Steps of madness: why there are more mentally ill people
According to the World Health Organization, the number of people with mental disorders is growing — more than 1 billion inhabitants of the Earth suffer from mental illnesses. What causes the increase in sad statistics, whether there is a risk of global spread of insanity and whether it is possible to prevent the development of diseases — in the exclusive material of Izvestia.
The pandemic of the 21st century
Mental disorders are one of the fastest—growing causes of loss of health and disability in the world, says a geneticist at the National Center for Genetic Research (Mygenetics). Anastasia Sivakova. She refers to a study published in the prestigious medical journal The Lancet. According to the publication, in 2023, almost 1.2 billion people suffered from various mental disorders, almost twice as many as in 1990.
— Scientists analyzed anxiety disorders, depression, schizophrenia, bipolar disorder, autism, ADHD, eating disorders and other conditions. It was not just about an increase in the number of diagnoses — mental disorders have become one of the leading causes of the loss of "healthy years of life", overtaking many oncological and cardiovascular diseases, - says the interlocutor of the editorial board.
The increase in the number of mental disorders cannot be explained by any one reason, since several factors are involved here, Dr. Isaev's psychiatric clinic explains to Izvestia.
"This is an improvement in diagnosis, a reduction in stigma (social disapproval towards patients of this profile), an increase in referrals and, at the same time, a real increase in the psycho—emotional burden on the population," says Ruslan Isaev, head of the clinic, psychiatrist, narcologist, Candidate of medical Sciences.
According to him, many anxiety and depressive states did not come to the attention of medicine 20-30 years ago. A person could live with severe anxiety, insomnia, panic attacks, or depression for years and never see a doctor. Now people are ready to discuss their condition with specialists.
— There is reason to talk about a real increase in the mental burden on the population. Modern people live in conditions of constant information stimulation, social competition, economic instability and an almost continuous stream of disturbing content. The COVID-19 pandemic has further increased the growth of anxiety and depressive disorders worldwide.
Anastasia Sivakova also believes that the growth of mental disorders is associated with chronic stress, information overload, social isolation, urbanization, sleep disorders, lifestyle changes, rising inequality, wars, pandemics and climate crises.
— The human brain has been forming for tens of thousands of years in a completely different environment. From the point of view of evolution, our body is poorly adapted to the round—the-clock information noise, constant anxiety, social networks and life in conditions of chronic uncertainty, - says the geneticist.
Today, anxiety has actually become a background condition for a huge number of people, as a result, the nervous system is on high alert for a long time, adds Ruslan Isaev. The risk of cardiovascular diseases, addictions, emotional burnout and social maladjustment increases.
As for bipolar disorder and schizophrenia, psychiatrists attribute the increase in statistics in these cases to improved diagnosis and early detection of problems. The availability of psychiatric care and knowledge about the first symptoms of psychosis have increased, which also affected statistics, the psychiatrist emphasizes.
Social factors play a huge role in disorders of the recently popular eating behavior, the clinic clarifies. People are pressured by standards of appearance and the need to constantly compare themselves with others, critically assessing their bodies. Social networks contribute to this in many ways. As a result, there is a serious risk of developing anorexia, which remains one of the most dangerous mental disorders in terms of somatic complications and mortality, as well as bulimia, especially among young people.
The fashion for bipolar
Anastasia Sivakova believes that humanity is moving towards an increase in mental vulnerability rather than a total "epidemic of insanity."
— It is important to understand that anxiety, depression, or emotional burnout are not the same as severe psychotic disorders like schizophrenia. Many modern diagnoses do not reflect the destruction of the psyche, but a chronic overload of the nervous system," explains the geneticist.
She adds that the adolescent brain is particularly vulnerable. The Lancet study showed the peak of mental disorders at the age of 15-19 years.
— In general, young people are more likely to be included in statistics not because they are "more psychotic", but because it is at this age that the maximum psychoemotional load and at the same time the maximum involvement in the digital environment occur, — says Ruslan Isaev. — The age of 15-19 is a period when a person is faced with studies, competition, professional uncertainty, separation from parents, building relationships, financial and informational pressure, and constant social evaluation.
Experts consider it a positive trend that the younger generation is much more attentive to their mental state. Previously, a huge number of people with anxiety, depression, or addictions simply did not reach a doctor.
"But sometimes the culture of mindfulness turns into a pathological fixation on one's own condition," the psychiatrist complains. — A person begins to consider any emotional fluctuation as a potential diagnosis, while a healthy psyche must withstand frustration, uncertainty, and rejection. Ordinary anxiety before an exam turns into a "generalized anxiety disorder," fatigue turns into "depression," and absent—mindedness after lack of sleep turns into "ADHD."
As a result, according to the expert, a paradoxical situation arises: on the one hand, society has really become more literate in matters of mental health, and doctors treat this moment positively. On the other hand, psychiatric terms are increasingly being used outside the medical context, and self—diagnosis is becoming part of online culture, which poses a serious challenge to psychiatry.
Isaev adds that different eras have their own "fashionable diagnoses." In the early noughties, panic attacks and depression were actively discussed in popular culture. Then bipolar disorder came into fashion. In recent years, public interest in ADHD, autism spectrum disorders, and so-called high-functioning autism has increased dramatically.
