Mental illness: does it really affect one in five?

That number can go up or down depending on our definition of ‘illness’

Flickr

“One in five Canadians experiences a clinical mental illness and many more struggle with stress or grief.”—Globe and Mail, 02/07/2012

One in five of us has or will suffer from a mental illness: for years, we’ve peppered our news stories, health pamphlets, and advocacy campaigns with this statistic about the goings on in our heads. There are even entire mental health websites dedicated to it, such as OneInFive.ca courtesy of Dalhousie University.

It’s a number that knows no boundaries. In the U.S., a new national report found that one-fifth of American adults experienced mental illness in the past year.

So how do we know that a cool 20 per cent of us suffer from a mental health condition?

In Canada, Science-ish traced the recent origins of this bit of wisdom about our national head troubles back to the statistics page of the Centre for Addiction and Mental Health: “1 in 5 Canadians will experience a mental illness in their lifetime.” They footnote a 2002 “Report on Mental Illnesses in Canada” by the Public Health Agency of Canada, which also published a 2006 update on mental health—featuring our favourite statistic.

The health agency’s key informant? “Previous Canadian studies.” In particular: A 1996 study of  Ontarians that showed almost one in five (18.6 per cent) had one or more of the disorders measured, and an even older 1988 study, which looked at Edmontonians over a six-month period, and found 17.1 per cent experience a psychiatric disorder—again, a little less than one in five.

To find out more about this figure, Science-ish contacted Dr. Scott Patten, a physician who researches the epidemiology of mood disorders at the University of Calgary. “The ‘one in five during their lifetime’ idea has had a certain staying power. It has been repeatedly referenced in national reports in Canada, and continues to be.”

Dr. Patten has been investigating the topic for a forthcoming paper in the Canadian Journal of Psychiatry, entitled, “Is Mental Health in the Canadian Population Changing Over Time?” and has seen 20 per cent figure used around the world. While the Canadian iteration rests on rather limited data, Dr. Patten underscored how difficult it is to put a yardstick up to mental illness anyway. “You cannot directly measure the proportion of people who have a mental illness in their lifetime since any sample that is representative of the population will have young people who may develop an illness in the future, so such figures are typically educated guesses,” he explained. Also, most mental illnesses have fuzzy boundaries. “A lot of specific phobias are very common, like fear of snakes, but of questionable significance, and most conditions exist on a spectrum rather than fitting into discrete categories.”

For statistical purposes, those ephemeral ailments end up being forced into boxes. So, Dr. Patten says, “If you are depressed for two weeks after the death of a loved one, the Diagnostic and Statistical Manual of Mental Disorders says you have bereavement, which is not a mental disorder, but if you have the same symptoms of the same duration after losing your job or being diagnosed with a severe illness, it says that you do have a mental disorder.”

Still, prevalence rates have been climbing in recent years. When Dr. Patten was in medical school in the early- to mid-1980s, for example, only one in ten Canadians were afflicted. Now, as we know, it’s one in five. In Europe, the number is even higher: 38 per cent have a mental disorder in any given year. This raises some questions: are we crazier now than in the past, and are Europeans more mentally ill than North Americans?

Dr. Patten says the changing rates of mental illness are related to changing definitions and study methodologies. For example, “The European researchers commented that the apparently increasing prevalence is due to the fact that more recent studies have included much larger lists of disorders, accounting for the extremely large proportion,” he explained. The same phenomenon has taken place in the U.S. over time, and some fear that with the updated version of the Diagnostic and Statistical Manual (DSM-5) coming out, the number is poised to surge.

There are a few ways to look at the one in five, Dr. Patten figures. Some believe that advocacy groups and charities cherry-pick and inflate these statistics to emphasize the importance of mental health conditions. Others, that it’s an accurate best guess since mental health issues are the most common of health issues. The most cynical view, he says, is that “by incorporating more and more conditions and claiming higher and higher prevalence, normal life experiences are being malevolently re-branded as medical issues.”

Then, how many of us are really mentally ill? Coming up with a number is as tricky as describing what’s going on in your noggin. As Dr. Patten puts it, “In psychiatry, we don’t have any really solid, objective way of defining these things, so the facts can’t be entirely freed from values and interpretations.”

