This is blatantly incorrect to the point of being offensive.
> If the individual is responsible for her own happiness, then she is also responsible for her own unhappiness
Just hold right there. There was nothing about "responsibility for unhappiness" in the source that was quoted. Author just casually added this part. "Responsibility for your own happiness" just means that it's _you_ who is in control and that you actually can change things - no matter how bad they look at the moment.
> It is a deeply moral message. Failing to be happy is simply immoral. If you are such an immoral and bad person that you have become unhappy — or depressed — it is you, and you alone that is to blame.
Being unhappy does not make yourself a bad person. This is literally one of the first things you hear when you visit psychologist to treat your depression.
> Yet the psychiatric and public discourse remain bent on treating depression as a personal problem devoid of context
Incorrect. Context is incredibly important and is being discussed a lot during therapy sessions.
> There was nothing about "responsibility for unhappiness" in the source that was quoted.
I'm sort of baffled by this claim of yours. The quoted source is very clearly saying that happiness is up to the individual:
> Happiness is a personal responsibility. Happiness is not something you can expect to get from others. Everybody has the key to their own happiness. And hence also the responsibility to put the key in the right lock.
Likewise, I think your other points seem to miss the point of the author. She's not claiming that being unhappy makes you a bad person, she's illustrating that that's a common viewpoint in modern society, and is attempting to refute it. She also views therapy very favorably, and is trying to imagine a therapy that focuses on the collective rather than the individual.
Depression isn't sadness. Sadness is healthy, depression is when it runs amok like a cancer, sometimes with no apparent cause. Someone with a great life, job, friends, health, can be horribly depressed. That's what makes it illness. It's not due to low serotonin levels. The serotonin / chemical imbalance theory has been out of favor for the past ten years: https://link.springer.com/article/10.1007/s12115-007-9047-3, right now we think it's more related to decreased levels of neurogenesis but we're not entirely sure. The "happiness is an inside job" thing works if you're not depressed. When you are, it's like your "happiness muscles" don't work at all. You're just a non-responder to positive stimuli. It's like telling someone that any other illness is really their fault, with the underlying message being that they want you to go away.
This article is very “inside baseball” for the far left. As far as I could understand, the article basically says: depression is caused by the world being terrible, and the world is terrible entirely because of capitalism, so depression is mostly capitalism’s fault. Therefore, we on the left (the article is explicit that it is only for “we on the left”), must learn that therapy is a kind of important political collective act to help us recover from our depression so we can fight capitalism, and not be fooled into thinking it’s something that our depression is something we have individual agency over.
I guess.
I don’t have a deep understanding of depression, except that it is a very real and difficult thing that many people struggle with. So let me caveat that first.
But I have to say, my gut reaction is that it’s rather sad to take a worldview that makes things so dire as to say one’s own depression and the apparent increase in depression around the world is entirely due to the politics you oppose.
To me this reads as the tragic consequences of ever escalating polarization. Instead of seeing the politics around you as merely diverse ideas held by your friends and neighbors, you see it as something more like a species differentiator - and “they” are in control. Well, yes, that would be dire.
But out in the real world it turns out the vast majority of people on the right and the left are not so far out to the wings of their ideology, and that if they sat down over a nice meal they could have a great conversation and really enjoy each other’s company, perhaps even learn from each other and positively influence each other.
The political world around us is indeed depressing, but I would argue we shouldn’t wish that we could get out of bed so we can “throw a brick through a window,” but perhaps instead so we can work toward understanding and reconciling with our neighbors instead.
You’re taking a rather crudely reductionist view on the article, and one the article directly admonishes the reader not to do:
> It would be an offense to say, well, it’s just politics... to understand depression through political frames does not mean that the problem of depression can be immediately solved by political means. There is a horror to depression that cannot and must not be translated too quickly into the sphere of politics, regardless of our critical and revolutionary aspirations.
