Part I: The silent pandemic
If we start being honest about our pain, our anger, and our shortcomings instead of pretending they don’t exist, then maybe we’ll leave the world a better place than we found it.– Russell Wilson
Did you know that 12% of the world’s population (a little more than 1 in every 10 people) live with a mental health disorder? And that Portugal is the 2nd European country with the highest prevalence of mental problems? Sadly, there’s no way of knowing by how much the real numbers surpass these (and there is no question that they do, particularly in less developed countries).
Mental health is as important as physical health. It comprises all dimensions of our well-being besides the physical one, namely the emotional, psychological, and social ones. Remember that our body and mind are more than two sides of the same coin. They’re like cogwheels on a machine, making each other spin. And if one of the wheels isn’t turning, you can’t expect the engine to keep running. Your body is a complex system, and if one element is damaged, the others will inevitably suffer too.
A mental health problem is a health problem. Just like a heart issue can limit your ability to exert physical effort, it affects how you think, feel and act. This way, this can interfere with how you cope with stressful situations, with your relationships, and (most significantly for Behavioural Economics) your choice-making process.
It should be noted that, contrary to general belief, not all mental health problems are situational, i.e., not all stem from traumatic events or abusive pasts. There are many factors that can make someone predisposed to these kinds of issues, including genetics, brain chemistry, or personality. At the end of the day, mental illness does not choose age, gender, or class. No one is immune, but there are some precautions everyone can take. Learn how to deal with the stress in your life. Take time for yourself. Do something you love (like reading the latest NAC article). Your mental health is to be taken good care of.
We should also remember that we are all different, and so are our struggles. Sometimes, the same condition will manifest itself in wildly different ways between individuals. And sometimes, a behaviour that is a cause for concern in one person can be completely a healthy and normal conduct for another.
Two of the most common mental illnesses affecting people are Major Depressive Disorder (colloquially referred to as depression) and Generalized Anxiety Disorder. These mood disorders can be identified by a professional and are treatable. Depression causes feelings of sadness, hopelessness, reduced energy, and sometimes agitation and restlessness. Anxiety causes nervousness, worry, or dread. It should be noted that all these feelings are expected to occur from time to time. However, they are not expected to overwhelm you. When these negative feelings start to show up too often and take their toll on your life, that’s when there could be a cause for concern.
We know mentally ill people are not at their best (they are ill, after all). Someone struggling with mental issues is, therefore, less productive than otherwise. This affects the labour force – if mental health problems are, at least, as frequent as current data shows (and we’ve already made the argument that they may be even more), then a relatively large share of the working-age population is not producing as much as they could be. Needless to say, this will hurt the economy. Depression and anxiety are estimated to cost the global economy $1 trillion per year in loss of productivity (WHO). Besides, the current solutions for these problems (therapy, drugs, among others) are costly and lengthy to apply, with patients often requiring a follow-up. This understandingly puts a heavy strain on healthcare systems, resources, and individuals.
Depression and Suicide
Depression is particularly prevailing. Around 280 million people worldwide suffer from it (the majority of which are women). Moreover, the large number of cases that goes unreported is mostly due to a general feeling of shame or lack of awareness of mental health conditions. Data usually shows higher numbers of mental diseases in developed countries. This does not, however, necessarily mean that such problems are more common in these countries, but rather that they are more readily diagnosed and reported, as developing nations often do not yet possess the resources required to properly address these illnesses.
The COVID-19 pandemic hasn’t helped: in 2020, the global prevalence of anxiety and depression increased by 25% (WHO). Young people have been particularly affected – they are disproportionally at risk of self-harming and suicidal behaviour. Worst of all, this boom in the prevalence of mental health issues was paired with severe disruption of mental health services. Although this situation had somewhat improved by the end of 2021, many of those who desperately need care are still unable to get it. Professional psychological support is not cheap or particularly easy to access in most healthcare systems, and there is still a lot of catching up to do after the major gap in services that the pandemic represented. And as if the difficulty in obtaining help was not enough, there are still people who don’t bring themselves to ask for help. It is still too common to believe that it is wrong, shameful or pointless to acknowledge our struggles and search for outside support.
The WHO currently estimates that, by 2030, depression will be the world’s most common disease in the world. If we are not careful, the next pandemic we face may be one of mental illness.
In some cases, depression may even lead to suicide. An individual suffering from depression has a risk of suicide around 20 times higher than one without it. The statistics are beyond troubling, they are outright alarming. Over 700 000 people end their own lives every year. This is the equivalent to one suicide every 40 seconds, making suicide one of the biggest killers in the world, and it is the fourth leading cause of death in 15–29-year-olds.
How does this affect how you think?
Depression doesn’t just get in the way of being happy. It causes chemical changes to happen in your brain, which can seriously impact your thought process. The condition can interrupt or reduce neurotransmitters (chemical “messengers” in the brain), such as serotonin, dopamine, and norepinephrine. These changes may either be what is causing you to be depressed or be another result of whatever triggered it.
Depression can impair your attention and memory, altering your ability to absorb new information and make decisions.
Depressed people tend to have more trouble making decisions, even trivial ones. Try putting yourself in such a person’s shoes. Imagine you’re going out to dinner with friends. You have to choose the restaurant, but which one? And there are so many tables there, where will you sit? And what will you order when the menu goes on for so many pages! All those light decisions can weigh so heavily when anxiety keeps telling you that every choice is the wrong one.
Depression frequently brings along hopelessness. People are unwilling to waste their time on plans that they believe will fail. Besides, they experience considerable anxiety when faced with the need to make a call, even the smallest decisions. This results in high levels of what economists refer to as risk-aversion (reluctancy in taking risks), leading to less information collection, idea production, and option consideration.
Fortunately, studies have shown that using specific techniques such as cognitive behavioural therapy can help depressed people make better decisions, leading to better long-term outcomes. Moreover, problem-solving treatment can train people to improve their problem-solving skills and distorted thinking patterns.
Depression may also impair your executive function, which affects your ability to process information. Executive function is often called the CEO of the brain (you are walking around with your version of a tiny Warren Buffet in your head!) because it is in charge of getting things done. Simple tasks, such as paying bills, cleaning your room, or getting out of the house, can be compromised if that CEO takes an unplanned vacation. Fortunately, the executive function can be improved with educational strategies and behavioural approaches. If you’re experiencing issues with executive function, try breaking large tasks down into smaller chunks, create to-do lists and review them frequently.
As we have seen, depression affects everyone differently, changing habits and the way people live. This translates into changes in behaviour, consumer patterns and decision-making.
There’s a reason why people say depression runs deep. It affects so much more than just your mood. Fortunately, this is a preventable evil – and Behavioural Economics (nudges, particularly) may be a part of the solution.
Sources: Mental Health Foundation, World Population Review, World Health Organization, WebMD, Yale University, PubMed Central, Medium, SAGE Journals, IZA World of Labor, Recovery Ways.