Cracked by James Davies Read Free Book Online

thought to suffer from the condition (with prevalence rates in North America and Europe being pretty much equal at around 5 percent). 26 This vaulting rise in ADHD is consistent with a growth in other childhood psychiatric disorders. If we add up the prevalence rates for all childhood disorders, for example, it is estimated that between 14 percent and 15 percent of children now suffer from a diagnosable mental disorder in any given year. 27
    But as high as these figures may be, they pale in comparison to those relating to the adult population. For example, the National Institute for Mental Health in the United States now claims that about 26.2 percent of all American adults suffer from at least one of the DSM disorders in a given year 28 while the Office for National Statistics on Psychiatric Morbidity in the UK reports a similar figure. 29 This amounts to saying that at least one in four people is afflicted by a mental disorder in a given year each side of the Atlantic, a figure made more startling when in the 1950s it was more like one in a hundred, and at the beginning of the twentieth century a meager one in a thousand. So what can account for this massive surge in mental disorders? Why in just a few decades have we apparently all become so psychiatrically unwell?
    There are at least three hypotheses the mental health community uses to try to account for the escalating rates. And as the book unravels, we will look at them in greater depth. But to give you just a quick snapshot, let me outline them briefly below.
    The first goes like this: As the pressures of contemporary life have increased, so too have our levels of stress and strain, leading to an upsurge in poor mental health. While this explanation seems reasonable enough, as we will see later it is difficult to ascertain whether contemporary life is really so much more stressful than life many decades ago. Indeed, as many sociological studies have shown, social stress may have decreased rather than increased in recent years, therefore putting this hypothesis under strain. 30
    The second hypothesis is also problematic: it says that mental disorders have increased because today’s psychiatrists are better than those in the past at recognizing psychiatric disease. Perhaps advances in technology now allow clinicians to more readily spot and diagnose disorders that once slipped below their radar. While this hypothesis again has some obvious appeal, its weakness is that by and large diagnostic technology has not improved—there are still no objective tests that can confirm the validity of any psychiatric diagnosis, a fact supported by the continued low diagnostic reliability rates.
    To be at our most generous, then, the first two hypotheses are, at best, plausible explanations that can partly account for the rise in disorder rates. But what if these hypotheses do not reveal the whole picture? What if they overlook a crucial yet not-so-obvious third possibility: that psychiatry, by progressively lowering the bar for what counts as mental disorder, has recast many natural responses to the problems of living as mental disorders requiring psychiatric treatment. In other words, has psychiatry, by redrawing the line between disorder and normality, actually created the illusion of a pandemic?
    Let’s now look at this third hypothesis in greater depth.
    2
    In March 2011, a group of scientists undertook a comprehensive study on nearly one million Canadian schoolchildren. What they did was look at the medical diagnoses all these children had received within the period of one year. These children were between the ages of six and twelve. The scientists were particularly interested in how many of them had been diagnosed with ADHD. Once the calculations were conducted and the results came in, the scientists were initially baffled by what they found: the precise month in which a child was born played a significant role in determining whether or not he or she would be diagnosed