In an age where television is full of shows on teenage sexual health, body image, and competitive cookery, mental health remains one of the last medical taboos. Even in the most advanced countries, popular understanding of the issues surrounding mental health remains at a superficial level out of all proportion with its extent and impact on society.
This article will look at why the rise of mental illness during periods of economic crisis shows us that class society, founded on artificial economic and social inequalities, promotes and is strengthened by an “out of sight, out of mind” attitude to Depression and suicide.
Diagnosis
If you tell someone you’re ill, their natural impulse is to define it by your physical symptoms.
But what if your illness has no external symptoms? What if, like millions of people, your illness is not understood by your friends, your family, and, least of all, your boss?
Depression is one of the most misunderstood of all mental illnesses. More than Schizophrenia, Autism, and related disorders, Depression remains shrouded in popular misconceptions about its causes, effects, and treatments.
It is well known that traumatic events such as having a baby or losing your job can trigger Depression, but such events are not a precondition. Depression can affect people over short or long periods, can be recurring or isolated episodes, and is not necessarily provoked by an obvious catalyst.
Any definition of Depression is complicated by the individual circumstances. Different people have different symptoms. The complex social pressures surrounding such illnesses complicates the task of separating cause from effect. Depression affects men and women differently, with a myriad of social institutions reinforcing the view that women are more prone to expressing their emotions, while men prefer to bottle them up.
Whatever the personal circumstances, general symptoms are often shared. These range from trouble sleeping and concentrating, through feelings of guilt and self-hatred, to repeated thoughts of death and suicide.
Social Attitudes
The idea that Depression is something people “snap out of” is common, partly because it is so varied, and partly due to its sheer extent throughout society.
1 in 3 of us will suffer from Depression at some point in our lives and will find it hard to talk to family, friends, and work colleagues about it. This is because of the stigma attached to mental illness – the notion that “if you can’t see it, it’s not real.”
These attitudes form a huge obstacle in the path of those for whom diagnosis is a vital and necessary first step. They mean that acceptance of a problem, let alone treatment, is very often suppressed under the weight of social pressures.
This means that entering treatment for Depression carries with it a new weight of worries. Just as nobody asks why they’ve got Flu, the questions from friends and family of sufferers are questions that the sufferer will often not be able to answer themselves.
The consequence is feelings of embarrassment or guilt, particularly if there are no obvious provoking factors. Such feelings serve to raise a further barrier between the sufferer and his or her family and friends, increasing the isolation and despair associated with Depression.
The combination of few resources and discrimination against the ill and disabled means sufferers are pressured into internalizing their illness – convincing themselves that it’s an overreaction and that they are as “normal” as everyone else. Inevitably, many sufferers will lie about feeling depressed to those closest to them.
This is only encouraged by the likes of Jeremy Clarkson who described people who jump in front of trains as “selfish.” Appropriate material for a tragic, middle-aged caricature like Clarkson, since it does no more than fall in with the establishment line that “you’re not really ill, until you’re too ill to work for someone.”
From a certain perspective, this point of view is logical, since your ability to survive under capitalism ultimately comes down to your ability to exchange your labor-power for wages or live off that of someone else’s.
Since only a small number of countries are rich enough to provide a welfare state, the majority of people suffering from mental issues are forced to cope in any way they can.
Without a safety net, the capitalist laws of the labor-market are unimpeded – if you are too ill to work, you are too poor to eat.
In countries with a developed health-care system, the ruling class maintains a constant barrage of propaganda promoting the idea that, short of a crippling physical handicap, everyone is equally capable of pulling themselves to the top of the greasy pole by their bootstraps.
Alienation
If we want to understand why so many of us will suffer from Depression, which goes beyond simply having a “bad day,” we need to understand the social context of the majority of people in the world.
Our conception of society and our relationship with illness is defined by the way we live our lives. We live in a world where the majority of people are forced to exist on the bare minimum, while the value of their labor-power is accumulated in unimaginable amounts by the capitalists.
This state of affairs, where almost every aspect of our lives is totally beyond our control or understanding, leads to what Marxists call “alienation.”
Under capitalism, humanity is alienated from itself and the world around it, because we live in a society where we have no real contact with the process of making the things we rely on to survive.
