Anxious Delusions

By Noni Mausa

Courtesy of Science News, here, we find that mental disorders are actually under-diagnosed, rather than the other way around.

Rates of common mental disorders double up
Depression, anxiety and substance abuse may affect many more people than previously thought
By Bruce Bower
Thursday, September 17th, 2009

Some mental disorders aren’t merely common—they’re the norm.

Depression, anxiety disorders, alcohol dependence and marijuana dependence affect roughly twice as many people as had previously been estimated, a new study finds. Nearly 60 percent of the population experiences at least one of these mental disorders by age 32, say study directors and psychologists Terrie Moffitt and Avshalom Caspi, both of Duke University in Durham, N.C.

That figure probably gets higher by the time people reach middle age, Moffitt suggests, as additional people develop at least one of these four ailments for the first time.

In a paper published online September 1 and in an upcoming Psychological Medicine, Moffitt and Caspi present results from a study of more than 1,000 New Zealanders assessed for mental disorders 11 times between ages 3 and 32. This study took a prospective approach, following people as they aged, and assessed prevalence rates based on long-term data. Moffitt’s team focused most intensely on the period from age 18 to 32, when these disorders first start to appear. Earlier prevalence estimates for mental disorders in the United States and New Zealand relied on self-reports and therefore adults’ ability to remember and willingness to recount their own past emotional problems. [more]

Well, it’s good news/bad news because they measured the proportion of people who ever had one of these disorders, not how many have one currently. I’d compare that to asking how many people would break a bone in their lifetime – not how many have a broken bone right now. Still, 60% ought to move these disorders up to the head table of health prevention and management, and away from the wobbly table near the kitchen.

I actually think we could take this farther. In addition to the depression, anxiety disorders, alcohol dependence and marijuana dependence mentioned in the article, I would add two other disorders that I suspect are pretty common.

One, PTSD, is not necessarily tied to wartime or crime victimization, nor to a single intense experience. But the effects are equally disabling. I witnessed a year of workplace bullying that led to three nervous breakdowns (I was not one of them.) After seven years, all three remained more or less affected. One was able to return to work at a position paying half his former salary. Another began to work from home after five years, and the third is still not working though she is much less fragile now than even three years ago.

Though out of the news at the moment, PTSD due to workplace bullying is commoner than ever. Plus, I would bet that other stressors like watching the bailiffs empty out your house, would have a similar effect.

The other condition I have in mind is delusional disorder, and I think it’s rampant in the US at present. Here’s a description:

Delusional disorder is an illness characterized by the presence of nonbizarre delusions in the absence of other mood or psychotic symptoms. The [Diagnostic Manual of Mental Disorders] defines delusions as false beliefs based on incorrect inference about external reality that persist despite the evidence to the contrary and these beliefs are not ordinarily accepted by other members of the person’s culture or subculture.

Nonbizarre refers to the fact that this type of delusion is about situations that can occur in real life such as being followed, being loved, having an infection, and being deceived by one’s spouse.

In contrast, bizarre delusions, which represent the manifestations of more severe types of psychotic illnesses (eg, schizophrenia) “are clearly implausible, not understandable, and not derived from ordinary life experiences”

What do these two have in common? Both can be induced by circumstances, or abuse, or indoctrination – they are not disorders in the same way that schizophrenia or lead poisoning are, with a clear biochemical origin.

So, what does this have to do with economics?

Simply this: if you really want to reduce the cost of health care and improve the health of Americans, stop making them crazy.

Rdan here…I noticed that the show Nurse Jackie was being panned because some saw no point to the show…I think it demonstrates quite well the world of many functioning addicts, whose reality glides from circumstance to circumstance in a controlled and smooth appearing fashion (of course it is not over time).

Nurse Jackie looks to have it all in typical TV fashion (loving husband and two children, a sincere lover, a stable job), remains a sympathetic figure, and glides from one compartment to another compartment of her life without the expected crash and burn within the first twenty episodes, and actually shows real compassion along the way. Won’t last of course…we need our devils and angels to look and stay predictable.