Increase in mental illness matter of debate; better treatment isn't

Q.

I keep hearing about the increase of mental illness in children. Is there truly an increase? What's causing it?

A.

There are those who feel that life is more stressful in America, and that this is reflected in mental disorders in children.

There are others who believe that there is no true increase, but there is more emphasis on minor problems, which inflate statistics.

In addition, we have "pathologized" certain human characteristics, such as shyness and temperament, and called them illnesses (such as social anxiety disorder and intermittent explosive disorder).

It is true we live in a different world, with different stressors than our parents.

Many would say, yes, different stressors but perhaps not more potent.

Are we just getting more impatient and intolerant? When do flaws become diseases?

These are all good questions, and I don't think anybody really has the answers.

But I do feel this is true: When we diagnose mental illness now, we can almost always help.

It may mean medication or it may mean any of a variety of therapies.

Our ability to help is growing. In many ways, we are in our toddlerhood of diagnosing and treating these conditions.

We are probably missing a lot of children who need to be treated as we tend to treat the "noisy" kid.

The hyperactive child with attention deficit hyperactivity disorder gets treated but not the inattentive one.

The aggressive and disruptive child gets help, but the withdrawn one doesn't.

If we are doing our job well, we will go digging for the hidden problems.

Pediatricians, educators and parents are already doing this.

Are we just looking for trouble? There is the concern about "labeling" a child with a condition. So therefore not everyone gets attention. But the problem is how we, as a society, view the label rather than the label itself.

Think about it.

• Would you have a problem labeling your kid as asthmatic?
• Would you have trouble labeling your child as nearsighted?
• We know that those labels are useful and instructive.

Sure, we could see how they might cause problems. (Some might be afraid to let an asthmatic child go out and play in the cold. Some might think that the nearsighted child shouldn't play baseball. Both of those things are OK, by the way.) But we never expect that the inability to breathe or see well is a moral issue.

And that's the rub - too many people see the problems with behavior as character issues.

My experience is that almost all kids want to do well, including wanting to behave.

Almost all parents spend time, energy and worry trying to raise kids properly.

They want their children to be safe and happy, and learn to live in this tricky world.

There are always things we wish we did better.

The myth of blame unfortunately has become a big part of present-day health.

If you get heart disease, it was caused by not enough exercise. If you get cancer, it was because you didn't eat enough vegetables. And if your child has a mental illness, it's because you as a parent fell down on the job.

This wasteful finger-pointing is cruel. But when things go wrong behaviorally, it almost is never the parents' fault.

They may have contributed, but most of that was unintentional. We all feel, when these circumstances happen, that we could have done better.

So why do we have this reluctance to admit that there is a lot of mental illness out there?

We don't do that with purely physical illness. We all know someone with depression, anxiety, PTSD, ADHD, psychosis or bipolar disease.

So I don't have the answers.

I think we have always had just as many people, including children, with mental illness.

It hasn't increased, but our awareness and our ability to do something about it has gotten better.

At one time, I will admit, our ability to make a difference was limited. But today, we can do a lot, and in the future, we will do even better.

(12/10/06)

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