In the Age of Anxiety, are we all mentally ill?
By Sharon Begley
NEW YORK (Reuters) - When Cynthia Craig was diagnosed with postpartum depression eight years ago, she told her family doctor she felt anxious about motherhood. She wondered whether she had made a catastrophic mistake by quitting her job, whether she could cope with the long, lonely hours stay-at-home mothers face - and even whether she should have had children.
"Anxiety is something I have always had, especially during times of change," said Craig, 40, who lives in Scotland, Ontario. "But I was never worried about the level of anxiety, and it never prevented me from leaving the house, driving, socializing or even speaking in front of people."
Her doctor referred her to an anxiety clinic, where a nurse asked Craig dozens of yes-or-no questions - are you afraid of snakes? do you hear voices? do you vomit from anxiety? - and made a diagnosis. "She said, 'Let's call it Generalized Anxiety Disorder with a touch of social phobia,'" Craig said.
That didn't feel right to her, but the clinic's psychiatrist agreed with the nurse and said Craig's concerns about motherhood constituted an anxiety disorder, a form of mental illness, and prescribed Pfizer's Effexor and then GlaxoSmithKline's Paxil. Craig says the drugs exacerbated the very anxiety that she doubted required medication.
Craig's case is one of millions that constitute an extraordinary trend in mental illness: an increase in the prevalence of reported anxiety disorders of more than 1,200 percent since 1980.
In that year, 2 percent to 4 percent of Americans suffered from an anxiety disorder, according to the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) of Mental Disorders, used by psychiatrists and others worldwide to diagnose mental illness.
In 1994, a study asking a random sample of thousands of Americans about their mental health reported that 15 percent had ever suffered from anxiety disorders. A 2009 study of people interviewed about their anxiety repeatedly for years raised that estimate to 49.5 percent - which would be 117 million U.S. adults.
Some psychiatrists say the increase in the prevalence of anxiety from about 4 percent to 50 percent is the result of psychiatrists and others "getting better at diagnosing anxiety," as Dr. Carolyn Robinowitz, a past president of the APA who is in private practice in Washington, D.C., put it. "People who criticize that are showing their bias," she said. "When we get better at diagnosing hypertension, we don't say that's terrible." Continued...