"This is especially strongly influenced by social networks and short pseudo—educational content, where the usual features of temperament or the effects of stress begin to be interpreted as a psychiatric diagnosis," the candidate of medical sciences is outraged. — Patients come to us with a ready-made "diagnosis" from social networks. Often, the supposed ADHD hides an anxiety disorder, depression, emotional burnout, the consequences of chronic lack of sleep, or simply high information overload.
The fact that Russians have become noticeably more likely to discuss mental disorders on social networks and search for information about them on the Internet is confirmed by a study conducted by the Pressindex analytical agency, provided to Izvestia on an exclusive basis. From May 2025 to April 2026, the number of reports of mental diagnoses in oneself or loved ones increased by 14.9% year-on-year, to 427.4 thousand. Users most often write about depression, anxiety disorders, and obsessive-compulsive disorder, discuss treatment, share personal experiences, and seek support.
— Search interest in the topic of mental disorders increased by 7.8% over the same period, to 53.4 million requests per year, and in total over two years, analysts recorded more than 103 million requests. The most popular topics were depression, addiction, ADHD, psychotic disorders, RPP, and anxiety. The fastest growing interest is in topics that are actively spreading through social networks and popular culture — dysmorphophobia, PTSD, BPD and Tourette's syndrome," the agency explained to Izvestia.
A separate trend is the growing interest in professional assistance. The number of requests to "make an appointment with a psychiatrist" increased by 45%, which is more than twice as high as to a psychologist, at 19.7%. The study also captures a massive trend towards self-diagnosis: users are actively looking for tests, symptoms, and ways to independently determine the presence of a disorder before contacting a specialist.
Is there a schizophrenia gene?
Almost no mental disorder is caused by one specific "schizophrenia gene" or a certain "anxiety gene," Anastasia Sivakova emphasizes.
"Psychiatric genetics is much more complicated," she says. — Most mental illnesses are polygenic. This means that hundreds or even thousands of genetic variants simultaneously affect the risk. Each of them makes a small contribution, but collectively they can increase predisposition.
The specialist also names the most studied groups of genes that can be "suspected" of this. These are neurotransmitter genes that regulate the work of serotonin, dopamine, norepinephrine and other substances that affect mood, motivation and anxiety.
"For example: SLC6A4 is associated with serotonin transport, COMT affects dopamine metabolism, DRD2 and DRD4 are dopamine receptors, and BDNF is responsible for brain plasticity," the geneticist lists. — Some variants of these genes are more common in people with depression, anxiety disorders, bipolar disorder, or schizophrenia.
But the presence of such an option is not a verdict, the expert emphasizes, but only an increase in the likelihood of a possible diagnosis. The hereditary component of many mental illnesses is really very high. According to current estimates, schizophrenia is inherited by about 70-80%, bipolar disorder by 60-80%, autism by up to 80%, anorexia by about 50-60%, anxiety disorders and depression by about 30-50%.
— But this does not mean that the disease will "necessarily manifest itself." Heritability only shows the contribution of genetics to risk within a population,— says Sivakova. — For example, if a person has a high genetic predisposition to anxiety, but they grow up in a stable, safe environment, then the disease may never develop. And vice versa: severe psychological trauma can trigger the disease even with moderate genetic stress.
Mental disorders are usually not inherited strictly from the maternal or paternal line. A child gets half of the genes from each parent, and the risk is made up of a huge number of options. However, there are nuances:
— some mutations are more likely to occur in the sperm cells of older men;
— mitochondrial disorders are really transmitted only from the mother;
— some genes can work through the mechanisms of epigenetics, that is, to change the activity of genes under the influence of stress, hunger, violence, or the lifestyle of parents.
Severe stress in parents can leave epigenetic "marks" that affect the functioning of the nervous system in children, explains the interlocutor of Izvestia.
What does the psyche depend on?
Even if both parents suffer from schizophrenia, this does not mean one hundred percent transmission of the disease, Anastasia Sivakova notes.
— On average, the risk of schizophrenia in the population is about 1%, — says the geneticist. — If one parent is sick, the risk is about 10-15%, and if both are sick, about 30-40%. That is, even in the latter case, the probability of having a child without schizophrenia remains high.
The opposite situation is also possible: mentally healthy parents may have a child with a mental disorder, Sivakova warns. The reason for this is a combination of multiple genes, new mutations, and environmental factors.
The mental health of the unborn child can only be calculated approximately so far. Modern genetics is able to evaluate the so-called polygenic risk scores (polygenic indicators or risk scales). This is an attempt to mathematically calculate the total contribution of multiple genes.
— But, first of all, the psyche depends not only on DNA, — the interlocutor of Izvestia continues. — Childhood, stress, family relationships, violence, sleep quality, nutrition, infections, and substance use play a huge role. Secondly, even a high genetic risk does not mean the development of the disease. Therefore, it is not yet possible to guarantee the birth of an "absolutely mentally healthy" child, and genetic tests can only show an increased likelihood of certain conditions.
Anastasia Sivakova notes that the main conclusion of modern psychogenetics is that mental disorders occur at the intersection of biology and the environment. Heredity creates a predisposition, but it is lifestyle, stress, injury, and social conditions that often determine whether this risk is realized. Therefore, the future of humanity depends not only on genetics, but also on how much society can reduce the level of chronic stress, violence, social isolation and psychological pressure.
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