According to a 2009 report from the Public Health Agency of Canada, a whopping 20 per cent of Canadians will experience some mental health issue in their lifetimes. This includes 4.8 per cent who will suffer from major depression; between 4.7 and 12 per cent who will suffer from anxiety disorder; and between six and nine per cent who will suffer from personality disorders. One could be forgiven for assuming that mental health problems amount to an epidemic in the early 21st century.
Ian Dowbiggin, professor of history at the University of Prince Edward Island, would like to know what accounts for such staggering figures among affluent, modern North Americans. What he discovers in The Quest for Mental Health, a survey of attempts to treat mental illness from the emergence of psychiatry in the 18th century right through to the present, is that affluence itself may be partly to blame.
Dowbiggin suggests the rampant diagnosis of mental illness in modern society results from the convergence of unbridled consumerism and what he calls “therapism,” the notion that a large number of mental illnesses are beyond the control of normal people and require professional intervention from “psychiatrists, psychologists, [and] counselors” to “educators, workshoppers, and life coaches.” The self-help movement, embodied by figures like Oprah and Dr. Phil, has convinced us that we are not to blame for any emotional distress we feel, and the pharmaceutical industry is more than happy to help us combat these problems – for a price – with everything from Prozac for depression to Xanax for anxiety.
By locating these issues on an historical continuum, Dowbiggin demonstrates how current attempts to medicate away ill feelings have evolved out of earlier such efforts. The physical symptoms that result from what is commonly diagnosed as anxiety, for instance, resemble those attributed to “neurasthenia,” a nervous condition identified in 1869 by American neurologist George Beard. Dowbiggin notes that treatment for neurasthenia was in high demand at the dawn of the 20th century, “though typically confined to the affluent classes and the so-called worried well.” It would appear that mental hygiene is always in greatest demand from those with the means to pay for it.
Especially strong is Dowbiggin’s final chapter, which finds a correlation between the demand for medication to deal with things like social anxiety disorder and post-traumatic stress disorder and a culture of victimization that encourages people to disavow any sense of personal responsibility, instead placing the blame for their dispositions on a vaguely defined set of mental disabilities. Although slow at times in its middle sections, The Quest for Mental Health provides a stark illustration of the ways humans have tried to combat melancholy and emotional distress, and the increasingly strident demands that medicine provide access to happiness.