Thank you to reader Andrew Phillips of Ottawa, Ontario for writing in about the “suspicious” one in five statistic.

Science-ish is a joint project of Maclean’s, The Medical Post, and the McMaster Health Forum. Julia Belluz is the associate editor at The Medical Post. Got a tip? Seen something that’s Science-ish? Message her at julia.belluz@medicalpost.rogers.com or on Twitter @juliaoftoronto




Browse

Mental illness: does it really affect one in five?

  1. Statistics like this are important to discuss and unpack, but I’m a bit concerned by the tone of your article. Phrases like ‘head troubles,’ ‘ephemeral ailments,’ and ‘are we crazier now than in the past?’ put a casual spin on what can be a very debilitating set of disorders. If you were writing about cancer or other diseases, I doubt you would use such casual language.

    • The difference between mental disorders and other diseases such as cancer is the presence of biological markers that make diagnosis relatively clear, definitive, and straight forward. There isn’t one mental disorder for which we have discovered a reliable, accurate biological or physiological method for diagnosing. Instead, the DSM relies on defenitions, which consist of lists of symptoms. While no one doubts that psychological and emotional problems can be severely debilitating, there is a problem with labelling them diseases, which has a strong biological, organic connotation, when we can’t actually pinpoint what is wrong with the person.

      • It is very interesting that you should delinate between so called medical diseases that have “biological markers” and mental illnesses that are diagnosed on the basis of symptoms.  Isn’t true that gifted physicians, including internal medicine specialists use their assessment skills to take a complete history, make a physical assessment and listen to all of the patient’s symptoms AND in doing so are often able to make an accurate diagnosis without obtaining any lab work or x-rays?  Isn’t true that specialists in Respiratory medicine, oncology, cardiology and dermatology only use the “biological markers” to re-inforce their initial diagnosis….made based on a patient’s presentation?
        You are ignoring the fact that illnesses such as Alzheimer’s cannot be definitively diagnosed without an autopsy and yet diagnosis are made every day without doubt of what the condition is. 

    • She might, if she were talking about warts.  One of the points here is that the “1 in 5″ figure very broadly includes far too much, while implying that what is being discussed are the more serious disorders.  “Can be a very debilitating set of disorders” – yes, but also can be minor nuisances.  When the “1 in 5″ figure is used, it’s to elicit sympathy, and to play up the scale of the problem, for a very good cause.  However, because it includes the mental health equivalent of “warts” when discussing cancer (such as fear of snakes, when talking about major depression), it’s misleading, and can lead to a backlash.  Do we really need well-meaning charities using a figure that can encourage distrust in the scientists and health professionals they are supporting?

      (and yes, I know the cancer/warts analogy isn’t perfect)

  2. The NP have a great article on the new DSM-5.  The big pharma companies couldn’t be happier.  Feeling blue – got a pill for that; uptight – lets call it GAD and here is a pill for that. There is now bi-polar I, II, III and IV.

     ”Millions of healthy people – including shy or defiant children, grieving relatives and people with fetishes — may be wrongly labelled mentally ill by a new international diagnostic manual, specialists said on Thursday. 

    In a damning analysis of an upcoming revision of the influential Diagnostic and Statistical Manual of Mental Disorders (DSM), psychologists, psychiatrists and other experts said new categories of mental illness identified in the book were at best “silly” and at worst “worrying and dangerous”. 

    Allen Frances of Duke University and chair of the committee that oversaw the previous DSM revision, said DSM-5 would “radically and recklessly expand the boundaries of psychiatry” and result in the “medicalisation of normality, individual difference, and criminality”. 