The article is suggesting we should eschew the hyper-individualization of our understanding, diagnosis, and response to depression—and do so by contextualizing it within the political economy in which it lives. It’s a call specifically to not reduce it to chemicals, subjects, and personal responsibilities—and, instead, recognize the impacts of capital, structures, and collective responsibilities which capitalism (and the defensive and capital-protecting ideology and politics it gives rise to) wishes us to ignore. This is the capitalist “realism” the author states runs in tandem with depressive realism—that there are no alternatives, that there really is nothing to be done about the current state of affairs.
The article is calling attention to the possibility—no, the need—to reject this false narrative. There are alternatives, but, the article suggests we instead find comfort in increasingly diagnosing and pathologizing what could be normal effects of capitalism on those who live under it. Instead of recognizing the ways in which our social, political, and economic structures impact subjects, we instead say it’s the subjects who have a chemical imbalance or defect:
> In this way, the diagnosis provides momentary meaning to meaningless misery. The suffering gets a name and a cause: a lack of serotonin. But this cause has causes which in the diagnostic system — and in the capitalist world as a whole — remain undiagnosed and untold.
Whether or not you agree with such a possibility, the very question is, I think, provocative and worth considering and discussing.
To be honest I’m not so bothered by the idea that depression could be extrinsic, or at least partially extrinsic.
What I find “crudely reductionist,” in the article is the very idea of “capitalist realism,” and the idea that some notion called “capitalism,” can be the cause of all depression.
Are we to think that depression did not exist in the Soviet Union? Or perhaps in the mercantilist kingdoms of the colonial era? Or perhaps not in the Roman Empire? Or what about ancient China or India?
There’s some irony in saying “capitalist realism tries to fool us that this is all there could ever be,” when the article itself is declaring that capitalism (or any -ism) can only be some kind of evil force which naturally causes depression.
It doesn’t read to me like a thoughtful scientific article, but like a religious text decrying another religion.
I find the real world is not nearly so black and white. Certainly the “capitalism” as practiced in the United States is far different than that practiced in Norway, as well as the statist system in practice in Cuba and currently falling apart in Venezuela.
It’s hard for me to see this author as doing anything other than taking a victim mentality and trying to prescribe it for everyone else, laying Universal blanket blame on the authors preferred heresy.
You seem to have a rather viscerally negative response to the article. I’m not advocating either way for the article’s premises or conclusions, I’m merely trying to present a rephrasing of the strongest form of its argument, in an effort to help intellectually engage with it.
> What I find “crudely reductionist,” in the article is the very idea of “capitalist realism,” and the idea that some notion called “capitalism,” can be the cause of all depression.
No, that’s your same reductionist interpretation of the article’s complex claims. You’re just re-stating your initial reaction to the article, while saying it’s what the article is arguing.
The article does not argue or suggest that capitalism “can be the cause of all depression”. Instead, it argues that, because capitalism is the political economy within which our current notion of depression is framed, the act of individualizing depression, while ignoring extrinsic factors as potentially causal and/or contributory, is something we should reconsider.
> Are we to think that depression did not exist in the Soviet Union? Or perhaps in the mercantilist kingdoms of the colonial era? Or perhaps not in the Roman Empire? Or what about ancient China or India?
This is a rather disingenuous bit of whataboutism. The article made no such claims. Given the article’s actual claims, I’d wager the author would suggest we should be looking to the social, political, and economic structures of those specific societies and systems to better understand and contextualize the depression that undoubtedly did exist.
Again, you’re being extremely reductionist here—you’re attempting to turn the article’s grappling with a complex problem, and attempts to contextualize it within the social, political, and economic structures in which it arises into some form of Universal Theory of Capitalist Depression. That’s your argument, not the article’s.
There’s some irony in saying “capitalist realism tries to fool us that this is all there could ever be,” when the article itself is declaring that capitalism (or any -ism) can only be some kind of evil force which naturally causes depression.
The article doesn’t quite declare that. That seems to be your own reaction to the article placing capitalism and the material conditions under which it subjects people (and the impact that may have on mental health) under its microscope. However, this irony you seem to see is quite unclear to the point of not seeming ironic at all.
