Of the many Americans who use alternative medicine, whether it be herbs, acupuncture, homeopathy, or whatever, about 15 percent seem to use those therapies specifically for their mental health difficulties. What’s more, persons with major depression or panic disorder especially seem prone to seek out alternative medicine, at least when compared with individuals without those disorders.

These are the results of a study conducted by psychiatrist Jurgen Unutzer, M.D., and his team from the University of California at Los Angeles Neuropsychiatric Institute in Santa Monica, Calif., and reported in the November American Journal of Psychiatry.

When Psychiatric News asked Unutzer why persons with major depression or panic disorder might be especially inclined to use alternative therapies, he replied, "We have no good data on this, but I have some thoughts. First, major depression and panic disorder are associated with high levels of psychological pain and distress. Patients who are suffering from these problems look at a wide range of treatments to reduce this distress. In addition to using complementary and alternative services, many of these patients also have higher use of conventional primary care services and medical specialty services.

"Second, a large number of people with major depression and panic disorder are not diagnosed. Even if they are diagnosed, they may not receive effective treatments in primary or specialty mental health care and continue to have distressing symptoms—even after multiple attempts at treatment in ‘mainstream medicine.’ They may then start looking for help more broadly. Lastly, the stigma associated with common mental disorders and the out-of-pocket costs for treatments such as psychotherapy or antidepressant medications may prove an additional reason why some patients use alternative treatments or why they supplement conventional treatments that are only partially effective with complementary treatments."

Most studies of the relationship between mental illness and alternative medicine use have been based on small, demographically nonrepresentative samples or have used simple self-reports of the presence or absence of mental disorders rather than standardized interviews. So Unutzer and his colleagues decided to launch an investigation that would be more demographically representative and that would also include standardized screening measures for specific psychiatric disorders.

The researchers asked 9,585 persons representing various areas of the United States and willing to be surveyed by telephone about their mental health and health habits. They were asked whether, during the previous year, they had used herbs, homeopathic remedies, acupuncture, massage therapy, spiritual healing, or other kinds of alternative medicine and whether they had used alternative medicine to counter mental, emotional, or substance abuse problems. They also used structured questionnaires to diagnose mental disorders in the subjects.

Of the 9,566 respondents, 14.5 percent reported having used alternative medicine during the previous year. Of this 14.5 percent, 21.3 percent met diagnostic criteria for one or more mental disorders, and 15 percent of the 14.5 percent reported that they had used alternative medicine expressly for their mental or emotional difficulties. What’s more, when persons with major depression or panic disorder were compared with persons without those disorders, the former group was especially likely to say that they had used alternative therapies. In contrast, when persons with generalized anxiety disorder or bipolar disorder or schizophrenia were compared with individuals without, they did not report significantly higher rates of alternative medicine use.