How Nervous Are We?

Every so often a major survey appears reporting the prevalence of a disease or group of diseases, and sometimes the numbers are eye-popping. Over this past weekend the popular press reported that nearly forty percent of Europeans are mentally ill.

Oh, come now, I thought. That has to be exaggerated. But the report was in a respectable publication, the journal European Neuropsychopharmacology, and it detailed the findings of a review of scientific literature that provided the basis for estimates of the prevalence of a range of mental disorders in European countries for the year 2010.

Among the results: 14% suffer from anxiety and 7% from major depression. Five percent of children are hyperactive and 7% of adults cannot sleep.

I guess when you start to add up all these numbers, the aggregate of 38% shouldn't be terribly surprising. In fact, some of the numbers seemed a bit low to me, but I realize that's because I spend so much of my time around people who are patients in emergency departments in the United States. This European study found only 1% of the population suffering from bipolar disorder, while among my patients that diagnosis seems as common as acne in high school kids.

And only 5% of kids are hyperactive? Europeans are clearly missing something. Here in the US we seem to want to medicate every kid who cannot abide by old-fashioned behavioral standards (sit down/shut up/fold your hands on your desk). When I was like that as a child, my teacher got sufficiently exasperated to make me sit out in the hallway about twice a month. Nowadays the thing to do is send a kid to see the school psychologist.

I cannot help thinking part of the reason the European numbers seem low is that they don't watch endless commercials for prescription medicines.

If you're shy, maybe you have social anxiety disorder and should be taking Paxil. Really? There are times when I'm not feeling especially sociable, but that disappears after one glass of wine. I bet if the folks who make those delightful Malbecs in the Mendoza region of Argentina engaged the right marketing people, they could double their exports to the US overnight.

If you think your outlook on life is affected by more than the occasional blues - in other words, if you're mopey more often than your friends - you should be taking an anti-depressant. And, by the way, if your mood has ups as well as downs, ask your doctor if you are bipolar and if she should add Abilify to the anti-depressant you're already taking.

Don't get me wrong: mental illnesses are very real, and many people benefit from pharmacotherapy for them. But I wonder how many of those people would do just as well if they had a good friend to talk to instead. Look at the woman below. Does she really need Zoloft? Or does she just need someone to say, "You wash, I'll dry. Tell me what's on your mind." I'm guessing a friend with a sympathetic ear would be her best bet - without the risk of serious side effects.