Depression is increasing among Americans reaching middle age

https://www.economist.com/democracy-in-america/2019/05/15/depression-is-increasing-among-americans-reaching-middle-age

by pseudolus • 7 years ago

157 122 7 years ago

irrational2• 7 years ago

Is it increasing, or is it being identified more often? I have teenage and early 20s age children. They and all of their peers have been diagnosed with anxiety, depression, and a host of other mental illnesses. When I was growing up I can't remember any kids in my high school (I had a graduation class of 900+ students) being diagnosed with any sort of mental illness. I've wondered if the frequency with which people are experiencing mental illness has increased, or if the rates have remained stable but diagnosis and reporting levels have improved.

cheeseomlit• 7 years ago

Diagnosing more people does not necessarily mean diagnosis is improving, especially when the criteria are purely subjective (and there are perverse incentives for pharmaceutical companies to diagnose more people)

50656E69732• 7 years ago

Indeed, there is a huge conflict of interest and positive feedback loop:

69% of the DSM-5 task force had ties to the pharmaceutical industry.

Diagnosis rates grow each year, and the number of ambiguously defined mental illnesses increases with every revision of the DSM. These data points are used as justification for further increases in funding, which in turn increases diagnosis rates.

https://en.m.wikipedia.org/wiki/DSM-5#Criticism

myth_drannon• 7 years ago

Just yesterday we had "City residents live with mental illness at higher rates than general population" https://news.ycombinator.com/item?id=19920393 Maybe population density is increasing and causing mental issues.

fsloth4• 7 years ago

Large cities have 15% more of everything when compared to a more loose population. Economic and creative output, but crime and disease as well. It's a statistical fact that no one has been able to explain fully.

P_I_Staker3• 7 years ago

If anything, shouldn't that result in decreasing suicide rates? Either that or treatment is worsening health outcomes. This would be extremely troubling.

I tend to think that depression is both on the rise, and historically under-treated. In fact, it's most likely still under-treated. I'm neutral on the efficacy of treatment.

sjg0073• 7 years ago

Treatment works. There is a subset of treatment resistant though.

cwkoss3• 7 years ago

Doctors are frequently prescribing SSRIs where no study has shown them more effective for that indication than placebo.

Many doctors still believe the "correcting neurotransmitter imbalance" theory of SSRI action which appears to be on its way to being disproved.

coldtea7• 7 years ago

Is it being "identified more often" or is it made into a thing when it's not more often (because experts follow fads too, because it helps sell drugs, because it helps justify various programs, plus it's not like measuring such issues it's some hard science, so nobody will be able to prove otherwise anyway).

"Kid's bored at school? Get them some ADHD drugs!".

(Not that there aren't legitimate cases, but there's also mass over-prescription).

DanielleMolloy2• 7 years ago

People who downvoted this statement should google "disease mongering": https://en.wikipedia.org/wiki/Disease_mongering They may also want to check out Allen Frances: "Saving Normal".

Mental health problems are real. Overprescription due to capitalist reasons is real too. They both do harm.

dev_dull• 7 years ago

Do you live in the Bay Area?

irrational2• 7 years ago

I do not.

jatins• 7 years ago

I have late 20s friends and have seen the similar behaviour. A lot of people I meet say they are in a bad place mentally.

Also, pardon my ignorance, but I am also curious what counts as being diagnosed with "anxiety" disorder? As in are there definitive definitions of these things?

TheOperator2• 7 years ago

I've wondered if the frequency with which people are experiencing mental illness has increased, or if the rates have remained stable but diagnosis and reporting levels have improved.

Both although I'm very skeptical that diagnosing more people as mentally ill is the same as an improvement. The criteria to be diagnosed with a mental illness has loosened. Probably the most extreme example is the DSM-V declaring bereavement over 2 weeks to be a form of mental illness - depression. What has been considered normal human behavior for most of human history has been medicalized.

I've seen no evidence that increases in diagnosis in the last 2 decades have improved mental health in the developed world. Metrics like the suicide rate have gotten worse during that time. Self-reported anxiety and depression is on its way up.

This is not to say you cannot find individuals or groups helped. However the increase in labelling causes insecurity/stigma, while the field itself like all field does have some deadweight costs. The mental health field also, even if it effective are getting overwhelmed by broader societal issues.

CalRobert6• 7 years ago

Ah, but we maximized profit extraction from those units!

