Mental Health

I was posed a question on Facebook: “let me ask you why, what, how, so many people have mental problems!?”

The answer may not be so straight forward.

Within the last 50+ years there has been a massive trend towards wellness. Could things that one must do to keep fit mentally and physically have gone “overboard”?  Maybe.  Thanks to the Media we now worry about our sleep, our exercise, our carbs, our calories, our drinking, our snacking, our meat, our vegetables, the provenance of our meat and vegetables, the number of steps we’ve taken in a day, how much time we spend sitting and/or standing and if our iPhone are killing us (probably while we sleep).

From the office for National Statistics we have these figures:

*    In 2017 there were 5,821 suicides registered in the UK, an age-standardised rate of 10.1 deaths per 100,000 population.

*    The UK male suicide rate of 15.5 deaths per 100,000 was the lowest since our time-series began in 1981; for females, the UK rate was 4.9 deaths per 100,000, this remains consistent with the rates seen in the last 10 years.

*    Males accounted for three-quarters of suicides registered in 2017 (4,382 deaths), which has been the case since the mid-1990s.

*    The highest age-specific suicide rate was 24.8 deaths per 100,000 among males aged 45 to 49 years; for females, the age group with the highest rate was 50 to 54 years, at 6.8 deaths per 100,000.

*    Scotland had the highest suicide rate in Great Britain with 13.9 deaths per 100,000 persons, and England the lowest with 9.2 deaths per 100,000.

The “Bible” for mental illness can be found in The Diagnostic and Statistical Manual of Mental Disorders (DSM). We are now at version 5 of this text-book and the DSM is considering five changes to the Fifth Edition (DSM-5) already.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) was created in 1952 by the American Psychiatric Association so that mental health professionals, in the United States, would have a common language to use when diagnosing individuals with mental disorders. There is a big tendency to fit people in a box. Since the initial publication of the DSM, there have been five subsequent editions of this manual published (including the DSM-III-R).

In spite of well-argued critiques, the DSM and the idea of “mental illness” on which it is based flourish, with ever more (mis)behaviours labelled as brain diseases. Problems in living and related distress are converted into medical problems, obscuring the role of environmental factors such as poverty and related political, social, moral, and economic factors such as the interest of the state in controlling deviant behaviour and maintaining the status quo. This view shrinks rather than expands opportunities for freedom, growth, and dignity. It ignores the vast literature showing that unusual environments create unusual behaviours and that by arranging learning opportunities we can change behaviour.

In 1952, DSM-I had 106 diagnosis listed in it, reaching the top with 365 diagnosis in DSM-IV.

Just to mention a couple of “disorders”, Autism and ADHD are on the increase and GPs have been “instructed” to respond with prognosis and medications.

The attention deficit hyperactivity disorder (ADHD or ADD) medications prescribed to both children and adults are categorized as stimulant – amphetamine or methylphenidate – or non-stimulant. Just for ADHD these are the most common medications:

*    Adderall XR (amphetamine)

*    Concerta (methylphenidate)

*    Dexedrine (amphetamine)

*    Evekeo (amphetamine)

*    Focalin XR (methylphenidate)

*    Quillivant XR (methylphenidate)

*    Ritalin (methylphenidate)

*    Strattera (atomoxetine hydrochloride)

*    Vyvanse (lisdexamfetamine dimesylate)

The first description of children with ADHD symptoms was made as early as 1902 by Sir George Frederick Still and was thought to have a ‘defect of moral control’. Now, children with ADHD say they do not understand why they sometimes feel out of control or very lonely. On the other hand, shyness has become ‘Social anxiety disorder” (social phobia) and, of course, several types of medications are available to cure this behaviour too.

So, going back to the original question on: “why, what, how, so many people have mental problems”, I would like to start with ‘so many’.

Are there really so many? Well, on my side of the fence, as a therapist, I would say that, yes, there are loads of people with a vast variety of problems. A friend of mine has a Facebook groups with over 25k member. Many of its members have argued, insulated, banned each other over the months (many offended or sulking away).

One major issue is “beliefs” and often these are distorted by parents, upbringing, peers, social media and so on. The major culprit on the ‘so many’ is again the Media.

During a seminar a psychologist said “well, of course, if you lose a job you become depressed”! Wrong thing to say or even think, was my immediate reaction. Why would anyone become depressed because of losing their job? The whole life scenario is to see and seek new opportunities. If we stop all the time and lick at our (passed) wounds, we are not able to focus on the future and simply carry on with life. That is the same with the end of a relationship, the loss of a dear one or other events in our life.

A woman in her late 20s with some form of disability was so grieved with her condition(s) that all of her energy was spent in telling others that they didn’t understand how much she was suffering. She spent all of her energy in negative thoughts.

News in UK are pretty pathetic and experts are often invited to make statements and give opinions. One of the most common comments on the news is about bullying.

The experts’ opinion, and this is where society is mostly moving in the wrong direction, is to give counselling to the victim, make him/her feel appreciated. The journalist Claire Fox and he book on the “Generation Snowflake” comes to mind.

I agree with Claire that over protecting children doesn’t achieve much. What sort of society are we having? Medications for “over active” children, medications for the shy ones, more medications for those that have been bullied and feel insecure? What has happened to personality and reacting to adversity accordingly?

Media has been at the forefront of these problems pushing issues in one direction only. GPs are following directives. Instead of looking at children diet and lifestyle, instead they promptly prescribe medications making the whole family happy. The child is sedated and the parents can spend more time on PC games or iPhone. Someone that I know gives Coca Cola to his 4 years old son and sugar cubes to eat – as, apparently he likes them a lot – onlyto give him Melatonin tablets at night to help him go to sleep.

The why so many have mental illnesses is based on medical statistics. On one side they are right, there are more problems and issues recognised than there used to be a few decades ago, on the other hand there is also the possibility that many have been over-diagnosed, that they have been given medications and that they have entered a spiral of addictions. We must not forget that mental health is relatively new and many, many mistakes in diagnosis and treatments have been made over the decades.

Lifestyle is very important. Everyone is keen going to the gym as this is the thing to do, to be seen doing it. Often with no supervision many rush to the pub or to the fridge after some good exercises. Mens sana in Corpore Sano used to say the Romans. (Healthy mind within a healthy body).

Walking is one of the best exercises that anyone can do to keep fit, alert and energised. And a balanced diet can also do a lot. Far too much junk food is around us, everywhere. The body needs minerals, vitamins and amino acids.

Often these are absent in our diet. Many take a multi vitamin tablet thinking that is the answer; it is not. There are no amino acids in multi-vitamins and often not the right type and amount of minerals.

How can we have a healthy society that feeds on junk and processed food, drinks tap water that has fluoride and chemicals added to it (no good for our pineal gland), drinks milk (that depletes body of calcium), feeds on sugar (that causes cancer and diabetes), flour which is dust, fruit that has been radiated to be kept fresh, vegetables that have no minerals thanks to depleted soils and so on?

Beliefs might make people stubborn and fixed in their ideas but that doesn’t make them mentally ill. For sure the extended classification and overzealous prescription of medications is not helping at all our society.