Let’s look in more detail at those mental health disorders which are the most prevalent and widespread in the U.S., each of them affecting millions and millions of people every single year, and the range of symptoms (from mild to severe) that impact sufferers on a daily basis.
#1. Anxiety Disorders
Anxiety disorders are by far the most common form of mental illness seen in the U.S., affecting 48 million adults in the U.S. (age 18 and older), or 19.1% of the population every year, according to “Mental Health By The Numbers,” published by the National Alliance on Mental Illness (NAMI).
Although anxiety disorders are highly treatable, only 36.9% of those suffering receive treatment. As with all types of mental illness, the stigma people wrongly associate with mental health issues is an obstacle to necessary treatment, as well as difficulties with finding a provider and the cost of treatment.
Anxiety disorders can develop from a complex group of potential risk factors:
- Brain chemistry
- Personality, and
- Life events
Did you know that people with an anxiety disorder are 3 – 5 times more likely to go to the doctor, and 6 times more likely to be hospitalized for psychiatric disorders than those without an anxiety disorder?
|Anxiety & Depression
Did you know that just under one-half of those diagnosed with depression are also diagnosed with an anxiety disorder?
Types of Anxiety Disorders
|Generalized Anxiety Disorder (GAD)||Affects 3.1% of the U.S. population (6.8 million adults); only 43.2% are receiving treatment.||GAD often co-occurs with major depression, and women are twice as likely to be affected as men.|
|Panic Disorder (PD)||Affects 2.7% of the U.S. population (6 million adults).||Women, again, are twice as likely to be affected by PD as men.|
|Social Anxiety Disorder (SAD)||Affects 6.8% of the U.S. population (15 million adults).||SAD is equally common among men and women, and typically begins around age 13. Many people will wait years and years before seeking treatment.|
|Specific Phobias||Affect 8.7% of the U.S. population (19 million adults).||Women are twice as likely to be affected as men, and symptoms typically begin when sufferers are 7 years old.
Types of phobia include: Emetophobia (fear of vomiting), fear of driving, fear of flying, fear of needles, and health anxiety.
Obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are closely related to anxiety disorders, and can be experienced at the same time, along with depression.
IMPORTANT: In our article, however, they are considered as separate conditions, particularly as PTSD is the 4th most common mental health disorder among U.S. adults.
In general terms, depression occurs more often in women than men. In men, it often manifests as tiredness, irritability, anger, reckless behavior, and substance abuse.
Additionally, men do not usually recognize that they are depressed, and often do not seek help.
In women, however, depression will manifest as sadness, guilt, and low self-esteem.
When someone experiences severe depression, regardless of its initial cause, they are likely to be clinically diagnosed with either major depressive disorder (MDD) or persistent depressive disorder (PDD, formerly termed dysthymia).
Major Depressive Disorder
Major depressive disorder (often termed as either clinical depression or major depression) is the leading cause of disability in the U.S. for those aged 15 to 44 years of age.
MDD affects more than 17 million adults in the U.S., or about 6.9% of the adult population (aged 18 and older).
While MDD can develop at any age, the average age of onset is around 32 years old. Additionally, like many disorders, it is more prevalent in women than in men.
The condition is clinically diagnosed by having at least 5 symptoms from the list of the 9 most common symptoms, as published in the “Diagnostic and Statistical Manual of Mental Disorders” (known by clinicians as DSM-5).
The 9 common symptoms of depression for diagnostic purposes are as follows:
The symptoms must last for a period of 2 weeks or longer, and the individual should show a steep decline in their daily functioning, such as social, occupational or educational functioning.
For example, the individual may start missing work or school or be opting out of their usual social activities.
|Did you know that current and planned firearm ownership is common among individuals with symptoms of major depressive disorder?
According to a recent study published online (JAMA Network Open), researchers from Massachusetts General Hospital in Boston assessed the prevalence of firearm ownership and found that 31.3% of respondents with depression reported owning a gun, and more than a third of these had purchased one within the past year.
Persistent Depressive Disorder
Persistent depressive disorder is a long-term form of depression, affecting around 1.5% of U.S. adults, or about 3.3 million adults. The main characteristic of this disorder is a sad mood that persists for most of the day, most days, for a minimum of 2 years.
For diagnosis, during the 2-year period, any symptom-free intervals can last no longer than 2 months.
The symptoms are considered not as severe as those of major depression. MDD can be present prior to PDD, and episodes of MDD can also occur during PDD.
#3. Co-Occurring Disorder
People with substance use disorders (SUDs), where they have become dependent or addicted to specific drugs or alcohol, are at an increased risk of developing one or more other primary conditions or chronic diseases.
One of the most common of these is the coexistence of both a mental illness and a SUD; this is known as a co-occurring disorder. Researchers have found that around half of individuals who suffer from a SUD during their lifetime will also experience a co-occurring mental disorder – and vice versa.
