Michael Bader: Depression is a social disease
March 5, 2018
Depression is caused by biological, psychological and social factors. Most people know about the biological — namely, that depression results from an imbalance in brain chemistry, an imbalance that can sometimes be corrected by antidepressants.
Most of us might also accept that psychological loss and trauma, whether originating in childhood or in adult life, can cause depression. We know for a fact that extreme conditions of neglect, deprivation and abuse causes aberrations in our brains and psyches.
My own experience as a psychologist has shown both factors to be true.
The relationship between social or psychological experience and the brain is a complicated one. We know for a fact that social experience and external stimuli can alter our brain chemistry. Thus, it isn't always clear whether our neurochemistry is a cause or result.
For example, the brains of London taxi drivers who have to memorize the map of London are different than the brains of normal people. Specifically, the brains of the cab drivers have enlarged areas devoted to spatial recognition.
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While most people might accept that depression can have biological and/or psychological causes, the social and cultural sources of depression are less well known.
In his recent book, "Lost Connections," Johan Hari reports on the science that shows how the wider world causes us to be unhappy. For example, in a Gallup poll conducted in 2011 and 2012, millions of people were surveyed as to their attitudes towards work. Only 13 percent said that they were engaged in their jobs, while 63 percent said that they were unengaged, and a full 26 percent admitted that they were actively hostile towards their peers and employers. Routinized and alienated work has been shown to contribute to depression and anxiety.
In addition, there is currently a mountain of evidence that loneliness and isolation not only damages the body and brain, but accounts for depression and anxiety.
After all, we are social animals, designed to be in groups. And over the last several decades, loneliness and social isolation in America have skyrocketed.
Hari also explores how our materialist culture, with its emphasis on acquiring more and more "things," creates a great deal of depression and anxiety. After all, advertising executives have admitted for almost 100 years that their marketing strategy involves creating feelings of discontent and then selling products to remedy the discontent that they themselves have created.
Disconnected from nature
Moreover, the tremendous inequalities of wealth and income in our society directly produce feelings of humiliation and self blame in millions of people. And, finally, there is mounting evidence that as we increasingly live in cities, and spend most of our time indoors, estranged from nature, this primal form of disconnection contributes mightily to depression and anxiety. It is simply impossible to correctly or humanely understand depression without considering these factors.
Therefore, before we ask people "what's the matter with you," we should be asking them "what matters to you?" And we have to raise radical voices that argue for democratizing workplaces and reducing income inequality and wealth. This is not to dismiss neurochemistry or psychology.
In fact, as Hari argues, the appeal of brain science and psychopharmacology in our understanding of depression not only results from the billions of dollars of marketing done by drug companies, but was, perhaps, originally a useful defense against accusations that our depression and anxiety were signs of moral failing and weakness. But however useful that might be in de-stigmatizing mental illness, it isn't an adequate explanation for what ails us.
If depression and anxiety are caused by social factors, then social change may well be the proper antidepressant. The World Health Organization — the leading medical body in the world — summarized the evidence well in 2011 when they explained: "Mental health is produced socially: the presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual, solutions."
If we want to change what's going on in our minds, we have to change what's going on in the world.
Michael Bader, DMH, is a psychologist in private practice in Grass Valley. He can be contacted at firstname.lastname@example.org.
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