The Economy of Depression

On October 14 2003 Simon Castles published Depression crosses class boundaries, yet talk therapy is a bit rich in the Sydney Morning Herald.

Castles notes that "like cancer, depression cuts brutally across class boundaries. There are scores of famous people who have experienced mental illness: Winston Churchill, Boris Yeltsin, Kurt Cobain, Billy Joel, Ernest Hemingway, Marilyn Monroe and Alanis Morissette."

He goes on to say that "if depression is indiscriminate, access to treatment is not.... Like almost any disease you care to think of, depression is greatly exacerbated by poverty. "

Castles says people on welfare have a rate of depression about three times as high as the general population. "In 1997 The New England Journal of Medicine reported a confirmed connection between sustained economic hardship and depression. It is a vicious circle: poverty is depressing, and depression makes it infinitely harder to escape poverty."

Castles points out an extraordinarily important thing: "What we're talking about is not simply people feeling a bit low because they are at the bottom of the heap but clinical depression, a paralysing physiological condition that leaves sufferers unable to cope with day-to-day life."

He asks if "we ever think about this when we come down hard on the unemployed for not meeting their mutual obligations?" I think we often don't. As a Uniting Church minister with kids I was automatically on welfare. There are Centrelink offices in South Australia where to walk through the door seems to immediately brand one as a malingerer. Retirees paying their first visit to Centrelink often report a profound shock! The notion that "non-compliance is sometimes possibly quite often a result of mental illness" and not rebellion or laziness would be completely foreign in this environment. To be depressed is to be a malingerer by definition, in much of our society.

When I was ill, the church looked after us. We had a place to live, by the grace of Synod staff who took our plight seriously. Wendy had work. If I had been required to appear at job interviews to keep getting dole payments, I simply would not have been able to do so. I could barely cope with washing dishes and cleaning the bathroom.

Castles says,

While debate still rages, most agree that depression is caused by genetic vulnerability activated by external stress. And no lives are more stressful than those of people stuck on welfare. (If you don't believe this, then you've never lived without money or purpose.)

Indeed, diagnosing depression among the poor can prove difficult simply because it is so common it can go unnoticed. As Andrew Solomon writes: "When depression hits someone in the middle classes, it's relatively easy to recognise. You're going about your essentially OK life and suddenly you begin feeling bad all the time. For the miserable and oppressed poor, life has always been lousy and they've never felt great about it; they've never been able to get or hold a decent job and they certainly never entertained the idea that they have control over what happens to them."

We saw this when we first came to live in Elizabeth. The number of miserable and depressed looking people walking around some shopping centres mid-week was shocking. We noticed how the atmosphere of these places changed on Thursday nights and Saturdays, when the employed population would come to do its shopping. And now, after a year or two, we scarcely notice. We are used to it.

One of the root meanings of the word compassion is to be empathic. To be with someone in their passion, or feeling. To understand. Mercy (the old word for compassion) does not mean to discount responsibility. Neither does it mean to allow someone to live for ever on welfare, as shock-jocks would seem to imply. In fact Castle's comments make it very clear that to leave a person on welfare is to do them a dis-service and be un-merciful. But the big stick of non-compliance by Centrelink is also un-merciful. It lacks compassion, and is totally unaware of the struggle some people are having to survive. As such, it becomes part of the problem, and is not wellfare at all.

Posted 9-11-2003  


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