Mental Disorders Common in America
Are mental illnesses becoming more prevalent, or is psychiatry overdiagnosing?
In the span of a few months, Jacqueline Castine went from making $2,000 as a motivational speaker to getting fired
from a minimum-wage post office job. She had successfully promoted a book on career enhancement, but then years later,
was cleaning houses because she couldn't hold jobs elsewhere.
The Michigan resident's highs and lows came to a head when, as a sales manager for a Detroit broadcasting outlet, she
had a grand delusion that God was telling her to bankroll one of the station's charitable events.
The result: Castine ended up with a $43,000 credit card debt and thoughts of suicide.
"It was as if the bubble of unreality and distorted thinking had (burst)," says Castine, noting periods of despair
coexisting with moments of great creativity. She sought psychiatric help and was diagnosed with bipolar disorder, also
known as manic depression.
Mental Disorders Are Common
Castine's story may seem unique, but millions of Americans share her plight. According to the Depression and Bipolar
Support Alliance, 3.7% of American adults have bipolar disorder, and 4 out of 5 of those who have it may not know it.
In the bigger picture of psychological illness, the statistics may be even more alarming. The National Institute of
Mental Health (NIMH) reports that roughly 22% of U.S. adults -- about one in five -- suffer from a diagnosable mental
disorder in a given year. According to the NIMH, about 1% of the population age 18 and older in any given year has
bipolar disorder.
Narrow's study and several others indicate that psychological illnesses are common, and there is evidence that the
problem may be growing.
Mental disorders account for a significant burden of disease in all societies. The World Health Organization (WHO)
projects that mental disorders will increase from nearly 12% of the all diseases worldwide to almost 15% by the year
2020.
The statistics have experts emphasizing the need for more awareness and treatment, and skeptics blaming psychiatry
for going overboard with overdiagnosing ordinary problems.
A Different World
There is dispute over whether a greater number of people have psychological illnesses now compared with past
generations, or whether there is just more awareness of the subject and more folks are diagnosed.
Some experts say depression and anxiety boost the number of people with mental disorders.
"Depression and anxiety are the common colds of the psychiatric field in that they come and go without getting
treatment," says C. David Jenkins, PhD, adjunct professor of epidemiology and psychiatry for the University of North
Carolina at Chapel Hill.
In his study of air traffic controllers, Jenkins found many of them met the criteria for depression or anxiety for a
month or two, and then they would "straighten up, and feel a lot better, until maybe six to eight months later when
they would have another month that was a little low."
Yet these mood disorders -- depression and anxiety -- do not always "come and go" so easily. Without treatment, the
disorders can prevent people from living productive lives, says Kathy HoganBruen, PhD, senior director of prevention
for the National Mental Health Association.
The global rates of schizophrenia and bipolar disorder have, for the most part, not changed, says Kessler, while
depression and anxiety disorders are more common.
He says urbanization probably had a role in the rise of stress-related mental disorders. "People are moving to
cities, moving far away from where their parents lived, and having jobs that their fathers didn't have before," says
Kessler.
With the uncertainty of the future and fewer family and community ties to help deal with problems, Kessler says more
people become anxious, breeding secondary depression, and the two are associated with drinking and using drugs.
"That triumvirate of anxiety, depression, and substance abuse -- those are the ones that are changing," he says.
"There's a lot of thinking that anxiety is right at the core of it. That's sort of the foundation."
Anxiety may also be heightened by other factors related to modern society, such as globalization and more advanced
technology.
At the same time, he says expectations now are higher than they were many years ago. People now expect to have jobs,
enough money to go to a dinner and movie, and many kids expect to have a cell phone in high school and a car at
graduation.
Shades of Gray
In 1996, the United Nations' International Narcotics Control Board raised concern about the increasing use of the
stimulant Ritalin for the treatment of ADHD in children, particularly in the U.S. Authorities reporting to the board
said the disorder may be diagnosed too often and the stimulant prescribed without considering other types of treatment.
Yet the much bigger problem, says HoganBruen, is that people who need help are not being assessed or treated for
mental health disorders.
Sometimes medicine draws the illness line at the point where doctors know how to treat, suggests Kessler. "If it
turned out that some pill was developed tomorrow ... and it would make (problems) go away ... we would declare it in
an illness, and we would start treating it," he says.
While psychiatry continues to search for more effective treatments and a better understanding of mental disorders,
there are some remedies - including drugs -- that are scientifically proven to work.
Kids with ADHD who receive treatment are less likely later in life to get divorced, be on welfare, get into trouble
with the law, or be dead, says Kessler.
Among children, the APA reports that ADHD is the most commonly diagnosed mental health condition in the U.S.
According to the Surgeon General's Report on Mental Health, ADHD afflicts between 3% and 5% of school-age children in
any six month period.
A Brighter Outlook
Castine says she didn't think there was anything to live for when she lost all her money while suffering with bipolar
disorder. But after taking medication and working with a therapist, she was able to find a job as a community
education specialist, publicly speaking about her personal experiences with mental illness.
The 63-year-old now has plenty of savings in the bank and hopes to earn enough for retirement from the publication of
her next book, due out this summer.