Treating co-occurring disorders successfully is often dependent upon both conditions being treated simultaneously. Co-occurring disorders can include:
While SUDs and other mental health disorders commonly co-occur, it does not mean that one has caused the other. Research suggests 3 possible explanations why co-occurring disorders feature so regularly together:
- Common risk factors: Both SUDs and other mental disorders share many common risk factors, such as genetics, and environmental factors, such as stress or trauma.
- Mental health disorders contribute to substance use and SUDs: Studies have found that people with a mental disorders, such as anxiety, depression, or post-traumatic stress disorder (PTSD), will often use drugs or alcohol as a form of “self-medication.” However, these substances over time will worsen both conditions.
- Substance use and SUDs contribute to the development of other mental disorders: Substance use has been found to trigger changes in brain structure and function that increase the likelihood of a mental health disorder developing.
#4. Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder, or PTSD (as it is commonly abbreviated), is a serious, potentially debilitating condition that occurs in those who have experienced first-hand or witnessed a traumatic event, like assault, combat, or disaster.
Such events can cause stress reactions, and if these reactions remain, and persist over time, disrupting their lives, the individual can develop PTSD.
Traumatic events that are known to result in PTSD include:
It is estimated that around 9 million adults suffer from PTSD, making the condition the fourth most common mental health disorder in the U.S.
PTSD is often characterized by the sufferer experiencing flashbacks of the traumatic event they experienced or witnessed. This can cause severe relationship issues with their close family, loved ones, and friendships.
Furthermore, women are twice as likely to develop PTSD as men, and it’s not just limited to adults – children can also develop it, too. In fact, childhood sexual abuse is a strong predictor of a lifetime likelihood of developing PTSD.
Tragically, the most likely trigger of PTSD in the U.S. is rape: 65% of men and 45.9% of women who are raped will develop the disorder.
Unsurprisingly, PTSD often occurs with depression, substance abuse, or other anxiety disorders.
PTSD presents as 4 different symptoms, but they may not be exactly the same for everyone. These are:
- Reliving the event (also called re-experiencing symptoms): Memories of the traumatic event can come back at any time, such as nightmares, actively reliving the event (flashback), or can be triggered by particular sights, sounds, or smells, eg. hearing fireworks..
- Avoiding things that are reminiscent of the trauma: Constantly trying to avoid situations or people that are reminiscent of the event; for example, avoiding crowds.
- Having more negative thoughts and feelings than before the event: The trauma makes sufferers think about themselves and others more negatively, eg. feeling emotionally numb, losing interest in activities that were previously enjoyable, having difficulty trusting, and believing the world is dangerous.
- Feeling constantly on edge (also called hyperarousal): This symptom is always feeling alert and jittery or on the lookout for danger. People in this state can suddenly become angry or irritable.
#5. Bipolar Disorder
Most people normally experience anxiety sporadically during their lives, and it’s perfectly natural for our moods to change or our anxiety level to rise when a stressful or difficult event occurs.
However, some people experience feelings of anxiety or depression or suffer mood swings that are so severe that they constantly interfere with their daily lives, as in their personal relationships, their work, and their normal functioning.
These people may be suffering from bipolar disorder, anxiety disorder, or both.
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes abnormal and dramatic shifts in a person’s mood, energy, and their ability to function as they normally do.
The “mood episodes” associated with bipolar disorder can last for days to weeks or even longer, and can be dramatic for others to witness, with periods of being really high and/or really irritable to periods of real depression, and a sense of hopelessness.
These periods of highs and lows, called episodes of mania and depression respectively, can be distinct episodes recurring over time, or they can occur together all at once, in what is known as a so-called mixed state.
Usually, people with bipolar disorder experience periods of normal mood in between their mood episodes.
Fortunately, both of these disorders – bipolar and anxiety – are treatable, both separately and together.
Before we had ever heard of the phrase “COVID-19,” the decline in mental health and general wellbeing in the U.S. was already becoming a rapidly growing public health crisis.
In 2020, the data from pre-pandemic studies and surveys reported that approximately 1 in 5 adults in the U.S. would experience mental health issues at some point in their lives – a ratio that amounts to millions and millions of Americans nationwide.
In fact, with such a high prevalence of mental health problems being continually seen in the U.S., it’s likely that someone you know is dealing with one right now, and it’s very likely that you do not even know what they are going through on a daily basis.
If you are now wondering what the most common mental health disorders might actually be, let’s answer that for you straight away:
Mental Health Disorder
|% of U.S. Adults||# of U.S. Adults (estimated)|
– a range of disorders, including: Generalized Anxiety Disorder (GAD)
Panic Disorder (PD)
Social Anxiety Disorder (SAD), and specific phobias
Major Depressive Disorder (MDD), and
– the simultaneous presence of a substance use disorder and mental illness
|4||Post-Traumatic Stress Disorder
– known commonly as PTSD
|5||Bipolar Disorder||2.8%||7 million|
Source: “Mental Health By The Numbers”
National Alliance on Mental Illness (NAMI)
In addition to these disorders, sizeable numbers of the U.S. population are also affected by:
- Borderline Personality Disorder: 1.4% (estimated 3.5 million adults)
- Obsessive Compulsive Disorder: 1.2% (estimated 3 million adults)
- Schizophrenia: <1% (estimated 1.5 million adults)
We will, of course, be adding more detail to these disorders as our article progresses. In addition, we’ll look at the impact of the coronavirus pandemic on the nation’s mental health, and how stigma continues to affect treatment take-up in the U.S.
