What is currently called “depression” needs splitting up into finer grained categories because it’s become a useless catch all term at this point. I would argue that the people who are really truly rendered catatonic (and so likely have something seriously wrong in the brain that needs addressing with drugs) should be in one category and I would argue this is quite a small minority. I personally believe that the “depression” the majority are experiencing is more akin to what Johan Hari talks about in Lost Connections and it’s root causes are absurd societal structures and political failures which are deeply harming people. If someone feels trapped in a hopeless situation and this drags on for years because society is not providing any means to help them escape and improve their lives then depresssion is a pretty inevitable outcome.
In a modern day society it really isn’t acceptable. Give people access to low cost housing. Reduce the cost of education so no one is priced out of it or forced into massive debts. Subsidise healthy food and tax junk. Subsidise gym memberships and sports clubs for the poorest. Increase the amount of therapists being trained and make them more accessible. Pay people proper wages. Watch depression plummet. The solutions are there - why is there no political will to enact them?
Edit:
I have no idea why but people are reading “subsidise” and seeing “free”. That is not what I said. Subsidise the things you want to encourage so it is cheaper for the consumer at the point of sale and do the opposite for the things you want to discourage. The cost you pay as a society ends up being less in the long run. Less people ill and ending up in hospital means more people working and paying taxes etc.
I would argue that most depression is something more philosophical and behavioral then simple material conditions.
It is a state of disconnect from one's own life and the World At Large. This is symptomatic of a loss of individual agency and ability to interact with their environment in a personally meaningful way.
All the free gym memberships and free food in the world is useless if individuals don't want to go to the gym or cook the food. In reality, there are opportunities for free recreation and cheap healthy food readily available, but that isn't the bottleneck.
Bottleneck is trained helplessness which leads people to self medicate and watch an average of 40 plus hours of Television a week instead of doing something that actually Sparks Joy.
I would argue we live in an era with the most access to everything you listed out ever. There are more programs to help the poor than any other period in history. The internet and YouTube give you access to the world's knowledge. You can get a membership to Planet Fitness for $10/month.
Also, I realize all of this is great, but the opposite side is true too. We also live in an era with the most amount of obstacles and vices people can fall into. Yes, there are amazing lectures on YouTube, but there are also millions of addicting cute cat videos.
I state all this to say depression and improving people lives is not as easy as providing them access. They need to want to put in the work themselves.
I agree that people do need to put the effort in themselves. I just think that they put the effort in when they have breathing space and hope. If people can’t see a way out of their situation then they won’t put any effort in, they’ve become hopeless and therefore depressed. You could argue that the disease in that case may be one of perception, and that you need to enrich the person’s life by opening up to new possibilities and ways of perceiving the world. But you can also build more visible progression paths into the system so people never feel that way in the first place and can always see a route out if they choose to take it.
I’d also argue that there are some social programs but:
- we’re drowning in information overload so people don’t necessarily know how to access them. For example, a lot of the poorest households in the Uk did not claim the money they were entitled to from the government for energy payments this winter.
- We don’t really have policies that are addressing the root causes of poverty which are unaffordable housing, unaffordable and/or poor quality education and low wages.
I agree with your first paragraph. However, I don't think your 2nd paragraph is a fix that'll help very many people at all.
This idea that just throwing free things at people will give them any amount of deeper happiness is typically proven false. I also don't find therapists all that useful but I guess that's a personal subjective take... maybe for the right people they can be. The healthy food thing is a cultural issue and no amount of subsidizing it to make it cheaper will get people to eat healthier. The percentage of obese people is too high to place all the obesity blame on food pricing.
The issue is simply that modern day life is typically TOO easy for most people and gives back very little deep meaning. We've created a culture that gives zero meaning to anyone and promotes nihilism. You will not fix that with welfare. Some of the most depressed mentally ill people you find will be very well off financially.
You need to reduce friction for good habits and increase friction for bad ones. At the minute, our societies do the exact opposite. Unhealthy food and Netflix and cheap. Healthy food and education are expensive.
It doesn’t matter how it happened, once someone is in the hole, the negative feedback loop makes it very hard for them to escape. If you are worked to the bone on minimum wage to keep an overpriced roof over your head you will likely fall into the trap of eating shit food and binging on Netflix because summoning the energy to cook, teach yourself skills and exercise is going to be difficult. And the more you give in to doing that the deeper into the hole you fall. People at the bottom need breathing space. Reduce the amount of money they have to spend to survive which means they don’t have to work themselves to the bone to survive and they can actually focus on improving themselves. I’ve literally seen it happen with my own eyes.
