Are more and more people suffering from depression and anxiety, or are we getting better at talking about mental health?

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Over the past decade, and especially since 2020, knowledge that more and more people suffer from mental health conditions has become routine, along with a dizzying list of interacting factors that contribute to this reality.

When a 75-year-old reader sent us the question, “Why does mental illness seem to be on the rise?” I thought I would put in this newsletter the many reasons why an increasing number of people are anxious and depressed.

The 24/7 news cycle is bad for our mental health. 40+ hour work week and grinding culture is bad for our mental health. Social media algorithms, designed to keep us angry, distracted, and isolated, are harming our mental health, as are social isolation, income inequality, climate change, racism, sizeism, homophobia, and transphobia. And on and on.

But this kind of reporting (although vital) is everywhere right now, saturating TV news and social media timelines. So I decided to stay away from the reasons of these conditions And look at How do we actually know Mental health issues are on the rise, and how this data is shaped by our growing awareness of mental health issues.

How is it tracked?

Prior to the 1970s, mental health conditions were only tracked through hospital report data. But this method revealed an incomplete picture, as the only people who were counted were largely those being treated in the midst of a crisis, as Bernice A. in health.

Then, in 1977, President Carter’s Mental Health Committee A report was issued which emphasized the importance of using epidemiological research to frame physical health and mental health policies. From this call to action was born the Epidemiologic Catchment Area (ECA) program, which aims to collect data on the prevalence of mental illness in the United States and identify the need for services to treat those disorders. It was one of the largest investigations ever conducted.

“These researchers were the first to go into the population and develop questionnaires that were really, really good at estimating the rate of depression and anxiety in the population, not just those who go to the hospital or the doctor,” Pescosolido told me.

Since then, surveys seeking to understand rates of mental illness in the US population have continued to change and be refined. Two of the large, ongoing, annual surveys that the federal government conducts are the Centers for Disease Control National Health Interview Survey — in which 88,000 people nationally are randomly selected to participate, which includes short questions about symptoms of anxiety and depression — and the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health. The latter sample size is about 67,000 and collects information about drug use and mental health issues among Americans ages 12 and older.

What these and other surveys have told us is that symptoms of anxiety and depression doubled during the pandemic. But mental health problems were already on the rise in the US, where emergency room visits related to depression, anxiety and similar conditions rose 28% between 2011 and 2015.

However, these surveys are not conducted in a vacuum. “The willingness to talk about these things has changed dramatically,” said Ronald Kessler, a Harvard sociologist whose research focuses on the social determinants of mental health conditions from an epidemiological perspective.

“In the last 15 years, we’ve had famous people on our evening talk shows, talking about their mental struggles and suicide attempts,” he said. This would have been almost incomprehensible in the not too distant past (when Suicide attempts were almost illegal).

Public opinion has changed dramatically over time, too. Like much of society it changed its views on cancer, which it was only referred to in whispers as “C big” More people are willing to talk about their mental health diagnoses. to me 2019 survey87% of American adults agreed that having a mental health disorder is nothing to be ashamed of, and 86% said they believed that people with a mental health disorder could get better. (It should be noted, however, that there is a difference between a society that embraces anxiety and depression, versus the way we view people diagnosed with mental illnesses with greater stigma attached to them, such as personality disorders and schizophrenia.)

Someone who might have been reluctant to report to a 2005 national survey worker about their symptoms of depression is probably willing to do so now.

“This is why the numbers are not a pure indicator of whether there are more mental health problems in the community,” said Pescosolido.

So, to what extent exactly does the changing narrative about mental health shape the reporting data?

“We know that reports of anxiety and depression are on the rise, and we think part of that is real, and part of it is due to increased awareness and a willingness to speak up,” Kessler said. “The question is, how are we really going to be able in a rigorous way to find out? We can’t.”

“The other part is – who cares,” he continued. We know it’s a big deal right now. The pandemic has helped us realize that the prevalence of mental disorders has always been high, and that many people suffer in silence.”

