It’s Not Just You: Inequality in Society Causes Depression

When we talk about helping people overcome depression the solutions we offer involve them finding confidence and improving their self-esteem so they can deal with the challenges they face and ‘live normal lives’, whatever that means. This puts the emphasis is on the individual to change and carries the connotation that the problem is internal. Speaking from experience, I know that the causes are not always from within. In the past few years many researchers and commentators have pointed out that the high instances of depression we see today are likely caused by social influences such as income inequality, consumerism and competitive lifestyles, ideas which have not been talked about enough.  

Of course, bar media coverage of a few exceptional speakers and the occasional feel-good stories, we have done a dismal job of talking about mental health in the media, in schools and in the public in general. If we are serious about addressing this epidemic, we should be looking at all the information, something we have not always done well. For example, the common belief for years was that depression is simply a chemical imbalance where low levels of serotonin would cause people to exhibit depressive symptoms that medication (antidepressants) could alleviate. This idea was perpetuated despite a lack of evidence to support it and many doctors reluctantly prescribed antidepressants despite knowing they weren’t necessarily going to make a difference, at least not in many cases.

Thankfully, things have changed somewhat, and now we acknowledge that the causes of depression are unique to the experiences and lifestyles of the individual, and therefore the help a person needs is also unique. But there has still been little discussion of the social causes of depression despite researchers and organisations including the World Health Organisation have been saying for years that the causes of the widespread instances of depression in part result from the way society is structured.

“It is No Measure of Health to Be Well Adjusted to a Profoundly Sick Society” – Jiddu Krishnamurti

To paraphrase Johann Hari who has written on this very topic, rather than viewing depression as the problem that needs to be fixed, perhaps we need to look at it as a symptom of much bigger problems we face. After all, if one in six people in this country suffer from depression and many of them because they are struggling with daily challenges like unemployment, economic uncertainty and material hardship, perhaps the system isn’t working as well as we like to think. Indeed, there are some pretty clear ways this is happening.

The Influence of Social Hierarchy

A popular theory is that top-down hierarchies adversely impacts an individual’s mental health, particularly that of those in the middle and lower end of the pecking order. Hierarchies cause those with less power to avoid conflict with those that control resources and wield economic and political power because they live in a state of perpetual fear; their position and access to resources that sustain their lifestyles are not guaranteed as they are dependent on those with more power. They must tread carefully, for to upset the powers that be too greatly is to risk losing much. Thus, they suppress their emotions, often choosing to keep a low profile and accept the status quo rather than expressing how they really feel, just as the middle and lower classes do in Western societies in the face of injustice. As we know, the worst thing people suffering mental health problems can do is keep things bottled up.

Surprisingly, it is often those in the middle who exhibit higher rates of anxiety and depression than those in the lower section, possibly because their position in the social hierarchy is so precarious. They are not at the top of the order but believe they are almost there, but they are also aware that they are not far from the bottom and only a few missteps could land them there. This fear of being inferior or becoming even more inferior adds to the likelihood of anxious or depressive symptoms.

“…social pressure to be polite and deferential to people with greater status and power results in more emotion suppression among those who occupy low positions within a social hierarchy” (Langner et al., 2012, p4)

The modern workplace is a great example of such a hierarchy. The more responsibility a person holds within an organisation, the more pressure they are subjected to. Those in supervisor and manager roles are subjected to pressure from above, the executive level, and are also the ones that have to deal with the workers and pressure from them. As they embody that precarious middle space, they are often striving for higher office (and therefore pay) while being aware that several mistakes could see them demoted, which would undoubtedly be embarrassing. The workers on the ground floor are equally miserable because they have little control over the allocation of resources and wealth, in particular receiving a relatively small share of the latter. The executives on top of the pile have all the power, significantly more money and less reasons to be stressed, anxious or depressed.

Income Inequality and Depression

Because of the obvious class divide in this country and similar developed countries, it goes without saying that the distasteful levels of inequality are having an impact on our mental health. Numerous studies have demonstrated a positive relationship between economic inequality and depression in countries all around the world which cite a range of reasons for this relationship. One reason is that people compare themselves to others who are better off and feel a sense of defeat at the structural unfairness. Other reasons include associated developmental disorders in adolescents and a sense of withdrawal or shame by worse-off people in a community.

