Health

Our mean government and the not so happy season

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Suicide rates rise significantly in the new year period and are worse under conservative governments implementing austerity policies, writes Lyn Bender.

DEPRESSION may seem an irrelevant topic when we are in the “happy season” but none of us is guaranteed immunity.

Promoted as a time of goodwill to all, and a time to relax and be with family and friends, the holiday season is often not so happy for many. It is a time when the lonely feel lonelier, the bereaved more bereaved, and the stressed feel more stressed.

Suicide is the ultimate expression of isolation, deep despair and loss of hope.

Contrary to popular belief, suicide rates fall at Christmas – perhaps because people connect with friends and family – but rise significantly in the new year.

Research also shows that suicide rates rise under conservative governments and that austerity kills. This can be tracked, in part, to the loss of welfare and social safety nets. Social support and connectedness are hugely important in reducing the risk of depression and suicide. So too, is a sense of power, control and ability to influence circumstances.

The Abbott Government’s callous Christmas cuts to vulnerable sectors will add to the misery, exclusion and powerlessness experienced by the disadvantaged in our midst. It delivers a further blow to many on the brink.

In his Christmas message, Tony Abbott, alongside a very unhappy looking Margie, thanked charities as he cut welfare.

Formerly the Minister for persecuting asylum seekers – Scott Morrison, the newly appointed social services minister – is out to “clean up.” He has begun, with a pre Christmas announcement of cuts to support for the homeless.

When I walk the streets of Melbourne’s CBD, the despair of those sleeping on the pavements and in doorways is etched on their faces. In the summer holiday season, their misery provides a shocking contrast to the frenetically shopping, plastic bag toting bargain hunters. I wonder how a society with such callous inequality can be a happy society?

But actually we aren’t all that happy.

Depression is a leading cause of disability worldwide, according to Beyond Blue. At least one million Australians will suffer from depression in any year. A Queensland study ranks depression as the second most common disability worldwide.

Experts are now naming depression as a contagious disease or, as in the comedy musical West Side Story, a social disease. It might be better to recognise depression as a kick in the guts from life.

Under the Medicare Mental Health Care Plan, there are no categories for heartache or life angst.

How useful is the paradigm of depression as a disease, or as a chemical imbalance? If medication rectifies this imbalance, it is hit and miss at best. The patient’s serotonin levels are not measured before or after treatment. When medication side effects cause agitation, or fail to lift the mood, the prescribed dose is often increased.

Conceptualising depression as a disease or the mythical chemical imbalance may challenge the ignorant “just pull your-self together” view, but can diminish help. Even – assuming the medical paradigm – not all depression is alike. Nor is all depression successfully treated. There is not always a magic pill to transform a person’s suffering or to make it “all go away.” Depression may remain intractable or resistant to medication in 40 per cent of cases.

Any claims that depression is simply a disease, that comes out of the blue, like seagull excrement, are not supported by the evidence.

Depression is complex, multi-causal and connected to the lived experience.

It comes as a fellow traveller, with grief, loss, trauma, bereavement, change, life transitions, ill health, childhood trauma and isolation.

The Diagnostic Statistical Manual (DSM-5) lists symptoms that persist beyond two weeks as making the grade to be diagnosed as depression.

The validity of the DSM-5 has been disputed as merely a dictionary of definitions. Such a broad definition, produces a large diagnostic pool of “customers".

Psychotherapist Gary Greenberg describes this phenomenon in his books Manufacturing Depression and The Book of Woe.

This pool of depression is a boon for the pharmaceutical companies, who incidentally do much of the research and evaluation on their own products.

Authors Ray Moynihan and Barbara Mintzes, describe a similar process of creating female sexual dysfunction as a disease, in their book Sex Lies and Pharmaceuticals. Firstly, a “syndrome” is constructed, then big pharma supplies the “cure”.

I am not disputing that many are suffering and in need. Philosophers have observed this for centuries.

Allain de Botton has revealed philosophy’s age-old solutions of adjusting the mindset, to counter common human unhappiness. Botton’s book The Consolations of Philosophy and his television series A Guide to Happiness validate the worthiness of the art of reflection in coming to terms with the crisis of human existence. Many of these sages were prompted by their own deep unhappiness to ponder the human condition.

A medical model of depression merely identifies a cluster of “symptoms”.

These include: eating and sleep disturbances, social withdrawal, crying, agitation, emotional numbing, relentless fatigue and difficulty in managing everyday living.

More seriously, people can experience suicidal thoughts and actions and a high degree of dysfunction to the point of becoming immobilised. Sufferers may describe themselves as in a fog or a haze, or constantly distressed and not seeing any meaning in their life. They may see themselves as outsiders and disconnected from friends and family, set apart and not like other people who seem "normal" and "happy".

Depression is also linked to physical illness and lowered immunity. Symptoms can become chronically solidified. However, “triggers” or events that impact emotionally can be traced as embryonic to these emotional states.

Grieving a deep loss can endure for over two years, as ongoing associated losses and adjustments evolve.

What makes us feel better?

Regular exercise reduces depression, as does a healthy diet, meditation, avoidance of alcohol and fostering the connection to family, friends and community. Talking things through with a trusted confidante is also helpful.

Men are less likely than women to seek help for, or to talk about, emotional problems. Worldwide, males are three times more likely to suicide than females.

Giving effectively to others, volunteering and active altruism can foster happiness.

Depression can be a warning that something is wrong in the person’s life or the world. It signals that something needs to change. Depressive symptoms may have evolutionary species survival value. They make us slow down and do a take stock. 

Defining depression as an “individual disease” renders us impotent to act and change. Making sense of the meaning of our “life shocks” can increase resilience and add depth satisfaction and focus. This can restore or create the capacity for empathy, love, and joy. As part of recovering from depression, we might make positive changes, rather than be reduced to the role of a passive patient.

Unfortunately, there may not be too much people can do about the Abbott Government until 2016, but we can always live in hope that positive change may be made sooner.

You can follow Lyn Bender on Twitter @lynestel.

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