    David Pilgrim of Britain’s University of Central Lancashire said it was “hard to avoid the conclusion that DSM-5 will help the interests of the drug companies.”

    http://news.nationalpost.com/2012/02/09/new-diagnostic-mental-health-manual-may-label-shy-children-grieving-relatives-as-ill/

    • Leo, I have not seen the DSM-V but I as a psychiatric nurse, I am going to tell you that bipolar disorder has always had a type one, type two and spectrum disorder.  If you want to learn more about the illness you read about it from an expert like Nassir Ghaemi.  Then you would understand the necessity for the distinction between the different types.
      As for GAD (generalized anxiety disorder), it existed in the DSM-IV and is dismissed by many psychiatrists as not being legitimate.  With regard to your statement about “pills for when your feeling ‘blue’”, that is just uninformed…people with major depression don’t just “feel blue”, they commit suicide and often therapy works as well as medication as a treatment.
      In all of this “controversy” you seem to have forgotten the psychiatrists….men and women with approximately eight years of medical/psychiatric education.   Despite what you might think, they are not all stupid nor are they shills for drug companies.

      • With respect for your professional expertise, I do not think that Leo was saying anyone was stupid.  Of course you are right, but it is also correct to note that many many of us will have low grade depression, and will be offered meds instead of any alternatives.  Really how can a physician understand when to medicate and when not when they do not know their patients well, or what they are normally like as compared to what they are presenting, and only take a few moments to assess?  And it’s not easy for the depressed person to say no to the drugs because we want to feel better and feel faith in the doctors’ expertise. 

        This is not to say that deeply depressed people may well benefit from drugs for a period of time, and that depression indeed can make people suicidal.  I understand that; but I also know that doctors offer meds all too quickly and without understanding the scope of the depression.

        • I don’t think you realize exactly how much of a family physician’s workload is psychiatric-related.  They face a big problem.  They have limited time to spend with the patients and there are limited resources in terms of available counselling or even specialists that they can send a patient onto.  In Calgary, the wait to see a psychiatrist is about nine months.  If a family physician is very concerned that the patient is suicidal, he can send them to the emergency department at the hospiital…otherwise, he is on his own using his best judgement.  He has to ask questions and determine if this person is at risk to hurt themselves or perhaps their whole family because of their depression; are they coping at home; do they have children that they care for; are they functioning in their job?  You can provide ways to keep serotonnin levels up – exercise; visiting with friends; taking a walk in the sunlight for one hour each day but when a person is in your office crying, you know that they don’t feel well enough to do those activities.  Today’s antidepressants are not happy pills, they work to allow you to keep the serotonnin that would otherwise be flushed away.  If you don’t have a shortage of serotonnin, they don’t work to make you feel at all better.  It is really hard for people who don’t suffer from depression to understand that people with it can’t put anything into perspective.  They cannot cope with life.  It is well and good to say “don’t medicate them” but they aren’t sleeping at night and they aren’t eating well…they are crying and their responsibilities haven’t gone away…they have children and jobs.
          For a family physician their worst nightmare is to hear that a women has drowned her kids or that a man has killed his whole family and himself.  With that in mind, how can you say that they offer meds too quickly.

          • Well maybe we’re saying the same thing but disagreeing on whether it’s alright or not.  Given that you cannot possibly know that all the GPs faced with the crying person know what questions to ask or take the time to ask them — and remember: they may be speaking to a patient they have never seen before, very likely given the doctor shortage — then how can you say there is no problem? 

            Too many doctors give too many patients too many meds too quickly.  I stand by that.  Perhaps you are too close to the situation to be objective.

          • Do you not realize that family physicians are trained in psychiatry as well as all medical illnesses?  They are a “jack of all trades & a master of none”.   Each family physician does a rotation in psychiatry during their residency (with a psychiatrist) plus they have studied a mental health component in medical school.  Of course they know the questions to ask….how do I know this…because each family physician has to pass a verbal examination which includes questions on assessing and treating depression before they are given their medical license to practice.  Do you think when someone comes to psych ER that we have met them before….no…we do an assessment for depression and a suicide risk assessment that is standardized.
            I did not say there was no problem….I said there is a shortage of time, a lack of resources for offering alternatives besides medication (counselling with a psychologist costs $160.00/hr and is not covered by medicare in most provinces) and a long wait list for seeing specialists…..given all of that and the risk/benefit to providing treatment vs. no treatment, I don’t think you should be so quick to judge that family physicians are handing out pills without giving it proper consideration.

