June 12, 2005


Who's Mentally Ill? Deciding Is Often All in the Mind (BENEDICT CAREY, 6/12/05, NY Times)

THE release last week of a government-sponsored survey, the most comprehensive to date, suggests that more than half of Americans will develop a mental disorder in their lives.

The study was the third, beginning in 1984, to suggest a significant increase in mental illness since the middle of the 20th century, when estimates of lifetime prevalence ranged closer 20 or 30 percent.

But what does it mean when more than half of a society may suffer "mental illness"? Is it an indictment of modern life or a sign of greater willingness to deal openly with a once-taboo subject? Or is it another example of the American mania to give every problem a name, a set of symptoms and a treatment - a trend, medical historians say, accentuated by drug marketing to doctors and patients? [...]

[M]ore than anything, historians and medical anthropologists said, the rise in the incidence of mental illness in America over recent decades reflects cultural and political shifts. "People have not changed biologically in the past 100 years," Dr. Kirmayer said, "but the culture, our understanding of mental illness" has changed.

Isn't it most likely that we'd prefer to think ourselves ill than take responsibility for ourselves?

Posted by Orrin Judd at June 12, 2005 12:00 AM

Well, Liberalism is a disorder.

Posted by: Sandy P. at June 12, 2005 1:05 AM

Absolutely, oj.

Blaming others is natural (I'm ill, it's not my fault -- my genes, my parents, society, anything but me). Responsibility is taught.

But learning this lesson takes dealing with a three year old on a daily basis!

Posted by: Randall Voth at June 12, 2005 4:36 AM

Whenever I'm in a mood to feel sorry for myself and blame my parents for this or that misfortune, I try to remember the great line the psychiatrist said to Natalie Woods in Splendor in the Grass: "Everybody wants to blame their parents these days, but they forget that their parents had parents too."

However, it won't do to just sniff impatience at malingerers here (although the caring professions and disability insurance do play roles for sure). Conservatives have been warning about the consequences of social anomie in the atomistic society for a long time and we can hardly be surprised that the predictions are coming true. Traipsing through a demanding life with the conviction that it is all a meaningless accident, abjuring family and community responsibilities, living in isolation, rejecting spiritual tradition, focusing entirely on the material, making up morality on the fly and being absorbed by the self as we are now taught to do will lead to mental disorders for many folks.

Young girls in particular are in a mess these days (viz eating disorders, self-mutilation and sexual blackmail), finding out too late that their sexual freedom is a demeaning servitude. Married couples who dwell on whether they would be happier elsewhere, parents who are frightened of their own children, people who bet everything on career progress and now are stalled for reasons they don't understand, fatherless kids, etc. etc., all leave a lot of people open to depression and other debilitating disorders. It's real.

Posted by: Peter B at June 12, 2005 7:48 AM


Depression also has a bio-chemical component. Although it is wrong to medicalize all behavioral problems, it is also wrong to moralize all of them. If someone is living a responsible life but is suffering from depression, what do you tell him, just suck it up, or that he must be hiding some sins that he isn't fessing up to? If an anti-depressant will solve the problem, is this person avoiding responsibility by taking it?

I like Dennis Prager's outlook on happiness. He teaches that we owe it to everyone we love to be as happy as we can make ourselves be. An unhappy, chronically depressed man who "toughs it out" out of some warped notion that he is taking responsibility for his behavior by refusing treatment is not doing any favors for himself or for his family. He is actually avoiding his responsibility to take the steps necessary to improve his happiness for the benefit of his family.

There is not more mental illness today, anymore than there is not more bacterial infections today than 100 years ago, although if you looked at the rate of antibiotic prescriptions today as opposed to then you would think that people were free of infection back then and are infested with disease today. All behavior was under the purview of religious notions of morality and character back then, all suffering was chalked up to the wages of sin.

What is needed is the ability to understand and separate the wages of sin from the tribulations of biology.

Posted by: Robert Duquette at June 12, 2005 9:23 PM

Robert, is it possible that that the bio-chemical compoment of the brain can be affected by how the brain is used?

Posted by: Bartelson at June 12, 2005 9:27 PM

Yes it can, but it can also be a persistent condition of the mind. You have to consider both.

Posted by: Robert Duquette at June 12, 2005 10:07 PM


No one doubts that mental illness and chronic depression are real diseases that call for medical interventions, and that they have always been with us. It isn't easy to fine the line between severe mental illness and the somewhat more benign notion of "emotional disorders". However, your statement that "there is not more mental illness today..." is an article of faith--(how would we know?)--that seems to suggest mental disorders exist independently of how people live and treat each other, and what they believe. It is also simply wrong to say that, in the past, all behaviour was chalked up to the wages of sin. Once again, you are setting up a strawman of some imaginary dark, theocratic past where everyone relied on incantations and exorcisms to treat the mentally afflicted in order to give comparative, uncritical credence to modern scientific whizzkids.

Presumably you would agree that a child subject to chronic abuse from his or her parents, or who lost a parent to suicide, is more likely to suffer emotional disorders in adulthood. Studies during the War showed that depression and other disorders dropped off sharply during the blitz. Introverts who live alone are more prone to difficulties than those in busy, hectic families. DSM-1V is now more than four times as thick as the first edition from the fifties. Was there a lot of anorexia around a hundred years ago? Was self-mutilation a noticeable problem among young girls?

If you are just cautioning me not to be a spiritual absolutist on this issue, then your caution is well-placed. Permit me to urge a similar caution about neuroscience.

Posted by: Peter B at June 13, 2005 5:32 AM