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Wellness Wednesday: Increased awareness can explain rising rates of mental illness

(Harishwer Balasubramani/Illustrations director)

By Appurva Goel

Feb. 22, 2017 4:41 p.m.

College may very well be the best four years of a person’s life, but reports show that college students are more stressed out nowadays than they have ever been before. This stress creates a breeding ground for mental health ailments, with approximately 37 percent of college students having depression, anxiety or stress. Daily Bruin blogger Appurva Goel will be delving into this phenomenon and investigating the major issues that affect the mental health of college students, as well as recapping what resources UCLA students can seek out for help.

The 19th century had yellow fever, the 20th century had influenza and now the “epidemic” of the 21st century seems to be mental illnesses – at least according to a few.

According to the fifth edition of the Diagnostic and Statistical Manual (DSM-5), over 50 percent of Americans will have mental illnesses at least once in their lives. For many, this appears alarming. But while there has been an increase in the number of reported cases – especially a lopsided increase seen in anxiety, depression and narcissism among adolescents and college students – the increased rates are not really of this magnitude. Many are just confusing incidence with prevalence.

Incidence refers to the rate of newly diagnosed cases of illnesses whereas prevalence refers to the number of cases occurring in a given period of time. The seemingly large increase in mental illness diagnoses is a product of an increase in mental illness incidence, or new diagnoses. By and large, prevalence of these illnesses, or probability of having one, likely remains unchanged.

This rise in incidence of mental illnesses can be attributed in part to an increase in people’s willingness to be more open about their illnesses due to destigmatization. This, in turn, causes them to seek treatment, which drives up the incidence rate.

The numerical increase in annual diagnoses and usage of antidepressants is often used as an indicator of the rising rates of mental illnesses. However, the increase in these two variables is more reflective of the growing incidence.

Annual diagnoses refer to the number of people who are treated for a particular illness during a year. While a fraction of the annual diagnoses of mental illnesses are new, the larger portion consists of pre-existing cases. As life expectancy grows, the number of recurring cases also increases since the same people are treated multiple times during their lifetime.

The rising usage of antidepressants is also often seen as a worrisome trend with respect to the rising rates of mental illnesses. While numbers show that a significant population of college students depend on antidepressants, medications like Prozac are also being used as a treatment, either self or prescribed, for conditions other than mental illnesses.

But while a slight misread of mental health-related data may be the a primary cause behind the notion of rising rates, it only explains one chunk of the overall increase in diagnoses. Another part of this increase is made up of people who were able to disclose their condition and seek treatment due to rising destigmatization.

These efforts are increasing the transparency surrounding mental illnesses. A deliberate continuous dialogue has resulted in increased acknowledgment of mental illnesses. One effect of this increased acceptance is that more people are willing to disclose their struggles and explore the possibility that their mental health challenges may be a result of a possible illness – trends that may not have been possible a generation or two ago.

For example, a college student with depression in the 1950s may have been unwilling to seek treatment and medication because of perceived stigma about their condition unless their situation was particularly chronic or acute. The same student, however, may be more open to the possibility about having depression in 2016 – even seeking treatment through therapy and medication.

This destigmatization of mental illness has also opened the opportunity for research in the field of psychology itself. The number of recognized mental illnesses has increased from the first DSM – DSM-I in 1952 that had 106 – to DSM-IV, which has 297. The latest manual, while not listing additional illnesses, has introduced new disorders as subtypes of current disorders.

However this increase in the number of recognized mental illnesses – and the veracity behind the DSM series itself – is a hotly debated issue among current experts in the field. The increase in the number of diagnosable illnesses means that more people who previously were not diagnosed may now be categorized as mentally ill if they show symptoms of these newly included disorders.

Destigmatization may be breaking down the barriers that restrict open dialogue about mental illnesses, but it also further blurs the difference between disturbances in psychological health and being mentally ill. Mental illnesses are a state of distress which interfere with daily functioning while psychological health refers to the ability to rationally respond to our emotions. For example, being anxious because of the quarter system is very different from suffering from generalized anxiety disorder.

This blur that may have negative ramifications especially when it comes to the DSM series.

A critique of DSM-5 is the argument that it has, to an extent, medicalized normal everyday actions and emotions like temper tantrums, grief, binge eating and even the absent-mindedness that is linked with old age.

This extensive classification may be an indication of our society’s need for easy solutions and instant gratification.

Our generation is used to satiating our every little need quickly – be it through online shopping, downloadable entertainment or having the world at our fingertips through the Internet. We have been conditioned to receive quick fixes for our problems. This instant solution to our problems and the easy gratification that we receive makes us, on the whole, more impatient.

This societal characteristic seemingly manifests itself when we try to find a reason for uneasy feelings or for the constant stress we’re under. Instead of delving deeper into our lifestyle habits or exploring possible negative externalities, our impatience for a quick fix makes us label our uneasy feelings as mental disorders or look toward medication for quick relief.

But a quick fix is not always a good one. While it may be tantalizing to envision mental illnesses as the tangible explanation for our current psychological distress, this hope sheltered within mental illnesses may just be a fallacy. Not only is this hope unrealistic, this fallacy that may have grave consequences for destigmatization efforts.

The large fraction of rising rates – based on increasing incidence and not on the true disease burden – are an indication of the overnormalization of mental illnesses. This overnormalization may very well lead to form of “reverse stigma” by undermining their gravity.

The increasing rates of mental illnesses do indicate a massive problem in our society – but this problem deals less with our mental health and more with our mindset.

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Appurva Goel
Appurva Goel is a Daily Bruin Quad contributor. She likes writing about different cultures, fashion and social issues.
Appurva Goel is a Daily Bruin Quad contributor. She likes writing about different cultures, fashion and social issues.
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