May is Mental Health Month. Did you know that more than 2.5 million Ontarians live with a mental illness and/or addiction? ^[1] Millions more – family members, friends and co-workers – are also affected by the devastation, which often results in job loss, financial losses, domestic violence and child abuse, birth defects, brain damage, family breakdown, crime, homelessness, concurrent health problems, road and industrial accidents, and suicide.

Still many sufferers go undiagnosed. Some suffer silently; others self-medicate with drugs or alcohol. They overwhelm family doctors or jam emergency wards which, of course, are ill-suited to their needs. And, even where counselling is available, clients face long waits for it, and it’s too time-limited to be useful. Most psychological care is paid privately, putting it well beyond the financial reach of many.

What can be done about it? Well, the drug companies believe the answer is in the scrawled handwriting of a doctor’s on a prescription pad. And, let’s face it, with the state of health care in Ontario, doctors often have neither the time nor the resources to offer their patients anything else but a prescription! And so they keep writing!

In March 2011, IMS Brogan[2], a company that tracks such things, reported that in 2010 the sales of pharmaceutical drugs in Canada totalled $22.4 billion. The number of retail prescriptions filled by Canadians (including new and refills) totalled 505 million.

And, by the way, the Canadian population in 2010 was 34 million. So that’s about 15 prescriptions per person, including about 8 million who were under the age of 20.

I don’t know about you, but I found those numbers alarmingly high; and I wondered: What were these prescriptions for?

Again, I cite IMS Brogan, who reported that the top three therapeutic classes of drugs being used by Canadians are as follows:

Most Widely Dispensed Retail Prescription Medications in 2010

Heart. Head. Stomach. Knowing what I know about the body-mind connection, it occurred to me that there is a good way to reduce these numbers significantly. The problem is that it’s not the doctor, but it’s the patient who should be doing the writing - expressive writing!

Expressive writing is personal writing. It expresses and explores the personal feelings of the writer. It may attempt to answer a question, state an opinion or recount the writer's personal experiences. Often, it does all of that. Expressive writing isn't focused on proper spelling, punctuation and grammar. It’s not about the product of the writing. It’s certainly not about producing a best-seller. Rather, it’s about the process of writing, and the impact of that process on the writer. According to the research, it has a very positive impact!

Expressive writing sets off a cascade of positive effects, not the least of which is an improvement in physical health. Perhaps best of all, considering the rise in health care costs, writing reduces the number of visits to the doctor (Pennebaker and Susman 1988)!

Well over 200 studies published in English language journals, over the past twenty years have demonstrated that expressive writing produces a number of very positive outcomes, including:

• Better sleep, enhanced immune function, reduced alcohol consumption, smoking, etc.
• General enhancement in immune function, including t-cell growth and antibody response (Lepore and Smyth, 2002; Pennebaker & Graybeal, 2001; Sloan & Marx, 2004)
• Better lung function among asthma patients (Smyth, Stone, Hurewitz, et al., 1999)
• Lower pain and disease severity among arthritis sufferers (Smyth, Stone, Hurewitz, et al., 1999),
• Higher white blood cell counts among AIDS patients (Petrie, Fontanilla, Thomas, et al. In press)
• Less sleep disruption among patients with metastatic cancers (De Moor, Sterner, Hall, et al., 2002)
• Reduction in blood pressure levels and heart rate (Crow 2000; mcguire, Greneberg, and Gevirtz, 2005; Pennebaker, Hughes, & O’Heeron, 1987), and
• Improved liver enzyme levels often associated with excessive drinking (Francis and Pennebaker 1992).

Expressive writing is not only a powerful tool for healing; it changes people’s lives!  

Researchers have also found that, after people write about troubling events, they:

• Spend less time ruminating on them, freeing up working memory (Klein and Boals 2001;
• Become more socially comfortable, better listeners, better friends(Pennebaker and Graybeal 2001);
• Feel happier, have fewer symptoms of depression or anxiety (Lepore 1997);
• Earn higher grades (Cameron and Nicholls 1998 Lumley and Provenzano 2003; Pennebaker, Colder, and Sharp 1990); and
• Achieve better employment results (Spera, Burhrfeind, and Pennebaker 1994).

Commenting on this research in the April 14, 1999 issue of the Journal of the American Medical Association (JAMA), Psychiatrist David Spiegel, MD, said:

“Were the authors to have provided similar outcome evidence about a new drug, it likely would be in widespread use within a short time…(T)he authors have provided evidence that medical treatment is more effective when standard pharmacological intervention is combined with the management of emotional distress.”

But expressive writing is not a new drug! Rather, it’s a highly effective, inexpensive, drug-free alternative!

Now I’m not saying that you should stop taking the medicine that has been prescribed for you. Certainly not!   Writing is not a panacea; and of course, you should continue to seek the medical care you need.  

But I do say that it’s not the doctors who should be doing the writing; it’s all of us. This is about prevention, and about healing the “dis-ease” before it gets to the critical stage.   And with a shortage of doctors, and the high price of therapy, what have you got to lose? Pick up a scribbler at the Dollar Store, and get writing!

And to the doctors I say, “Before you reach for that prescription pad, why not log on to my website, or reach for my card!   And give it to your patients!