perfect because Mrs. Smith across the street can do it and she has three more kids than you and her hair is always in place. I think the cultural issue is very real. There is the expectation that you should be happy, and if you're not happy you're failing."

The study did not break down drug use by sex. But according to statistics from the National Institute of Mental Health, about twice as many women as men suffer from depressive disorders. Discussion of the issue inevitably falls along Utah's traditional fault lines. Some suggest that Utah's unique Mormon culture -- 70 percent of the state's population belongs to the church -- requires perfection and the public presentation of a happy face, whatever may be happening privately.

Helen Wright, 71, of Taylorsville, has been using various antidepressant drugs for 20 years and says she's never had problems obtaining prescriptions.

"Look around, you can easily find people who take them. I think it's the cultural environment," said Wright, whose three grown children also take antidepressants. "Most men here would just as soon their wives take pills than bother to delve into the problems, and maybe find out they might have something to do with the problems."

Not so, says Fred M. Riley, commissioner of LDS Family Services. The church maintains 10 offices in Utah staffed with licensed counselors. Riley said he has heard the various explanations of the study but he dismisses suggestions that the Mormon religion imposes any expectation of perfection.

"The fact that the church has established family services shows they care about the emotional side of members," Riley said.

Utah's large families -- the biggest in the nation according to the 2000 Census -- are often cited as a contributing factor to depression, again, largely among women. Others call the "harried housewife" explanation the stuff of urban legend.