recent World Health Organization (WHO) study revealed that the
incidence of schizophrenia has increased 45 percent in developing
nations since 1985. By far the hardest hit have been women. A separate
WHO study of 14 countries showed women have twice the rate of depression
as men. In Santiago, Chile, the rate was five times as high for
women. (Chinese women, a previous study found, had nine times the
rate of neurosis and depressive neurosis as men, and 75percent
The WHO findings reinforce what Myrna Weissman and colleagues
reported in a 1992 JAMA report on depression. In most of the countries
they studied, people born since 1950 are at a much higher risk
for depression than those born earlier. What makes the WHO studies
so remarkable, though, is that they focus on developing nations
such as India and Egypt, whose populations have seen dramatic improvements
in medicine and infrastructure.
This appears as puzzling, at first glance, as the Vega studies
on Mexican immigrants. But closer scrutiny solves the mystery.
The very changes that have brought improved health and infrastructure
in these countries have also led to significant disruptions in
cultural practices, social routines, and traditional roles in work
and family. To paraphrase David Byrne, These people got what they
wanted, but lost what they had.
When we look closely at patterns of mental disorders around the
world, one thing becomes clear: rising wealth does not improve
mental health. In fact, globalization seems to leave mental degradation
in its wake. Canadian psychologist Bruce Alexander has come to
the same conclusion.
"Because [our] western free-market society proves the model
for globalization," he says, "mass addiction is being
globalized, along with the English language, the Internet, and
If the mental environment is so toxic, why arent we all
sick? For the same reason were not all suffering from colds
or the flu. People differ biologically and developmentally in their
vulnerabilities which may explain why, in the calculus of
a societys mental health, the impact of toxic culture tends
to get overlooked. Mental disorders are considered the problems
of individuals. But lets be clear: the crisis in mental health
that we face is a crisis of ecology and culture, not one of brains,
biochemistry, and medicine.
The WHO predicts that depression will become one of the most common
disabling disorders in the world by 2020, second only to heart
disease (it has already reached the number one spot for women).
Pretty soon, Mexicans and other immigrants wont have to come
to North America to be exposed to toxic culture, USA. It will come
to them. Culture is, after all, Americas greatest export.