Whatever the reasons, the fact remains it is a serious problem. The graph below shows how in the United States, states that have higher levels of income inequality according to the Gini Coefficient tend to have higher instances of depression.why-greater-equality-makes-societies-stronger-richard-wilkinson-and-kate-pickett-bestselling-authors-of-the-spirit-level-why-equality-is-better-for-everyone-38-638

This phenomena is not unique to the United States, and nor is it limited to mental health. As the graph below demonstrates, more unequal countries experience a range of health and social problems which combine to create a perfect storm for those less fortunate.

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In unequal societies, competition for resources and wealth creates a host of problems.

Competition breeds misery

The defenders of the capitalist status quo love the idea of competition because apparently financial incentives foster innovation. To be fair, they are correct. It is amazing how much money and effort companies will invest to extract as much value from workers without paying them their fair share, or how to extract as much capital from the natural environment without having to pay to fix the problems they create. From that point of view, competition certainly does lead to innovative thinking, but not necessarily thinking that will benefit the majority of people.

Elsewhere, competition leads to misery in other ways. Financial wealth is often a determinant of social status, as it allows individuals to afford the symbols of wealth. In our consumerist society, clothing brands, expensive cars and the price of one’s house are common symbols of wealth, and targeted advertising convinces us either subconsciously or consciously to pursue these things. When societies are as unequal as New Zealand is, the class divide is noticeable. Because people want to climb higher up the social ladder, they pursue as much as possible the appearance of high social status, often by purchasing material goods like those mentioned above and often to the detriment of their health and well-being.

What should we be doing about it?

We should be working together

The strength and quality of relationships between people within communities plays a significant role on mental health. Alienation, isolation and loneliness are causes of depression that are themselves caused by inequality. Neoliberalism favours individualism and places emphasis on ‘individual responsibility’, even for socially-created problems, which only further isolates and alienates people. Therefore, we can live healthy lifestyles in which we accomplish things by working together.

In a clip discussing this very topic, Johann Hari presents an anecdote of a woman suffering from crippling anxiety and depression who finds purpose by working with others to create a garden. The best thing about this story is that it isn’t some unsubstantiated ‘hippy cure’ or anything; there are plenty of studies that link improved mental health to exposure to green space and working on collaborative projects like community gardens. We should be thinking how our communities can be restructured to encourage neighbourhoods the care for and empower each other.

We need a society that works for everyone

Perhaps the best way that we can care for each other is by creating a society that is fair and just. Currently, our neoliberal capitalist system is designed to continually advantage a select few while an increasing majority are left with less. This is making the mental health problems so many people face even worse and there is no legitimate reason why such an unfair regime should continue. Not that long ago, the distribution of wealth was more fair and those who earned more than enough would pay higher taxes that would ensure they are making positive contributions to society. Now, with essential services like healthcare and education so underfunded, it is beyond time for them to give back and use their wealth for good.

Currently there are a range of wonderful and aspirational organisations working on initiatives to combat mental health by empowering people, and while it is great they are making a difference in communities, imagine how much more they could accomplish if they didn’t have to rely on charity and volunteers. Imagine how much happier and productive people would be if they weren’t living with the constant anxiety of worrying whether they will be able to make rent or put food on the table. If people were taxed appropriate to their means and needs then those struggling to get by wouldn’t have to endure tax hikes for necessary infrastructure upgrades and others could have access to suitable, equitable education, housing and health services that are needed to improve mental health. Finally, imagine the things we could accomplish if society didn’t pit people against each other and valued cooperation and working for the collective good.  

Understand That It’s Not You

Perhaps the most important thing to take away from this is that depression and anxiety are not always caused by chemical imbalances or traumatic experience, but can actually be a response to a world that isn’t right. The problem, certainly in my case, is with the society we have created, a society that compels us to compete with each other and to be critical of ourselves. As we work to combat mental health in New Zealand and abroad, while our efforts should certainly empower people to find joy and purpose in each day and encourage openness about our feelings, we should also be talking about how our values as a society need to change. A happier society will be found when things are more fair and equal.

 

