THE BLOG

Over-diagnosis of Mental Illness

04/10/2010 05:12 am ET | Updated Nov 17, 2011

After my last piece, which focused on mental illness as a global phenomenon, one of the commenters suggested that there is too much diagnosis in this country. I tend to agree.

The New York Times Magazine ran a feature not long ago, titled "Is there an ecological unconscious?" In that piece, the writer, Daniel B. Smith, discussed the possibility of certain mental illnesses having a basis in the ecology of the planet. Terms like "nature-deficit disorder," "ecoanxiety" and "ecoparalysis" have sprung up in recent years and are used by ecopsychologists to diagnose their patients.

The article presented a fascinating look at the "direct line between the health of the natural world and the health of the mind." There is no question that the planet is suffering a trauma from global warming, and there is no question that for 99.9% of our existence as homo sapiens we all (even residents of major metropolitan areas) lived in close contact with nature. Many of us still do, and many are distressed with the disruptive weather patterns, increasing number of hurricanes, unusual extremes in temperature, etc.

Yet I would question the usefulness of including nature-deficit disorder in the Diagnostic and Statistical Manual of Mental Disorders, the bible on mental illness.

Already the DSM is loaded with diagnoses du jour like attention-deficit hyperactivity disorder and obsessive-compulsive disorder.

At least nature-deficit disorder would be based on something with which we have an historic, spiritual connection: nature. It wouldn't be based on the latest gadgetry.

Evidently, the DSM will be adding a new diagnosis regarding the depression children feel when they don't perform well at video games. In the near future, kids might emerge from the psychiatrist's office with a diagnosis of obsessive-video game disorder, or obsessive-texting disorder or obsessive-twitter disorder. What happens when they are replaced by the next newfangled technological invention? Will it too bring its own new diagnosis like iPad compulsive disorder?

I recognize that some kids truly do get depressed over their video game scores as opposed to their grades in school, but it strikes me that most of these kids are not mentally ill at all; their depression is unlikely to be permanent if it revolves around their performance in video games.

When I was a child, I was depressed, but my depression had nothing to do with technology or even a deficit of nature. It was something I was born with, an existential dread that never went away. It didn't come and go based on my performance in some game.

Years later, when I was in my early thirties, that depression turned psychotic. Again, it had nothing to do with technology or nature, and everything to do with my feelings of failure, alienation and powerlessness as a human being. Those feelings reached me and exuded from me at a deep, ontological level.

I don't doubt that our natural and technological environment can add to our problems, perhaps even traumatize us. I just don't think that such traumas rise to the level of pathologies, and I can't help but think that we really are over-diagnosing our children and our adults.

While mental illness, as I pointed out in my last piece, is prevalent throughout the world, it should not be cheapened by the latest fads. Mental illness, at least as I have experienced it, comes from the core. It is not fashionable in any sense.