The real crisis, Kessler said, is how many people are not getting enough care, if any at all. “We know how to deal with people,” he said, “but the vast majority of people who need it don’t get help.”

Less than half of Americans with a specific mental health condition were treated in 2020, according to the National Alliance on Mental Illness—and that doesn’t even explain the quality of care. The average delay between the onset of symptoms of the disorder and treatment is 11 years.

Lord of beneficial harm

TLDR; Experts believe that both are spread And Awareness of mental health conditions is increasing. And I think there is a silver lining to all of this. As the statistics get so grim and people finally talk about mental health, there is increasing pressure on state and federal governments to provide access to care and, hopefully, to fund relevant research. People realize that job-related stress is affecting their mental health and quietly stop working or literally quit, so an increasing number of employers are offering mental health benefits to retain workers.

I hear more people in my life talk about their anxiety and depression than I did 10 years ago. It’s hard knowing that so many of my family and friends are struggling, but it gives me some hope that we’re finally able to talk about it openly, without the burden of shame. I hope so for you all too.

until next week,

Lura

If what you learned today from these experts spoke to you or you’d like to tell us your own experiences, please email us and let us know if it would be okay to share your thoughts with the larger group therapy community. GroupTherapy@latimes.com email goes directly to our team. As always, find us on Instagram at @employeeWhere we will continue this conversation.

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More views on today’s topic and other resources

Article after article shows us that America’s teens aren’t doing well, without really putting their finger on what’s wrong Beyond the issues of individual “mental illness,” writes clinical psychologist Jamison Webster, the usual causes — social media, video games, and the weakening of the family unit. But what do teens tell us is wrong? “We seem to have forgotten that teenagers are the lightning rods of the zeitgeist,” Webster said. “They live on the fault lines of culture, exposing our vulnerabilities, showing the available range of solutions and indissolvable states. They hold up a mirror so we can see ourselves more clearly.”

Is the United States experiencing a mental health pandemic? in This widget By psychiatrist Ronald Baez, he argues that while millions of people are suffering emotionally due to COVID-19, the CDC’s surveys can’t tell us whether more people are actually meeting the mood or anxiety threshold. disturbance, But instead, just check out the symptoms. “The difference between symptoms and disorder is not mere semantics,” he wrote. “A formal clinical diagnosis of a mental disorder has very different implications—medical, legal, and psychological—than those associated with, say, a normal or adaptive response to stress and stress caused by the COVID-19 pandemic.”

These two major shifts sparked a mental health crisis among LGBTQ+ children and teens in California: the The ripple effects of the pandemic’s isolation combined with a hostile political climate targeting LGBTQ youth. One survey found that during the 2021-22 school year, nearly 80% of intersex, gay, and lesbian middle school students reported depression, stress, and anxiety as an obstacle to learning, double the rate of straight students.

Other interesting things

The mental health field is increasingly looking to chatbots to relieve mounting pressure on a limited pool of licensed therapists. But it is entering uncharted ethical territory as it faces questions about how closely AI will be involved in such highly sensitive support, According to this piece of STAT news.

Disability and civil rights advocates filed a lawsuit last week Asking the California Supreme Court to block Gov. Gavin Newsom’s far-reaching new plan to treat severe mental illness Through compulsory treatment of thousands of people. Human rights advocates have urged the state Supreme Court to drop the program known as the CARE Court (for Community Assistance, Recovery and Empowerment) as unconstitutional. The groups argue that the new court system will violate due process and equal protection rights under the state constitution, while “unnecessarily burdening basic rights to privacy, autonomy, and liberty.”

How can we support older Asian Americans affected by recent mass shootings? The victims of the Monterey Park and Half Moon Bay shootings were first-generation Asian American immigrants in their 50s, 60s, and 70s. Experts say their recovery will be aided by younger generations checking in with their elders – those who have been directly affected as well as those who feel secondary trauma from seeing the violence inflicted on people who look like them. Write my colleagues Karen Garcia and Ada Tseng.