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Should universal basic income be used as an antidepressant?
Johann Hari knows that mental health is really a social issue.
- Johann Hari believes we need to treat universal basic income as an antidepressant.
- In his book, Lost Connections, he writes that 65-80% of people on antidepressant medication are still depressed.
- Instead of treating depression as a chemical imbalance, we need to look at the social causes really driving it.
In 2015, a team of researchers led by Brett Ford at the University of California, Berkeley (now at the University of Toronto), asked a seemingly simple question: Can you consciously make yourself happy? Populations in Japan, Russia, Taiwan, and the United States were studied. It turns out that you can will yourself into happiness—except if you live in America.
As the team writes,
"This pattern of results suggests that a culture's degree of collectivism may play a role in shaping the correlates of pursuing happiness."
In his book, Lost Connections, Johann Hari discusses this landmark study with Ford. The differences between individualistic cultures like America and collectivistic societies, such as Japan, China, and South Korea, have long been investigated by social scientists. Time and again, the latter produce better outcomes in terms of happiness, well-being, and life satisfaction. A question has long been hanging in the air: Why isn't America more like these countries? Surely, the richest nation on the planet should be able to provide for its citizens' mental health.
I've written about this difference before, and the criticism I receive tends to trend political—communism versus democracy, socialism is evil, etc. On that front, let's consider South Korea's response to the coronavirus pandemic. The constitutional democracy reported its first case the same day as the United States, yet the country was able to flatten the curve within weeks. That's what happens when a functional government immediately intervenes, tests as many people as possible, and puts restrictions in place on day one.
Meanwhile, our miracle never happened. An unprepared government might be the major problem, but public health issues are multivariate. Here's where the social distinction matters. In South Korea (as in China), citizens honored the restrictions because they knew that the orders were in the best interest of society. Meanwhile, in freedom-loving America, a "liberty rebellion" was recently held in Idaho, while across the country pastors call for the faithful to gather. Some Floridians even want beaches to open.
Depression and anxiety: How inequality is driving the mental health crisis | Johann Hari
Reports from Italians and South Koreans and Chinese tell us that sheltering at home is hard. These videos also reveal something important: The citizens know their compliance serves a greater good, protecting their health care workers, elderly, and immunodeficient peers. Over here we're experiencing an uptick in anxiety and depression. This isn't surprising in a culture that's all about the individual.
Depression is Hari's wheelhouse. He went through the ringer trying to fight it with prescription meds. In the process of conducting research for his book, a number of uncomfortable truths emerged. Namely, that the normal course for fighting depression—SSRIs and SNRIs—isn't working. They never really did, at least not in the long term. Reporting on extensive research on antidepressant medication, he writes,
"The numbers showed that 25 percent of the effects of antidepressants were due to natural recovery, 50 percent were due to the story you had been told about them, and only 25 percent to the actual chemicals."
In 2010, journalist Robert Whitaker came to the same conclusion: It's the environment, dummy. The problem is that the story of a chemical imbalance is easy to grasp. Complex social dynamics—income disparity, racism, verbal and physical abuse, gender discrimination, technology addiction—are cognitively taxing, though these are the real drivers of depression. "The medicine clearly doesn't fix a chemical imbalance in the brain," he writes. "Instead, it does precisely the opposite."
Hari writes that between 65-80 percent of people on antidepressants continue to be depressed. Clearly the drugs aren't working. What then to do? You have to address the root problem. Let's start with income disparity so that the citizens of the richest nation in the history of Earth can pay their rent. Perhaps, as Hari recently suggested, we should try universal basic income.
"The single biggest thing that will affect people's anxiety is not knowing if you're going to be thrown out of your home next month or how you're going to feed your children. And I think there's an element of cruel optimism in telling a country of people living paycheck to paycheck that they should be responding to the anxiety they're experiencing this moment primarily by meditating and switching off the news. That's not going to solve the problem. The single most important thing that has to be done to deal with people's depression and anxiety is to deal with the financial insecurity they're facing."
Bottles of antidepressant pills named (L-R) Wellbutrin, Paxil, Fluoxetine and Lexapro are shown March 23, 2004 photographed in Miami, Florida. The Food and Drug Administration asked makers of popular anti-depressants to add or strengthen suicide-related warnings on their labels as well as the possibility of worsening depression especially at the beginning of treatment or when the doses are increased or decreased.
Photo Illustration by Joe Raedle/Getty Images
Rather socialist of him, but really, the "we can't afford this" argument aimed at everything our administration can't monetize has always been wrong. It's getting dangerous out here, and it's not clearing up.