      • My point is that GPs are handing out anti-deppressants/anxiety drugs and they do not have the psychiatric education.  Many of them simply believe what they are told by big pharma and ignore potential side effects. 
         
        “Pristiq, “New” Anti-Depressant, Approved
         
        This is certainly a fabulous Friday for pharma execs in the land. Abilify gets approved for kids this morning and this afternoon we learn that the FDA just approved Pristiq for depression. The drug is made by Wyeth and is essentially a rejiggered Effexor, only this one was originally developed to help women with hot flashes. You know Wyeth is going to give this drug a huge roll out since Effexor goes off-patent fairly soon and I’m sure that the made-for-hot-flashes-but-good-for-depression sales pitch is going to work wonders with men and women of every age.
         
        As CL Psych and I noted last year, this smells like another episode of Celexa gets tweaked and becomes Lexapro. In other words, this is another me-too anti-depressant that will probably not have an unique features or efficacy.
         
        One hopes that the drug proves less gnarly to take than does Effexor and that patients can actually get off the drug without going through the Effexor joneses.”
         
        http://www.furiousseasons.com/archives/2008/02/pristiq_new_antidepressant_approved.html 

        • I am not arguing with you that pharmaceutical companies are in this business to make money.  I also agree that new medications are often slightly changed old medications to allow for patons to be extended.  However, I think you should talk to someone who has suffered from major depression and whose life has been saved by antidepressants before you demonize the medications. 
          How is it that you don’t go on a rampage about medications for heart disease, epilepsy, hypertension or diabetes?  Are those illnesses more legitimate to you?  I honestly wish you could encounter a person with bipolar type I having a psychotic episode.  Then you would not be so doubtedly about the validity of these illnesses or necessity of the medications that keep them regulated.
          As for your comment about Effexor, many drugs require that wean off them so that you don’t have a withdrawl side effect.  Prozac is one of the few that does not. 

          • I feel the same way about other medications  – diet and exercise can do wonders for hypertension or diabetes.    My mother was smart enough to tell her GP she did not want any more Vioxx after having strange side effects.
             
            Sheesh HCI, of course you need medication for a bi-polar I having a manic or depressive episode.  

            I’m just saying that my personal experience is many GPs have become very comfortable handing out drugs on the first visit.  In B.C. you used to get six visits to a psychologist with your GP’s referral – not anymore.  You can get referral to a program where you get sessions with a psychiatric nurse – a friend of mine finds it a big help.  We have months of waiting for a psychiatrist as well.

          • Leo, the worrisome thing is that new information comes out about the ill effects of hypertension and what constitutes hypertension….it used to be the 140/90 was an okay blood pressure.  That is no longer the case….you need to ask yourself if you are so anti-medication that you are unwilling to go on an anti-hypertensive short-term until you lose that 20 pounds and get your blood pressure down into the 120/70 or lower ideal, are you also okay with risking a debilitating stroke?
            Are you so against medication that you okay with suffering gastric reflux and ending up with esophogeal cancer in 15 years?
            Are you so against medication that you are okay with having high blood sugar and ending up losing your teeth, eyesight and legs to diabetes?
            I am glad that you see that a Biplor I have a manic attack needs medication but the truth is that the depression is much worse than the mania.  It is great in BC that a patient gets sent to a psych nurse, it isn’t the case in all the provinces.  As for your belief that family physicians don’t know psychiatry…they are trained in it the same as in all medical illnesses.
            You have to remember that they have to assess the risk to a person when they come to see them.  Would you look down on your friend if he/she decided to try an antidepressant?  I would sincerely hope not.  Maybe he/she has but doesn’t feel they can tell you.

