I was reading an article the other day that made the claim that the United States is the most medicated country in the world, which got me thinking. Obviously we have issues with obesity in America, and all of the health risks associated with it, and I'm sure there are many other medical issues that Americans take medication for, but what really interests me is medication for mental health. When talking about my ex girlfriends to girls, there is a stark contrast between reactions from Americans and foreigners. When I bring up that one was on medication for depression and anxiety and another had been diagnosed as bipolar, American girls often have the response, "That is a serious issue. I take those medications too." Foreign women generally respond, "She must really have issues if she is taking medication." I decided to investigate.
I looked up mental disorder statistics for several English and German-speaking countries (their health reports are the only ones I can read), with emphasis on depression, bipolar disorders, anxiety disorders, and ADHD, in order to compare. However, the report from the US Health and Human Services (USHHS), Health, United States, 2010: With Special Feature on Death and Dying, used a different method to gather its data, making comparison somewhat difficult. The USHHS counted only the number of people actually taking medication for these problems within the period of a month. The other countries involved, including Australia, Austria, Canada, Germany, New Zealand, Switzerland, and the United Kingdom, used methods counting the number of people who experienced symptoms or who were diagnosed, not necessarily medicated, over the period of one year. In order to make comparisons, the German report, Gesundheitsberichterstattung des Bundes: Gesundheit in Deutschland (Health Report of the Federation: Health in Germany) gave both one-month and 12-month data for depression. I will use the ratio from this data, which says that the one-month data is 55% of the 12-month data.
Another issue with the USHHS report is that it is very vague when addressing anxiety disorders. The other reports break down anxiety disorders into general anxiety disorder, panic disorder, phobias, Post Traumatic Stress Disorder, and a couple other classifications. I doubt that anxiety disorders, such as phobias, are included in the US report because I can't imagine what kind of medication you would take for that, which leads me to believe that, in addition to only being for those taking medication for the disorder, the anxiety numbers are even lower than they should be for the United States.
The reports are also all from different years, which also skews the data, but they are all from the year 2000 or later, so even though some of the reports show that rates have increased in several of the countries since 2000, for the purpose of this study, we will presume that these changes are insignificant.
We will start with the worldwide figures. Unfortunately, figures on mental disorders were not available from the World Health Organization (although lots of other fun information was, which I'm sure you will get to see in later posts), so the only worldwide information I have is from the German report, and the data is only one-month data on depression. Once adjusted using our ratio to a 12-month level, on average, worldwide, 3.4% of men and 5.8% of women suffered from depression in the year 2000. However, the numbers have likely grown in the past 11 years. 2.4% of people worldwide are bipolar, according to a report by CBS News in 2011. I found no reliable data on anxiety disorders or ADHD worldwide.
After adjusting the United States to a 12-month study, in 2008, 7.2% of men and a whopping 21.6% of women have taken medication for depression within the past year. 3.6% of American men and 7.2% of American women have taken medication for anxiety within the past year. The number of men taking medication for depression was four times higher than in 2004, and the number of women taking medication for depression was six times higher than in 2004. The number of both men and women taking medication for anxiety doubled from 2004-2008. 4.4% of Americans are bipolar according to CBS News. In 2008, 9% of American boys between the ages of 5 and 17 took prescription central nervous system stimulants, commonly prescribed for ADHD, in the past year, while 5.4% of girls 5-17 have taken these medications. Nine percent of Americans under 18 had been diagnosed with ADHD in 2009. Again, most of these figures are only the people taking medication for these disorders, not the number diagnosed or experiencing symptoms, making these numbers lower than they should be when comparing them to numbers from other countries.
Next up is Australia. I got their data from the 2007 report The Mental Health of Australians. In a one-year period, 20% of Australians reported symptoms of some sort of mental disorder. More specifically, 5.4% of Australians experienced symptoms of depression (4.1% of men and 6.6% of women). In this same period, 14.4% of Australians experienced symptoms of some sort of anxiety disorder (10.8% of men and 17.9% of women). Also, 1.8% of Australians experienced symptoms of bipolar disorder (1.8% of men, 1.7% of women). I found no data on ADHD.
The Austrian data came from the Österreichischer Psychiatriebericht 2001 (Austrian Psychiatry Report 2001). In Austria, 29.5% of the population experienced symptoms of a mental disorder in 2001 (27.7% of men, 31.2% of women). 12.8% of the population experienced symptoms of depression (9.8% of men, 15.9% of women). The Austrians seem to be a very anxious people, with 17.2% experiencing symptoms of anxiety disorders (11.8% of men, 22.6% of women). Only 1.3% of Austrians experienced symptoms of a bipolar disorder. I found no data on ADHD. Since this report is from 2001, it is likely that these numbers are now even higher.
According to the 2002 report A Report on Mental Illnesses in Canada, women who suffer symptoms of depression are double the number of men, but I have no exact gender percentages from Canada. However, 4-5% of the total population suffers from symptoms of depression. Additionally, 1.1% of the population suffers from symptoms of anxiety disorders, 1% of the population suffers from symptoms of a bipolar disorder, and 15% of the population suffers from symptoms of ADHD, although having lived not too far from Canada, both in northern Wisconsin and in Erie, Pennsylvania, my guess is that is not ADHD, just boredom.