Also, remember that old millenials are pushing middle age (late 30's). Their mortgages have been used to fund a bunch of boomer retirements, they can't afford to see a doctor, they watch a lucky few (including many readers here) collect a huge chunk of the output of human labor, and they were left a dying world where the thought we might literally see the collapse of civilisation is not completely outlandish.

I mean, hell, I'm not diagnosed but I've had points where I'm pretty fucking depressed. I'm trying to check out of the system (cheap house, no commute, etc.) because it seems purpose-built to make other people happy. but I still worry my kid will need to learn to shoot, trap, grow, organize, and hide in order to get by in the world we're leaving her.

Maybe people feel depressed because the world is depressing?

DisruptiveDave2• 7 years ago

The world is depressing? That's obviously subjective. There's nothing special about me or my circumstances and the only way I can label the world as depressing is if I choose to see it that way, consciously or not. A lot of what you outlined above is purely your mind fucking with itself, because those things, quite literally, are not reality. By no means do I think it is an entirely fruitless endeavor to consider the future, but anyone who lets that lead them into anything negative - nevermind life altering - has themselves to blame.

behringer• 7 years ago

Why? When my parents were working, a simple factory job by one person in the family unit was enough to get them a house. Nowadays, professionals don't have health insurance, they have a failing justice system, they have high crime and low paying jobs.

Today the American Dream is impossible to attain for, I'd say, the majority of people.

dillonmckay2• 7 years ago

Negative thoughts are one’s own fault because nothing is bad?

ridgeguy• 7 years ago

Implicit in your view is the assumption that depression is a choice. Current medical understanding of depression doesn't support that assumption.

Your last sentence shows how readily that assumption leads to dismissive blame. That doesn't seem like a road to progress for anyone.

oceanghost• 7 years ago

This. Precisely this.

makerofspoons2• 7 years ago

Everywhere there is evidence that we have overshot as a civilization.

In the garden there aren't as many insects anymore. They're in decline worldwide.

The weather isn't how it used to be when you were growing up. It's hotter, colder, harsher.

We are inundated with articles about the collapse of nature- how half the animals that existed in 1970 are now gone, the coral reefs are dead, and there is no end in sight. We are adding yet more people every day.

It's very easy to fall into despair that regardless of what you do today the collapse we are careening towards will erase all of it and more.

CalRobert6• 7 years ago

It's frustrating that with all this talk of famine, collapse, etc. almost nobody will say "billions of people will die and it could be very very very horrible".

You think you're going to be able to do permaculture on your plot? You'll be fine, until someone with more guns than you takes it from you.

This is why, as a bleeding-heart lefty greeny hippie who moved to Europe for largely philosophical reasons, I desperately want the EU to get its act together and build a credible military defence.

seppin3• 7 years ago

It's very easy to fall into despair that regardless of what you do today the collapse we are careening towards will erase all of it and more.

The demographic of boomers are to blame for the shift and the lack of response to said threats.

Forgive me if i'm not sympathetic to their depression.

anon1m0us2• 7 years ago

And the only solution is to suffer even more.

We have to turn down air conditioners, then We have to stop buying air conditioners We have to stop buying new cars we have to stop buying new phones new tvs new computers We have to learn how to fix things We have to learn how to grow things We have to learn how to kill and eat things

We have to wind the clock back and go backwards in our lifestyles to a time when we didn't have cheap oil. We'll ride horses again. Take trains again.

That's what the future looks like -- the past.

CalRobert6• 7 years ago

Perhaps I am naive, but in the ways that matter, I don't think it _does_ mean suffering more.

Don't live in the middle of Arizona if you don't like heat. Eat less meat - you'll get used to it.

Honestly just living in a well-insulated flat a walk or bike ride from most amenities, eating little meat, and using renewably-sourced electricity would get us a long ways there.

Our entire society is _designed_ to trap you.

You either start life with no educational debt BUT no job prospects, OR you have the prospect of a decent job BUT massive student loans.

You are "free" to do what you like, unless you decide you don't want to be in debt for housing (or owe money to a landlord).

Homelessness is increasingly illegal and we let homeowners create a housing cartel, so you're forced to buy whether you want or not.

A huge part of the value people generate is captured by others, and living a life where you opt out of this is increasingly illegal.