          •  Hi Heather, your first two statements say a lot really, makes them a but suss doesn’t it? I think if anyone wants to take a drug thats one thing,it usually means their happy with it, or feel a benefit, but if they don’t thats another story, that usually means their not happy with it, and its causing them to feel disturbed in one way or another, medications for heart disease, epilepsy, hypertension or diabetes aren’t drugs they lock you up in psyche wards for, and force down your throat are they, So i think that says a little bit about the difference don’t you? They cant, and shouldn’t even be compared to drugs like Zyprexa,Haloperidol, Epilim, Ritalin and Focalin XR, Clozapine, lithium,all hallucinogens, the list is far to long to put them all here, but It is estimated that psychotropic medications contribute to 22% to 39% of
            all causes of delirium,  and of course street drugs like methamphetamine’s, ice, cocaine, etc can do the same, most clued up people know these are drug induced psychosis, and the symptoms of an amphetamine-induced psychotic disorder is not
            considered to be “permanent” and will eventually subside with a sufficient
            duration of abstinence. and the right non invasive care by the right evolved in the know people, Unless of course they aren’t clued up, or don’t have anyone clued up enough to steer them correctly, and not see them as real psychosed, at least for the first five days, and the drugs causing them the psychosis have eliminated from their bodies, and the right amount of restorative sleep has been had, they say even up to ten days, and thats certainly before any diagnosis should be made, but thats not happening is it,anyway thats not depression parse, although it might have been to some extent what led them to where they are at, or played a part, and most people regardless of what they’re feeling at a given time will think ok, if they can feel ok, convincing them of that is what mental health and psychiatry should be doing, but there too busy looking for sick and convincing them of that, and the saddest part about what their doing is that their forcefully poisoning them instead, with hallucinogens, instead of nurturing them with guidance, and a plan, and fostering hope. Lets leave it there hey.

        • Effexor has been off patent for years. I worked in a pharmacy – we got generic venlafaxin as early as 2002 or so. Also, Pristiq seems be well-tolerated in some patients who could not tolerate Effexor, and vice-versa. There is some legitimate concern over “evergreening” whenever a new substance is produced from an old one (e.g. ezopiclone, ecitalipram, or in the case of Pristiq, desvenlafaxin) but given the side-effects of these drugs, and the tremendous variation in responses and tolerability from one patient to the next, sometimes a patient needs to try 6 or 7 of them in fairly rapid succession before they find one they can tolerate. Try explaining the criticism of “me too” drugs and “evergreening” to a patient that has tried 8 different drugs before finally finding one that works with tolerable side effects. They won’t much care about the criticisms; they’re too relieved that the choices were available and that they finally stumbled across one that works. And I do mean stumbled. There’s just no way for doctors – even experienced psychiatrists – to know which drug will work for which person. 

  3. comment removed by user

  4. Julie, this may be more a question of semantics than diagnostics, particularly after a traumatic life event.  As Alaska cardiac psychologist (and himself a heart attack survivor) Dr. Stephen Parker likes to say:
    “There are damn good reasons to feel anxious and depressed after a heart attack. 
    A heart attack is a deeply wounding event, and it is a wound that takes a long time to recover from, whatever the treatment.”

    I’m a heart attack survivor myself, and couldn’t agree more. Most studies actually suggest that what we know as depression, for example, tends to
    be a naturally self-limiting mental health condition that generally
    improves over time with or without the pharmaceutical assistance of antidepressant drugs. University of Connecticut researchers*
    examined 38 pharmaceutical company-funded studies involving over 3,000
    depressed patients, and found that those taking antidepressants did
    improve, but the improvement differences between the medicated and
    placebo-taking groups were actually described as “miniscule”.

    Meanwhile, for those worried about the ‘marketing-based medicine’ motivations of those now writing the DSM-5 for next year’s publication, consider instead “10 Non-Drug Ways To Treat Depression in Heart Patients” at http://myheartsisters.org/2011/08/05/non-drug-therapies-for-depression-in-heart-patients/

    • carolynthomas, Thank you for the link.  I find your comment fascinating.  I just want to point out to you that psychiatry uses ALL the tools mentioned in your article.  Unfortunately people who are very depressed (not mildly depressed), are often incapable of finding the energy to exercise, practice mindfullness meditation, go for a walk in the sunlight or even get out of bed.  When they do get abit of energy, they use it to execute their suicide plan.  You see when people are very depressed all they can they think about is the pain they are in and that their family and friends would be so much better off if they weren’t in their lives.  In psychiatry we see people who are depressed to the point of catatonia and psychosis.  We have had patients who have come from the heart surgery unit because they refused to get out of bed post surgery.  They don’t want to live.  Yes, we used anti-depresants, we used electro-convulsive shock therapy, we use talk therapy, we use light therapy….we use every tool in our box to keep people alive.  Should people feel guilty because they need to take a medication to keep their serotonnin level at a place where they don’t want to take their own lives……I don’t think so.   Afterall, we aren’t asking people to refrain from taking heart medication or getting heart surgery when we know that increased exercise often is just as efficient as bypass surgery.