  1. Gilbert, P., McEwan, K., Bellew, R., Mills, A. & Gale, C. (2009) The Dark Side of Competition: How Competitive Behaviour and Striving to Avoid Inferiority are Linked to Depression, Anxiety and Self-Harm. Psychology and Psychotherapy, 82(2), 123-36.
  2. Lacasse, J. & Leo, J. (2015) Antidepressants and the Chemical Imbalance Theory of Depression: A Reflection and Update on the Discourse. Florida State University Libraries.
  3. Langner, C., Epel, E., Matthews, K., Moskowitz, J. & Adler, N. (2012) Social Hierarchy and Depression: The Role of Emotion Suppression. Journal of Psychology, 146(4), 417-436.
  4. Macintyre, A., Ferris, D., Goncalves, B. & Quinn, N. (2018) What Has Economics Got To Do With It? The Impact of Socioeconomic Factors on Mental Health and the Case for Collective Action. Nature.com, <https://www.nature.com/articles/s41599-018-0063-2>
  5. Patel, V., Burns, K., Dhingra, M., Tarver, L., Kohrt, B. & Lund, C. (2018) Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms. World Psychiatry, 17(1), 76-89.
  6. Schultz, W. (2015) The Chemical Imbalance Hypothesis: An Evaluation of the Evidence.  Ethical Human Psychology and Psychiatry, 17(1), 60-75
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Talking About Depression Helps Break The Silence – Here’s My Contribution

When a celebrity commits suicide we have a brief and tentative public discussion about mental health and suicide before it quickly dissipates and we forget about the issue for a time. While we are having that conversation, we remind ourselves and each other again and again that if you are struggling to get through the day that you should reach out to your friends or family and ask for help. Considering the number and impact of celebrities committing suicide and our country’s horrific statistics , it is an increasingly important message. However, as much as we say it is okay to feel down and that you should reach out, it isn’t always that easy. It’s not even easy to admit that you have depression.

Trust me, I know.

Until now I have told only a handful of people, but I feel like I need to do my part to help break the taboo and silence we seem to have around mental health. I want to talk about my experience with depression not  because I think I am special or that I have particularly amazing insights or experiences that will help others overcome their problems, but because hopefully it helps at least one person realise that they are not alone in their struggles. I am not after pity or attention because I am okay now, and if I wasn’t alright I doubt I would be so open. More importantly, I hope that if I am willing to admit to having these feelings and can post it online for anyone to read, someone who has suffered in silence might feel that by comparison, opening up to a couple of close people isn’t so bad.

Dealing With The Black Dog

For years I struggled with depression without really knowing what it was. I stayed up late most nights feeling miserable and I would either break down and cry or I  just lay there running circles in my mind, overthinking my personal situation and criticizing myself. In my mind, I was dim, unattractive and socially awkward compared to everyone around me. Despite this, I was still a fairly social person and in those moments spent in the company of others, I was happy and content. The problem was that as soon as I was left with my own thoughts too long,  the wallowing and self-pity would kick in. I often thought about self-harm and all those dark things, but fortunately they remained thoughts and nothing more. I would often became withdrawn, irrational, and a touch aggressive (emotionally, not physically) although that was normally only inflicted on my partners. Alcohol made everything worse, and more than once I lost the plot during a night on booze.

While it is hard to explain why I felt these things, I know that some of that was down to my insecurity and worrying about how others perceived me. As easy as it is to say “Who cares what other people think!”, it isn’t that simple. In a time where social media plays such a massive role in our lives, it’s hard not to compare yourself to the standards set by others. We see the best parts of other people’s lives on our news feeds and make the assumption, whether consciously or not, that their lives are always like that. Similarly, we are bombarded by ads that promote preconceived standards of beauty and attractiveness, and when we don’t meet those standards, our self-esteem naturally takes a hit. No matter how hard I tried, I couldn’t shake those insecurities because I was constantly comparing myself to people around me and subsequently finding aspects of my personality or appearance to dislike, despite my best efforts to think positively about myself.

I can explain all this with the benefit of hindsight, but at the time I didn’t understand why I felt this way. At almost no point did I think about talking to anyone because if I couldn’t understand what was going on inside my head, how could they? From my point of view everyone was just so confident, they had their lives sorted and knew what they wanted to do, and I was just a mopey kid pretending to be an adult. I had no idea what I wanted to do with my life other than wanting to help others, and I wasn’t sure how to go about doing that. The lack of direction made me doubt everything I did and see those actions as pointless. I often felt like I was just going through the motions day to day. I felt lost.

To make things worse, I couldn’t shake the belief that I had no legitimate reason to feel this way. See, everyone has their own reasons for feeling depressed and they vary. Some people have traumatic experiences that affect their confidence and sense of self-worth, while others experience financial and material hardship that takes an understandable toll on their mental health. Whether is because of failed relationships, losing loved ones and struggling with one’s identity, there are a range of factors that contribute to depression. For me personally, most of these didn’t apply.

I’ve mentioned before that I was raised well. I never went hungry, was never mistreated, I was loved and learned from my parents how to be a good person, which I think I have done a reasonable job of so far. We weren’t poor, but we also weren’t flush with cash. I had everything I needed. Maybe a six-pack or more confidence would have made life a bit more enjoyable but I can’t complain. When I thought about the life I had lived, I felt I had no good reason to feel depressed, which made things even more depressing.