Of course, this isn't new. One of the silver linings of the black plague was helping to end feudalism. It was pretty damn brutal though.

NikkiA• 7 years ago

the thought we might literally see the collapse of civilisation is not completely outlandish.

To be honest, as someone that the world has decided is worthless, that thought is the most uplifting thought around.

Let it all burn.

seppin3• 7 years ago

Let it all burn.

The rich westerner who never had to struggle to survive wants chaos. I wonder what a person raised in chaos has to say about that..?

CalRobert6• 7 years ago

I don't know your situation, but I'm sad you feel that way. I'm not even saying your feelings, or experience of them, are wrong, but it can get better.

mistermann• 7 years ago

I still worry my kid will need to learn to shoot, trap, grow, organize, and hide in order to get by in the world we're leaving her

I've thought about this exact thing (teaching this as a prudent backup plan for my kids) not because I necessarily think things will be impossible for them, but if the wage vs cost of living trajectory continues in the same direction, living a more difficult life in nature might be preferable (more rewarding, all things considered) to living an easier life in our increasingly dystopian societies.

bernardlunn• 7 years ago

Maybe something to do with diagnosis means more money selling Pharma drugs? Or is that too cynical?

jimbokun• 7 years ago

After the opioid crisis, no, that's not too cynical.

P_I_Staker3• 7 years ago

No, but it's not just diagnosis. There's a troubling tend towards rising suicide rates. This is especially true among middle aged poor whites.

coldtea7• 7 years ago

Well, there's also a declining middle class -- middle aged poor people that used to be predominantly white middle class.

nikanj• 7 years ago

When the economy and population were properly booming, pretty much everyone had a decent change of getting promoted and building a strong career. If your office had 10 people today and 100 in a decade, odds are good that every one of the original ten made it into manager.

We still build career expectations around this model, but it's mostly not true anymore. If you start in the mail room today, you'll retire from the mail room. Actually, you won't even retire, because mail handling is going to get outsourced.

jellicle• 7 years ago

You'll be fired from the mail room, but you'll be eligible to apply to be a subcontractor with Mail Room Supply, Inc. As a subcontractor, you'll be eligible for the standard hourly rate of $9 and you'll have the freedom to arrange for your own healthcare, own payment of all contractor taxes, and own retirement. You're also required to purchase your own Mail Room Supply, Inc. uniforms, but there's an easy payment plan for those that cannot afford them. Conveniently, your assigned work location at Mail Room Supply, Inc. will be in the basement of Acme Corp., where you used to work. (Work location not guaranteed.)

NeedMoreTea• 7 years ago

You'll also be fined for failing to deliver on the contract if you take time off due to sickness. You'll be sent home without pay when conditions find the mail room short on mail, but you are required to be available for work the rest of the day, just in case the delivery was late.

You'll be repeatedly told how much more convenient this is for you.

coldtea7• 7 years ago

Which, incidentally, is not really different from how workers were treated in the US before the 40s, when many important laws for labor protections, minimum wage, etc were passed.

Including purchasing your own uniform and tools (which you did at the "company store", often with "company money" (scrip), which you could only spend for products (food, drink, etc), there anyway.

coldtea7• 7 years ago

If your office had 10 people today and 100 in a decade, odds are good that every one of the original ten made it into manager.

I don't think that's the problem for most - that they didn't become managers. And I doubt that many blue collar / working class people become managers in the 50s to 80s anyway, much less "10 out of 10".

Having travelled around the US and talked with friends a bit, it's more destroyed rural communities, ex-industrial cities, etc. Blue collar jobs who offered work for life and let people buy a house quite easily in the 50s-80s, now are non existent, people have difficulty making ends up, are a health issue away from losing their whole savings (or house), or don't have even $2K in the bank.

And for an increased number of the population it's not very different in many parts of Europe nowadays either, even the supposedly "going strong" ones like Germany (and you've already seen the Yellow Vest protests in France of course).

mrep• 7 years ago

When the economy and population were properly booming, pretty much everyone had a decent change of getting promoted and building a strong career. If your office had 10 people today and 100 in a decade, odds are good that every one of the original ten made it into manager. We still build career expectations around this model, but it's mostly not true anymore.

