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Coronavirus needs to make us rethink depression as a truly capitalist illness

Friday 8 May 2020, by siawi3

Source: https://www.thecanary.co/opinion/2020/05/03/we-need-to-talk-about-coronavirus-and-mental-health-because-all-is-not-what-it-seems/

Coronavirus needs to make us rethink depression as a truly capitalist illness

Steve Topple

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Part 1: We need to talk about coronavirus and mental health. Because all is not what it seems.

Steve Topple

3rd May 2020

THIS ARTICLE DOES NOT CONSTITUTE MEDICAL ADVICE. IF YOUR ARE HAVING A MENTAL HEALTH CRISIS, YOU CAN CALL SAMARITANS UK ON 116 123. IF YOU HAVE CONCERNS ABOUT MEDICATION YOU TAKE, ALWAYS SPEAK TO YOUR DOCTOR.

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A London-based psychologist has put his head above the parapet and warned that the coronavirus (Covid-19) pandemic could cause a surge in unnecessary mental health diagnoses and drug prescriptions. But his statement poses far bigger questions about depression, and whether it’s ‘all in our heads’ – or if society’s obsession with mental wellbeing is actually something more worrying.

‘Pathologising human responses’

Dr John Read is a professor of clinical psychology at the University of East London. He gave an interview to My London about mental health during the coronavirus lockdown. But there was one part in particular that stood out for me. And it was Read’s dissection of what feelings associated with depression are actually ‘normal’. He said:

I think being scared at the moment is normal, people grieving is normal, to be worrying about things is normal.

It’s dangerous to pathologise [treat as psychologically abnormal] understandable human responses. These are social problems not mental health problems, but what we fear is we are going to see an increase in prescribed medication – such as in the US where there’s been a 30 per cent increase – that is a worry.

We don’t want to have people in five years struggling to get off medications. Many of us currently feeling isolated may do well to heed Read’s words. Because antidepressants, specifically, are not always what they seem.

Antidepressants: grounded in fact or fiction?

Whether antidepressants have grounding in medical fact is often debated. As New Scientist noted, their design is based on the out-dated theory that chemical imbalances in the brain cause depression.

Correct these imbalances, and people will feel better, allegedly. Although this isn’t entirely accurate. But that’s not to say they don’t work, though. They can often be life-saving. I’m testament to the fact that for some people, they really help. You can read my story about addiction and mental health here.

In my own case, a 45mg dose of mirtazapine last thing at night allows me to navigate life without it all becoming too much. I feel in control (most of the time), productive, and more importantly worthwhile. The chaos in my head that was ruining my life has dissipated somewhat. I see the purpose of getting up every day, whatever that day may throw at me. But there’s an elephant in the room. There’s a reason the number of antidepressant prescriptions doubled in the last decade. And it’s corporate capitalism.

Ideological austerity

Our understanding of why people are depressed, and therefore why antidepressants work, is all too often unwittingly grounded in the faults of mainstream medicine and our health systems. As Dean Burnett wrote in the Guardian:

Perhaps reliance on antidepressants is due to incredible pressures of time, money and workload on medical professionals, and alternative treatments require many hours of one-on-one interaction with trained experts, rather than swallowing a few capsules a week?

Successive UK governments in the previous decade took wrecking balls to mental health services. As has been widely accepted, the notion of austerity is one of political and social ideology. Banker bail-outs, shrinking the state, increasing corporations’ profit margins and propping up the stock markets all played their part in the slashing of public spending.

So, many doctors know support services like therapy are already at breaking point. Therefore, if the choice was between giving a patient a pill which would help, or not helping at all and seeing that patient spiral out of control, they’ll plump for the former. But the diagnosing of depression and prescribing of pills also revolves around our social and economic systems. Again, namely corporate capitalism.

A study from Norway, for example, found the highest use of antidepressants was among the poorest socioeconomic groups (the poorest people). Other research often backs this up. And severe depression can be completely different: life changing and disabling.

Yet this still doesn’t explain why depressive symptoms more broadly can affect anyone, regardless of their socioeconomic background. But some psychologists’ theories on addiction could apply here.

Unconscious pain

Catherine G Lucas is the author of the book Alcohol Recovery: The Mindful Way. I previously interviewed her about her work. She believes that understanding alcoholism isn’t always as simple as mainstream psychology makes out. She told me:

Whether it’s wounding, trauma, a sense of spiritual emptiness and longing, or being highly sensitive, there’s always something underlying the drinking.

The challenge, of course, is that sometimes the cause of that pain is unconscious. And the drinking creates such drama and chaos in our lives that we can think the alcohol is the problem. But Lucas also thinks corporate capitalism plays its part. She says in her book:

Why, as a society, are we pursuing a level of consumerism that is destroying our planet, our source of food and life, stripping the earth of her natural resources faster than she can possibly replenish herself?

