It is tempting to read prescription volume as a thermometer for how ill a population is. The record does not support that, in either direction. In England, antidepressant items rose 50% in nine years while hypnotic and anxiolytic items FELL 16% over exactly the same period, from the same prescribers under the same system. In the United States, antipsychotic use among adults rose from 1.9% to 3.0%, while among children and adolescents it fell, 1.3% to 1.1%. And where a national registry lets diagnosis be counted directly, Denmark's new schizophrenia diagnoses went slightly down, 1.8 to 1.6 per 10,000, across eighteen years in which antipsychotic prescribing rose almost everywhere it was measured. Prescribing moves for its own reasons — guidance, capacity, recognition, duration of treatment, the licensing of new drugs, deliberate deprescribing campaigns. Sometimes it tracks illness. Here it demonstrably moves in opposite directions at once.