Got any sources for that because while I don't have don't have data sources, I do have anecdotes from friends who work at Amazon and work for directors/VP's who started out as fulfilment workers despite everyone here loving to hate on Amazon fulfillment centers.

shams93• 7 years ago

What happens now is if you don't found something your a permanent temporary.

osrec• 7 years ago

So true. I felt like this in my supposedly stable investment banking job. The stability is a farce - I've seen lifers get let go abruptly in an afternoon.

Ultimately, the instability drove me to set up my own business, and while it was tough initially, I'm so glad I did.

rchaud2• 7 years ago

We still build career expectations around this model, but it's mostly not true anymore.

Back in the day, the stodgy "legacy" SV companies like HP recruited for all positions internally. The NYT had a story in 2017 about a custodial worker who worked her way up into a corporate role over 10+ years. That was only possible because she saw and spoke with office staff every day and the familiarity and mutual respect helped her get a foot in the door when non-custodial positions became available.

That would be impossible today because most firms use contract labour, that rotate across different employers. If I remember the article correctly, Google's policy even puts technical contractors and FT staff in separate canteens, so there's even less ability to share ideas and network with FT staff who might be able to recognize your work and recommend you to the internal HR team.

babyslothzoo• 7 years ago

Presumably this tracks economic and social status closely, and perhaps the meeting (or not) of traditional American life goals; marriage, kids, house, safety, economic security, etc

In that case, an increase would not be surprising. Many people are simply falling through the cracks, or are a decade or two behind where prior generations were by the same age.

msie• 7 years ago

When I was young I used to laugh at the middle-agers living dull lives. Not anymore, the joke's on me.

house9-2• 7 years ago

I grow up too slow, I don't wanna go
But those I loved so much they underwent this change
They're working fourty hours they got caught in the game
But now I'm working just like everyone else
But I'll get out
I'll get out of here

- Operation Ivy: Junkie's Running Dry

univalent• 7 years ago

Wait, 40 counts as middle aged? I guess I'm middle aged. Now THAT is truly depressing.

hyko• 7 years ago

The generally accepted definition of middle age is 45 years old; and young adulthood ends at 40, which gives you five years to adjust I guess!

copperx2• 7 years ago

I thought that I became middle aged when I turned 35.

I refer to myself as middle aged when talking to people (e.g., "I'm middle aged but single"). I have even mentioned getting getting screened for cancer now that I'm middle aged to my doctor and he didn't disagree or say anything.

Are you sure middle age starts at 45?

beamatronic• 7 years ago

That’s depressing.

ASalazarMX• 7 years ago

My uncle literally cried when he reached 60 and was able to get his (very useful) senior discount card. I thought it was cute until I realized I'm almost 50.

Said card: https://www.mexperience.com/inapam-mexicos-discount-card-for...

padseeker• 7 years ago

While my heart empathizes with the anti-consumerist and fear of the end of the world sentiments expressed on this thread, I wonder if it is the loneliness issue that keeps being cited in many modern studies.

I think I could have easily been on this path to misery, but then I formed a soccer team that plays once a week. We play and then go out for beers. The whole team has bonded. I cannot tell you how much a difference it has made in my life. The joy I get from playing together and then hanging out afterwards is immeasurable.

I have people in my close circle, even my significant other, who feels like they have limited social interactions. The rise of social media, lack of group activities, the rise of suicide, social isolation, blah blah blah, you can fill in the rest.

I am very scared for our collective future but I cannot emphasize enough how important this small social activity of playing a sport together with people I have come to really like has given me purpose and joy that made an enormous difference in my life.

davesque• 7 years ago

Very good advice. I think people used to get together more because it was necessary in order to communicate. Now, we can communicate pretty effectively without actually meeting anyone. But we still need to be social and interact. These days, we have to be more proactive about that whereas before it happened more naturally.

dorchadas2• 7 years ago

Agreed. Just being in the presence and interacting with other people can often help me on my worse days. Even somethig as simple as interacting with a waitress or a cashier at a fast food restaurant. It's something we're losing at a rapid rate, and it sucks.

This lack of face to face communication also hurts us in other ways too. I've an 11 year old cousin who's had a phone since he was 8. He can't understand tone and jokes, and unless it's obviously meant to be funny, he'll often come back with a really rude remark about something too. He just doesn't understand empathy or how to interpret jokes because he spends all his time watching YouTube...

copperx2• 7 years ago

What makes YouTube different than TV, which many of our parents watched as kids? TV used to be a babysitter, too, for the previous generation.

