Can antidepressant use spur financial flights of fancy?
Millions who suffer from severe depression, anxiety or bipolar disorder find relief with antidepressants. Yet while these medications can dramatically improve the way patients feel and function, they may also cause an unexpected and financially devastating reaction: irrational shopping sprees, atypical gambling jaunts and reckless investment decisions.
The Centers for Disease Control and Prevention reports that about 11% of people in the U.S. age 12 or older are currently prescribed antidepressants. If you or a loved one is among them, be alert to unusually compulsive or risky financial behavior -- and know what preventive steps to take if the urge is coming on.
Meds affect financial choices
The number of antidepressants on the market today is vast, from selective serotonin reuptake inhibitors (SSRIs) with such trade names as Lexapro, Prozac, Paxil and Zoloft, to serotonin-norepinephrine reuptake inhibitors (SNRIs) including Effexor and Cymbalta.
According to San Diego psychiatrist David Reiss, any antidepressant and stimulant can trigger hypomania, a psychological state of euphoria. And while a patient may experience positive effects such as being confident, creative and outgoing, antidepressants can also contribute to extremely poor financial judgment. Reiss sees many patients through the California Workers Compensation system who have experienced depression due to their injuries and are treated with antidepressants. Among this group, he has noticed a spike in gambling.
"I am now much more aware to listen for and more closely ask how they are spending their time," says Reiss. "Perhaps 20% of the time, people who are limited in their activity by physical impairment and finances will tell me that they go once a week or once a month to local casinos," he says. As a result, they can't meet their expenses and assume losses that their disability income cannot support.
Many are surprised by what they've done after the euphoria passes -- and are shocked and dismayed when they see their credit card bills. "This often triggers guilt and depression," says Reiss.
Grandiose self-perception is also a feature of hypomania, and it, too, can lead to daredevil actions. "They think they can walk into a casino and win a million dollars," says Soroya Bacchus, a Los Angeles psychiatrist. "When you're hypomanic, you can do a lot of things mere mortals can't. Or you think you can, anyway."
Shopping till they drop
In addition to prompting unrealistic and obsessive betting, hypomania also may result in "unrestrained buying sprees" and "foolish business investments," according to the Diagnostic and Statistical Manual of Mental Disorders.
That was true for Wendy Honeycutt of Bellevue, Texas. She had been prescribed antidepressants after a series of tragic events, including the death of her young son. While medicated, she began to spend and charge recklessly.
"My needs were being met by grabbing a credit card," says Honeycutt. "I ended up with closets full of crap. When you're on those drugs, you don't care. They cause you to be selfish. It doesn't allow you to see yourself though a proper perspective. . . . I would order stuff on eBay and Amazon, and days later it came in the mail, and I didn't remember buying it. By the time it came I didn't want it anymore."
When Honeycutt stopped taking her medication, she was nearly $25,000 in debt.
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Sterling, Va., resident Elisa-Ruth Nelson was on antidepressants for only nine months, and during that time felt compelled to acquire not only things but also credit cards, especially retail accounts. "They were pretty!" says Nelson, "I amassed so many of them. The Limited, Macy's, Bloomingdales . . . I just did what I wanted. I bought St. John suits and Louis Vuitton. Whatever was in the window, I bought it. If the salesgirl said I looked good -- I bought it."
When she went off the medications, says Nelson, "Miraculously, it was over." Debt remained, though, and, like Honeycutt, Nelson is using a credit counseling agency's repayment plan to deal with it.
Stories like Honeycutt's and Nelson's are not uncommon, says Alesandra Rain, a co-founder of Point of Return, a nonprofit that helps people find a natural way to address their psychological needs through education programs and counseling and which also sells related supplements. (Honeycutt is a member of Point of Return's executive team.) In fact, Rain, too, went on bizarre spending sprees when she was on antidepressants.
"I bought an entire wardrobe of sundresses, and I only wear jeans!" says Rain. "I can't wear heels, yet I bought an entire collection of 3-, 4-, 5-inch heels. With SSRIs, there is no turn-off switch. I bought a T-shirt folder -- not one, but three! It was crazy."
Today, Rain and her organization help others identify the side effects associated with antidepressants. "I hear it all the time -- impulsively buying cars, trading stocks, selling in the stock market," says Rain.
Treat the ailment and remain solvent
If you believe a friend or relative has antidepressant-induced hypomania and is spending, charging or gambling detrimentally, don't simply take away the credit cards. "It will escalate the mood, and if they're bipolar, you risk a bad reaction," says Bacchus. "Ask if you can take them to the doctor. Even the emergency room. They are equipped to handle these situations."
Rain suggests sitting down with the person and calmly asking, "Do you know how much you've changed?" Don't place blame on them, she advises. Instead, you might say, "I looked it up, and overspending and gambling are side effects of your medications. It must be so uncomfortable for you."
Offering hard evidence can be beneficial, says Laurie Campbell of Croton, Ohio. Campbell had been prescribed Paxil for irritable bowel syndrome, and she says her spending was so out of control she drained her 401k because of it.
"If someone has a loved one going through this and you know they were prescribed something because they were depressed, print out the information that is out there," she says. "Be firm and say, 'You don't see what is going on with you, but here's what has happened in the last six months before taking this drug.' Do the tough-love thing. It might have helped me," says Campbell.
And if you identify the problem in yourself? Tell your prescribing doctor that your spending habits have changed and ask if it could be medication-related. A change may be in order. You may also be able to control your own financial actions before or during a hypomanic state. For example:
- Tell trusted friends and family members about the problem. Ask them to tell you if you're sounding or acting unusual, and ask if they would be willing to talk to you before you make large purchases.
- Unsubscribe from retailers' email advertisements.
- Avoid places where you tend to overspend. For example, if you're a "shoe person," do not even enter a shoe store.
- Redirect your energy. Write, garden, clean or contact old friends. Use this time in a positive way until the episode has passed.
The bottom line: Any change in antidepressant use has the potential to send some people into a hypomanic episode. It could be starting the medication, changing the dosage, discontinuing it or even adding an extra cup of coffee to the mix. If you fear the medications might be causing you to make foolish or dangerous financial choices, let your doctor and caring family members know.
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