Our Mental Health - Our Mental Health

According to the National Institute of Mental Health (NIMH), 4 out of the top 10 leading causes of disability in the United States and developing countries are mental disorders such as those seen in the graphic — major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder. Some of these illnesses are well understood, some less so. In many cases we don't even have good estimates of the number afflicted. This panel serves as an introduction to the whole area of our mental health. Some of these disorders/illnesses will be examined more closely in panels to come.

Depression and anxiety disorders top the list. They also cast wide nets. According to the NIMH, nearly 19 million adults suffer from some kind of depressive disorder. These can include major depressive disorders, dysthymic disorders (chronic, mild depression), and bipolar disorder. (The topic of depression is introduced in Chapter 2, Depressing Statistics.) Bipolar disorder affects roughly 2.3 million Americans, or slightly more than 1% of the population. Unlike depression, men and women are equally likely to develop bipolar disorder. The first manic episode usually occurs in the early 20s.

Anxiety disorders includes panic disorders, obsessive-compulsive behavior, post- traumatic stress disorder and specific phobias. Again, about 19 million Americans between 18 and 54, or 13% of the age group, have some affliction in this category. Anxiety disorders, according to NIMH, frequently appear coupled with depression — which tends to accompany any physical/mental issue that diminishes the quality of one's life in some way. Women again lead in this category. Females being twice as likely as males to suffer from a panic disorder, phobia, and post-traumatic stress.

An estimated 4 million seniors are affected by Alzheimer's Disease. The disease destroys portions of the brain that control thought, memory, and language. The cause of the disease is unknown. As we continue to live longer, and the number of seniors grow, many in the health industry expect to see an increase in the incidence of Alzheimer's disease, largely a disease of old age. The disease has become so talked about — with many of us caring for our aging parents, etc. — that its early symptoms are well known: confusion with names, forgetting how to do simple everyday tasks, and problems in speaking and reading.

Roughly 1% of the population, or 2.2 million adults are afflicted by schizophrenia. The causes of schizophrenia are not known, although some combination of genetic predisposition and profound disturbance to the brain during development appear to be implicated. Drug use may set off schizophrenia in those predisposed to it. The disease affects the sexes equally, although it tends to manifest in males in their late teens or early 20s; women come down with schizophrenia in their 20s and early 30s.

Autism is a developmental disability that usually appears in the first three years of life. The disability affects the development of the brain responsible for social interaction and communication skills. Children and adults typically have difficulties communicating at all levels (verbal, non-verbal). This manifests in play and social interactions. Those with autism may display repeated body movements (their hands flap, they rock), display unusual reactions to people, become highly attached to objects, and they exhibit unusual sensitivities in vision, hearing, touch, smell, and taste. The Autism Society of America estimates that 500,000 to 1,500,000 individuals may be affected.

There are three main types of eating disorders: binge eating, anorexia nervosa, and bulimia. These disorders are tough to track. The behavior takes place behind closed doors. Initial symptoms are so subtle, they can be missed easily. Between 1 and 2% of women are thought to develop anorexia nervosa. The figure for bulimia ranges from 1.1%-4.2%. One source claims that 4% of college age women suffer from the disease. Roughly 9 million women fall into this age range, meaning that 360,000 women may be abusing their bodies in this manner. Is this to be believed?

Suicide, of course, is what may happen when we can no longer cope with the world around us. It was the 11th leading cause of death in 1999, beating chronic liver disease and even homicide. We kill ourselves more than each other. Men are four times more likely to take their own life than women. There are thought to be 730,000 attempts annually — nearly three quarters of a million — but this is an estimate, again, because so much of this takes place behind closed doors and goes unreported. How many make an attempt and then seek help? How many make multiple attempts? Also, the 730,000 figure is an estimate. No one tracks attempted suicide.

Some of these numbers may quite rightly prompt the reader to raise a skeptical eyebrow. More than 19 million Americans suffer from some sort of anxiety disorder. Really? We seem to have a disorder for everyone: panic disorder, obsessive compulsive, and generalized anxiety disorder. One could argue most of this nation's population could fall into one of these important but vague sounding categories. Women in particular seem to carry a difficult burden in balancing personal and professional lives. We all lead lives with stress and worries. But where does the line get drawn between a difficult life and a disordered one?

We'll now take a closer look at some of the mental states shown in this panel.

Source: Chart data are estimates. Data for bulimia refers to college age women. "The Numbers Count: Mental Disorders in America." Retrieved May 2, 2002 from http://www.nimh.gov.