> Certainly the “capitalism” as practiced in the United States is far different than that practiced in Norway, as well as the statist system in practice in Cuba and currently falling apart in Venezuela.
The author points this out directly on multiple occasions. The author is primarily concerned with Danish society, but alluded to the great differences in the US and elsewhere, and wonders aloud about what impact the different material conditions in which people live might have on their mental health individually and collectively.
> It’s hard for me to see this author as doing anything other than taking a victim mentality and trying to prescribe it for everyone else, laying Universal blanket blame on the authors preferred heresy.
That seems to be your interpretation, and clearly explains why you’re so completely missing the article’s point. The article is directly arguing against the hyper-individualistic pathology of depression as it exists in current discourse. The article is suggesting that what we call depression could very well be a normal reaction to the material conditions within capitalist political economy. If it is, the article thinks, that’s a game-changer.
It really sounds like you’re offended by taking a critical look at capitalism, as if you believe capitalism (or any other kind of ism) does not engender social, political, and economic structures that both serve and reinforce it—or that humans might not have universally positive reactions to such structures and conditions. From crippling, life-long reliance on debt, extreme competition, increasing inequality, and social expectations to be always happy, coupled with always laying the blame for failing to navigate such structural pressures directly on individuals, the author suggests perhaps we should be careful about absolving the structures themselves of any responsibility for their impact on people.
Again, it’s fine to disagree with the author’s conclusions. But I think you should be engaging with the strongest version of the article’s arguments, not reducing them to overly simplistic forms that make it feel easier to dismiss without consideration.
Hah! This got downvoted in the first second after posting, which to me says the down-voter couldn’t have read past the first sentence. Come on now, HN downvotes are for unconstructive or inappropriate comments. If you disagree you’re not supposed to downvote, you’re supposed to reply :)
People are also brigading comments from other accounts despite them being substantive. HN guidelines say not to comment on voting but something sure seems up here.
Yes, I saw that after another commenter pointed me toward the guidelines. I would delete the parent comment, but then I wouldn’t get to offer an apology. Thanks for flagging this to me.
Thanks for that clarity on the rules. I’m neither upvoting or downvoting... I think the first half of the comment is very well written and something I would have liked to have written myself. The second half, the idea that we must all sit down together and have lunch, I struggle to accept. In my opinion, regardless of part of the political spectrum you are, i don’t think you should have to shed your guiding principles. However, that said, I don’t think your organizing principle should be to get everyone to agree with you or to implement your system as the only system. Just as there are thousands and thousands of plant species and what? Millions of insect species, I think it’s important to reflect on the fact that our individual minds in a way make each of us an individual species. While we may from time to time see beauty in collective acts, humans are not meant to be starlings flying in a well orchestrated flock. I cannot begin to suggest I understand depression but I can say that I resist psycho-labeling what goes on in my mind or in yours. Every thought is a gift.
Well, I re-read the guidelines, and I have to admit they do say to reply but don’t specifically say not to downvote. Not sure where I got the idea that was one of the rules.
I see it also says don’t comment on votes, which I hadn’t noticed before. I would go back and delete that comment but then your reply would make no sense, so oh well.
Thank you for posting your explanation and helping set me straight on HN etiquette, I appreciate it!
@mattrp, looks like we’re at the max thread depth. Thanks for your comment.
I certainly don’t mean to say people should shed their ideas, or that we should be starlings that flock together.
But I do think it’s important to see humanity as one species, one people, who have most things in common and thrive by working together constructively.
That’s why I feel it’s important to seek to understand the people who see the world differently than you, rather than just exist in blind opposition to them.
When we let our ideology define who we are it becomes a religion, and world history has plenty of examples of people taking religious ideology as a reason to blindly oppose and eventually wage literal war on “the other.”
Meanwhile, healthy mutual tolerance comes from seeking to understand and then arranging life in such a way that each person can have their own ideas and worldview without needing to quash the others.