These notions of alcoholism, and addiction more broadly, being responses to the horrors of society also feature in psychologist Dr Gabor Maté’s work.

Hungry ghosts

In his book In the Realm of Hungry Ghosts: Close Encounters with Addiction, Maté describes his experiences with treating addicts. But he also sets out his thoughts on the causes of addiction more broadly. One striking section gives an idea of just why people abuse substances:

A sense of deficient emptiness pervades our entire culture. The drug addict is more painfully conscious of this void than most people and has limited means of escaping it. The rest of us find other ways of suppressing our fear of emptiness or of distracting ourselves from it. When we have nothing to occupy our minds, bad memories, troubling anxieties, unease or the nagging mental stupor we call boredom can arise. At all costs, drug addicts want to escape spending ‘alone time’ with their minds. To a lesser degree, behavioural addictions are also responses to this terror of the void.

So, while alcoholism and drug addiction are often worse the lower a person’s socioeconomic status is, they can affect anyone – regardless of financial, material, and social wealth. Could this principle of societal horror causing addiction be applied to depression? I think so.

Human devolution

We think we are the all-encompassing species. Smarter, more developed, and able to play God at our own will. But in reality, our systems of society over thousands of years have held us back; made us arrogant; given us a misguided sense of intellectual superiority to every other creature and ultimately entrenched the notion that some people are more important, smarter, and better than others. For around 5,000 years we’ve had a problem as a species. We have lived in hierarchies for most of that time. A few people at the top have control over what the rest of us do.

And, if we’re honest with ourselves, we know this has never really worked.

Anthropological inequality

Because if it had, why have there generally always been poor people at the bottom? Why have there commonly been some human lives that are worth more than others? Throughout our history, the majority of us have willingly accepted a minority telling us what to do. When has it benefited us? And why, in 2020, is society no more truly equal than it was thousands of years ago? Even with all our academic, scientific, and technological advances?

Today, we may be led to believe that just because we own a car, rent a house, and buy the same shopping each week that we’re ‘more equal’ to Richard Branson than Egyptian slaves were to their pharaoh. Looks can be deceptive. Because it’s all relative. Many of us may not be physical slaves – but only the so-called ‘1%’ truly have freedom in 21st-century society.

You only have to look at the not-so thin end of this wedge, where we have leaders like Donald Trump and Boris Johnson, to see where humans have gone horribly wrong. Sadly, the majority of us (the ‘99%’) have been unwitting passengers in this evolutionary car crash. And it’s here where the roots of depression may well lie.

The “dark mirror”

As psychologist Gabor Maté wrote, in the darkest places of human society:

We see the dirty underside of our economic and social culture, the reverse of the image we would like to cherish of a humane, prosperous and egalitarian society. We see our failure to honour family and community life or to protect children; we see our refusal to grant justice to Aboriginal people and we see our vindictiveness toward those who have already suffered more than most of us can imagine, Rather than lifting our eyes to the dark mirror held in front of us, we shut them to avoid the unsavoury image we see reflected there.

In the age of 24/7 news, social media, and extremes of inequality, no one can escape these horrors. You’re either living them or viewing them from the outside, in. But you can’t really avoid them. And like it or not, most people on some level know that society shouldn’t be like this.

Alan Kurdi

Most people in the developed world would have seen the image of little Alan Kurdi’s dead body, washed up on Turkey’s shores in 2015 when he and his family were trying to escape the civil war in Syria. Many people will have been horrified. Some will do something about it, like becoming campaigners. But most would have glanced at this “dark mirror”, shut their eyes, and distracted themselves from the abject horror that his wasted life represented. Here’s where depression comes in.

Somewhere in the deepest recesses of their minds, Alan will have stayed with them. They may distract themselves with work, alcohol, drugs, shopping, television, family matters, or celebrity gossip. These people may consciously think that ‘it’s not my fault that little boy drowned’. They may perceive it as being a world away from their lives. But the human brain is complex, and we’re not a genetically selfish or uncaring species. We’ve been conditioned to be that way by hierarchies, where all of us are encouraged to ‘aspire’ for this, ‘strive’ towards that, under the illusion that one day we too may have power, wealth, and luxury. Of course, we never get any of it. But it keeps us working, keeps society’s cogs turning, and keeps the wealth flowing to those at the top.

Living the horror

At some point, this horror coupled with our own distractions from it has to come out somewhere. And I think in many cases it comes out in depression. Because people are consciously or subconsciously aware of how wrong everything is.

Some, like the single mother working two gig economy jobs to feed her kids, are living the horror. But she may not be totally aware of it: ‘it’s just how it is – that’s life for me’, she may tell herself. Yet she may have been given a depression diagnosis because of her ‘inability to cope with her circumstances’. Blame the mother, of course.

