It needs repeating:
Epidemic? Half of US teens `meet criteria for mental disorder'
By Agence France-Presse
Thursday, October 14th, 2010
WASHINGTON -- Around half of US teens meet the criteria for a mental disorder and nearly one in four report having a mood, behavior or anxiety disorder that interferes with daily life, American researchers say.
Fifty-one percent of boys and 49 percent of girls aged 13-19 have a mood, behavior, anxiety or substance use disorder, according to the study published in the Journal of the American Academy of Child and Adolescent Psychiatry.
In 22.2 percent of teens, the disorder was so severe it impaired their daily activities and caused great distress, says the study led by Kathleen Merikangas of the National Institutes of Mental Health (NIMH).
"The prevalence of severe emotional and behavior disorders is even higher than the most frequent major physical conditions in adolescence, including asthma or diabetes," the study says.
Teen mental disorder rates mirror those seen in adults, suggesting that most adults develop a mental disorder before adulthood, say the researchers, calling for earlier intervention and prevention, and more research to determine what the risk factors are for mental disorders in youth.
"Intervention" is code for treatment with drugs.
Like so many other insights, the understanding precedes the documentation. We chose to leave the United States because the above trend and some of its implications and precursors was apparent to us twenty years ago. The following simply added more evidence to the box :
From "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the astonishing rise of Mental Illness in America", by Robert Whitaker, Jan. 2010, pp 8-9
This plague of disabling mental illness has now spread to our children, too. In 1987, there were 16,200 children under eighteen years of age who received an SSI payment because they were disabled by a serious mental illness. Such children comprised only 5.5 percent of the 293,000 children on the disability rolls-mental illness was not, at that time, a leading cause of disability among the country's children. But starting in 1990, the number of mentally ill children began to rise dramatically, and by the end of 2007, there were 561,569 such children on the SSI disability rolls. In the short span of twenty years, the number of disabled mentally ill children rose thirty-five fold. Mental illness is now the leading cause of disability in children, with the mentally ill group comprising 50 percent of the total number of children on the SSI rolls in 2007.13
The baffling nature of this childhood epidemic shows up with particular clarity in the SSI data from 1996 to 2007. Whereas the number of children disabled by mental illness more than doubled during this period, the number of children on the SSI rolls for all other reasons-cancers, retardation, etc.-declined, from 728,110.
(It should be noted that during the time period from 1955 to the present, the criteria for inclusion on the rolls of the disabled have been made more exclusive, and the bureaucratic side of that process has been rendered positively byzantine in it's complexity. As a result, the real numbers of eligible, as judged by earlier standards, are probably much greater).
"In sum, there were 56,000 people hospitalized with anxiety and manic depressive illnesses in 1955. Today, according to the NIMH (National Institute of Mental Health) there are at least 40 million adults who suffer from one of these affective disorders. More than 1.5 million people are on SSI or SSDI because they are disabled by depression, anxiety or bipolar illness, and according to Johns Hopkins data, more than 14 million people who have these diagnoses are severely impaired in their ability to function in society. That is the astonishing bottom-line result produced by a medical specialty that has dramatically expanded diagnostic boundaries in the last fifty years, and has treated it's patients with drugs that perturb normal brain function."
"A Scientific Inquiry
The puzzle can now be precisely summed up. On the one hand, we know that many people are helped by psychiatric medications. We know that many people stabilize well on them and will personally attest to how the drugs have helped them lead normal lives. Furthermore, as Satcher noted in his 1999 report, the scientific literature does document that psychiatric medications, at least over the short term, are "effective." Psychiatrists and other physicians who prescribe the drugs will attest to that fact, and many parents of children taking psychiatric drugs will swear by the drugs as well. All of that makes for a powerful consensus: Psychiatric drugs work and help people lead relatively normal lives. And yet, at the same time, we are stuck with these disturbing facts: The number of disabled mentally ill has risen dramatically since 1955, and during the past two decades, a period when the prescribing of psychiatric medications has exploded, the number of adults and children disabled by mental illness has risen at a mind-boggling rate. Thus we arrive at an obvious question, even though it is heretical in kind: Could our drug-based paradigm of care, in some unforeseen way, be fueling this modern-day plague?"
Whitaker goes on to document in chilling detail a social disaster- the results of applying a market-profit (predatory) model to mental health. He shows us relentlessly what should be easy to see without him- that there is a loop here- or more precisely, a downward spiral:
- of redefining disruptive or non-standard behavior as disease,
- of "discovering" disease, so to speak,
- then finding a pharmaceutical that can be convincingly marketed as being effective in "treating" this newly discovered disease, and, best of all, produces the "need" for more drugs,
- and then reaping enormous profits by selling vast quantities of these newly-discovered "Magic Bullets".
