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May 2006

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U.S. Mental Illness Epidemic

By Bruce e. Levine
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May 2006
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B y 2003 in the U.S., 1 in 50 had been classified as disabled mentally ill, an increase from the 1987 rate of 1 in 75 (based on Social Security Administration payments for the mentally ill). This was reported in the journal Ethical Human Psychology and Psychiatry in 2005 by science writer Robert Whitaker who also noted that 1 in 300 were considered disabled mentally ill in 1955, an increase from 1 in 500 in 1903 (1955 and 1903 statistics based on U.S. mental illness hospitalizations). 

In 1998 Martin Seligman, then president of the American Psychological Association, spoke to the National Press Club about an epidemic of depression in the U.S.: “There is now between 10 and 20 times as much of it as there was 50 years ago.” In 1999 the World Health Organization ranked depression as the world’s fourth most devastating illness, projecting that it would climb to second place by 2020. The WHO reported in 2001 that there was a higher prevalence of depression in the U.S. and other high-income nations compared to less wealthy ones. 

Mexican immigrants who have accommodated to U.S. society have twice the rate of mental disorders as newly arrived Mexican immigrants, according to a 1998 study by public health researcher William Vega. Vega discovered that the rate of mental disorders steadily grew after immigration, so that Mexican immigrants who had been in the U.S. for more than 13 years had nearly the same rate of mental disorders as native-born Americans. 

By 2004 the U.S. annual combined sales of antidepressants (such as Prozac, Zoloft, and Paxil) and antipsychotics (such as Zyprexa, Risperdal, and Haldol) had reached $20 billion, a 40-fold increase from $500 million in 1985. In 2006 the Journal of Ambulatory Pediatrics reported that the rate of children prescribed antipsychotics increased from 8.6 per 1,000 children in 1995-1996 to 39.4 per 1,000 by 2001-2002. 

Psychiatric drug commercials tell us the culprit for mental illness is our faulty neurotransmitters; however, our innate biochemistry is one of the few things that has not recently changed, so why such a dramatic increase in the rate of mental illness? What has significantly changed is society and that’s where it makes sense to search for the culprits. The following are some of the likely sources for the epidemic. 

Decimation of Community: Sociologist Robert Putnam’s Bowling Alone makes it clear that U.S. society in the last century has been ravaged in terms of social capital, his term for social connectedness. Americans spend decreasing time with family, friends, and neighbors and have fewer significant human relationships. Putnam reports that, “Low levels of social support directly predict depression…. Countless studies document the link between society and psyche: people who have close friends and confidants, friendly neighbors, and supportive coworkers are less likely to experience sadness, loneliness, low self-esteem, and problems with eating or sleeping.” 

Loss of Meaningfulness and Autonomy: Andrew Kimbrell, director of the International Center for Technology Assessment, reported in 1999, “Studies consistently show as many as 80 percent of workers in our society feel their jobs are meaningless.” The leading growth jobs in the U.S. now include cashiers, janitors, maids, retail clerks, and restaurant servers.  At the end of the 19th century, a majority of Americans still worked for themselves—mostly family farmers—but by the end of the 20th century the overwhelming majority were working for someone else; and most of those still classified as self-employed are in fact at the mercy of corporations and governmental bureaucracies.  

Not too long ago, Americans had far more physically demanding and difficult lives, but these lives included antidotes to mental disability. In addition to genuine community, family farmers and artisans had work with greater autonomy, creativity, and meaning. 

Psychiatric Drug Explosion: Psychiatric drugs given for non-psychotic behaviors can trigger psychotic behaviors. The attention deficit disorder drugs Adderall (an amphetamine) and Ritalin (amphetamine-like) affect the same neurotransmitters as cocaine and can cause mania, hallucinations, and delusions. Antidepressant and antipsychotic drugs that are often prescribed for acute symptoms can result in chronic disabling disorders because of the body’s adaptation to these drugs, e.g., serotonin-enhancing drugs such as Prozac cause the body’s neurons to release less serotonin as well as to decrease the number of serotonin receptors, resulting in an ever-increasing need for more of the drug, without which withdrawal, sometimes with psychotic symptoms, can ensue. 

Extreme Consumerism: Psychoanalyst Erich Fromm believed that the increasing rate of severe emotional problems in modern society was connected to increasing consumerism. Fromm saw Americans as dominated by the having mode— greed, acquisition, possession, aggressiveness, control, deception, and alienation from self, others, and the natural world, resulting in increasing mental illness. Unlike modern mental health professionals who take seriously drug studies that are funded by drug companies, Fromm took seriously Buddha, Jesus, and Spinoza. 

According to Spinoza—not only a great philosopher, but a psychologist (he discovered the power of unconscious passions more than 200 years before Freud)—“If the greedy person thinks only of money and possessions, the ambitious one only of fame, one does not think of them as being insane, but only as annoying; generally one has contempt for them. But factually, greediness, ambition, and so forth are forms of insanity, although usually one does not think of them as ‘illness.’” 

If we take Spinoza seriously and then consider how many Americans take Donald Trump seriously, we may well conclude that perhaps there is a pandemic of mental illness in the U.S. If we take the research and common sense seriously, we will likely conclude that the cause of increasing rates of depression, psychoses, greed, and other self-destructive behaviors is an ill society that is increasingly difficult to transcend.  

Bruce E. Levine is a clinical psychologist and author of Commonsense Rebellion: Taking Back Your Life from Drugs, Shrinks, Corporations, and a World Gone Crazy (Continuu m). 
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