
Mental illness: is there a global epidemic? - pseudolus
https://www.theguardian.com/society/2019/jun/03/mental-illness-is-there-really-a-global-epidemic
======
empath75
Since mental illness is largely defined as any sort of behavior or thoughts
that make it difficult for one to be a productive member of society, however
that society defines ‘productive’, if the structure of society changes such
that previously normal and healthy behaviors and beliefs become destructive
and difficult for people, that will lead to an increase in so-called mental
illness even if people as individuals haven’t changed at all.

~~~
asveikau
> Since mental illness is largely defined as any sort of behavior or thoughts
> that make it difficult for one to be a productive member of society

I have seen enough of this up close to know that it isn't society's construct,
that many sufferers are objectively having problems.

Maybe not all cases and conditions are like this. But it doesn't do anyone
favors to handwave some of those serious conditions away.

~~~
challenger22
The more society becomes increasingly oriented around thought-work the more
these problems will manifest. Humans evolved to cooperate, but we didn't
evolve to spend all day thinking about long-term work-related stressors that
are only indirectly related to our own well-being. Once it became trivially
easy to obtain food, water, and shelter, a good portion of our biological
imperative was left without anything to be concerned with.

For an interesting tangentially-related thought, try asking people what the
definition of "healthy" is for a human. Mental health is the hardest part to
define out of all health.

~~~
Cookiesaurusbex
> Once it became trivially easy to obtain food, water, and shelter

I would argue that the average human being doesn't consider these things easy
to acquire. For society it COULD be easy to distribute these things if we
decided that was a goal of ours, but we haven't gotten there yet. I would be
very interested in seeing the ideas (or problems?) invented by children born
into a world where this was true, but unless things get very interesting very
quickly, I doubt we'll get the chance.

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jokoon
I think that since industry has boomed, we exposed ourselves to hazardous
chemistry.

While testing for toxicity, cancers and other illnesses, I think science is
not able to foresee the effect of all the new chemicals we created, especially
cocktail effects, endocrine disruptors, and every bit of thing which is a
product of industry. If we investigate product per product when something goes
wrong, there will be a lot of things that won't be detected.

I'm sure there are many effects of all those products, but we cannot remove
those components, because of cost/benefits and all the great things they
bring. As long as public health agencies can be happy, things are okay. When
we are not able to really make quality studies on how the brain is affected
because we cannot measure a brain, things become foggy.

Add this the norm of 9 to 5, lack of sleep, bad diet, sedentary life style,
political frustration, it's expected to have mental illness or imbalance.

~~~
iSnow
Without some sources, I remain a bit skeptical that any old cocktail of
chemicals will interact in a way to cause the whole spectrum of mental or mood
disorders we are seeing. It is hard to refute with authority as this is just
such a sweeping statement that encompasses most everything around us.

I believe there are some indications that it is not that accurate: firstly,
depression and anxiety disorders as well as schizophrenia have probably been
described in ancient times (of course with a very different wording) and in
different regions of the world.

Second: if you look at this chart ([https://ec.europa.eu/eurostat/statistics-
explained/index.php...](https://ec.europa.eu/eurostat/statistics-
explained/index.php?title=File:Share_of_the_population_reporting_that_they_had_chronic_depression,_2014_\(%25\)_HLTH18_II.png)),
and squint a bit, you can see depression tends to be more frequent in rich,
northern European countries like Ireland, Germany, Finland, Sweden than poor,
southern countries like Greece or Cyprus. Public awareness is a probable
confounding factor, but it could still be that the amount of daylight and
outdoor activity is helping in the South, even though living conditions are
objectively worse as are environmental standards.

It could also be related to social media use (correlation with this:
[https://www.internetworldstats.com/stats4.htm](https://www.internetworldstats.com/stats4.htm))
but this is a very recent phenomenon, so I doubt it is the causal reason.

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RaceWon
In God We Trust. After a fashion that is, because if you told your doctor you
just met god, they'd lock you up for being delusional or at the minimum
prescribe anti-psychotic medication. Yet Billions of people claim to believe
in a "magic man in the sky", think of it; some parents are Actually Proud that
their children blew themselves up to kill other who disbelieved.