Next up, we have Germany. Their 2006 report reports that 5.8% of men and 9.5% of women suffer from symptoms of depression, while 14.2% of the population (9% of men and 19% of women) suffer from symptoms of anxiety disorders.
A 2006 study published as Te Rau Hinengaro: The New Zealand Mental Health Survey shows that 6.8% of New Zealanders suffered from depression over the period of a year (5.2% of men and 8.4% of women), 14.8% of the population suffered from anxiety disorder (10.7% of men and 18.6% of women), 2.2% of the population suffered from a bipolar disorder (2.1% of men and 2.3% of women), and 6.7% of New Zealanders suffered from ADHD.
The only reliable information I could find on the Swiss was from the 2009 report Diagnose von Depressionen in Hausarztpraxen (Diagnosis of Depression by General Practitioners). The report states that 20-25% of the Swiss population has been diagnosed with some sort of mental disorder, while 7% of the population was diagnosed with depression over the period of a year (33.1% of these are men, 66.9% are women). It is important to note that this number is the number of actual diagnoses, not number of people reporting symptoms in a survey, so the number is somewhat lower than it should be in comparison to other countries, with the exception of the United States.
Information on the United Kingdom came from a 2006 spreadsheet called Estimating the Prevalence of Common Mental health Problems: Additional Data from the UK Department of Health. According to this data, 16.6% of the population suffers from symptoms of some sort of mental disorder, 11.4% of the population suffers from symptoms of depression, and 13.4% of the population suffers from symptoms of an anxiety disorder. In order for these numbers to be correct, a high percentage of those suffering from anxiety or depression must experience symptoms of both.
Additionally, according to the CBS News report on bipolar disorder, only 0.1% of the population in India, 0.7% of the population in Japan, and 2.6% in Colombia suffer from bipolar disorder.
So who is the craziest? I will now rank them in each category. Keep in mind that these rankings are likely off due to discrepancies in rate criteria and dates.
Depression:
- American Women 21.6%
- Austrian Women 15.9%
- The British Population 11.4%
- Austrian Men 9.8%
- German Women 9.5%
- New Zealand Women 8.4%
- American Men 7.2%
- Swiss General Population 7%
- Australian Women 6.6%
- Worldwide Average for Women 5.8%
- German Men 5.8%
- New Zealand Men 5.2%
- Canadian General Population 4-5%
- Australian Men 4.1%
- Worldwide Average for Men 3.4%
Anxiety:
- Austrian Women 22.6%
- German Women 19.0%
- New Zealand Women 18.6%
- Australian Women 17.9%
- British General Population 13.4%
- Austrian Men 11.8%
- Australian Men 10.8%
- New Zealand Men 10.7%
- German Men 9.0%
- American Women 7.2%
- American Men 3.6%
- Canadian General Population 1.1%
Bipolar:
- American General Population 4.4%
- Colombian General Population 2.6%
- Worldwide Average 2.4%
- New Zealand Women 2.3%
- New Zealand Men 2.1%
- Australian Men 1.8%
- Australian Women 1.7%
- Austrian Men 1.4%
- Austrian Women 1.3%
- Canadian General Population 1.0%
- Japanese General Population 0.7%
- Indian General Population 0.1%
ADHD
- Canadian General Population 15%
- American Boys 9.0%
- New Zealand General Population 6.7%
- American Girls 5.4%
All sources say that depression and anxiety disorders often occur together, so since the Americans are near the top of the list for depression, they should also be much higher on the anxiety list. The Canadian anxiety rate also seems surprisingly low.
As demonstrated by the USHHS report, depression and anxiety rates are quickly rising. Why is it that these rates are growing and the United States is at the top of the list for depression and bipolar disorder and its place on the anxiety list is questionable? Is it because people really are getting more depressed and anxious? Is it because people are more aware of these disorders? Or is it because people need an excuse - something to blame for certain behaviors?
Are people getting more depressed and anxious? Maybe. Several of the sources I used cite diet and exercise as a way to fight depression and anxiety, and Lord knows Americans are lazy (Americans probably work more than most other developed countries, but are lazy when it comes to physical activity) and eat crap.
Is it because people are more aware of these disorders? I doubt it. Take Canada, for example. Canada is a developed, Western country. Why would Canadians be less aware of these disorders or have less access to help than Americans?
Is it that people need an excuse? It wouldn't surprise me. In today's world of youth sports where they don't take score, every little girl is a princess, and teachers and parents aren't allowed to hit children when they act up, people can never be at fault. This gives them an explanation beyond just making stupid decisions and acting irrationally.
Whatever the reason, is medication really the answer? Improving diet and being more active, as well as putting yourself in a more positive environment, are good steps to take. Whatever it is, except possibly in extreme cases, you can beat it on your own. All it takes is determination. Medication is just going to mess up your hormones and screw you up even more.