Do you think America is a little bit fixated on mental disorders?

Question

I moved to the USA a few years ago and I have been struck with how liberally people use mental disorders to describe traits which in the UK would simply be seen as small quirks of personality.

For example last year the buzzword was 'Bipolar Disorder' but I feel it is over-diagnosed and moody people seem to be quickly diagnosed - at the drop of a hat.

Obsessive Compulsive disorder is used to describe the smallest quirk

This year the buzzwords are 'Narcissism' and 'Sociopath'

I was having drinks with a friend last week and my mind wondered when he was telling a very boring story and I looked away and he said I have'Attention Deficit Disorder' !!

Children are now being medicated with strong psychotropic drugs and are even being diagnosed with Bipolar disorder and A.D.D at the drop of a hat, it seems. The children of the USA are being prescribed anti-dpressants and other meds very often, it seems.

Get drunk a couple of times and you are an alcoholic.

It seems very odd

Answer 1

It is odd, and dangerous. Sometimes it isn't at all serious, but often it's used as an excuse. Also, there's an American quirk that even native-born Americans find difficult to explain: As a physician, I spend a considerable amount of time investigating symptoms that may represent either trivial or serious disease. When I find that it's trivial, my patients are often disappointed! We've developed a culture in which being a victim is de rigeur.

Answer 2

As personal opinion from a mental health professional in America, we have seen a progressive shift from individual responsibility to societal responsibility over the last 40 years (possibly longer, but I'm not that old).  People want to feel their problems are a disease, not their own issues.  It is soooo much easier to say, "I'm sorry I cheated, it was my bipolar/narcissism/s*x addiction" than to simply take responsibility for their own mistakes.  So "It's not me, it's my disease".  Or, even more disturbing "It's not that I am a bad parent, it is that my child has ODD"  This argument goes for PMS, depression, ADHD and many others.

But there really are disorders such as ADHD, bipolar, and depressive disorders.  The symptoms of these are readily available online and the drug companies now market directly to consumers.  "Where does depression hurt/?  Try cymbalta".  So patients self diagnose and come to doctors demanding agreement and treatment.

And the reality is, in many cases, the medicines we use to treat true hard-and-fast mental disorders also will work to help these squishy almost disorders.  And most docs, in any field, work to relieve pain and suffering.  So when a kid with attention problems that may not really have been called ADHD by strict criteria 15 years comes in, concerta WILL often help him/her do better.  Same with "bipolar".  OK, Johnny really doesn't meet the strict (old) criteria for the diagnosis but he is out of control (largely due to poor parenting in the past - most of the damage is done and even if the parents agree to work on their issues, and they often won't (see first paragraph) it will be a long struggle) and starting a mood stabilizer may help them reach a peace where we can begin to approach the real issues.  So sometimes we treat varieties of normal but unhappy, because we feel we can make normal a better normal.  Sometimes treating also gives us enough trust with the patient to try to address the more fundamental issues of locus of control and adequate parenting.

Long, philosophical answer, but I do agree with you.  The central issue, IMHO, is a societal shift from being responsible for oneself to finding someone else to blame.  I expect a flurry of hate mail from this response so don't disappoint me.

Answer 3

Yes, within the US there is a dangerous overuse, both socially and clinically, of diagnoses of mental disorders. Often layman's "Bipolar Disorder" or "Schizophrenia" or what-have-you is out of touch with the actual diagnostic criteria, but as those criteria are increasingly being applied more liberally the clinical definition is reaching the layman's definition. Just one example, which you cited, is that children today are being medicated for Bipolar Disorder because they express fantastical thoughts and act out in class. What is telling in this case especially is that very few of these children's parents are offered psychotherapeutic alternatives to medication. Thus, I believe the default to mental illness as an explanation to differences in personality or problems in living you see in the US is partly due to how the pharmaceutical business operates here. People watch television commercials for brand-name psychiatric drugs that give a broadened and abbreviated definition and symptoms for depression, ADHD or bipolar etc. and then they apply that liberally and dangerously to themselves or to others in every day conversation. They may identify with one or two of the symptoms and "ask their doctor", who is often a GP with little to no training in psychology or psychiatry, but who can still write a prescription. The main effect is that instead of working out the social or individual problems, in the US we often try to treat everything as if it is a mental illness, and try to treat mental illness as if it is any other illness that can be cured with a few pills.  This is reflected in the language.

(If you are interested, PBS aired a documentary about ADHD and bipolar disorder in children): http://www.pbs.org/wgbh/pages/frontline/...

Answer 4

Viewing over the entire landscape of the USA's mental and behavioral health concerns, it would seem so, that America IS a bit fixated on mental disorders.

Then, looking at the issues from the door of my own home, I feel so very fortunate to have found answers for the genuine inability to function, and effective treatments to be able to move beyond the problems, finding true health and function.  For which, I am ever so grateful.