And yes, for some people life can be too easy and that can also cause depression. Which is why I believe we need finer grained categories to narrows down the root causes and provide more tailored solutions than just handing out happy pills willy nilly to everyone.
>You need to reduce friction for good habits and increase friction for bad ones. At the minute, our societies do the exact opposite. Unhealthy food and Netflix and cheap. Healthy food and education are expensive
I would argue the opposite. healthy food is already dirt cheap, and education is free.
One hour at minimum wage can buy enough clean healthy food to last an adult most of a week.[1]
Free education as available at online and at libraries, ranging all the way from simple tasks to Phd courses from Stanford.
My point isn't to minimize the hardship of the depressed, but point out that friction isn't the issue. If 5 minutes of cooking, picking up a book, or typing an educational topic into youtube is too much effort, there is a different problem.
Why does reading a book, cooking, or learning seem like work, and not fun? It certainly isn't because it is too hard in reality, especially when the same depressed person found pleasure and relaxation in doing these things before they were depressed.
[1] I was at the store yesterday and pork was 88 cents/lb, frozen vegetables ~ $1/lb, and rice and beans ~$1/lb.
I agree with some of your points but not all of it. Healthy food can be affordable if you know what to buy and how to cook it. But I disagree that it is cheaper than junk food and it is certainly less convenient to cook and purchase. In the UK at least, there are also 'food deserts'[1] which means it is difficult to access healthy food.
I also agree that you can teach yourself stuff online for free. However it doesn't change the fact that you don't have the piece of paper saying you've got a degree which is one of the societal structures that holds a lot of people back. If you want the certification for an online program, you have to pay a similar amount of money to what you would have if you'd attended in person. There are lots of immigrants working in Western countries as taxi drivers who are scientists, doctors and the like back in their home countries but can't practice here for whatever reason, normally to do with the paperwork. IT/Dev is an outlier in that they will hire people without degrees in ways that don't happen in other industries. Something like 'Good Will Hunting' where a self taught janitor makes it into a white collar career is pretty rare.
> My point isn't to minimize the hardship of the depressed, but point out that friction isn't the issue. If 5 minutes of cooking, picking up a book, or typing an educational topic into youtube is too much effort, there is a different problem.
I still believe friction is a key component. Say you're on the minimum wage and you have to work as many hours as you possibly can to keep a roof over your head. Plus you have a lengthy commute. When you return home you are physically and mentally depleted, particularly if you are an ill fit for whatever job you've had to take on to survive. You want to turn your life around, but you've only got limited time available outside of work to do it. So you start looking for ways to save time. Maybe you'll cut back on exercise, or start eating more junk food so you don't have to cook as much and you can study. Or maybe you'll cut back on sleep. You keep this up for a while but eventually the physical and mental effects start to become overwhelming and you become more and more ill and eventually you burn out. You've worked hard, you've studied and you've still gotten nowhere. And your body and mind are a mess. Maybe you end up losing your job as a result. You lose faith that anything will ever pay off and you stop studying. You fall into depression and the cycle gets even worse. Maybe you even turn to alcohol and drugs to numb the pain. What that person needs is less friction in their life and a bit of help. Maybe it's work from home, maybe it's cheap and healthy takeaway food and probably a higher wage.
> Why does reading a book, cooking, or learning seem like work, and not fun? It certainly isn't because it is too hard in reality, especially when the same depressed person found pleasure and relaxation in doing these things before they were depressed.
Because the person is engaged in a fight for survival. They are not necessarily studying a topic because they want to but because it's the only thing that will help them get a job in their current location. They can't move away because they have no savings. Whatever they have to learn becomes high stakes. You can't afford to mess up or fail because if you do then you're toast. And learning requires failure so it's a stressful experience on top of your already stressful life. You've got society telling you you're worthless due to paying you barely enough to survive and now you've got a compiler error or a textbook you can't decipher saying the same thing. It takes a large amount of strength to hold fast and have faith that you will eventually come out the other side victorious, especially if this kind of thing goes on for years.
When I talk about access to learning, I am not talking about obtaining a piece of paper increasing economic mobility. I am talking about learning for the sake of personal enjoyment.
Most poor people are not depressed, so you have to ask what sets the depressed apart from the rest. Why can one person find joy in learning, and not another?
I think this points to something greater than money= happiness. Im not saying it doesnt matter, just that I don't think is accurate simplification.
You constructed an elaborate and plausible narrative why someone is depressed because of their economic situation. However, it ignores the person in identical situation who is happy. What is different between them?