He also documents thoroughly, using the very best source, the "outcomes" literature, the results of such treatment. What do these drugs really do in the long term?
It's a nightmare.
For only one example, take Ritalin therapy.
What about that group who seem to benefit, at least in the short term, from moderate drug therapy??
A good-sized subset of those children who initially responded, which generally means that they displayed more "appropriate" behavior and learning patterns, suffer "remissions" and are moved up to a drug cocktail that includes but is not limited to Prozac and Zoloft. Outcomes literature shows no long term benefit, and in fact shows great potential harm.
Since this diary is not about ritalin therapy per se, I will recommend you read his very well researched book, and summarize a single example of Whitaker's findings:
Here's his careful, conservative assessment, --from outside the commercial community:
"The drugs alter a hyperactive child's behavior over the short tern: in a manner that teachers and some parents find helpful, but other than that, the medications diminish a child's life in many ways, and then may turn a child into an adult with a reduced physiological capacity to experience joy-."
And what about the other group- those whose parents pursue drug therapy more determinedly?
There is one other area of heartbreaking risk with such therapies that remains to be explored in detail. It often works like this: A child who shows mood swings- emotional volatility that, in an earlier time would likely have been accepted as a normal personality trait that would likely moderate with age is treated with Ritalin, to temporary good effect, from the point of view of the parent and teacher. The effect fades, old behavior reappears, in spades, Prozac is used, then other symptoms appear, and he or she is diagnosed as bipolar, bringing on yet another batch of mind-altering drugs. Several years of this, and this child may well be diagnosed as " Bipolar, Rapid-Cycler", a pernicious variety of bipolar disorder for whom the outcome is quite grim, and quite permanent, and will produce a lifetime of drug therapy with no good outcome.
So do we now know why there is such an epidemic of mental illness in the US?
Whitaker thinks so. I think he has only one piece of the puzzle. He's seeing a symptom, instead of the disease. Whitaker and the NIMH, Agence-|France-Press and others now belatedly see --only a part of the picture.
I think the "disease" is American society as a whole.
The structural-functional sociologists see as the central explanadum of society the notion that an institution or coherent cultural element's structure has an intimate relationship to, and can be best understood by what it actually does, not necessarily what the popular mythology says it does. Thus, if one dons their glasses, one might say that for much of American history, newspapers and media in general defined, among other things, crime- who commits it and what the risks and costs were. And prisons in America were there to, of course, make criminals. And the two together compose a loop that creates a class of untouchables-a class of "black Hats", disobedient semi-human motes, for us to hate. A process hardly unique to the US.
The deeply human tendency to latch onto a single perspective and demand that it explain everything always rears it's head in searching for explanations for the complex ways of mankind. I suggest it's good to think of such notions as this, and of theories involving market functioning, as sort of thought bubbles in a grand cartoon of near-universal oversimplification. Reductionism is in our blood. It runs our media, friends, and is dangerous. But, within limits, the structural-functional point of view is useful. For example:
The New World Consumer Culture is an entire package that was largely made in America, and has, at it's core, little to do with wealth. It capitalizes on several human frailties, atavistic and self-destructive, and manipulates them to render the popular mass powerless. "Stuff" is the most effective technique for social control ever invented.
Begin with the notion that emerged early in our history that self-reliance was good, and that competition, whether personal or economic, "improves the breed", as if we were motes in some vast experiment in eugenics. The notion is vapid. It ignores the conception behind Leaky's eloquent "People of the Lake" that what elevates and empowers humans is our ability to cooperate to achieve an abstract, imagined goal. We dream. We build.
Making dreams real is a cooperative enterprise.
But self-reliance was a useful notion to push a lot of dreamers into a Conestoga wagon and to a desperate, often deadly existence on the frontiers of barbarism in the Great Move West(tm).
But- ask yourself if you could, if necessary, produce a light? By yourself? Or a hamburger, or a pencil, or---
---the grand dream of Apollo Project? Or the Concord?
And we need our dreams. Without them, humanity does not prosper. We sicken, we grow cynical and bitter, we turn inward and self-destructive, we savage our own social body.
