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August 26, 2016
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The Dollar$ Side of Depression

I don't often write about mental health issues. Mostly that's because I was brought up to believe in "pull yourself up by your bootstraps" and "therapy usually does more harm than good". That story is not up for discussion; it's at least as strongly ingrained in me as Creationism is in literalist religious denominations.

That said, it's hard to live surrounded by modern media and remain ignorant of the "signs and symptoms of clinical depression". But just like any chronic physical health condition, it's sometimes hard to tell when something jumps over from the second or third standard deviation of "normal" into "a disease state". The arbitrary lines have been drawn and redrawn, time and again, as we learn more about the human body and more about how we can use pharmaceuticals to change its performance. (I remember when "100-plus-your-age"/90 was considered a healthy blood pressure. Today, doctors are told to start intervening when it's 115/75. And what was behind the seemingly arbitrary number of 126 mg/dl fasting for an initial diagnosis of diabetes?) So, unless someone is honestly and obviously suicidal, or cops to "being under psychiatric care", I'm more likely to consider the contribution of external factors than bona fide mental illness.

Which brings me down to brass tacks. Or tacky plastic. Or bean-counting, with or without the raised-or-unraised plastic, magnetic strips, RFID chips, or NFC chips beside the (rarely signed anymore) signature strips. While money may not be the source of happiness, lack of money can be the source of many signs of what some would call "clinical depression".

You don't feel like going anywhere. As my late mother said, "How can I go anywhere when I don't have the money to go there?" Unless you're in the middle of a major city, or are used to doing a lot of walking, going somewhere requires money: gas and tolls, bus or train fares, and sometimes taxicab fares. Where you go also may require money: even if you don't plan to buy anything, there's always the extra bottle of water, the emergency orange juice for the low-out-of-nowhere, the cab money home (or to medical care) if you get sick or injured...

You're constantly tired. Not going anywhere, not having money for any food other than fatigue-inducing carbs, getting eye strain from unsuccessful job hunting, and not having anything "interesting" (or that doesn't seem to require extra money) on the TV, what else is there to do? (How long can you just surf the Internet? And how long will you have access, if you can't get the bills paid?)

You feel trapped. If you leave your house, someone may try to turn off the electricity, the gas, the Internet. Someone may try to lock it and impound it, or try to evict you.

You don't take care of yourself. I've mentioned in a number of earlier posts that sometimes having the rent and utilities paid, and gas to get to and from work, taps out the budget to the point where medical care becomes a luxury. The "Affordable Care Act" has so far shown to be anything but: my employer has had to cease offering medical benefits to part-time workers; the plan-displaced workers' costs under the ACA have doubled or tripled. Many are finding it cheaper to pay the penalty and hope for the best.

At the moment, The Other Half and I are holding on by a shoestring. My sister's current joblessness and lack of resources are dragging that down, as are recent unexpected-and-expensive car repairs. I'm finding my sister beginning to fall into my mother's paths of anxiety — paths I've fallen into when we've been in tighter spots, and paths that are all too likely to repeat. (I'm not at all sanguine about "economic recovery": too many jobs can be automated or shipped overseas, and there are too many legal and financial obstacles to entrepreneurship, for there to be much hope here.) She's also tapping out my underemployed wages, repeating Mom's oft-used "just kill me and put me out of my misery" line to try to force us to pay for her overpriced haircuts and her eating out (she's kitchen impaired and refuses to eat leftovers) while we struggle to pay the rent and car repairs.

Where pill-pushers would see "depression", I see "realism". Where they see pharmacology as cure, I see it as another burden in an already underfunded household. Just as we only treat the symptoms of diabetes, we're often treating only the (pharmaceutical-company-determined) symptoms of depression. We need to work at reversing the underlying conditions in both cases.

We don't just need a cure for diabetes. We need a cure for joblessness and underemployment.

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