This made me feel helpless and feeling helpless made me feel weak. As we often mention when we discuss mental health and suicide, it is not weakness to ask for help. People like myself don’t reach out because we have this idea that showing emotions is weakness and if we appear vulnerable, people will think less of us. We worry what they might say to others behind our backs, maybe laugh at how weak we are or that they will give us a hard time for feeling down. I felt so weak I resisted the idea that I was even experiencing depression and almost convinced myself that I was just an impostor who was passing their melancholy feelings off as depression. Eventually I did go get treatment, but I threw the pills away before long because I thought I didn’t need them and they weren’t doing anything anyway. To this day, I’m not sure they ever did.

It Gets Better

I have written this in the past tense because much of this no longer applies. As I said earlier, I got better over time. Perhaps the biggest source of my self-loathing was the disconnect between my values and actions. Like so many others who study Arts subjects, I went in wanting to change the world. The more I learned about the social and environmental problems in the world, the more resolved I became to help solve them. This led me down a path many others have walked down before me, where a greater understanding of the global economy, politics and human nature took me from youthful optimism to cynical pessimism, and the problems became so large and the solutions so much more unlikely that there seemed no point to even try make a difference.

I had an idea of the person I wanted to be and I constantly failed to live up to those standards which made me even more disappointed in myself and perpetuated the whole depressing cycle. Things only started to change when I got so sick of being miserable and I seriously re-evaluated what I was doing with my life and questioned how much longer could I continue to wallow in self-pity. I realised that I needed to start living up to the values I believed but rarely lived up to and resolved to do something that in any way, shape or form made the world a better place. I accepted that I may not find it straight away, but if I am moving in the right direction and I am happy with what I am doing then that is enough. This is ultimately what led me to teaching and now, years later, things are much better and I am happier. Having purpose and direction helped me put my insecurities in perspective and while they still affect me a bit now, I don’t get caught up in vicious cycles of overthinking like I used to.

With this and the support of an understanding partner, I managed to overcome many of these feelings, but that doesn’t mean the dark thoughts have gone away completely. Some days I will wake up feeling crap about myself and just feeling downright miserable.  And you know what? That is okay. I’ve come to accept that feeling this way from time to time is alright as long as I don’t dwell on things for too long. Those feelings of hopelessness and despair are always there, lurking just out of sight, but if managed right they don’t have to bother me too long. For a while I had convinced myself that I had beaten it, like it was the flu, and that  it no longer plagued me. Now I know it’s not something that goes away with the snap of the fingers, but it does get better. For me, accepting that it is an ongoing process and that bad days are a part of that process helps me get by.

What also helps me cope is the knowledge that, contrary to what some would have us believe, the causes of depression are not just internal. We live in a society where we are convinced to compete with each other for jobs and for money, and in order to make ends meet, we are working longer hours for stagnant pay while our bosses and celebrities become excessively rich. Meanwhile, we are struggling to make ends meet, adding stress and uncertainty to our lives.  We are materialistic and often place our sense of self-worth in purchased goods that serve as symbols of social status that we use to compare ourselves to others. When we don’t behave or look a certain way, we are ridiculed and made to feel isolated. I could go on, and indeed researchers have linked depression to inequality and capitalism which shows that aspects of the structure of society is exacerbating our mental health problems, but realising that many insecurities are manufactured aren’t just in my head is reassuring.

You Are Not Alone

Remember that this is just my experience. I haven’t reached the lows that other people have felt nor such dire circumstances that led them there, but that shouldn’t diminish my experience. Mental illness is still mental illness, and while some may have it worse than others, comparing experiences accomplishes nothing. Everyone suffering needs love and support from those around them. We all need to start caring for each other and thinking, before we say something that might cause pain, what struggles a person is going through. I would disappoint people if I didn’t get political for at least a moment to say that the government should be funding the crap out of mental health services.

This shouldn’t be something we only do when a celebrity commits suicide. This should be normal. We need to get into the habit of being open with how we feel, not necessarily online for the world to see and not for the purpose of garnering sympathy, but because we should be able to get help from those around us. To reiterate what I said earlier, if you are struggling, reach out to someone you trust. I can’t say to anyone how they might overcome their struggles because we are all unique, but they’re probably not going to be conquered if they remain a secret. I can say that opening yourself up is not weakness but strength, and I know this because writing this up and sharing it is one of the hardest things I’ve done in a long time.