How Did COVID-19 Worsen Mental Health in the U.S.?
As the coronavirus pandemic (known more commonly by COVID-19) began to virulently spread throughout the U.S. as a whole, we all soon became aware of the huge numbers of those being infected, and the numbers who were dying.
All you needed to do was to switch on your local TV news channel at any time during 2020 and the first half of 2021, and you would instantly know the ongoing death toll – in your town, your county, your state, and across the U.S.
Medical experts already understood that physical conditions such as cardiac disease, asthma, hypertension, and diabetes, among others, made you more susceptible to more serious COVID-19 infection, and even death.
Now, with so much more medical data having been analyzed by researchers worldwide, it has also become painfully obvious that those with mental illness, and those using and abusing addictive substances, are also more susceptible, more vulnerable, and more likely to be hospitalized.
The Restrictions COVID-19 Placed on Mental Health Services
However, for many of these existing sufferers, the immediate impact of the coronavirus pandemic was to shut down and close off their normal access to vital treatment. Many mental health clinics and addiction services (where they could) had to quickly transfer their service methods, with many using telehealth and online or phone contact with their patients.
Let’s not forget that the pandemic itself was a traumatizing event, affecting the entire population, and the source of much grief for those families affected, such as the children orphaned by the virus.
For new sufferers of mental health disorders, the usual routes to diagnosis and treatment were closed, and many were simply left to suffer in silence.
Furthermore, the COVID-19 pandemic has also both highlighted and exacerbated the existing treatment issues faced primarily by black, indigenous, and people of color (BIPOC) in the U.S.
All of these factors, on their own, would affect an individual’s mental health in a negative way. However, in combination, they are responsible for a national public mental health crisis in the U.S. on a scale never seen before.
Post-Pandemic Mental Health in the U.S.
The COVID-19 pandemic, and the economic recession that followed, have negatively affected many people’s mental health, in particular, by creating new barriers to treatment for people already suffering from mental health and substance use disorders.
“In the best of times, there is untreated mental illness. Even a small increase in the rates of people with new or worsening mental illness is going to be a problem. [With the pandemic] it has been the entire country.” – Susan Borja, Chief of the Dimensional Traumatic Stress Research Program, National Institute of Mental Health
According to data gathered by KFF, the health policy organization, around 4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder, a ratio that has significantly increased following the pandemic. Only 1 in 10 adults reported symptoms from January to June of 2019 (see graphic below).
Average Share of Adults Reporting Symptoms of Anxiety Disorder and/or
Depressive Disorder, January-June 2019 vs. January 2021 (Source: KFF)
Additionally, a KFF Health Tracking Poll (from July 2020) found that many adults were reporting specific impacts on their mental health, such as:
- Difficulty sleeping: 36%
- Poor appetite: 32%
- Increases in alcohol consumption or substance use: 12%, and
- Worsening chronic conditions due to added worry and stress: 12%
Furthermore, it is becoming increasingly clear to medical experts that severe COVID-19 infection – termed “long COVID-19” by the national media – is a condition that results in varying degrees of damage to the mental health of sufferers.
A recent article entitled “Acute COVID-19 Severity & Mental Health Morbidity Trajectories” (published in The Lancet, and dated March 14, 2022) reported that severe acute COVID-19 illness, as shown with extended time bedridden, is associated with long-term mental illness (or morbidity) among recovering individuals.
Stigma & Mental Health Treatment in the U.S.
Sadly, stigma and even feelings of shame, continue to be barriers to treatment in the U.S. for those suffering from a mental health disorder. Although attitudes and public perceptions have shifted immeasurably in recent years, the shadow of stigma still affects a vast number of people who need this necessary treatment.
In 2020, again according to NAMI’s “Mental Health By The Numbers,” only around half of those who required treatment actually received it. The statistics below include evidence of how those in sexual and racial/ethnic minorities are even more affected:
Annual Treatment Rates among U.S. Adults with Mental Illness
- 46.2% of U.S. adults with mental illness received treatment in 2020
- 64.5% of U.S. adults with serious mental illness received treatment in 2020
- The average delay between onset of mental illness symptoms and treatment is 11 years
- 11% of U.S. adults with mental illness had no insurance coverage in 2020
- 11.3% of U.S. adults with serious mental illness had no insurance coverage in 2020
- 55% of U.S. counties do not have a single practicing psychiatrist
- Nearly 130 million people live in a designated Mental Health Professional Shortage Area
“The mind is its own place and, in itself, can make a heaven of hell or a hell of heaven.” – John Milton, British poet and author of “Paradise Lost”
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