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The Newtown Shootings - The View from 300.01


Since December 14th, when Adam Lanza walked into Sandy Hook Elementary School and murdered 26 people, including 20 schoolchildren, the world's attention news has been on the tragedy in Newtown, Connecticut. There are many theories as to why he did this. The latest is his opposition to his mother planning to have him involuntary committed for treatment as reported in the Christian Monitor on December 19. We don't know exactly what was wrong with Adam. And perhaps we never will. What we have seen is a call for better coverage of mental illness and better mental health screening, calls for prayer and healing and President Obama promising to reinstate the ban on assault weapons.

There have been moving speeches from President Obama , state and local politicians, family members, and the clergy. We have heard comments from the psychiatric community, state and local politicians, members of Congress, advocacy groups. Even the National Rifle Association broke their silence.

I want to give my perspective as a person who has suffered from a mental illness about the media coverage of this tragedy and how mental illness is viewed by the public.

You may know me as a writer. But to the psychiatric community and insurance industry I am 300.01. This is my diagnosis according to the Diagnostic And Statistical Manual of the American Psychiatric Association. A person with this diagnosis has panic disorder. I've had panic attacks since I was 19. You can read about my history of panic attacks in my article Prone To Panic. It goes into great detail about how they started and my long search for treatment for a problem that was not classified as an illness at the time.

Whenever there is a mass shooting by a lone gunman the killer is usually portrayed by the media as a troubled loner with a history of mental illness. His neighbors, coworkers or schoolmates say he acted strange, was withdrawn and never seemed quite right. "He was a loner. He was a quiet man. I never quite trusted him. He just didn't fit in."

As a person who has been diagnosed with a mental illness, I know that if I ever was involved in a violent crime, the media would refer to my history of mental illness, the fact that I was under the care of a psychiatrist and that I lived alone. Never mind that I have worked my entire life, successfully raised two children and have accomplished many things that I am proud of in my career and in my life.

Rob Reiner, the actor and film director, played Archie Bunker's son-in-law in the TV show All in the Family. The character he played was called Meathead by Archie. "Literally every day of my life, somebody will say, 'hey Meathead!' No matter what I do with my life -- I could win the Nobel Prize -- it will say 'Meathead wins Nobel.' It doesn’t matter. I have Norman Lear to thank for that," Reiner said.

I don't expect to win the Nobel Prize. But like Meathead, I know that many people who knew me when I was really suffering could not see beyond my illness. I was the "young man with panic attacks." I was defined by my illness. I understand why. If you've ever witnessed a person having a panic attack it is pretty frightening. And if you are a fellow sufferer, you have my sympathy. There is nothing noble about a panic attack. It doesn't give you any great insight into the world. It doesn't make you more creative. Panic attacks are not fun.

According to National Institute of Mental Health (NIMH) "People with panic disorder have at least four of the following symptoms during an attack."

  • Chest pain or discomfort
  • Dizziness or faintness
  • Fear of dying
  • Fear of losing control or impending doom
  • Feeling of choking
  • Feelings of detachment
  • Feelings of unreality
  • Nausea or upset stomach
  • Numbness or tingling in the hands, feet, or face
  • Palpitations, fast heart rate, or pounding heart
  • Sensation of shortness of breath or smothering
  • Sweating, chills, or hot flashes
  • Trembling or shaking

Please note that the symptoms do not include violence, hostility, the urge to pick up a gun or a desire to harm people. When I had a panic attack, I thought I was dying. I wanted to be brought to a hospital. The furthest thing from my mind was being violent.

There is a very strong history of mental illness in my family. It is one of the reasons I never drank alcohol and was very wary of drugs when I was in college despite the fact they were everywhere and readily available. I recently read that Bruce Springsteen has a long history of depression. His family also has a history of mental illness. Because of this he shied away from drugs and alcohol as well.

OK. So people with panic disorder and depression aren't violent. What about people with schizophrenia or bipolar disease? Don't they hear voices? Aren't they violent? The answer is no. Mentally ill people have committed violent acts. But they are rare.

But don't take my word for it. There is plenty of very good research out there which has shown that the mentally ill are no more prone to being violent than people who are not mentally ill. In an article in the Archives Of General Psychiatry, the authors found that the vast majority of homicides, arsons and assaults in the United States are not done by mentally ill people. In fact, unemployment, a recent divorce and a history of physical abuse were found to be better predictors of violent behavior than a diagnosis of schizophrenia.

"Our study shows that a link between mental illness and violence does exist, but it's not as strong as most people think," said Eric B. Elbogen, Ph.D., lead author of the study and assistant professor in the forensic psychiatry program at the University of North Carolina at Chapel Hill School of Medicine. "We found that several other factors – such as a history of past violence or substance abuse or a recent divorce or loss of one's job – are much more predictive of future violence than mental illness alone," Elbogen said. "Only when a person has both mental illness and substance abuse at the same time does that person's risk of future violence outweigh anyone else's." UNC co-author Sally C. Johnson, M.D. added, "These findings challenge the perception some people have, and which you often see reflected in media coverage, that mental illness alone makes someone more dangerous. Our study shows that this perception is just not correct."

The reality is that mental illness is very common in our country and throughout the world. So is heart disease, diabetes and cancer. I don't know anyone who is afraid of a person with heart disease or cancer. Yet people fear the mentally ill despite the fact that it affects millions of people in this country and around the world.

According to the National Institute of Mental Health "Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people." The figures of 2012 are probably higher.

The World Health Organization lists depression as the fourth-leading cause of the global disease burden and the leading cause of disability worldwide. Yet despite the commonality of mental illness, a study in the American Journal of Public Health found that 75% of Americans believe that mentally ill people are dangerous. In fact, mentally ill people are more likely to be the target of violence than the average person.

The sad reality is that most people with mental illness are scared by their disorder. They do not see violence as a solution to their problems. They don't have the desire to harm others. Mass murders scare the mentally ill just as much as those who are not mentally ill.

So yes, let's find better treatments. Let's have better access to mental health practitioners. And let's pressure insurance companies to cover mental health and not make people have to fight for visits to clinicians as they do now. And most importantly, let's ban guns. After a mass shooting in Australia in 1996, the Prime Minister put tight controls on weapons and banned assault rifles. Since these aggressive measures were put into place, the risk of dying by gunshot in Australia fell more than 50 percent and there have been no mass shootings. It would be nice if our leaders had this courage.

Image: Edvard Munch, Scream, 1893. In public domain.

The views expressed are those of the author and are not necessarily those of Scientific American.

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