The process of crafting these notions into a means of social control unequaled in human history was decentralized and almost inchoate, and did not require any great conspiratorial machine, though I have no doubt there is an element of conscious cooperation. A structural-functional perspective might say that the necessary element was a simple confluence of common needs - by the industrial magnates, the railroad barons, the economic elite who always wish to remain in their elevated aeries. But the long process of the creation of "Stuff Culture" has some obvious components:
--Human and environmental predation redefined as "victory". A popular, cartoon-like mythology of good guys, bad guys, white hats and black. We like it simple. Particularly when it's not. Hence the "conquest"- of nature, of enemies, of the hemisphere. With sporting overtones.
--An overarching economic analysis, a prayer book to fill the market for a quasi-academic justification for such predation. Hayek, Uncle Milty and the rest of the fig leaf makers, bringing with it it's concomitant political analysis.
--The emergence of cultural myths for the non-academic, embodied best by Ayn Rand, but present in solid form in a hundred other writer's screeds. Heinlein's imaginings, which included the idea that those who could not afford to pay for air ought fairly to be left to suffocate, and their heirs, if any, charged for the cleanup costs, to endless equally vicious but unremarked pronouncements from our late, great heroes of the White House, from Reagan, the Bushes with their endless list of enemies, or-- but you get it. And then, just when we knew who to hate,
--The loss of easily villainized or fabricated enemies with its resultant turning within in the search for replacements, turning a preexisting tendency into a veritable flood. A huge prison population with degrees in criminality, producing a yet greater surge in the prison population, producing an entire new privatized prison industry depending, very much like medicine and psychiatric medication, on amplifying the problem that created it, rather than reducing it. All participants, outside and in, must tell themselves patently unbelievable stories about how we're all good guys here, and how it all makes sense.
--And now, we have created a whole new panoply of evil doers, a rogue's gallery so inclusive, so sweeping in its scope as to justify endless war almost everywhere.
Consider how the components above might play out over the recent historic past, from the point of view of the ordinaries like myself.
Emerging slowly from the Great Depression, my parents sought victory over the black hats, on whom we projected our fear and anger, our desperation after a decade of failure, and they sought also a bit of material security. WWII seemed to bring that. A generation of psychologically traumatized veterans (WWII was no picnic. Bataan, Corregidor,, Hiroshima, etc.) landed in the rich humus produced by the world's greatest (impossible) command economy: the US after WWII. Their enthusiastic participation brought a bountiful crop- a vast tsunami of doodads, and thus more good jobs plundering and ploughing the remains of the continent and then the rest of the hemisphere in the quest to produce and then sell all that stuff. And then, of course, we needed a lot of that shit to defend ourselves from the Communist Russian evil, then the evil empire, then the drug war, then the Axis of Evil, then the Global war on Terror, then--
It's an unsurvivable crash, composed of life stories that we as atomized and isolated people tell ourselves, stories of the evils of others, violence saturated, endless, with no good outcome, stories where victory is always bought at the cost of another's defeat, stories where the kind are losers, compassion is someone else's job and hopeless cynicism is the hallmark of my son's generation (or so he says) requiring that we drug ourselves with a new I-pod, canned dreams and then, ultimately, powerful psychotropics, to numb our capacity to feel, to suffer, and above all to feel the pain of others- that pain machine that is at the heart of our national "business model".
Our own pain, fear, sense of failure.
A world of wounded, hurt and angry victims.
No dreams for a better future. Few dreamers. It's all done for us, so we live their dreams- the ones they give us.
As good as he is, Robert Whittaker has only one piece of the puzzle. The drugs are a symptom. They are there to respond to, to soften the realities of an otherwise unsurvivable national culture.
That culture has made huge inroads into Western Europe, and the same human frailties that were exploited to impose it on my country have proved powerful here too. I came to Europe with many hopes, among them the hope of pointing out this fact to some, and was eventually dissuaded by the sometimes thinly veiled contempt of those who saw me as just another sour expat, or loser at the great game of life. And by my fear of being seen as the crackpot on the corner with the sign saying, "Repent, for the end is near!"
I no longer care if you see me as such a one, because I am not alone. There are millions who see a lot of what Whittaker, from his position in the belly of the beast, cannot. Perhaps I was arrogant to think I needed to say it at all.
The question Whitaker did not ask is this:
Why would such draconian application of powerful, poorly understood drugs be felt to be necessary? For children, as well as for adults?
Remember the huge strike over the CPE? They said to the world,
"We are the future of France! We are not disposable!"
"Ni Pauvre, Ni Soumis!" (Neither Poor, nor Submissive!)-A different view of wealth?
My heartfelt thank you to the many, many people of France who can see what Bob Whittker cannot.
It's not just mental illness, or retirement.
It's life itself.