If you suspect that you or a loved one might have a mental disorder, experts suggest a visit to a primary care doctor
or a mental health professional
In the span of a few months, Jacqueline Castine went from making $2,000 as a motivational speaker to getting fired
from a minimum-wage post office job. She had successfully promoted a book on career enhancement, but then years later,
was cleaning houses because she couldn't hold jobs elsewhere.
The Michigan resident's highs and lows came to a head when, as a sales manager for a Detroit broadcasting outlet, she
had a grand delusion that God was telling her to bankroll one of the station's charitable events.
The result: Castine ended up with a $43,000 credit card debt and thoughts of suicide.
"It was as if the bubble of unreality and distorted thinking had (burst)," says Castine, noting periods of despair
coexisting with moments of great creativity. She sought psychiatric help and was diagnosed with bipolar disorder, also
known as manic depression.
Mental Disorders Are Common
Castine's story may seem unique, but millions of Americans share her plight. According to the Depression and Bipolar
Support Alliance, 3.7% of American adults have bipolar disorder, and 4 out of 5 of those who have it may not know it.
In the bigger picture of psychological illness, the statistics may be even more alarming. The National Institute of
Mental Health (NIMH) reports that roughly 22% of U.S. adults -- about one in five -- suffer from a diagnosable mental
disorder in a given year. According to the NIMH, about 1% of the population age 18 and older in any given year has
bipolar disorder.
Narrow's study and several others indicate that psychological illnesses are common, and there is evidence that the
problem may be growing.
Mental disorders account for a significant burden of disease in all societies. The World Health Organization (WHO)
projects that mental disorders will increase from nearly 12% of the all diseases worldwide to almost 15% by the year
2020.
The statistics have experts emphasizing the need for more awareness and treatment, and skeptics blaming psychiatry
for going overboard with overdiagnosing ordinary problems.
A Different World
There is dispute over whether a greater number of people have psychological illnesses now compared with past
generations, or whether there is just more awareness of the subject and more folks are diagnosed.
Some experts say depression and anxiety boost the number of people with mental disorders.
"Depression and anxiety are the common colds of the psychiatric field in that they come and go without getting
treatment," says C. David Jenkins, PhD, adjunct professor of epidemiology and psychiatry for the University of North
Carolina at Chapel Hill.
In his study of air traffic controllers, Jenkins found many of them met the criteria for depression or anxiety for a
month or two, and then they would "straighten up, and feel a lot better, until maybe six to eight months later when
they would have another month that was a little low."
Yet these mood disorders -- depression and anxiety -- do not always "come and go" so easily. Without treatment, the
disorders can prevent people from living productive lives, says Kathy HoganBruen, PhD, senior director of prevention
for the National Mental Health Association.
The global rates of schizophrenia and bipolar disorder have, for the most part, not changed, says Kessler, while
depression and anxiety disorders are more common.
He says urbanization probably had a role in the rise of stress-related mental disorders. "People are moving to
cities, moving far away from where their parents lived, and having jobs that their fathers didn't have before," says
Kessler.
With the uncertainty of the future and fewer family and community ties to help deal with problems, Kessler says more
people become anxious, breeding secondary depression, and the two are associated with drinking and using drugs.
"That triumvirate of anxiety, depression, and substance abuse -- those are the ones that are changing," he says.
"There's a lot of thinking that anxiety is right at the core of it. That's sort of the foundation."
Anxiety may also be heightened by other factors related to modern society, such as globalization and more advanced
technology.
At the same time, he says expectations now are higher than they were many years ago. People now expect to have jobs,
enough money to go to a dinner and movie, and many kids expect to have a cell phone in high school and a car at
graduation.
Shades of Gray
In 1996, the United Nations' International Narcotics Control Board raised concern about the increasing use of the
stimulant Ritalin for the treatment of ADHD in children, particularly in the U.S. Authorities reporting to the board
said the disorder may be diagnosed too often and the stimulant prescribed without considering other types of treatment.
Yet the much bigger problem, says HoganBruen, is that people who need help are not being assessed or treated for
mental health disorders.
Sometimes medicine draws the illness line at the point where doctors know how to treat, suggests Kessler. "If it
turned out that some pill was developed tomorrow ... and it would make (problems) go away ... we would declare it in
an illness, and we would start treating it," he says.
While psychiatry continues to search for more effective treatments and a better understanding of mental disorders,
there are some remedies - including drugs -- that are scientifically proven to work.
Kids with ADHD who receive treatment are less likely later in life to get divorced, be on welfare, get into trouble
with the law, or be dead, says Kessler.
Among children, the APA reports that ADHD is the most commonly diagnosed mental health condition in the U.S.
According to the Surgeon General's Report on Mental Health, ADHD afflicts between 3% and 5% of school-age children in
any six month period.
A Brighter Outlook
Castine says she didn't think there was anything to live for when she lost all her money while suffering with bipolar
disorder. But after taking medication and working with a therapist, she was able to find a job as a community
education specialist, publicly speaking about her personal experiences with mental illness.
The 63-year-old now has plenty of savings in the bank and hopes to earn enough for retirement from the publication of
her next book, due out this summer.
If you suspect that you or a loved one might have a mental disorder, experts suggest a visit to a primary care doctor
or a mental health professional
