The increase in bipolar diagnoses among women is interesting. The prevalence is estimated to be around 2-3%, give or take, but Canadian women get to 3-4x that number. The exact prevalence is hard to measure for all kinds of reasons, and true bipolar 1 disorder probably ranges somewhere between 1-5% (leaving aside more questionable diagnoses like bipolar 2 and cyclothymia).
Bipolar disorder is notably overdiagnosed (many are either self-diagnosing or being diagnosed after a short appointment and a few mentions of "mood swings").
Ultimately I think the entire "rise of mental health problems" literature is basically saying that people are increasingly dissatisfied with life because (1) they feel dislocated from others and (2) fewer and fewer people occupy their time with meaningful work that they know is important. The use of the term "illness" could start to be misleading, and we start getting into "pathologic ways of living", or something like that. Further medicalization of the problem and solutions are, in my view, thoroughly counterproductive.
What's interesting about this survey is they did it all through asking about symptoms rather than diagnoses. So the increase in rates of things like bipolar would have to be people exhibiting more symptoms of that. Now one option is as people are more "educated" on what mental illness is they more accurately identify the correct symptoms. But another option is if people are over educated or self-diagnosing then they might be more likely to report symptoms they know to be associated with bipolar disorder. I may write an article on BPII as I do think there is some interesting theoretical debates around whether the category makes sense or not (overall I think it does but there is probably a lot of overdiagnosis).
Overall agree with you on rise of mental health issues, although I do think it's hard to separate the objective from the subjective. Like it's quite possible we've all psyched ourselves into being less happy and then calling it mental illness, but it seems plausible that itself is leading to real negative outcomes. One example is some of Jon Haidt's work which shows the social media caused decreases in young girls mental health. But this actually correlates with rising suicide rates among them! So even if we're probably right that a lot of this is more cultural or spiritual than biological, it has biological ramifications.
Oct 4, 2023·edited Oct 4, 2023Liked by Jonah Davids
Psychiatric diagnosis is a great example of a subject where having a little knowledge can be a dangerous thing, especially re: self-diagnosis. Diagnosing bipolar disorder accurately is often difficult. Many psychiatrists misdiagnose. I'd have to see the methods of the study to really pass judgment, but I'm (often) extremely skeptical of psychiatric studies based on self-report.
Re: medicalization, I agree there are negative outcomes, for sure. My point is that viewing the problem through a "mental health" perspective is only one perspective among many, and it carries its own liabilities and unintended consequences. Haidt's work is a good example, actually. Lots of social media + smartphone use seems to be bad for many young girls. We all agree it is a problem, but is it "psychiatric"? Yes and no. Basically I'm saying we should be theoretical pluralists about this issue.
The increase in bipolar diagnoses among women is interesting. The prevalence is estimated to be around 2-3%, give or take, but Canadian women get to 3-4x that number. The exact prevalence is hard to measure for all kinds of reasons, and true bipolar 1 disorder probably ranges somewhere between 1-5% (leaving aside more questionable diagnoses like bipolar 2 and cyclothymia).
Bipolar disorder is notably overdiagnosed (many are either self-diagnosing or being diagnosed after a short appointment and a few mentions of "mood swings").
Ultimately I think the entire "rise of mental health problems" literature is basically saying that people are increasingly dissatisfied with life because (1) they feel dislocated from others and (2) fewer and fewer people occupy their time with meaningful work that they know is important. The use of the term "illness" could start to be misleading, and we start getting into "pathologic ways of living", or something like that. Further medicalization of the problem and solutions are, in my view, thoroughly counterproductive.
What's interesting about this survey is they did it all through asking about symptoms rather than diagnoses. So the increase in rates of things like bipolar would have to be people exhibiting more symptoms of that. Now one option is as people are more "educated" on what mental illness is they more accurately identify the correct symptoms. But another option is if people are over educated or self-diagnosing then they might be more likely to report symptoms they know to be associated with bipolar disorder. I may write an article on BPII as I do think there is some interesting theoretical debates around whether the category makes sense or not (overall I think it does but there is probably a lot of overdiagnosis).
Overall agree with you on rise of mental health issues, although I do think it's hard to separate the objective from the subjective. Like it's quite possible we've all psyched ourselves into being less happy and then calling it mental illness, but it seems plausible that itself is leading to real negative outcomes. One example is some of Jon Haidt's work which shows the social media caused decreases in young girls mental health. But this actually correlates with rising suicide rates among them! So even if we're probably right that a lot of this is more cultural or spiritual than biological, it has biological ramifications.
Psychiatric diagnosis is a great example of a subject where having a little knowledge can be a dangerous thing, especially re: self-diagnosis. Diagnosing bipolar disorder accurately is often difficult. Many psychiatrists misdiagnose. I'd have to see the methods of the study to really pass judgment, but I'm (often) extremely skeptical of psychiatric studies based on self-report.
Re: medicalization, I agree there are negative outcomes, for sure. My point is that viewing the problem through a "mental health" perspective is only one perspective among many, and it carries its own liabilities and unintended consequences. Haidt's work is a good example, actually. Lots of social media + smartphone use seems to be bad for many young girls. We all agree it is a problem, but is it "psychiatric"? Yes and no. Basically I'm saying we should be theoretical pluralists about this issue.
Thanks for sharing. I've also seen stats that show in the UK the rates of disability-claims for mental illness are quite high.