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Mental illness is not growing in the U.S., says NEJM study

Mental illness is not growing in the U.S., says NEJM study

Picture of Martha Rosenberg

The statistic seems to be everywhere: One out of four people in the United State is “mentally ill.” Mental illness is “under-diagnosed” and children are particularly "at risk."  More than 10,000 2- and 3-year-olds in the U.S. are on drugs like Ritalin and Adderall for attention deficit hyperactivity disorder reported the New York Times last year--yet there is no medical basis for the treatment. American Academy of Pediatrics' guidelines for ADHD "do not even address the diagnosis in children 3 and younger--let alone the use of such stimulant medications," wrote the Times, especially because "hyperactivity and impulsivity are developmentally appropriate for toddlers."

Now, the New England Journal of Medicine has published a report suggesting that the rate of severe mental illness among children and adolescents has dropped substantially in the past generation--not risen. “This study shows that the extremely high rates of childhood mental disorder reported by the C.D.C. and others result from flawed assessment methodology that includes many kids who have very mild impairment or no impairment at all,” said Dr. Allen Frances, a professor emeritus of psychiatry at Duke University.

There are two factors which have driven the perception of growing "mental illness" in America's youth. First, the definitions of many mental conditions have been expanding, abetted by their lack of blood or lab tests which makes them judgment calls and gray areas. Whereas depression was once considered a self-limiting condition it has expanded into a lifelong disease that requires lifelong drugs. Needless to say, patients can't know if they  need the drugs month after month, year after year.

Anxiety was once an intermittent problem treated transiently but has been expanded into “generalized anxiety disorder,” also requiring continuous and constant treatment--when patients have anxiety and when they don’t.

Manic depression was once a rare psychiatric illness but is now called bipolar disorder and said to afflict anyone who is “up” and “down”--even if their mood swings stem from real reasons like job, money or relationship problems.

The other driver of the estimates is the sheer money involved in pediatric "psychopharmacology." Dr. Joseph Biederman, for example, unabashedly pushed Johnson & Johnson to finance a research center at Massachusetts General Hospital, in Boston, with no other goal but to “move forward the commercial goals of J.& J,” reports the New York Times.

 

Children with "mental illness" have also been a unique focus of Dr. Joan Luby, professor of child psychiatry at the Washington University School of Medicine and Dr. Mani Pavuluri who founded the Pediatric Mood Disorders Program and the Pediatric Brain Research and InterventioN (BRAIN) Center at the University of Illinois, both of whom report drug company funding.

Sadly the mainstream and medical press have even reported the "growing" mental illness problem among children. "One in 40 Infants Experience Baby Blues, Doctors Say," said an ABC News story a few years ago; "Preschool Depression: The Importance of Early Detection of Depression in Young Children," read a Science Daily story.

It is no secret that drug company funded disease awareness groups like the National Alliance on Mental Illness (NAMI) have helped to inflate the perception of mental illness rates in the U.S. Mental illness is a “biologically based brain disorder” like diabetes or Alzheimer's and best treated with medications said a NAMI spokesman, in explaining the group's unremitting drug focus. Disease awareness groups also seek to cast addiction and alcoholism as “mental illness” though both are traditionally treated for free and without pharmaceutical drugs in self-help settings.

Kudos to New England Journal of Medicine for helping to set the record straight about mental illness rates in the U.S!

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