To me that feels like just a description of liberal philosophy, so it’s surprising I most often have this conversation with friends leaning far left who are so angry they are thinking more in terms of how to wage a war than how to find a workable mutual tolerance.
I'm surprised that you're surprised. As far as I understand it one of the fundamental differences between what we generally call 'leftists' and 'liberals' is that the latter think we should solve problems by talking and trying to understand, whereas the former considers this as silly as expecting a slave to sit down with his masters and discuss the inconvenience of the beatings and workload.
Better for the slaves to sit down and write complex analyses on what is wrong about slavery and bicker amongst themselves about the details (I joke)!
But anyways, obviously most 'leftists' wouldn't equate slavery with their own situation, and I'd argue most of them do want to go as far as possible through understanding and conversation. But to some degree I'd say that's the basic point of view.
> The political world around us is indeed depressing, but I would argue we shouldn’t wish that we could get out of bed so we can “throw a brick through a window,” but perhaps instead so we can work toward understanding and reconciling with our neighbors instead.
Reasoning from this perspective, wouldn’t this require a society that is more collectively and communally-oriented that one based around extreme competition with each other as the means of survival?
I don’t see how you resolve this antagonism in a society like the US, where failing to ruthlessly compete against others can mean losing healthcare for your family and children, slipping into homelessness, etc. Obviously, other countries mitigate this more with robust safety nets, but you seem to be mistaking a symptom for a cause.
The article seems to articulate that happiness is the opposite of depression and that unhappiness is synonymous with depression. That could be arguably a thing in a purely rhetorical sense but is absolutely incorrect in a clinical sense.
Clinically speaking depression is the multi symptom result of one or more chemical imbalances in the brain resulting in arrhythmic emotional states. The opposite of depression from a clinical perspective is emotional balance. This is why treating specifically the symptoms of depression often results in relapses at later times.
If it is a chemical imbalance only, why are there large differences in rate in different time periods in the same culture, with suicide rates hand in hand (https://bmjopen.bmj.com/content/8/9/e023144)? Why does the depression rate go way up during recessions and other economic phenomena (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741013/)? What biological-chemical thing happens during an economic recession?
Financial distress is a key catalyst associated with suicidal ideations. That doesn’t mean financially distressed people are generally suicidal or even depressed. It does mean that stresses associated with finances are a frequently identified/measured trauma that can impact depressed persons who may not be clinically diagnosed as depressed. Depression is often undiagnosed and self-managed like many other mental health diseases.
So it's the trauma that does it? Where's the biochemical basis of trauma?
I mean, when you get hit by a car and you get shock from blood loss, you die of shock from blood loss but you also die from the car. You could solve the problem with better EMT's and blood transfusions and stuff but you could also solve the problem by having better public transit and not having cars everywhere, you know?
I mean, if you think about what a brain is, you could consider basically any any mental disorder is just a "chemical imbalance". Saying that depression is one isn't false, but, to your point, I think pharmaceutical companies harp on this point in order to sell antidepressants.
What GP gets right, though, is that depression != sadness. It is normal (and often healthy) to feel sadness after experiencing loss or other hardships. It is not healthy to feel hopeless and devoid of energy for months on end... that's what depression is.
Have you ever tried to seek treatment for depression? I and others I know have found it incredibly hard to get any sort of treatment other than the SSRI at the top of their list.
> To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.
The chemical imbalance theory is BS and dead https://qr.ae/T6UgWb. We don't understand depression fully, but more signs are pointing to low neurogenesis in the hippocampus. Chem imbalance may draw from medieval notions of imbalanced humors.
It draws from the preferred means of treatment for suicide survivors: controlled boredom under observation by mental health professionals in a hospital until emotional equilibrium is reestablished from the lack of external stimulus.
Mark Fisher addresses a component of the chemical imbalance theory, and why it doesn't go far enough:
>This commodification lay in the so-called ‘bio-chemicalization’ of depression. This is the assertion that depression is caused primarily by biochemical imbalance in the brain, namely low serotonin levels. To treat mental health illness is to treat the symptoms of a single person who ‘owns’ their illness. Depression is internalised and individuated. As such, we lose a sense of collective responsibility for mental health illness in terms of causation, understanding and treatment.