The majority of us get a job, get paid a wage, then go to the shops and spend the money we earn, but we have no idea how it gets there, who made it, or how much they got paid. The operation of the theories of surplus-value, labor-power, and capitalist accumulation, which are fundamental to the functioning of every society, seem as obscure as particle physics.
In addition to this, we’re alienated from each other because the capitalist system doesn’t teach us to value each other or treat each other as equals. We cannot understand what other people do in their lives, because we are not part of them; we are atomized in the workplace and in the home.
This shows us that we cannot separate illness of any kind from the social structures which incubate and exacerbate those illnesses.
Family
In a world in which we are divorced from the basic knowledge underlying so many processes inherent to our lives, it is no surprise that when confronted with the challenges of mental illness, many people look to the apparent stability and security of the family.
Yet in the majority of the world, where there is little-to-no access to support services, the pressure of coping with Depression places an intolerable strain on the atomized individual and family-unit.
In capitalist society, the economic necessity underpinning the social basis of the nuclear family is the fact that it forces women to carry out all the necessary tasks of maintaining a home: cooking, cleaning, and caring – for free.
That this is both oppressive and inefficient is a secondary concern. Its value lies in the fact that it also ensures that the majority of humanity is divided into hundreds of millions of tiny family groupings limited to defending their own interests.
This arrangement is integral to class society. Firstly, it allows the dominant ideas within society – i.e., the ideas of the ruling class, the owners of the means of distributing information – to be reproduced with each generation. Secondly, it ensures that it is the private family which must find the means for caring for sick relatives rather than the State. Finally, it ensures that the experience of living with mental illness is not shared; it becomes the private burden of each family, trapped by convention and shame within the walls of the family home.
Cuts aren’t the cure!
As unemployment and home repossessions rise, the prices of everyday goods soar and benefit cuts drive people into poverty, it is little surprise that divorce, Depression, and suicide rates jump during economic crises.
Existing services for mental health are put under severe pressure as cuts to “red tape” and “efficiency savings” result in the closure of dozens of day-centers and reduced coverage for those who need it most.
If young people’s problems aren’t identified quickly then they are not just going to vanish, they will simply get worse; intervention and support amongst young people in education and work is key to reversing the tide of lives blighted by Depression.
With nothing motivating them beyond a naked desire to put healthcare under the control of millionaire profiteers, these cuts will leave thousands of young people suffering decades of severe illness.
Making cuts in mental health is seen as a “soft cut” as those who use the services are not or do not feel able to speak up about it. More than others, they are “invisible.”
Since cutting funding for mental-health support does not involve closing hospital wards, it is not as immediate, yet there is no benefit or savings in the long term for sufferers and their families.
Capitalism’s recurring crises are periods of massive turmoil and stress for the millions of people who have nothing to live on except their job. We need to be fighting to defend the services that do exist and arguing for more spending on priorities like our health and less on wars, occupations, and bailouts for the rich.
The biological and hereditary roots of mental-health problems are well documented, if not necessarily conclusive. As with other illnesses, a fixation on treatment over prevention reflects the power of private, profit-motivated interests against the common interests of those who produce, consume, and distribute the medicines.
This is even more true with an illness like Depression. After all, dishing out happy pills to treat the symptoms is easier and more profitable than laying bare the selfish, alienating, and antagonistic fabric of capitalist society.
In a world divided between a minority of haves and billions of have-nots, the pressure of constant competition for basic human needs is shouldered by the individual and the family, instead of being socialized – planned, organized, and shared by society as a whole.
The horrendous toll from military testing, poisonous chemicals, and disasters like Bhopal, bear emotive and tragic witness to the dangers of a system which sets the self-interest of a minority against the lives of the masses. Less visible, yet no less destructive, is the impact of an oppressive and exploitative society on our mental health.
The struggle for diagnosis, treatment, and cures for illnesses like Depression must go hand in hand with the struggle to abolish the social order which sentences millions to a lifetime of financial, social, and intellectual poverty.
As socialists we organize everywhere we can to defend the gains of the working class – our healthcare, our education, and our pensions, to extend those rights to those denied them.
Through the struggles to defend what we have, and fight for what we’re owed, we campaign for socialists to build an international, working-class struggle against the capitalist system.
Only the common ownership and democratic management of the world’s resources can enable us to lay the basis for achieving a permanent improvement in social relations and mental health.