Does living in the U.S. literally drive a person insane? It’s a question many psychologists and psychiatrists are investigating while examining whether Big Pharma is pushing for an overdiagnosis of psychiatric disorders to increase sales of psychiatric drugs.
According to a June 2013 Gallup Poll, 70 percent of Americans hate their jobs or have “checked out” of them. In sum, most Americans feel some combination of being overworked and underappreciated.
Part of the reason Americans feel so blue is blamed on Americans’ high expectations that life should be more progressive and satisfying than it is. This mass disappointment has prompted many to feel hopeless and depressed as a result.
In a 2011 report, the U.S. Centers for Disease Control and Prevention (CDC) found that antidepressant use in the U.S. has increased nearly 400 percent in the last two decades, making antidepressants the class of medications most frequently used by Americans aged 18-44 years. By 2008, 23 percent of women aged 40–59 years were taking antidepressants.
Is it coincidence that, as reported by the CDC in May 2013, the suicide rate among Americans aged 35–64 years increased 28.4 percent between 1999 and 2010 (from 13.7 suicides per 100,000 population in 1999 to 17.6 per 100,000 in 2010)?
According to “The Epidemic of Mental Illness: Why?” by Marcia Angell, the former editor-in-chief of the New England Journal of Medicine, Americans “are in the midst of a raging epidemic of mental illness,” if one solely looks at the number of Americans being treated for mental health disorders.
While there are not necessarily more Americans being diagnosed with more severe mental health illnesses such as schizophrenia, a 2003 survey from the National Institute of Mental Health found that almost 50 percent of Americans meet the criteria for at least one mental illness within four broad categories at least once in their lifetime.
The categories included anxiety disorders, which includes phobias and post-traumatic stress disorder; mood disorders, which includes major depression and bipolar disorders; impulse-control disorders, including various behavioral problems and attention-deficit/hyperactivity disorder; and substance use disorders, which includes alcohol and drug abuse.
The NIMH report found that of those Americans who met the criteria for a mental illness under at least one category, a large majority of them also met the criteria for other diagnoses.
Epidemic or increased awareness?
Martin Seligman, former president of the American Psychological Association, spoke to the National Press Club about an American depression epidemic in 1998. “We discovered two astonishing things about the rate of depression across the century,” he said. “The first was there is now between 10 and 20 times as much of it as there was 50 years ago. And the second is that it has become a young person’s problem.
“When I first started working in depression 30 years ago. . . the average age at which the first onset of depression occurred was 29.5. . . .Now the average age is between 14 and 15.”
Angell found similar shocking statistics and said the leading cause of disability in U.S. children right now is actually mental illness and not physical disabilities.
In her book, Angell stresses that just because more Americans are being diagnosed with mental illnesses doesn’t mean that mental illness is necessarily increasing in prevalence. While Angell does not blame just one group or environmental effect for the increased diagnoses, she says that a lot of the increase in mental illness diagnoses can and should be blamed on an increasing expansion of mental illnesses and Big Pharma.
Angell reported that while mental illnesses have historically been treated with talk therapy, since psychoactive drugs were first introduced in the 1950s, pharmacological therapy has become the most common way to treat illnesses such as psychosis, anxiety and depression.
According to the JFK Medical Center, research has proven that talk therapy “can be as effective as taking antidepressant medication” for many common mental illnesses including depression, anxiety, high-level stress and addiction.
“What we found is, if you can get yourself to talk therapy, and if you stick with it for at least seven weeks, you are going to get results as good as you would if you just popped a pill,” said Nancy Metcalf, senior program editor at Consumer Reports Health.
But Big Pharma disagrees, most likely because they don’t want to see the $330 billion psychiatric drug industry fold.
Charles McAtee, a spokesman for Eli Lilly and Company, which makes Prozac and Cymbalta, two commonly prescribed antidepressants, released a statement disputing the findings. He said, “Depression is a highly individualized illness. Treatment decisions, including what type of treatment is appropriate for a given patient, are best determined by the health care professional and patient working together and based on the individual patient’s needs.”
In order to diagnose a mental illness, psychologists and psychiatrists use the Diagnostic and Statistical Manual of Mental Disorders book. The first edition was published in 1952 and the most recent edition, DSM-5, was published in May of this year. But as the news organization Salon pointed out, 69 percent of the task force members who helped create the DSM-5 reported ties to the pharmaceutical industry.
Once diagnosed, Americans are often given a prescription to fix the “chemical imbalance” in their brains, but the problem, Angell says, is that many of these drugs used to treat mental illnesses were not initially developed for this purpose. Instead many were developed to treat infections and it was only discovered later they altered a person’s mental state.
Angell’s perspective closely resembles that of investigative journalist Robert Whitaker, who has long argued that psychiatric medications are the primary cause of the mental illness epidemic in the U.S.
He said these drugs, for many patients, are actually what causes “episodic and moderate emotional and behavioral problems to become severe, chronic and disabling ones.”
Whitaker reported that after reviewing scientific literature that had been published throughout a 50-year period, it appeared that while some psychiatric medications may help some patients in the short term, the drugs often increased the likelihood a person would become chronically ill in the long-term.
“Once psychiatrists started putting ‘hyperactive’ children on Ritalin, they started to see prepubertal children with manic symptoms,” Whitaker said. “Same thing happened when psychiatrists started prescribing antidepressants to children and teenagers. A significant percentage had manic or hypomanic reactions to the antidepressants.”
Once these children and teenagers had symptoms that had worsened, they were prescribed heavier drugs, including drug cocktails.
According to an article written by clinical psychologist Bruce E. Levine for Salon, the mental illness epidemic should not be blamed solely on Big Pharma, as he says mental health professionals often diagnose someone who has inattention or fails to follow orders as having a mental illness.
Levine wrote that “The reality is that with enough helplessness, hopelessness, passivity, boredom, fear, isolation, and dehumanization, we rebel and refuse to comply. Some of us rebel by becoming inattentive. Others become aggressive. In large numbers we eat, drink and gamble too much. Still others become addicted to drugs, illicit and prescription. Millions work slavishly at dissatisfying jobs, become depressed and passive aggressive, while no small number of us can’t cut it and become homeless and appear crazy. Feeling misunderstood and uncared about, millions of us ultimately rebel against societal demands, however, given our wherewithal, our rebellions are often passive and disorganized, and routinely futile and self-destructive.”
He added that “When we have hope, energy and friends, we can choose to rebel against societal oppression with, for example, a wildcat strike or a back-to-the-land commune. But when we lack hope, energy and friends, we routinely rebel without consciousness of rebellion and in a manner in which we today commonly call mental illness.”