      • The number one cause of depletion of serotonin is stress.  You need to determine if it is external or clinical.  I had a wonderful GP who has since retired, that had to take a year off and he was depressed – busy practise, six kids, divorce.

        • It is typical if a person takes an anti-depressant that they only remain on it for six months.  Now, I want to ask you Leo.  If stress is the issue and we decide that the depression is ‘situational” but there is no way to alleviate the situation….busy mom, kids getting in trouble at school, separated from kid’s father, demanding job……how do you treat it?

          • As a person who is currently battling my depression and anxiety, I can tell you there is no control over the experience. Four years ago , I was a highly functioning individual with a well paid demanding career, a husband, and busy social life. I was happy, loved fishing, travelling, and cooking for friends and family.
            It all changed in an instant when my Husband passed suddenly. The trauma of the event and the downward spiral I found myself in, was uncontrollable, dark, and paralyzing. I have never been a drug person, dependent, or needy. I made my own money, looked after my own finances, and loved my career.
            Four years of hell have followed with short periods of relief, but I have had to leave my employer, who really didn’t understand the severity of my condition. I took severance in order to focus on protecting my health and sought help with a private medical practice for women and also changed physicians, which has helped my health. 
            The problem with treatments is the refusal by some in medical community to recognize the medical conditions are brought on by stress. That’s why I sought help with my symptoms at a private clinic. 
            I had adrenal fatigue, no hormone levels that were detectable, add to this peri -menopause and my grief and anxiety. I wanted to treat the
            physical and mental as separate, yet co-dependent conditions.
            I have never blindly followed a doctor’s orders or opinions, but expect to be heard and respected and discuss my options. It is hard to find a doctor that is used to this dialogue, or who is really listening to what you are saying. I have an excellent balance between the two physicians I am seeing, and although they don’t necessarily agree with each other, they are both essential in my recovery, and respect my choices. I had to choose my health over my career, and chose health. . I knew it was time to leave when a Manager asked me if I was on Lithium or something? That is the culture of Mental Illness in the work place.

          • Four years is a long time to be struggling with feeling awful.
            In reading the description of your illness trajectory, I was struck by the notion that it seems to surprise you that depression anxiety makes you feel “out of control” of your life   I assure you this is a common experience for people with all kinds of illness.  Guilt is also a common emotion…guilt that they cannot tasks that they used to do with ease or that they can’t feel happy or less anxious.  Interestingly enough, some people like to be in hospital because then some of the control is taken and they don’t have to feel that they are surrendering something by choice.  They feel less guilt because there are no expectations of them completing any tasks or presenting themselves in anyway except as how they really feel….for them, it is a vacation of sorts.
            I hope that you are on the road to a full recovery and wish you all the best.

      • As long as we’re being extra strict with definitions, I think you meant to say something like “…OFTEN when they get a bit of energy it is used to carry out their suicide plan”

        • Yes, you are right.  I just wanted to relay that when a very depressed person suddenly becomes happier, if OFTEN means that they have made a choice to end their lives and they are relieved that they have a plan to end the pain.
          It is troublesome to me that people make such a distinction between cancer and mental illness.  If you had cancer, no one would tell you “don’t take medication” but with depression, they feel free to tell you that you can “cure yourself” by exercising and meditating….if the person had the energy, clear thoughts and will to do so, they would not be drowning in feelings of worthlessness, self-loathing and hopelessness.  People talk about removing the stigma.  How will that ever happen when we refuse to see that mental illness is a biological problem as real as any medical illness and the trick is to get people well as fast as possible, by any means possible, so they don’t give up living.