Perhaps the crisis is far, far worse than even the pill pushers proclaim. Just
a thought.

~~~
dsego
It's different. Nobody will prescribe anti-psychotic medication to a religious
person. It's just not the same thing. Speaking as someone who has a family
member with mental illness, you know it when you see it, it's just a different
thing. When someone who's never in his life had religious inclinations,
suddenly starts doing weird rituals, not sleeping, and claiming to be the
messiah and behaving differently then before,... well, it's just, has nothing
to do with being a religious person.

~~~
RaceWon
> It's different. Nobody will prescribe anti-psychotic medication to a
> religious person

I feel you are missing the point(s) I made. I am not referring to someone with
a Messiah complex; and I dated someone who was suicidal (for almost a year)
and interacted with some people in her therapy group--schizophrenics, people
with mania and so on. So I'm not a "virgin".

I just wanted to point out the blatant hipocrosy that some, not all, of the
experts in this arena. I think my points do stand on their own merit--despite
the fact that I'm low on sleep due to a 16 hour work related grind yesterday,
and I could have been a bit more precise with my original post.

~~~
dsego
I didn't just mean the messiah complex, it's someone experiencing a distorted
reality and no amount of evidence will sway their delusional ideas. It's very
noticeable. I don't really understand where the hypocrisy is and what your
actual point was. I don't think anyone considers religious extremists
completely sane.

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rjkennedy98
Worth pointing out Robert Whitaker's book Anatomy of an Epidemic.
[https://en.wikipedia.org/wiki/Anatomy_of_an_Epidemic](https://en.wikipedia.org/wiki/Anatomy_of_an_Epidemic).
It goes in depth into the conflicting paradox of a dramatic increase in amount
of mental health care and the paradoxical increase in the burden of mental
health on society. It concludes that the latest generation of psychiatric
drugs are hurting long term outcomes of psychiatric diseases.

~~~
AstralStorm
Pretty bad conclusion on insufficient data.

What we see is medicalization of mental illness, which also includes sharp
diagnostic tools and accurate data.

In past someone like that could be called Bohemian or eccentric or moody or
slow, work at physical tasks to which they were still suited; with exception
made for truly insane (mostly schizophrenics, murderers and catatonics) got
committed, and even the it was layperson or law's idea, not of medical
profession.

Remember how new even psychoanalysis is...

------
erentz
Read Lost Connections by Johann Hari recently. It’s a touch repetitive but a
quick and easy read. And I think it hits some important notes on why we might
be seeing this. A lot has changed about how we live and that deserves more
attention.

~~~
jdietrich
I wouldn't recommend it - Hari is a notorious bullshitter.

[https://en.wikipedia.org/wiki/Johann_Hari#Plagiarism](https://en.wikipedia.org/wiki/Johann_Hari#Plagiarism)

[https://www.theguardian.com/science/brain-
flapping/2018/jan/...](https://www.theguardian.com/science/brain-
flapping/2018/jan/08/is-everything-johann-hari-knows-about-depression-wrong-
lost-connections)

~~~
outlace
I read it and would give it a mild recommendation for the layperson that holds
onto old misconceptions about mental illness and psychiatry (eg that
depression is a deficit of serotonin).

That guardian article doesn’t really refute anything Hari says, it mostly
complains that what Hari says is well understood by modern mental health
practitioners, which is true but he’s not writing for mental health
practitioners.

~~~
dorchadas
Exactly. I read it and enjoyed it because it opened my eyes to a new way of
looking at things, and it also kinda made me realize that is where some of the
problem with my depression does lie. Enough that I know if I'm feeling down,
simply doing something with people is a great way to help lift myself up
before it gets into full blown can't leave my room depression.

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ciconia
"It is no measure of health to be well adjusted to a profoundly sick society."
\- Jiddu Krishnamurti

~~~
PavlovsCat
> _The fact that millions of people share the same vices does not make these
> vices virtues, the fact that they share so many errors does not make the
> errors to be truths, and the fact that millions of people share the same
> form of mental pathology does not make these people sane._

\-- Erich Fromm

> _Of course it 's extremely easy to say, the heck with it. I'm just going to
> adapt myself to the structures of power and authority and do the best I can
> within them. Sure, you can do that. But that's not acting like a decent
> person. You can walk down the street and be hungry. You see a kid eating an
> ice cream cone and you notice there's no cop around and you can take the ice
> cream cone from him because you're bigger and walk away. You can do that.
> Probably there are people who do. We call them "pathological". On the other
> hand, if they do it within existing social structures we call them "normal".
> But it's just as pathological. It's just the pathology of the general
> society._

\-- Noam Chomsky

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teilo
Isn't part of the rise due to the fact that, in 1990, DSM-5 classified a
substantial number of additional symptom sets as mental illnesses?