Hari isn't denying that there can be biological and genetic causes of depression. As he argues in his book, we completely overlook the social causes. Decade after decade, the American social structure has been fragmenting more and more. Our close relationships are shrinking. A million online friends will never replace the one person you can call at midnight to work through troublesome thoughts with.
Depression isn't a brain malfunction. That might be a result, but it's rarely the cause. Rather, Hari writes, it's "an understandable response to adversity." Right now, we're collectively trying to manage the most widespread adversity in generations. Pretending that you can slay that dragon yourself will only get you burned.
The first level is individual: strengthen your social connections. This might prove difficult at this particular moment, but framing this challenge as a societal issue is going to serve you better in the long run than taking it personally. Of course, none of this is easy. We've been raised to believe that each one of us can be our own brand—a rather lonely occupation. Humans are social animals. We need to honor that.
The second level requires participation in our democracy, which means voting for representatives that champion concepts like health care for all and UBI. This nonsensical argument that we can't pay for it while a tiny percentage of the wealthiest citizens pay little to no taxes is ludicrous. In Lost Connections, Hari reported from Berlin's low-income neighborhood of Kotti, where rent hikes were driving lifelong residents out. Conservative Turkish immigrants, German hipsters, and the owner of a gay club, usually wary of one another, came together to fight back. Not only did they win (not every victory, but some important ones), they were bonded by their shared sense of community. Many became friends.
Hari notes that El Salvador, which happens to be among the world's poorest nations, has canceled every citizen's rent and utility bills for the next three months. "If El Salvador can do it," he says, "America can do it." It will require, as he writes, rethinking what medicine actually is.
"An antidepressant...isn't just a pill. It's anything that lifts your despair. The evidence that chemical antidepressants don't work for most people shouldn't make us give up on the idea of an antidepressant. But it should make us look for better antidepressants—and they may not look anything like we've been trained to think of them by Big Pharma."
If you want to fight depression and anxiety, you need to change the story you tell yourself. As a society, we need to empower everyone so that they can climb the bottom rungs of Maslow's hierarchy of needs—ensure everyone's health and provide enough financial support for basic needs—and encourage group participation instead of espousing the bootstraps rhetoric. It's not rocket science and it's certainly not modern psychiatry. It's common sense.
- What Happens When You Give Basic Income to the Poor? Canada ›
- COVID-19 accelerates automation and the need for UBI - Big Think ›
- How the chemical imbalance theory of depression damages patients - Big Think ›
- If depression isn't caused by a chemical imbalance, how do we treat it? - Big Think ›
The COVID-19 pandemic is making health disparities in the United States crystal clear. It is a clarion call for health care systems to double their efforts in vulnerable communities.
- The COVID-19 pandemic has exacerbated America's health disparities, widening the divide between the haves and have nots.
- Studies show disparities in wealth, race, and online access have disproportionately harmed underserved U.S. communities during the pandemic.
- To begin curing this social aliment, health systems like Northwell Health are establishing relationships of trust in these communities so that the post-COVID world looks different than the pre-COVID one.
COVID-19 deepens U.S. health disparities<p>Communities on the pernicious side of America's health disparities have their unique histories, environments, and social structures. They are spread across the United States, but they all have one thing in common.</p><p>"There is one common divide in American communities, and that is poverty," said <a href="https://www.northwell.edu/about/leadership/debbie-salas-lopez" target="_blank">Debbie Salas-Lopez, MD, MPH</a>, senior vice president of community and population health at Northwell Health. "That is the undercurrent that manifests poor health, poor health outcomes, or poor health prognoses for future wellbeing."</p><p>Social determinants have far-reaching effects on health, and poor communities have unfavorable social determinants. To pick one of many examples, <a href="https://www.npr.org/2020/09/27/913612554/a-crisis-within-a-crisis-food-insecurity-and-covid-19" target="_blank" rel="noopener noreferrer">food insecurity</a> reduces access to quality food, leading to poor health and communal endemics of chronic medical conditions. The U.S. Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and Type 2 diabetes, as increasing the risk of developing a severe case of coronavirus.</p><p>The pandemic didn't create poverty or food insecurity, but it exacerbated both, and the results have been catastrophic. A study published this summer in the <em><a href="https://link.springer.com/article/10.1007/s11606-020-05971-3" target="_blank">Journal of General Internal Medicine</a></em> suggested that "social factors such as income inequality may explain why some parts of the USA are hit harder by the COVID-19 pandemic than others."</p><p>That's not to say better-off families in the U.S. weren't harmed. A <a href="https://voxeu.org/article/poverty-inequality-and-covid-19-us" target="_blank" rel="noopener noreferrer">paper from the Centre for Economic Policy Research</a> noted that families in counties with a higher median income experienced adjustment costs associated with the pandemic—for example, lowering income-earning interactions to align with social distancing policies. However, the paper found that the costs of social distancing were much greater for poorer families, who cannot easily alter their living circumstances, which often include more individuals living in one home and a reliance on mass transit to reach work and grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and health care, where maintaining physical distance can be all but impossible.