John Prideaux

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Steven Pinker has argued, pretty persuasively, that humankind is less violent than ever before. If so, that’s a real sign of human progress. But what about the wars waged within, the kind that know no detente without intervention?

Mental illness is detected now more than ever, and there are logical reasons for that–greater awareness and diagnosis, longer lifespans–but it also often seems like a mismatch disease of modern life, and one influenced by our technological epoch. In smart Economist essay “The Age of Unreason,” John Prideaux thinks through the received wisdom of a link between mental illness and economic development and also wonders if a small Belgian town’s treatment of those with disorders holds lessons for the rest of the world. An excerpt:

The statistical relationship between mental illness and development is new evidence for an old theory. Since the 19th century, people have been arguing that mental illness is a price to be paid for progress. In Civilisation and its Discontents, Sigmund Freud popularised the notion that neurosis increased in tandem with profit. Before Freud, an American neurologist, George Beard, had noted that a nervous disorder he labelled neurasthenia (and others nicknamed “Americanitis”) was on the rise. He put it down to the speeding up of modern life, facilitated by the telegraph, the railway and the press.

Neurasthenia disappeared from the psychiatrist’s lexicon in 20th-century America but enjoyed a long afterlife in China; Chairman Mao himself was said to suffer from the condition. It faded from view only after Arthur Kleinman, a Harvard anthropologist, conducted fieldwork in China in the 1980s and concluded that the symptoms of neurasthenia were rather like those of depression. Drug companies spied an opportunity to sell pills that they were already making. Rates of diagnosis for depression, which was virtually unknown in China 20 years ago, are now catching up with those elsewhere.

This is not because economic progress, of which China has seen more than any other country over the past three decades, makes people sick. Rather, it is due to a combination of the profound effect that growing richer has on diagnosis and the less forgiving standards for normal behaviour set by modern service-sector jobs. Dealing directly with customers makes different demands on the brain from work in a factory or on the land.

Surveys suggest that the incidence of serious mental illnesses such as schizophrenia (a condition characterised by hearing voices and withdrawal from society) and bipolar disorder (which causes extreme, uncontrollable mood swings) is fairly constant at between 1.5% and 3% of the population around the world.•

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