      •  In fact, I was one of those people who were “very depressed, not mildly depressed” so I do know full well this experience from having lived it personally, not just from having studied it in textbooks or Big Pharma-funded journal ads (although I’ve done plenty of that, too!) 

        Each of us approaches issues like this one from the very narrow lens of our own experience – hence your opinions based on working with desperate and suicidal patients.  But, as you know, most patients diagnosed with depression are not suicidal, and that issue is not the point of Julia’s article here, yet treatment protocols (based on drug industry-influenced guidelines in the past four versions of the DSM) clearly call for a “drug-first” approach to ward off this cloud of allegedly omnipresent suicidal ideation, an alarming sense of overkill that is pervasive.

        From a patient’s perspective, I can tell you that when it comes to the mental health issues of their patients, GPs tend to first reach for the big fat copy of the current DSM, what  Dr. Allen Frances (the editor of the current DSM-IV) calls the “birdwatcher’s guide to psychiatry.  THIS is what the average GP relies on (if there is such a thing as “average” – and let’s face it, a med school psych rotation decades earlier hardly counts as being “educated” on emerging mental health issues – besides being educated by one’s drug rep, of course).  I agree with Le_o’s very sound comments on this point.

        And when the former editor of the DSM-IV himself now admits: “We made mistakes that had terrible consequences” in producing this guidebook, mental health professionals need to sit up and pay attention to him.  More on Dr. Frances’ frank disclosures at http://ethicalnag.org/2011/07/02/dsm-5-shrinks-bible/

        After surviving a heart attack, and increasingly debilitated by the knowledge that something was “terribly wrong” with me, pleading with my own GP for a referral for psychiatric counselling, I found that she was completely resistant to the idea of talk therapy, first blaming a one-year waiting list for psychiatrists, and then blaming the scarcity of “good” psychiatrists in town. Instead, she reached immediately for the prescription pad. And then another. And then another. At no time did she recommend or even discuss any other non-drug options, even though, as a heart attack survivor, I was already taking a fistful of cardiac meds each day and she knew I was VERY reluctant to keep adding more toxic chemicals to my daily regimen. After an entire  year of suffering in a drugged haze (which could be “cured” by just switching to new improved meds, of course!)  I again begged for a psych referral, this time reminding her that, had she arranged this referral one year ago when I had first asked, I’d already be seeing one.  Reluctantly (!) she finally agreed – and I was in my shrink’s office within ONE WEEK.  Best thing that could have ever happened.

        • I read your link and Dr. Thomas’ comments with regard to childhood bipolar disorder, etc.  I am sorry that YOU had one family physician who didn’t want to listen to you and give you what you wanted….a referral for talk therapy.  That sounds like an excellent reason to say all family physicians deserve to be thrown under the bus for providng poor psychiatric care.
          You say that I have a “narrow view” because I have worked in acute adult psychiatry for 15 plus years but I have also worked in outpatient psychiatry where people live in the community and are not in hospital. I think I explained that we use every tool in the tool box to keep people well…including exercise, mindfulness meditation, behavioral therapy, etc.
          Believe me, if you asked to talk therapy, you would get it.
          I understand your feelings toward “toxic chemicals” as you refer to the “handful of cardiac meds” you were taking everyday.  Are those the meds that were keeping you from having another infarct?  I am sure you see sense in Leo’s comments because both of you hate medications even if they are responsible for you staying alive after a heart attack.
          As for you being in a “drugged haze”…you obviously were not taking just an SSRI (antidepressant)….those meds don’t cause anyone to be in a drugged haze…unless you are severely allergic. 

      • It sounds like you’re advocating prescribing medication for anyone presenting any sign of depression.

        • What I am advocating is not being judgmental about the choices that depressed people make in order to get well.  Major depression is a serious illness…no different than heart disease or diabetes.  People with heart disease or diabetes can often chose not to take medications as Leo suggested and instead do a regime of losing a significant amount of weight and a regimented exercise program.  In fact some studies have shown that a strict exercise program involving a brisk three mile walk per day can be as successful as bypass surgery when no surgery is available.  The point is people do not tend to judge people with illnesses below the neck for the choices they make to take medication or have surgery.  I am just pointing that medication is one of the choices of treating major depression and it isn’t a “bad choice”.
          If you asked most psychiatrists what choice they would make if they were suffering from major deprepression, they would tell you, electroconvolsive shock therapy (ECT).