>This is not to dispute that depression is not neurologically verifiable. Rather, it is to dispute that the neurological disposition of depressed people is caused only by internal, biochemical factors. If, like Fisher, we ask: ‘What causes low serotonin levels?’ we are forced to comprehend mental health illness as a culturally contingent phenomena caused by a conjuncture of biochemical and societal factors.
>This is a crucial question. The way in which social and political problems are converted into individual pathologies, to be explained via chemical imbalances or family history, neatly sums up so much of what has happened under capitalist realism. It’s what I’ve called the privatisation of stress. Depression has been described as a pathology of responsibility: you feel intensely responsible for the state that you’re in. The excruciating paradox is that, while you feel that only you can get yourself out of depression, the condition consists precisely in your inability to act. There’s more than an analogy with the political hopelessness and fatalism that have characterised capitalist realism.
You can actually see just how much scrutiny the pure theory of chemical imbalance has come under from psychologists and sociologists on Google Scholar[0].
"The cause of mental disorders such as depression remains unknown. However, the idea that neurotransmitter imbalances cause depression is vigorously promoted by pharmaceutical companies and the psychiatric profession at large. We examine media reports referring to this chemical imbalance theory and ask reporters for evidence supporting their claims. We then report and critique the scientific papers and other confirming evidence offered in response to our questions. Responses were received from multiple sources, including practicing psychiatrists, clients, and a major pharmaceutical company. The evidence offered was not compelling, and several of the cited sources flatly stated that the proposed theory of serotonin imbalance was known to be incorrect. The media can play a positive role in mental health reporting by ensuring that the information reported is congruent with the peer-reviewed scientific literature."
Thanks for responding with thoughtful messages and references; I'd agree that the simplification of depression (which I have no doubt is the result of multiple, complicated factors; social, environmental, political and nutritional).
It'd seem much more inline with the spirit of the HN guidelines if others could respond and critique to your messages instead of downvoting (which feels like it may be more of an attempt to suppress a message).
'Anxious? Depressed? You might be suffering from capitalism: Contradictory class locations and the prevalence of depression and anxiety in the United States'
Excellent article, and to anyone interested in the topic, I'd suggest going beyond the review and reading Mark Fisher himself. His book, Capitalist Realism, as mentioned by the article, is short but an essential read to understand the politics of mental health: its current privatization at the hands of pharma companies and individualization at the hands of self-help authors and YouTube stars.
Privatization, pharma? Between regulation and licensing it was my understanding that in practical terms pharma is at least as much public as it is private.
claudiawerner is talking about the privatization of mental illness, not Pharma, as outlined by Mark Warner in the essay “The Privatisation of Stress” from 2011.
I've had this same thought for a while now. Mental illness (and I am not using this term judgmentally) is, essentially, when your perception of the world persistently does not agree with the external reality: for example, you're under the impression that you're fat when in reality you're nigh emaciated.
If that's a correct characterization, is depression really a mental illness? If people perceive their lives to be dreadful, whereas in reality their lives are dreadful, where does the misconception come in?
This is too simple. A lot of depressed people know that the world is not as bad as they feel but they still feel bad. People with OCD know that the world won’t go under if they don’t count the number of traffic lights in the way home but the emotion is still there.
Only people with hardcore mental illness don’t even know that their perception of the world is not correct. Most people know but still can’t do anything about it.
I think actually, knowing your perception of the world is not correct is the really hard part, because then you can’t just go through your day comfortably, you have a constant mental struggle against a faulty autopilot.
Imagine driving a car with misaligned steering that pulls sharply to one side. You could do it, but it would get tiring, and it would feel dangerous to go on a long road trip because if you lost focus for a minute you could crash.
My own experience with mental health issues is that it feels about like that.
