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Depression as Unmet Social Need


There is scant research on the importance of group and community engagement in preventing depression. Over the past 30 plus years the vast majority of depression research has been funded by drug companies, who obviously have no profit incentive to investigate non-pharmaceutical approaches to depression. There is a small amount of government and foundation funding to investigate “non-medical” factors that can trigger or aggravate depression. However the competition for these non-corporate grants is fierce – which translates into a dearth of good studies into the effect nutrition, exercise, emotional intimacy, prenatal influences, early poverty, job satisfaction and fulfillment of social needs in an individual’s ability to regulate their mood.

Most Social Needs Research Focuses on Work

The limited research around unmet social needs has mainly focused around work – specifically the importance of having a rewarding job. I am not terribly surprised that there are corporate interests keen on funding studies that “prove” that regular employment is a fundamental human need. I have feeling proving this hypothesis will be uphill work, as it flies in the face of 150 years of anthropological research. Which shows that most people in most cultures are motivated mainly by biologically driven need – and the only “work” animals most do revolves around finding food and grooming. Except for periods when they are rearing young, this amounts to only a few hours a day.

This is in contrast to the vast majority of human beings, who in industrialized (and post-industrial) society, must work between 8 and 10 hours a day simply to survive. This is the result of a very unequal division of work. Some of us work extremely hard for very little money to pay stockholders, who do no work, and to pay CEO bonuses to people who work a few more hours a week and receive a pay packet a thousand or more times the size of ours.

The Importance of Work in Fulfilling Social Needs

The whole notion of going out to work for an employer is a relatively new phenomenon in human history. Prior to the industrial revolution in the mid-nineteenth century, people worked at home – either as farm laborers for a landowner or in “cottage industries” (producing soap, candles, wool, clothing, etc to sell at local markets). Some economists and political analysts have questioned whether formal employment will continue to be fundamental to human existence (especially in the face of steadily rising unemployment over the past 30 years). The work of economist by economist Jeremy Rifkin (The End of Work 1995) and by anarchist Bob Black (The Abolition of Work 1985) are the most well known.

I agree (and nearly everyone I know who works for a wage or salary – unfortunately I don’t know any corporate CEOs so I can’t speak for them) with Karl Marx’s observation that human beings find working for an employer who pockets the profits from the goods or services they produce profoundly alienating. Nevertheless the way society is presently organized, people find it very difficult to meet fundamental social needs without regular employment. I am aware of many people who continue to work well past retirement – not out of financial necessity – but they can find no other way to maintain social ties with the wider community.

One of the many positive outcomes of the nineties Voluntary Simplicity movement was the decision by many middle class professionals to deliberately downsize their lifestyles (in some cases by choosing not to have children) to reduce or eliminate their reliance on paid work. The individuals I know who have chosen this path all found they had to go out of their way to find ways to maintain social and community ties – which can be quite difficult when everyone else in your neighborhood is at work all day and planted in front of the TV at night.

The Decline of Civic Engagement

Both Harvard Political Science Professor Robert Putnam and former presidential candidate Ralph Nader have been writing and speaking for years on the importance of civic engagement on the overall health of communities and political systems. Putnam’s research (published in Making Democracy Work 1993, and Bowling Alone 1995, 2000) has focused mainly on the link between effective civil engagement and the performance of political institutions. Making Democracy Work was based on 20 years of research in Italy regarding specific measures of civic engagement, political equality, solidarity/trust/tolerance and strong associational life and the effective functioning of regional political institutions. Bowling Alone is based on similar research in the US linking public disenchantment with political institutions to the continuing erosion of American civic life.

Nader has approached the issue of civic engagement from a somewhat different perspective – emphasizing the need for greater citizen involvement in civic life as an essential precursor to reclaiming democracy from the multinational corporations who have taken it over.

Gang Banging as Civic Engagement

As a psychiatrist, I have a particular interest on the effect civic engagement (or its absence) has on human beings’ biological functioning – specially on brain function.  Recent advances in neurophysiology been quite spectacular – to the extent that we can identify electrochemical events in the human brain associated with specific psychological functions, such trust, bonding, empathy and altruism. My special area of interest is the profound sense of bonding and solidarity that occurs in teenage street gangs – and increasing evidence this phenomenon is reinforced by powerful biochemical events in the brain. As much as I hate to admit it, there is no question that gang banging is a form of civic engagement. One that, to the great consternation of politicians and community leaders, is flourishing rather than declining. To be continued.

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