</p><p>The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. "Our interpretation is that poorer people are less able to protect themselves, which leads them to different choices—they face a steeper trade-off between their health and their economic welfare in the context of the threats posed by COVID-19," the authors wrote.</p><p>"There are so many pandemics that this pandemic has exacerbated," Dr. Salas-Lopez noted.</p><p>One example is the health-wealth gap. The mental stressors of maintaining a low socioeconomic status, especially in the face of extreme affluence, can have a physically degrading impact on health. <a href="https://www.scientificamerican.com/index.cfm/_api/render/file/?method=inline&fileID=123ECD96-EF81-46F6-983D2AE9A45FA354" target="_blank" rel="noopener noreferrer">Writing on this gap</a>, Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and impair the prefrontal cortex and other brain functions through anxiety, depression, and cognitive load. </p><p>"Thus, from the macro level of entire body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear," Sapolsky writes. "It is outrageous that if children are born into the wrong family, they will be predisposed toward poor health by the time they start to learn the alphabet."</p>Research on the economic and mental health fallout of COVID-19 is showing two things: That unemployment is hitting <a href="https://www.pewsocialtrends.org/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/" target="_blank" rel="noopener noreferrer">low-income and young Americans</a> most during the pandemic, potentially widening the health-wealth gap further; and that the pandemic not only exacerbates mental health stressors, but is doing so at clinically relevant levels. As <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/" target="_blank" rel="noopener noreferrer">the authors of one review</a> wrote, the pandemic's effects on mental health is itself an international public health priority.
Working to close the health gap<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDc5MDk1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTYyMzQzMn0.KSFpXH7yHYrfVPtfgcxZqAHHYzCnC2bFxwSrJqBbH4I/img.jpg?width=980" id="b40e2" class="rm-shortcode" data-rm-shortcode-id="1b9035370ab7b02a0dc00758e494412b" data-rm-shortcode-name="rebelmouse-image" />
Northwell Health coronavirus testing center at Greater Springfield Community Church.
Credit: Northwell Health<p>Novel coronavirus may spread and infect indiscriminately, but pre-existing conditions, environmental stressors, and a lack of access to care and resources increase the risk of infection. These social determinants make the pandemic more dangerous, and erode communities' and families' abilities to heal from health crises that pre-date the pandemic.</p><p>How do we eliminate these divides? Dr. Salas-Lopez says the first step is recognition. "We have to open our eyes to see the suffering around us," she said. "Northwell has not shied away from that."</p><p>"We are steadfast in improving health outcomes for our vulnerable and underrepresented communities that have suffered because of the prevalence of chronic disease, a problem that led to the disproportionately higher death rate among African-Americans and Latinos during the COVID-19 pandemic," said Michael Dowling, Northwell's president and CEO. "We are committed to using every tool at our disposal—as a provider of health care, employer, purchaser and investor—to combat disparities and ensure the <a href="https://www.northwell.edu/education-and-resources/community-engagement/center-for-equity-of-care" target="_blank" rel="noopener noreferrer">equity of care</a> that everyone deserves." </p><p>With the need recognized, Dr. Salas-Lopez calls for health care systems to travel upstream and be proactive in those hard-hit communities. This requires health care systems to play a strong role, but not a unilateral one. They must build <a href="https://www.northwell.edu/news/insights/faith-based-leaders-are-the-key-to-improving-community-health" target="_blank" rel="noopener noreferrer">partnerships with leaders in those communities</a> and utilize those to ensure relationships last beyond the current crisis. </p><p>"We must meet with community leaders and talk to them to get their perspective on what they believe the community needs are and should be for the future. Together, we can co-create a plan to measurably improve [community] health and also to be ready for whatever comes next," she said.</p><p>Northwell has built relationships with local faith-based and community organizations in underserved communities of color. Those partnerships enabled Northwell to test more than 65,000 people across the metro New York region. The health system also offered education on coronavirus and precautions to curb its spread.</p><p>These initiatives began the process of building trust—trust that Northwell has counted on to return to these communities to administer flu vaccines to prepare for what experts fear may be a difficult flu season.</p><p>While Northwell has begun building bridges across the divides of the New York area, much will still need to be done to cure U.S. health care overall. There is hope that the COVID pandemic will awaken us to the deep disparities in the US.</p><p>"COVID has changed our world. We have to seize this opportunity, this pandemic, this crisis to do better," Dr. Salas-Lopez said. "Provide better care. Provide better health. Be better partners. Be better community citizens. And treat each other with respect and dignity.</p><p>"We need to find ways to unify this country because we're all human beings. We're all created equal, and we believe that health is one of those important rights."</p>
Astronomers spot an object heading into Earth orbit.