Sorry, but that's a pretty terrible definition of mental illness. Mental illness can be any case where your mind has fallen into a pattern of being chronically unhelpful to you; this can mean it doesn't report on reality correctly, or that it sends incorrect (or merely destructive) emotional signals, or whatever else.
That said, this is one of the reasons I like to think of it as "mental health" rather than "mental illness". It's more like weight/nutrition, where a person doesn't simply have a problem or not have a problem; it's a sliding-scale. Everyone's mind benefits from care, the degree of one's challenges just varies based on personal history and genetics.
It's been my experience that the human psyche fundamentally needs a certain amount of self-delusion (or at least suspension of disbelief) to be able to function. Any hopes or dreams or beliefs are in some sense disconnected from reality, but are also extremely necessary. We must be able to step outside of reality, without losing track of it.
Aren't both of those examples special case of my definition though? "[i]t doesn't report on reality correctly, or [...] it sends [...] incorrect signals."
But what if the mind is reporting on reality correctly, and the signals it's sending are correct, it's just that we do not like them very much?
Can a signal be entirely correct, but destructive? If so, it just seems like a special case of the expression "the truth hurts". It's not my mind which is defect by informing me of the present state of affairs, it's the present state of affairs which are regrettable.
> Mental illness... is, essentially, when your perception of the world persistently does not agree with the external reality
I don’t think that’s correct. I’ve had depression and anxiety my entire life, and I’m well aware that sometimes things aren’t as awful as my mind makes them out to be (and sometimes they are), but the conflict with reality isn’t what fuels my despair and angst. If it were then I think it would be a lot easier for people to just think or reason their way out of the “pit of despair” that is depression.
> If that's a correct characterization, is depression really a mental illness?
I don’t think it’s useful or helpful to try to define our way out of the problem. Changing the definition of a thing doesn’t really help the people who are suffering and trying to just get out of bed in the morning.
Depression is much more than perceiving your life as being dreadful.
> Mental illness (and I am not using this term judgmentally) is, essentially, when your perception of the world persistently does not agree with the external reality
The incongruity comes from the collective ideological demands of Capitalist societies (that they are sustainable, don’t lead to ecological collapse, endless war, devolve into fascism in their periodic crises, etc) and the lived experience that, yes, they do actually do all of the things their ideology denies.
As a kind of society-wide psychological complex, Capitalism can’t function without massive amounts of this denial and projection. But the threadbare nature of those defenses is everyday more exposed, and inwardly directed, especially following the collapse of the USSR (which existed in a similar, but differently conjugated state).
Existing in all systems is not the same as it having nothing to do with political systems - especially political systems that occupy all of daily life, as they do. There is no aspect of urban daily life that is free from the compulsion to use one's time to make money, either to survive or accumulate, and nobody - neither the capitalist nor the worker - is free from that concern.
You’re continuing to elide both my and the parent’s point not that any political systems are free of mental illness, but that they result in different rates, experiences, and forms of instantiation.
This isn’t even contested in the psychological literature. For example, go read about how schizophrenia manifests and is experienced in the developing vs. developed world. Or how depression and rates of suicide increase in the wake of economic crises.
I am sure even there people would find ways to be unhappy. Same for perfect communism. A lot of people would be happy but then you also would have people who think hey are better and would try to get ahead of others.
> If the individual is responsible for her own happiness, then she is also responsible for her own unhappiness
Just hold right there. There was nothing about "responsibility for unhappiness" in the source that was quoted. Author just casually added this part. "Responsibility for your own happiness" just means that it's _you_ who is in control and that you actually can change things - no matter how bad they look at the moment.
> It is a deeply moral message. Failing to be happy is simply immoral. If you are such an immoral and bad person that you have become unhappy — or depressed — it is you, and you alone that is to blame.
Being unhappy does not make yourself a bad person. This is literally one of the first things you hear when you visit psychologist to treat your depression.
> Yet the psychiatric and public discourse remain bent on treating depression as a personal problem devoid of context
Incorrect. Context is incredibly important and is being discussed a lot during therapy sessions.
And so on and so forth.
Source: my own experience with depression.
Edit: grammar