A few months ago, Dr. Ken Duckworth, a psychiatrist  in Massachusetts, was swimming in his community's pool, chatting with other swimmers. When he mentioned his career, one man wanted Duckworth's opinion on his struggles with depression; another asked for advice on a family member's mental illness. "I was sort of amazed. They were talking openly about their mental disabilities with a stranger in a swimming locker room, " said Duckworth, "That wouldn't have happened 15 years ago. " New research shows that these swimmers aren't the only ones opening up. According to a new study, more American adults than ever are reporting being disabled by the symptoms of depression, anxiety or other emotional problems. The report, published Thursday in the American Journal of Public Health, found that people who said they couldn't perform everyday tasks or engage in social and leisure activities because of a mental illness increased from 2 percent in 1999 to 2.7 percent in 2009. That increase amounts to nearly 2 million more people disabled by mental distress   in the past decade, the report said. Although people did not say they felt more mental distressed compared to past years, they reported that their mental health problems had a greater impact on their daily lives. Dr. Ramin Mojtabai, the study's author, said it's unclear whether the findings tell a sad story of greater mental distress in recent times or point to a victory for public education about the importance of acknowledging and evaluating mental illness. "It is possible that people are realizing the effects of mental illness more acutely now than before," he said. "People could be becoming more aware. " Mojtabai said it's also possible that a number of factors could be taking a toll on the population's mental well-being. High unemployment, economic hardships and a growing sense of isolation could be putting greater stress on Americans. But Duckworth said there could be a more positive explanation -- like his fellow swimmers, people may be getting more comfortable with talking about their mental distress. "I wonder if this tells us that American culture is becoming more open and is giving people the ability to speak about it," he said. "If people have this problem and are willing to acknowledge it, then we're getting closer to dealing with it." What does the underline phrase "taking a toll on" in para.8 mean?
making a contribution to taking part in playing a part in doing harm to
Question: A few months ago, Dr. Ken Duckworth, a psychiatrist  in Massachusetts, was swimming in his community's pool, chatting with other swimmers. When he mentioned his career, one man wanted Duckworth's opinion on his struggles with depression; another asked for advice on a family member's mental illness. "I was sort of amazed. They were talking openly about their mental disabilities with a stranger in a swimming locker room, " said Duckworth, "That wouldn't have happened 15 years ago. " New research shows that these swimmers aren't the only ones opening up. According to a new study, more American adults than ever are reporting being disabled by the symptoms of depression, anxiety or other emotional problems. The report, published Thursday in the American Journal of Public Health, found that people who said they couldn't perform everyday tasks or engage in social and leisure activities because of a mental illness increased from 2 percent in 1999 to 2.7 percent in 2009. That increase amounts to nearly 2 million more people disabled by mental distress   in the past decade, the report said. Although people did not say they felt more mental distressed compared to past years, they reported that their mental health problems had a greater impact on their daily lives. Dr. Ramin Mojtabai, the study's author, said it's unclear whether the findings tell a sad story of greater mental distress in recent times or point to a victory for public education about the importance of acknowledging and evaluating mental illness. "It is possible that people are realizing the effects of mental illness more acutely now than before," he said. "People could be becoming more aware. " Mojtabai said it's also possible that a number of factors could be taking a toll on the population's mental well-being. High unemployment, economic hardships and a growing sense of isolation could be putting greater stress on Americans. But Duckworth said there could be a more positive explanation -- like his fellow swimmers, people may be getting more comfortable with talking about their mental distress. "I wonder if this tells us that American culture is becoming more open and is giving people the ability to speak about it," he said. "If people have this problem and are willing to acknowledge it, then we're getting closer to dealing with it." What does the underline phrase "taking a toll on" in para.8 mean?
A. making a contribution to
B. taking part in
C. playing a part in
D. doing harm to
Answer: