In the span of a few months, Jacqueline Castine went from
making $2,000 as a motivational speaker to getting fired from a minimum-wage
post office job. She had successfully promoted a book on career enhancement,
but then years later, was cleaning houses because she couldn't hold jobs
Adjustment disorders may cause serious problems in daily life.
An adjustment disorder occurs when the patient's reaction to a stressful event:
Is more severe than the expected amount of distress.
Affects relationships or causes problems at home or work.
Includes symptoms of depression and anxiety or other emotional, social, or behavioral problems.
Causes of adjustment disorders in cancer patients include the following:
The Michigan resident's highs and lows came to a head when, as
a sales manager for a Detroit broadcasting outlet, she had a grand delusion
that God was telling her to bankroll one of the station's charitable
The result: Castine ended up with a $43,000 credit card debt
and thoughts of suicide.
"It was as if the bubble of unreality and distorted
thinking had (burst)," says Castine, noting periods of despair coexisting
with moments of great creativity. She sought psychiatric help and was diagnosed
with bipolar disorder, also known as manic depression.
Mental Disorders Are Common
Castine's story may seem unique, but millions of Americans
share her plight. According to the Depression and Bipolar Support Alliance,
3.7% of American adults have bipolar disorder, and 4 out of 5 of those who have
it may not know it.
In the bigger picture of psychological illness, the statistics
may be even more alarming. The National Institute of Mental Health (NIMH)
reports that roughly 22% of U.S. adults -- about one in five -- suffer from a
diagnosable mental disorder in a given year. According to the NIMH, about 1% of
the population age 18 and older in any given year has bipolar disorder.
The numbers, however, may vary depending on the diagnostic
criteria used by researchers, says William Narrow, MD, associate director of
the division of research at the American Psychiatric Association (APA). He was
part of the study that came up with the 22% figure cited by the NIMH.
That number, he says, may include people who may have a mild
disorder -- those who may benefit from preventative treatment to keep symptoms
from impairing their lives.
After reanalyzing the data, Narrow says the number of Americans
with a mental disorder is closer to 15% in all ages. "I think it's more
realistic in terms of who needs treatment acutely," he says.
Nonetheless, Narrow's study and several others indicate that
psychological illnesses are common, and there is evidence that the problem may
Mental disorders account for a significant burden of disease in
all societies. The World Health Organization (WHO) projects that mental
disorders will increase from nearly 12% of the all diseases worldwide to almost
15% by the year 2020.
The statistics have experts emphasizing the need for more
awareness and treatment, and skeptics blaming psychiatry for going overboard
with overdiagnosing ordinary problems.