Mentally Ill?

by Richard P. Weigand

 

Or are we classifying damaged bodies and damaged lives as mental illness? The mental health epidemic has become impossible to ignore. But before we accept it as proof that humanity is becoming mentally ill, we should ask what these astonishing figures actually measure.

The latest numbers are almost beyond comprehension. Look at them one at a time.

Worldwide • In 2023, about 1.17 billion people had a mental disorder. Roughly one in seven on Earth. • Cases nearly doubled since 1990. • After adjusting for population growth and aging, the rate still rose about 24 percent. • Mental disorders account for 17.3 percent of years in a person’s life, lived with disability worldwide. Mental disorders cause more years of nonfatal disability worldwide than any other condition group in that study.

Lancet Global Burden of Disease: https://pubmed.ncbi.nlm.nih.gov/42167272/

Young American women • 2010–2014: 48 percent of women ages 18–29 said their mental health was excellent. • 2020–2024: 15 percent said the same. • That is a drop of 33 points in about a decade. • Young men fell too, but less.

Gallup: https://news.gallup.com/poll/658082/pandemic-effects-linger-americans-health-ratings.aspx

Diagnoses by politics • Among white liberal women ages 18–29, 56 percent said a provider had diagnosed them with a mental-health condition. • Among moderate and conservative women, about 28 percent. • This is self-report, not an independent exam. A warning light. Not a verdict.

From a reanalysis of 2020 Pew data, cited by Dr. Robert W. Malone.

Life satisfaction • Liberal women ages 18–40: 12 percent completely satisfied with life. • Moderate women: 28 percent. • Conservative women: 37 percent. • Liberal women also reported frequent loneliness at nearly three times the rate of conservative women. • Marriage, religion and social connection explained part of the gap.

American Family Survey analysis: https://cosm.aei.org/why-so-blue-liberal-women-are-less-happy-more-lonely-but-why/

Malone puts heavy weight on what modern culture and feminism have taught women about independence, family, marriage, motherhood and men.

Under that fight sits a larger question:

What exactly are we counting as mental illness?

The Experience Can Be Real While the Explanation Is Wrong

Serious mental illness exists. Depression, psychosis, bipolar disorder and other conditions can wreck a life. People living with them deserve real help.

Suffering does not prove the cause.

A person can be exhausted, anxious, sleepless, frightened, irritable or crushed. That is real. The symptoms alone do not say why.

Some of it is mental disease. Some is produced or intensified by brain injury, chronic pain, sleep disorders, hormonal dysfunction, thyroid disease, infection, medication effects, substance use, nutritional deficiency or toxic exposure.

The National Institute of Mental Health itself says certain medical conditions and medicines can mimic depression and should be ruled out by examination and testing. NIMH: https://www.nimh.nih.gov/health/publications/depression

Others are answering grief, isolation, fear, broken family, purposelessness, money pressure, rejection or the loss of a place in the world.

The pain can be real while the label, the treatment and the lasting identity built on that label are wrong.

A diagnosis should start an investigation. It should not end one.

What Does the Diagnosis Actually Explain?

A psychiatric diagnosis usually names a cluster of symptoms. Enough symptoms for long enough, and the pattern gets a title.

The title can help. Professionals can talk. Treatment can be tried. The person may learn others have been here.

Naming the pattern does not identify what produced it.

“Depression” can describe the present. It does not automatically explain why this person became depressed.

“Anxiety” names an experience. It does not say whether the alarm came from thought, body, medicine, environment, relationships, old injury or present life.

Even the 1.17 billion figure needs care. The Lancet counted across 12 categories. One person can land in more than one. This is a modeled estimate under the researchers’ definitions. Not 1.17 billion separately examined human beings.

The suffering is real. The meaning of the number is not simple.

When Classification Replaces Investigation

Modern systems classify and treat. A diagnostic code opens a path: appointments, billing, prescriptions, disability.

The system has an answer.

Does the person?

Once the diagnosis becomes the explanation, the search for cause can stop. Treatment follows the category, not the individual. Success becomes symptom scores, pill compliance and staying in care. The person may still not work, sleep, keep a relationship, feel useful or live independently.

That is management. It is not restoration.

A better measure asks whether the person regained health, function, relationships, judgment, purpose and an ordinary life.

Not only: Which diagnosis fits?

Also: What is blocking this person from functioning, what is causing or holding it, and what would have to be corrected to restore him or her?

That is differential diagnosis. Not a slogan. A job.

Is Some “Mental Illness” a Crisis of Life?

Malone raises another possibility medicine is poorly built to answer.

What if a large part of the mental-health epidemic is a crisis of family, belonging, responsibility, purpose and human connection?

Loneliness hurts. Purposelessness hurts. Fear hurts. Living with no one who depends on you can hurt. So can having no one to depend on.

Those conditions produce real mental and physical symptoms. A pill cannot create a family. A diagnosis cannot supply purpose. Therapy alone cannot build a community, meaningful work or a lasting place in other people’s lives.

Treatment and therapy can still be essential. Sometimes they save a life.

They must still address what is actually wrong.

If the person is lonely, the goal cannot be only to make loneliness more bearable. If purpose is gone, success is not only a lower score for the pain of that loss. If an undetected physical condition is driving emotional or cognitive symptoms, psychiatry alone cannot fix the root.

Some suffering needs medicine. Some needs physical restoration. Some needs changed circumstances. Some needs family, work, friendship, faith, responsibility or a reason to get up. Most people need a mix.

The Missing Question

The most startling possibility is not that more than a billion people suddenly became defective.

It is that we may have built a system that piles genuine mental disease, undetected physical illness, understandable human distress and the wreckage of social disconnection under one heading: mental disorder.

Then we point to the total and say the world needs more mental-health treatment.

Doubtful it does.

It also needs a harder question:

Why is this happening to this person?

What happened in the body? What happened in the brain? What changed in sleep, hormones, medicines, nutrition or health? What happened in the family? What was lost? What is feared? What purpose disappeared? What is keeping this in place? And what would restoration look like?

Diagnosis has value. It must never replace investigation. It should describe where the person is. It should not declare where that person must stay.

The suffering is real. The disability is real. The collapse in reported well-being is real.

What is not settled is whether we have named all the causes.

Before we accept a world with one mental-disorder case for every seven people, we should ask whether the epidemic sits entirely in the mind, or also in the bodies, institutions, relationships and culture around it.

Perhaps the people are not all broken.

Perhaps much of the life around them is.

This article was prompted by Dr. Robert W. Malone’s essay, “Well Being: ‘Mental Illness’ in Women” (https://www.malone.news/p/well-being-mental-illness-in-women), which assembled several of the statistics and cultural questions discussed here.