> You constructed an elaborate and plausible narrative why someone is depressed because of their economic situation. However, it ignores the person in identical situation who is happy. What is different between them?
From my viewpoint, there are four components:
- Personality
- Expectation
- Perception
- Resilience
Starting with the first, imagine you’re really, really into the arts. Maybe you’re really into musical theatre or something like that because you saw them on TV. Now imagine you’re stuck living in an isolated town in Alaska.
Now we can move on to expectation. Maybe you grew up as kid and thought one day I’ll make it out of this town and move to a city where I can work in musical theatre. Or maybe you don’t even have that high expectations, you just want to live in a city where you can watch musical theatre. You think you’ll grow up and earn the money and get out of the town. But it doesn’t go to plan. Maybe you struggle to find a job because you don’t have the skills needed in the area. You’re working as a bartender and don’t seem to have any money left over at the end of the week to put towards your new life. Years go by and you’ve not made any progress. Your dream is fading further and further into the distance.
Which moves on to perception. So many years have gone by that you no longer see any possible way of achieving your expectations and living somewhere that matches your personality. You know what you’re doing isn’t working but you can’t think of anything that will. You fall into a depression. You let your body and mind go to shit.
A year or two goes by and maybe your perception changes and you think “maybe if I train as a lumberjack then I can earn more money and then I’ll be able to save and get out of here.” So you go to college to train as a lumberjack. But you’ve been out of school for a while and you’ve forgotten how long it takes to learn a new skill. You fuck up a lot. You’re not really a lumberjack type so the other students take the piss out of you and you become the butt of the jokes. You try and start running for your mental health but you’re that out of shape that you can’t even run a mile. You give up on both because you haven’t built up enough resilience through previous challenges to make it through.
That last part is absolute key. When you’re exercising, the total stress the body endures needs to be appropriate for it to have the intended effect. If you push someone too hard who is out of shape you risk injuring them.
Even if you’re a seasoned athlete and overtrain, your fitness decreases. Similarly if you don’t work hard enough to trigger growth, your fitness won’t increase.
It is the exact same thing with depression and why some people on here are saying depression is caused because life is too hard and others are saying it’s caused because life is too easy. The stress stimulus needs to be tailored for the individual. For a lot of people the stress is either too high or too low and it is causing major, major problems.
We’re calling both of these polar opposite cause and effects “depression” and it means everyone is shouting at each other rather than coming together and helping each other.
Going back to our original scenario, you might have another poor person who lives in that small Alaska town. Maybe he loved musical theatre too. But maybe his personality extended to other interests so he was happy. Or maybe he never expected much out of life so he was happy. Or maybe he could perceive different opportunities to escape. Or maybe he took the same lumberjack and running route but he knew that it was going to take a long, long time to get good at either and he was going to have suffer and persevere for a long long time.
It doesn’t matter how someone got in the hole, when they decide that they’re ready to get out, society needs to rally around them to offer support. That doesn’t mean to completely molly coddle them but it means that, just like a good coach or physio, you’ve got to realistically evaluate how much stress and damages they’ve endured and how much they can currently tolerate and then gradually increase their ability to handle more over time until they’re back on their feet again. At the minute, in my opinion, society is far too much Led Tasso and not enough Ted Lasso.
I disagree that modern day life is too easy for most people and that's why people are depressed. Specifically, I don't think there's any evidence that lives with more adversity are less prone to mental illness. By this logic, PTSD shouldn't exist, neither should the myriad of studies that prove beating your children statistically results in a whole host of negative outcomes.
I think you personally just might not be engaging with people who aren't well off financially. The rate of mental illness among the homeless and the jailed populations is way, way higher than the rate of mental illness among the wealthy.
I believe you're interpreting the OP's second paragraph differently to how it was intended.
The idea isn't that you're "giving" or "providing" or "subsidizing" with welfare - the point is that the subsidization has already occurred, just in a non-human focused way. Factory farming has been subsidized so processed sugars and unhealthy food are the norm. Companies are effectively subsidized by allowing minimum wage scheduling without providing healthcare.
This all has knock on effects. Healthy food isn't just a cultural issue, many people simply don't have the time or access to be able to cook healthy natural food. For the vast majority of people, they have no possible access to a therapist, even if they wanted to or were able to afford it (unlikely in the case of the US healthcare system). And of course, since there's minimal insurance support for general therapy, there's a much smaller market for people to go into it. The negative feedback loop continues.