  5. Great way to lose your job.

    • Yes, what is the message here….give up your job but for goodness sakes don’t take an antidepressant!

  6. Thank heavens that MacLeans Magazine has a proper handle on mental illnesses, along with journalists with appropriate credentials to quash the myths that these illnesses still seem to attract.

    Serious mental illnesses (SMI) like schizophrenia, manic depression, and related brain diseases, including Alzheizmer’s syndrome, require specialized medical treatment and care. It would be a tragedy to ignore this difference,  by including lesser illnesses in the same general category as these medical diseases of the brain. They do not share SMI’s awful symptoms, of hallucinations, delusions, paranoias anasognosia and ahedonia and even more importantly, are not known to be chronic, no-fault biological brain diseases.

    The recent 1 in 5  figure lumps all mental illnesses together as if they were alll the same in severity and treatments. This is a mistake. We must separate out these illnesses as we have already done with Alzheimer’s diseases and give each each one the treatment they desperately need.  

    This line must be clearly drawn if we are to have any hope of finding the cause and cure for these severe medical brain diseases, without more muddying of the waters. 

  7. You want to use these magazines to flex your political muscles and it’s got nothing to do with anyone’s health.  Nobody wants your help.

    • What the hell are you talking about? 

  8. That number can’t be right. For instance it would be much lower if you subtracted the number of people who subscribe to Maclean’s who stickily speaking are just stupid.

  9. LIFE TIME PREVALENCE OF SERIOUS MENTAL ILLNESS
    BIPOLAR DISORDER (4.4%)SCHIZOPHREINA(0.4%)MAJOR DEPRESSION(20-30%)

    • Stop shouting and learn how to spell.

  10. Julia,

    I haven’t read all comments above but I strongly agree with Dpmmatthews.
    Though it’s important that we challenge and investigate stats floating around in the media, whatever they be related to, I found the tone of this article very unsympathetic and even degrading.
    ‘are we crazier than in the past’
    Comments like these contribute to the stigma surrounding mental illness.
    I have flagged the article to both the mood disorders society of Canada and the McMaster Health Forum.

    Addressing the question of one in five, the article doesn’t seem to be objectively researched. Unlike some of the other articles in science-ish, not a single systematic review was referenced. More and more studies are validating that mental health is a hugely prevalent issue. So maybe it’s not 20%. Maybe it’s 15%. What’s the difference?

  11.   It is time to face MENTAL illness right in the face.  Once being “labelled ” as bipolar; has provided me with excellent coping skills and unconditional compassion.  LISTEN and LEARN….  Blessed be..

  12. Are medically ill people being put in psych hospitals to cover up medical negligence by police who are told by doctors not to file an incident report,
    I can assure you that this is going on and the public should be very afraid as they can  disable your brain function  and end you can end  up in a psych hospital.
    I had a spinal tap done in an ER. My medical condition lied about. The condition I was left in immediately deemed a mental illness and I was eventually put in a psych hospital by police who are told not to file an incident report.
    Doctor then brought over to the psych hospital to treat me medically because of the failure to treat me in the ER at the time of the spinal tap. A cover up ensued the involved many including psychiatrists who were willing to go along with this fraud.
    Any damage and injuries are then concealed by a denial of tests so you cannot sue and expose what is going on. Also a form of blacklisting you from medical care.

  13. I have no problem with questioning the validity of certain statistics, but the language used in this article is very disrespectful of people suffering from mental illness (e.g. head troubles, crazier now than in the past).  Is the author trying to be funny or provocative?  I don’t know.  I’ll I know is that I had trouble taking the author seriously.

  14. This is a dismissive article that hurts the cause of mental health. It doesn’t really matter if the “1 in 5″ figure is exactly right. Of course there is no totally objective answer to the question “How many people suffer from mental illness?” The important thing is that we use good-enough measures and raise awareness. This article contributes to stigmatizing and belittling what is a major and underappreciated health epidemic.

Sign in to comment.