P_I_Staker3• 7 years ago

Yup. I've become isolated, and it's caused numerous issues. I have friends and stuff, but I haven't built the types of relationships and interactions you're referring to. It's too easy to just go home and chill after a frustrating day at work.

asdff• 7 years ago

I started skateboarding again!

neonate• 7 years ago

https://outline.com/V5JWbk

olivermarks2• 7 years ago

'poorly educated white men' hitting middle age in past years typically lived in a warm bath of feel good US TV BS. In our current era television and social media are very abrasive and aggressive. Matt Taibbi's forthcoming book Hate Inc is very good on this. I wonder whether the corrosive effective of this is an element in the mass depression claimed by the Economist. Chris Hedges and Taibbi discuss on RT https://youtu.be/8_vla4l-AX8

sjg0073• 7 years ago

For sure media has a big impact.

beenBoutIT• 7 years ago

Most Americans are obese or overweight and 40% of Americans wouldn't be able to scrap together $400 in an emergency. Suffering from one or both of those conditions at middle age would be good cause for situational depression.

rchaud2• 7 years ago

As a non-American, shows like King of Queens puzzled me because it paired a massively overweight delivery guy with a svelte, stylish wife.

I originally thought it was an opposites-attract kind of show, but the same template is there in Family Guy, According to Jim, The Honeymooners, Two and a Half Men, etc....all highly successful shows that ran for many season and continue to rake in the cash on syndication. Conventionally unattractive, cartoonishly dumb middle-to-lower class white man with fashionable spouse with witty one-liners and putdowns.

Initially I thought these shows were simply lampooning the "working stiff", but as time went on, I think the "lampoon" bit was lost, and the audience actually began to see the show as symbolic of the reality they feel they should be experiencing.

agumonkey• 7 years ago

I don't think it's the medias per se, it's a whole bunch of changes due to the experience gained by society. In the 80s the goal was glamour. Everything was so lush and shiny. I used to find it gross but todays false structure and analytic realism creeps me deep. Both are lies, one of them makes you aiming at happy though.

seppin3• 7 years ago

Wow when did Chris Hedges become a Russian propagandist? I used to really represent him, how did he get banned from western media?

olivermarks2• 7 years ago

I think you are confusing Chris Hedges, ex NYT, and RT which is the Russian equivalent to 'voice of America'. Chris Hedges appears on lots of media including RT. He is not 'banned from Western media' as you will see with a simple search.

camdenlock• 7 years ago

Y’all need to read Enlightenment Now by Steven Pinker.

Life is better than it ever has been, and there’s an embarrassing amount of data backing up that claim.

We’re depressed because our brains didn’t evolve to live in this kind of society, but that doesn’t mean our civilization is falling apart.

patrick5415• 7 years ago

Yeah that book radically changed my perspective. I just laugh now when people talk all this doom and gloom.

scottlocklin• 7 years ago

I like Pinker, but his utility function is egregiously broken here. This sort of Panglossian thing is typical of the smug upper middle classes in the West who look at the lower orders in their own societies as being morally defective somehow; downstream fallout of the ideology of "meritocracy." It's a tale of the hero-bureaucrat; a very questionable story indeed -most of the actual progress we've experienced in recent years is made possible a handful of individuals, just as it has always been. Aka no fracking, no green revolution: things would look a lot different.

If you're a descendant of an American factory worker, or one of the Gilets Jaunes who can't afford to have a normal life like your parents did, you really don't give a shit that many people in Asia have much better lives now, or that childhood immunizations are so much better. Worse, one ought to be suspicious of shrinking metrics collected by bureaucracies whose definition of success is shrinking metrics.

HNLurker23• 7 years ago

You just described the doomer

25 year old
Kinda given up on girls.
Realized videogames is a waste of time watches YouTube instead
Waits for societal collapse
Does a lot of weed, knows he needs to stop. He doesn't.

History of the meme: started in 2018 September but the underlying cause is as old as time (depression and anxiety)

triplee• 7 years ago

It's almost as if a few decades of being told that mental health is for wusses and making it exceedingly expensive due to crappy health care is paying off with a bang.

Not to mention that middle aged people at this point are firmly in the generation that the media has literally been ignoring for a very long time. At the same time, that generation is taking care of the two generations that always do get all the attention (their kids and their parents).

Depression is increasing among Americans reaching middle age

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