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LifeLiverTransp
Redeclaring what for aeons was wanted and usefull behaviour as sickness? Yes,
your ancestors wanted that hobo under the bridge.

He made a excellent scout, he was fearless and his pattern search skills where
superior to yours. He kept you fed, he kept you save, until he was no longer
useful. If it has no skin colour, and the difference is all in the head- one
could obviously not term this a race. It has to be visual, to be a acceptable
concept.

Look at him, going the way, you will go, once your usefullness has ended.

------
mensetmanusman
I like to think of mental illness like myopia. Many people used to be blind,
but then we figured out the technology, it got cheap, and now 60% of adults
wear glasses.

As there is an incentive to classify mental illness for insurance, occupation,
and drug development reasons, there is going to be 60% of people on ‘mental
illness’ treatment, because we have an ‘ideal human’ (20/20 analogy) that we
are trying to reproduce.

As the ideal changes (e.g. homosexuality was thought of in the past as non-
ideal, so it was a mental illness, now these things have changed in many parts
of the world, so those parts of the world do not classify it as such
anymore.), the treatment options/norms change.

tl;dr, it is entirely possible due to biology that eventually ~60% of us will
have some classification of mental illness that we will be treated for.

~~~
graeme
Pretty sure myopia rates increased quite a bit in the 20th and 21st centuries.
Scientists now think myopia is heavily related to sunlight exposure in youth:
don't get enough bright hours, get myopia. 3 is the recommended minimum for
outdoors time.

~~~
alexandercrohde
I've spent a few hours looking into myopia. You're correct that it's been
increasing and is still increasing, it's increased so quickly genetics can't
explain it, and the sunlight hypothesis is new to me.

Some areas in Asia have >80% myopia rates.

(As an ally myself, I also think it's worth pointing out that Gen-Z having a
7% LGBTQ rate theoretically could also have an environmental cause. There is
evidence of a biological basis for transexualism.)

[1] [https://en.wikipedia.org/wiki/Near-
sightedness#Asia](https://en.wikipedia.org/wiki/Near-sightedness#Asia)

~~~
Qwertystop
Personally I think the increase in LGBTQ people would most likely be caused by
increasing public acceptance and/or awareness - if you're going to be
ostracized by everyone you know it's a lot harder to come out, and if you
think feeling however you do is bizarre/unprecedented/obscene you similarly
won't tell people. Plenty of anecdotes out there of people who didn't think
they were gay/bi/trans/etc because they didn't think of it as a thing-you-
could-be; you see things like "oh, I thought everyone thought girls were hot"
(or equivalent).

As acceptance and awareness grow, the bar gets lower -- fifty years ago it'd
take a _lot_ of dysphoria to justify trying to transition; now it's still not
_simple_ but it's a lot easier, and so more people who are comparatively less
dysphoric are willing to take that particular plunge, and more of them know
it's a doable thing.

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alexandercrohde
>>First, to bust some myths: there is no global epidemic. It is not growing
exponentially. It is not a disease of western capitalism.

>>Second, a warning. Data is remarkably patchy.

Well, if the data is remarkably patchy then don't boldly claim something is or
isn't happening. Admit the uncertainty, so we can proceed with due caution.

~~~
jdietrich
Confidence is inextricably linked to effect size - we can be very certain that
nothing _major_ is happening, even if we're completely unsure if _something_
is happening. Put more crudely, it takes a very large sample size to ascertain
if bacon might increase your risk of colorectal cancer, but a very small
sample size to ascertain if a bullet to the head causes brain damage.

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thrownaway954
no... there are just more people and we are more connected than ever.

