How ill are we really?
Having good mental health is probably as important as having good physical health, if not more so. But when our mental health is “not so good,” would most of us call ourselves ill, as in “mentally ill?”
Suppose you find it difficult to sleep or lose your appetite for a couple of weeks because you’ve been diagnosed with a serious physical illness or suffered the loss of a loved one. Would you say you had a mental illness?
Apparently, our government would, and does.
I was rather taken aback to see the recently-released “mental health findings” of the National Survey on Drug Use and Health.
Based on interviews and self-administered questionnaires from more than 68,000 Americans, the annual survey estimates that 46 million people in 2010 — 20 percent of adults in the United States — had a “diagnosable mental, behavioral or emotional disorder” sufficient to consider them to suffer from a “mental illness.”
This included people with “depressed mood or loss of interest or pleasure in daily activities” lasting two weeks or more, even if such short-term depression was brought on due to a medical illness or bereavement.
According to a report in the Washington Post, other diagnosable mental disorders that qualified as mental illness “could include spider-phobia and staying upset for a long time after arguing with one’s spouse.”
One psychiatrist the Post interviewed about the survey characterized it as “kind of alarmist.” Another said he was “skeptical that rates this high make sense.”
To be fair, the survey also estimated that only 5 percent of U.S. adults suffered from a “serious mental illness,” defined as a mental illness that results in “serious functional impairment, which substantially interferes with or limits one or more major life activities.”
Certainly when symptoms interfere with daily life to a significant extent, a person should take it seriously and seek immediate help.
But what does that say about the 35 million Americans whose “mental illness” was not considered “serious?” Presumably, their conditions donot interfere in any substantial way with even one major life activity. And if that’s the case, are we doing ourselves a favor by labeling them, even as a group, with a diagnosis of “mental illness?”
I’ve gotten to know enough people over the years to recognize that almost everyone has quirks, tics, skeletons and phobias, many of which have labels in the psychiatric profession’s DSM-IV manual of mental disorders.
And I understand why psychiatrists would want to catalogue every possible symptom and disorder. That enables more accurate and comprehensive diagnoses, and presumably helps them develop better treatment plans.
I also appreciate that, when even relatively minor or temporary conditions cause a person distress, it is valuable and important to seek help. Therapy, behavioral modification and medications can make a world of difference and vastly improve a person’s quality of life.
Still, I’m disturbed when our government utilizes the vast expansion of catalogued disorders to declare that one in five Americans has a mental illness. Just because a condition is “diagnosable” doesn’t mean we as a society necessarily want to stigmatize it.
Perhaps the intent of those behind this effort is actually to remove the stigma of the term. If most of us could be classified as suffering from mental illness at one time or another, then being (or having been) mentally ill would actually become “normal.”
If anyone asked me, however, I’d say let’s do what we can to help everyone overcome their psychological and emotional limitations and issues — but hold back on the labels, please.
By the way, I was intrigued to see tables in the government’s report that indicated the older one gets, the less likely one is to exhibit symptoms of mental illness. That applies not only to “any mental illness,” but also to serious mental illness, suicidal thoughts, and major depressive episodes.
The highest incidence of all such conditions was found among 18 to 25 year olds, while the lowest incidence was among those 50 and older.
At the same time, those 50 and older were the most likely to seek treatment for any such symptoms.
The two probably go together. With age comes perspective, experience and a certain wisdom about life that, one hopes, helps keep anxiety, fear and panic at bay.
At the same time, older adults have lived long enough to know that taking action to address a problem is the first step in solving it.