Trends in Mental Disorders

What is going on?

Is ADHD just social disapproval of boys being boys? Are mental disorders caused by or spreading through social media? Are there fads and fashions at work?

Having no credentials in psychology, I am inclined to avoid the term “mental disorder.” Instead, let us say that you may have some chronic behaviors that either you or those around you wish would change. For “mental disorder,” substitute “bothersome behavior.” Note that “feeling depressed” does not count, unless it results in bothersome behavior (which it often does).

To discuss “bothersome behavior,” we do not have to rely on a process of diagnosis or a diagnostic category. We do not have to rely on either self-diagnosis or professional evaluation. We do not have to wait for someone to attach a particular label; there is just behavior that is bothersome. And the same behavior that can be bothersome in one particular person at one particular time may not be bothersome in a different person or in a different context.

Some treatments work to change some behaviors for some people. Diets are an example—the same diet does not work for everyone. Talk therapy works for some people, but not for others. The same with drugs. But one advantage of drugs is that I think that one usually finds out relatively quickly whether or not they work.

There is a cultural element in defining bothersome behavior. For a man, engaging in sex with another man was considered bothersome behavior in 1950. Not so today, at least in Western societies.

Among women, fainting behavior used to be common. Now it is less so. Sigmund Freud and his followers had very different notions of what was bothersome female behavior than do contemporary psychiatrists and their followers.

I suspect that when the majority of people lived and worked on farms (which was still true as of 1800, even in the “developed world”), a lot of bothersome behavior was overlooked. But when people congregate in cities and work in offices, bothersome behavior tends to stand out more.

My Speculations

So why are we seeing an increase in people being labeled as depressed, or autistic, or ADHD?

Some of these labels have become high status. Nonbinary is high status among affluent teenagers. But I do not believe that the desire for status is the main driver.¹

In addition to urbanization, which I think is the main reason that bothersome behavior has become more observable, I list below some of the factors that might be involved. There is no definite causal pathway. A child can grow up without any of the factors I list and nonetheless grow up to engage in bothersome behavior.

I suspect that more children are being born with innate mutations, because their parents are older, reducing sperm and egg quality. These mutations result in unusual personality characteristics.

I suspect that children are spending less time with other children. Families are smaller. There are fewer neighborhoods with a lot of children. And there is a reluctance to let children go out on their own seeking children with whom to play. I suspect that having close adult supervision most of the time stunts children’s growth in social competence and confidence.

I think that an important part of growing up is learning self-control. My impression is that this is more difficult for parents to model and to teach nowadays.

Children are skilled at manipulating their parents. When parents are easily manipulated, the child’s self-control is less likely to develop. When there are four children, no individual child has a good chance to manipulate parents. When there are one or two, manipulation is easier.

Parents are at fault when they make what I call the idle threat. Suppose that you say, “That’s it, you cannot go to the birthday party tomorrow.” You may think that you are giving your kid consequences, but you are not.

This threat is not one that you want to carry out. You want to take your kid to the birthday party. Otherwise, you will have to put energy into coming up with something for the kid to do.

Chances are, you will forget all about the threat. And even if you are actually compulsive enough to carry it out the next day, the child does not really see the connection between his actions and the consequences. There is too much of a gap in between.

I am against spanking, but at least you can say that the old-fashioned approach meant consequences that were definite and immediate. Consequences that are uncertain and delayed are not effective.

Finally, I suspect that family structure matters. I suspect that some of the increase in bothersome behavior comes from children not growing up in stable, two-parent families. An only child of a single parent strikes me as especially problematic. The child and the parent are in a relationship that revolves around one another. I doubt that this is conducive to healthy emotional development.

In short, I believe that the increase in bothersome behavior does not have a single dominant cause. There may be some socially fashionable diagnoses. There may be some social contagion. There may be some excessive labeling going on. But those are not the primary explanations. I think that most of the increase is real.

1. I was surprised to see Freddie DeBoer, who has argued that society needs to treat schizophrenia as a serious disorder, argue for a status-seeking explanation for some mental disorders. @

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