Meanwhile, the fairly rich hedgefund manager, working 24/7 to create wealth for himself and his family, may never give a thought to the single, gig economy mother. But he probably will have seen Alan Kurdi. He’ll think he’s depressed because of the pressures of his work: a Harley Street psychiatrist would probably agree.

Then there’s the chronically ill, disabled woman, in a constant state of lockdown as she can’t leave her own home. She may well have been told by a doctor ‘Of course you’re depressed! You’re chronically ill!’. She probably thinks of the single mother, but is unlikely to compare herself to the hedge fund manager.

Are antidepressants the answer?

So, all three of these people may be on antidepressants. Whether it’s due to the stress of being a single mum, the pressures of being a hedge fund manager, or the trauma of living with chronic illness. On the surface, these will be the causes of all these peoples’ depression. And they’ll believe that they are. But ultimately, the roots of their feelings are probably all the same. Deep down, they know the system is horrific, because when you check it, it doesn’t work for any of them. They’re all stuck, in their own way, fighting some part of it. But putting these people on antidepressants is not necessarily the answer. And for people concerned about their mental wellbeing during coronavirus lockdown, they may not be the answer, either. What may be needed is looking deeper into why we have depressive thoughts and feelings in the first place.

Part two will explore how corporate capitalism has replaced religion, how this is misguided and ultimately creates mental health crises. It will also explore how we should respond to this.

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Source: https://www.thecanary.co/opinion/2020/05/04/coronavirus-needs-to-make-us-rethink-depression-as-a-truly-capitalist-illness/

Coronavirus needs to make us rethink depression as a truly capitalist illness

7th May 2020

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As a society, we are actively encouraged to discuss mental health and wellbeing. At no time more so than during the coronavirus (Covid-19) pandemic. But after a psychologist warned that there may be an upsurge in mental health diagnoses and drug prescriptions due to lockdown, are our notions of depression actually true?

Part one of this article started by quoting psychologist Dr John Read, who was worried about “normal human responses” being treated as mental health issues during lockdown. It then explored antidepressants; our understanding of depression; the human history behind mental and emotional wellbeing in relation to inequality, and how species-level problems can manifest in the individual. You can read part one above . Part two is below.

Rock bottoms

I was told I was depressed. My scores on all the questionnaires that doctors make you fill out to diagnose depression were through the roof. I was told depression was the reason why I was an alcoholic. So, I accepted this, took the tablets and had the therapy. But the more I thought about it, the more I realised it wasn’t me that was the problem. I was merely reacting to my life, and the system that had shaped it.

I was outwardly angry, socially awkward and beset by horrendously bad decision-making. But actually, all these traits were a result of what society had done to me. Bullying throughout school because I was smarter than most kids; going to an elite college with the one scholarship it had – and being isolated because I was the only working-class person there; working 24/7 for pitiful pay and not getting anywhere; seeing it all collapse around me in 2008 and ending up homeless, unemployable, sick and then having no way out of the mess long into the 2010s.

Raising consciousness

I’d done everything the system wanted me to do. I’d got a job, had a house, gone on holiday, bought material things. And yet still, the system betrayed me and left me staring death in the face in 2016.

My therapy made me believe it was me who had to adapt. I had to address my negative thought processes and change the way I behaved. So I did this, and, like the antidepressants, it helped. I have a lot of time for therapy, but when it’s done in the right context. And for me, when you really check it, I should have approached it differently. My anger, social problems and ultimately my addiction were perfectly natural reactions to the horror of my life. And my life was horrible because the system made it that way.

The new religion

I’m not religious. But in his book In the Realm of Hungry Ghosts: Close Encounters with Addiction, psychologist Dr Gabor Maté makes a comparison between faith and the causes of addiction. One patient told him “I had no mother – God forgot me – and I fell”. He said of her:

Serena, in her deepest depression, lives in cosmic isolation. Her core anguish is that her sense of trust and connection with the infinite within her and without has been severed. Given all she had suffered, the God they told her was all she needed could not hold her faith intact. For any young person, if the deity she hears about is not manifested in the actions of the people who make up her world, the God-word turns into hypocrisy. If she does retain an image of God, it’s likely to be the vindictive moraliser who judges her mercilessly or the impotent sky phantom I rejected as a child.

Replace “God” with “corporate capitalism” and you have the answer to my addiction and depression. I put my undying faith in a system that I was taught from a young age would serve me well. But ultimately, it abandoned me. I know that now. So, my previously “depressive” thoughts have changed into anger at the system, but also hope that we as a species can change. And I believe this is the case for many people who think, and have been told, they’re depressed. The challenge with this is the ‘system’ likes us depressed, on tablets and obsessing with our own behaviours, feelings and mental state.

