A paradigm change has been happening. The shift began long ago, but it’s starting to gain traction in the mainstream. Here is one recent example, an article from Psychology Today—Anxiety and Depression Are Symptoms, Not Diseases by Gregg Henriques Ph.D.:
“Depression is a way the emotional system signals that things are not working and that one is not getting one’s relational needs met. If you are low on relational value in the key domains of family, friends, lovers, group and self, feeling depressed in this context is EXACTLY like feeling pain from a broken arm, feeling cold being outside in the cold, and feeling hungry after going 24 hours without food.
“It is worth noting that, given the current structure of society, depression often serves not to help reboot the system and enlist social support, but instead contributes to the further isolation of the individual, which creates a nasty, vicious spiral of shutting down, doing less, feeling more isolated, turning against the self, and thus getting even more depressed. As such, depressive symptoms often do contribute to the problem, and folks do suffer from Negative Affect Syndromes, where extreme negative moods are definitely part of the problem.
“BUT, everyone should be clear, first and foremost, that anxiety and depression are symptoms of psychosocial needs and threats. They should NOT be, first and foremost, considered alien feelings that need to be eliminated or fixed, any more than we would treat pain from a broken arm, coldness and hunger primarily with pills that takes away the feelings, as opposed to fixing the arm, getting warmer or feeding the hungry individual.”
It’s a pretty good article. The focus on symptoms seems like the right way to frame it. This touch upon larger issues. I’d widen the scope even further. Once we consider the symptoms, it opens up a whole slew of possibilities.
There is the book Chasing the Scream by Johann Hari. The author discusses the rat park research, showing that addiction isn’t an individual disease but a social problem. Change the conditions and the results change. Basically, people are healthier, happier, and more well-adjusted in environments that are conducive to satisfying basic needs.
Then there is James Gilligan’s Why Some Politicians Are More Dangerous Than Others, an even more hard-hitting book. It shows (among other things) suicide rates go up when Republicans are elected. As I recall, other data shows that suicide rates go up in other societies as well, when conservatives are elected.
There are other factors that are directly correlated to depression rates and other mental health issues.
Some are purely physical. Toxoplasmosis is an example of that, and its related parasitic load that stunts brain development. Many examples could be added, from malnutrition to lack of healthcare.
Plus, there are problems that involve both the physical environment and social environment. Lead toxicity causes mental health problems, including depression. The rates of lead toxicity depend on how strong and effective are regulations, which in turn depends on the type of government and who is in power.
A wide variety of research and data is pointing to a basic conclusion. Environmental conditions (physical, social, political, and economic) are of penultimate importance. So, why do we treat as sick individuals those who suffer the consequences of the externalized costs of society?
Here is the sticking point. Systemic and collective problems in some ways are the easiest to deal with. The problems, once understood, are essentially simple and their solutions tend to be straightforward. Even so, the very largeness of these problems make them hard for us to confront. We want someone to blame. But who do we blame when the entire society is dysfunctional?
If we recognize the problems as symptoms, we are forced to acknowledge our collective agency and shared fate. For those who understand this, they are up against countervailing forces that maintain the status quo. Even if a psychiatrist realizes that their patient is experiencing the symptoms of larger social issues, how is that psychiatrist supposed to help the patient? Who is going to diagnose the entire society and demand it seek rehabilitation?