I agree with your general point that life gives back very little meaning in our society, but its important to understand that this doesn't just occur because life is too easy. For many people, life is hard. And there isn't a visible path out of the situation they're currently in. Checking out/dropping out/giving up is honestly a reasonable response.
TLDR: Try not to think of Welfare as a handout. See it as a signal of a broken society that needs fixing.
> modern day life is typically TOO easy for most people and gives back very little deep meaning.
That is about accurate for USA. People can start a garden or put a pepper plant under a CFL bulb. Grow some food to get some appreciation for how life has become easier.
You really missed the point. He's saying "depression" means a lot of different things[0], and that many people are unhappy simply because their societal (economic and social) situation sucks and thus their life sucks.
[0]: It would be interesting to have a discussion about "depression" without actually using the word, since it's so overloaded.
No not at all. Rich people who benefit from the system can also be victim to it in other ways. Not all managers are sociopaths and I’m sure a lot of them feel shit about some of the things they have to do in order to maintain their jobs. And everyone, regardless of wealth and status, is subject to the “slings and arrows of outrageous fortune” and whatever personal tragedies they may bring. As I said we need finer grained diagnoses. You might have for example:
- Catatonic depression, likely physical in nature
- Shit Life Syndrome [1], likely societal cause, possibly other issues are play
- Privilege Pathos, likely caused by past trauma, loss or existential issues
These are obviously exaggerated groupings to make the point. At the end of the day, at the receiving end of every diagnosis is an individual with a unique biology and backstory that lead to their depression. But if you want to have the most impact on reducing the ever skyrocketing amount of depression cases, you would be best to focus on the societal issues and that, in my opinion, is what is causing the most symptoms in the most amount of people. The people in the other two categories (the catatonic and the rich) are the people most likely to be currently receiving treatment anyway, the first because they can no longer look after themselves and so wind up in the system and the second because they have the means to access therapies.
If politics is being blamed for depression, it is because people voluntarily consume media about politics. Just say no. Refuse to be sucked in to that pattern.
If the main cause of poverty is unaffordable housing and low wages and poverty is one of the leading causes of depression then the people who have the ability to tackle the housing crisis and low wages but instead choose to do nothing are also responsible for the causation of a lot of depression. The people who are able to do something about the housing crisis are politicians. I do agree with you though if you think political media is pretty toxic.
I tend to disagree. Our society is seriously not that bad, the fact we can talk freely about how bad it is show that is better than many other societies. While I didn't experience it first hand, a common thing I see when people visit really shitty places is how happy people are, from North Korean farmers to women of Saudi Arabia. On the other hand, Scandinavian countries are often a model when it comes to a "good" society, topping all the "happiness" charts, and yet, they are in the worst quartile when it comes to suicide rate.
So, I won't blame society for depression, it looks like mentally healthy people are pretty resilient, and if put in extreme situations (ex: torture) to beyond breaking point, the result is usually more anxiety than depression. I know a few people with depression, treated and followed by psychiatrists. And while the trigger can be some hardship, which can be related to society, or can be a simple breakup, it is just that, a trigger, most people would have just moved on.
And one trait I notice the most is apathy, not sadness. And it is really unsettling. At least, when people are sad, they react to your sollicitations, they may cry, get angry, complain, attempts to get them out will be warmly welcome or they will oppose resistance. For the depressive people I know, there is no reaction, it is not catatonia, their intelligence is unaffected, but it looks like they can't have emotions of their own. They may get good support from friends, family, and even society, but it all seem to go down in a black hole, I really think it helps, but it doesn't show. Drugs seem to be the most effective treatment, unfortunately, because these things induce tolerance and are addictive.
Depression is a disease, and we don't know the cause. We know heredity is important, being healthy and well supported is certainly better than sick and alone, but we are not sure about the details, and therefore what society can do. Quoting scientists favorite phrase: "more research is needed".
As for what society can do to promote healthy habits, this is really a complex thing. You may not realize but that's what Hitler tried to do (for their own people), in fact Hitler could have seriously tackled depression, though eugenics, healthy labor and campaigning against unhealthy habits like smoking. And yet, it would be an absolutely terrible society to live in.
So, I don't think a better, more equal society, as good as it is, is the ultimate solution to depression. Still nice to have though.
> I tend to disagree. Our society is seriously not that bad, the fact we can talk freely about how bad it is show that is better than many other societies.
This seems analogous to Stockholm Syndrome. The “kidnappers aren’t that bad, if they were really bad they would have taped our mouths shut rather than just tying us up and locking us in this room”.
> While I didn't experience it first hand, a common thing I see when people visit really shitty places is how happy people are, from North Korean farmers to women of Saudi Arabia.