Zombification

It suits corporate capitalism, and hierarchies more broadly, to have people subservient. I’m in no way saying there’s some ‘New World Order-like’ grand design here – where a few shadowy men in some secret boardroom are pulling the strings of doctors to put us all on antidepressants. What I am saying is that the collective consequence of people’s actions is that it ends up that way.

The system is such that it makes us depressed. But due to us living in the system, we have to go to it for answers. Meanwhile, some doctors and psychiatrists, who have been trained by the system, are also part of it because they have bills to pay and houses to keep like the rest of us. Many of them (not all – check Psychologists for Social Change and Counselling for Social Change) believe in the system’s view of depression because it’s given them nice things in life.

So, often unwittingly, they play into it by telling us we’re suffering from depression. They often go so far as to recognise that people’s economic and social circumstances are the cause. But then the system gives us the solution: pills and talking therapy. And ultimately, thanks to multinational pharmaceutical companies and private healthcare making huge profits, and in turn buoying up stock markets, this process continues ad infinitum.

Missed logical conclusions

Women are particularly hardest hit by the system’s notion of depression. All too often this is due to entrenched patriarchy, misogyny and notions of ‘hysteria’, hormones’ and the menopause. There’s a reason why 23% of American women in their 40s and 50s are now on antidepressants. Again – it’s the system.

Yet depression is never taken through to its logical conclusion. Rarely does a medical professional say to you: ‘You’re depressed because humans have made the world horrific, and your feelings are a natural response to this’. Nor do many say: ‘Why not, instead of taking tablets, have a productive outlet for that anger, hurt and upset, like political or social activism?’ Most have jobs to keep and mortgages to pay. Moreover, that realisation about depression probably hasn’t even dawned on many them.

So instead, we look into ourselves for the problem, change our behaviours and take pills to sedate us enough to cope with the horrors of life.

Creating corporate capitalist “subjects”

Dr Ashley Frawley is a senior lecturer on public health, policy and social sciences at the University of Swansea. On the show Renegade Inc, she perhaps summed it up best:

A lot of… psychological interventions are sold on the ability to produce these ideal neoliberal subjects who won’t call in sick and won’t call on expensive state services and so on. But the reality isn’t this perfect neoliberal subject. It’s an upward spiral of demand. The more that we’re told we can’t possibly cope with the vicissitudes of life on our own, the more we call upon these expensive services. And that’s actually part of the deal, that’s actually part of what happens…

The self-esteem movement promised that it was going to inoculate people against future social problems. They called it a social vaccine. That didn’t happen. All that happened was we encouraged this excessive internal introspection. And when you do that, you’re always going to find problems.

The “meaning of life”

She continued:

The meaning of life isn’t something bigger than yourself, isn’t something beyond yourself. [But] paradoxically, if you have nothing bigger than yourself to live for, life becomes insufferable. Anything becomes impossible to bear. If the purpose of your life is your own internal feelings, it’s impossible to feel happy all the time. You’re always going to find it wanting… that’s a very limited sense of what it is to be human.

Essentially, corporate capitalism has created a society so obsessed with ‘self’, we’ve forgotten about each other.

So, you may be wondering if I truly believe all of this, why I still take such a high dose antidepressant. I’ve come to a fairly simple resolution about that in my head.

Take the pills and take on the system

My anger and upset was so seething that it made me chaotic and unproductive. Antidepressants take the edge off that. They give me the clarity of thought against all the noise to channel my feelings into something positive – like writing or caring for my partner, for example. This is probably something many conscious people, activists and campaigners feel. So, I know why the system wants me to pop my pills. But I’m using the system’s weapon of choice against it.

I would never advocate a person not taking antidepressants if they needed them. Because ultimately, a person’s life is far more important in the here and now than the big philosophical questions about why depression happens in the first place. But there needs to be a shift in the narratives.

Our obsession with psychiatry in its current form is ultimately keeping this horrible world the way it is. If everyone who doctors labelled as ‘depressed’ was encouraged to look further than just their own feelings, the superficial actions of those around them and the choices they’ve made in life, and look at their mental health as part of a global system of seven billion people, maybe people would begin to wake up to why there’s been such a surge in mental health diagnoses.

System reboot

We’re not all sick. Society is. So before you go to your doctor about how you’re feeling ‘depressed’ during the coronavirus lockdown, maybe consider whether those feelings are because of the pandemic, or in spite of it. And whether you’re truly OK with living in a world that, in reality, doesn’t actually make most of us happy.

But the pandemic also gives us an opportunity. It’s one to reboot many parts of the system. Within this, our own notions of what it means to be human, be part of a society and how collective horror plays out in the individual are central. We have the chance to create a better world. But it starts within each and every one of us.