The Epidemic of Mental Illness: Why? by Marcia Angell | The New York Review of Books

[Guest guest]

The Epidemic of Mental Illness: Why?

June 23, 2011

Marcia Angell

http://www.nybooks.com/articles/archives/2011/jun/23/epidemic-mental-illness-why\

/

The Emperor's New Drugs: Exploding the Antidepressant Myth

by Irving Kirsch

Basic Books, 226 pp., $15.99 (paper)

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the

Astonishing Rise of Mental Illness in America

by Whitaker

Crown, 404 pp., $26.00

Unhinged: The Trouble With Psychiatry---A Doctor's Revelations About a

Profession in Crisis

by Carlat

Free Press, 256 pp., $25.00

<http://www.nybooks.com/multimedia/view-photo/2513>

[image] An advertisement for Prozac, from /The American Journal of

Psychiatry/, 1995

It seems that Americans are in the midst of a raging epidemic of mental

illness, at least as judged by the increase in the numbers treated for

it. The tally of those who are so disabled by mental disorders that they

qualify for Supplemental Security Income (SSI) or Social Security

Disability Insurance (SSDI) increased nearly two and a half times

between 1987 and 2007---from one in 184 Americans to one in seventy-six.

For children, the rise is even more startling---a thirty-five-fold

increase in the same two decades. Mental illness is now the leading

cause of disability in children, well ahead of physical disabilities

like cerebral palsy or Down syndrome, for which the federal programs

were created.

A large survey of randomly selected adults, sponsored by the National

Institute of Mental Health (NIMH) and conducted between 2001 and 2003,

found that an astonishing 46 percent met criteria established by the

American Psychiatric Association (APA) for having had at least one

mental illness within four broad categories at some time in their lives.

The categories were " anxiety disorders, " including, among other

subcategories, phobias and post-traumatic stress disorder (PTSD); " mood

disorders, " including major depression and bipolar disorders;

" impulse-control disorders, " including various behavioral problems and

attention-deficit/hyperactivity disorder (ADHD); and " substance use

disorders, " including alcohol and drug abuse. Most met criteria for more

than one diagnosis. Of a subgroup affected within the previous year, a

third were under treatment---up from a fifth in a similar survey ten

years earlier.

Nowadays treatment by medical doctors nearly always means psychoactive

drugs, that is, drugs that affect the mental state. In fact, most

psychiatrists....

..