So if the people there are that happy, why are some of them risking their lives to flee?
> On the other hand, Scandinavian countries are often a model when it comes to a "good" society, topping all the "happiness" charts, and yet, they are in the worst quartile when it comes to suicide rate. So, I won't blame society for depression,
This argument doesn’t make sense. You seem to be saying:
- autocracies and democracies are societies
- some poor people in autocracies are happy
- some people in well regarded democracies kill themselves
- therefore societal factors do not play a leading role in depression.
> it looks like mentally healthy people are pretty resilient, and if put in extreme situations (ex: torture) to beyond breaking point, the result is usually more anxiety than depression.
not sure on this. PTSD correlates pretty strongly with both anxiety and depression.
> I know a few people with depression, treated and followed by psychiatrists. And while the trigger can be some hardship, which can be related to society, or can be a simple breakup, it is just that, a trigger, most people would have just moved on.
> And one trait I notice the most is apathy, not sadness. And it is really unsettling. At least, when people are sad, they react to your sollicitations, they may cry, get angry, complain, attempts to get them out will be warmly welcome or they will oppose resistance. For the depressive people I know, there is no reaction, it is not catatonia, their intelligence is unaffected, but it looks like they can't have emotions of their own. They may get good support from friends, family, and even society, but it all seem to go down in a black hole, I really think it helps, but it doesn't show. Drugs seem to be the most effective treatment, unfortunately, because these things induce tolerance and are addictive.
I agree with the apathy part. But I think it has varying levels of severity, and at its most severe is when it leads to a catatonic state. I agree that these people are the most likely to need medical treatment. I think this illustrates the first point I’m making though which is that we need to either do away with “depression” as a term or that people need to get more specific with it. Also just because drugs are the cure for the disease, doesn’t rule out the fact that the social triggers may have been responsible for causing the biological issues.
> Depression is a disease, and we don't know the cause.
Well if this thread is anything to go by, people can’t even agree on what the term ‘depression’ is meant to represent. You’re making a bold claim here stating it is a disease, which implies that the cause is purely biological. Most medical definitions state it is a mood disorder.
> We know heredity is important, being healthy and well supported is certainly better than sick and alone, but we are not sure about the details, and therefore what society can do. Quoting scientists favorite phrase: "more research is needed".
> Rates of depression, anxiety, and suicide correlate negatively with income (4–7) and employment (5, 8). Those with the lowest incomes in a community suffer 1.5 to 3 times more frequently from depression, anxiety, and other common mental illnesses than those with the highest incomes.
It would seem that actually yes, as a society we do know what to do to alleviate depression. We can help these people out of poverty.
> As for what society can do to promote healthy habits, this is really a complex thing.
Well yes but also no. We seem to have reduced smoking very effectively. Sugar taxes work well. It seems that in general, if you tax unhealthy things and subsidise healthy things, it tends to have the intended effect.
> You may not realize but that's what Hitler tried to do (for their own people), in fact Hitler could have seriously tackled depression, though eugenics, healthy labor and campaigning against unhealthy habits like smoking. And yet, it would be an absolutely terrible society to live in.
You seem to be trying to make the point that any societal attempts aimed at boosting physical and mental wellbeing should be avoided because Hitler also ran societal programs so any such initiatives are destined to lead to fascist societies. This does not appear to be the case.
> So, I don't think a better, more equal society, as good as it is, is the ultimate solution to depression. Still nice to have though.
No, it is not the “ultimate solution” (ironic choice of words given the contents of the last paragraph) to depression but it is a giant leap in the right direction.
Way to completely ignore the point. It is also addressing a spiritual problem with material concerns. Just throw more money at it and the problem goes away?
It is also founded on the premise that the government is in a position to remove any and all risk from people's lives. Indeed, it would be obligated to do this. It is extending a guarantee it has no way of fulfilling.
In a modern day society it really isn’t acceptable. Give people access to low cost housing. Reduce the cost of education so no one is priced out of it or forced into massive debts. Subsidise healthy food and tax junk. Subsidise gym memberships and sports clubs for the poorest. Increase the amount of therapists being trained and make them more accessible. Pay people proper wages. Watch depression plummet. The solutions are there - why is there no political will to enact them?
Edit:
I have no idea why but people are reading “subsidise” and seeing “free”. That is not what I said. Subsidise the things you want to encourage so it is cheaper for the consumer at the point of sale and do the opposite for the things you want to discourage. The cost you pay as a society ends up being less in the long run. Less people ill and ending up in hospital means more people working and paying taxes etc.