Minimoons<p>Scientists have confirmed just two prior minimoons. One was <a href="https://en.wikipedia.org/wiki/2006_RH120" target="_blank">2006 RH120</a>, which orbited us from September 2006 to June 2007. The other was <a href="https://en.wikipedia.org/wiki/2020_CD3" target="_blank">2020 CD3</a>, which got stuck in the 2015–2016 timeframe, and is believed to gotten away in May 2020.</p><p>2020 SO, the new kid on the block, is expected to arrive in October 2020 and pop out of orbit in May 2021.</p><div id="37962" class="rm-shortcode" data-rm-shortcode-id="f4c0fc8a2cba6536ea4cd960ebed3e6e"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1307729521869611008" data-partner="rebelmouse"><div style="margin:1em 0">Asteroid 2020 SO may get captured by Earth from Oct 2020 - May 2021. Current nominal trajectory shows shows capture… https://t.co/F5utxRvN6Z</div> — Tony Dunn (@Tony Dunn)<a href="https://twitter.com/tony873004/statuses/1307729521869611008">1600621989.0</a></blockquote></div>
Identifying 2020 SO<p>The first clue 2020 SO isn't your ordinary asteroid is its exceptionally low velocity. It's traveling much more slowly that a typical asteroid — their <a href="https://www.lpi.usra.edu/exploration/training/illustrations/craterMechanics/" target="_blank">average rate of travel</a> <a href="https://www.lpi.usra.edu/exploration/training/illustrations/craterMechanics/" target="_blank" rel="noopener noreferrer"></a>is 18 kilometers (58,000 feet) per second. Even <a href="https://en.wikipedia.org/wiki/Moon_rock" target="_blank">moon rocks</a> sent careening into Earth orbit by impacts on the lunar surface outpace pokey 2020 SO.</p><p>For another thing, 2020 SO has an orbital path very similar to Earth's, lasting about one Earth year. It's also just slightly less circular than our own orbit, from which it's barely tilted off-axis.</p><p>So, what is it? <a href="https://cneos.jpl.nasa.gov/ca/" target="_blank">NASA estimates</a> that the object has dimensions very reminiscent of a discarded Centaur rocket stage from the <a href="https://en.wikipedia.org/wiki/Surveyor_2" target="_blank" rel="noopener noreferrer">Surveyor 2 mission</a> that landed an unmanned craft on the moon. Back in the day, rocket stages were jettisoned as craft were aimed toward their desired position. This stuff, if released high enough, remains in space. It appears that this Centaur rocket, launched in September 1966, is now making its way back homeward, at least for a little bit.</p><p>When 2020 SO arrives at its closest point in December, the rocket is expected to be about 50,000 kilometers from Earth. Its next closest approach is much further: 220,000 kilometers, in February 2021.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQzMDk3NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyODg1MTQ1MX0.HGknDwqp0GmeuczKY_AS7vrPG7KMFUc_XO95tNoI2xo/img.jpg?width=980" id="e5cda" class="rm-shortcode" data-rm-shortcode-id="85eb1f790d8c3ee5b261f7ba13eaa5e1" data-rm-shortcode-name="rebelmouse-image" alt="Centaur rocket stage" />
Centaur rocket stage
What we may be able to learn<p>Earthly space programs being as young as they are, scientists would love to know what's happened to our rocket during a half century in space.</p><p>While 2020 SO won't get close enough to drop into our atmosphere, its slow progress has scientists hopeful that they'll still get some kind of a decent look at it.</p><p>Spectroscopy may be able to reveal what the rocket's surface is like now — has any of its paint survived, for example? Of course, being out in space, it's likely to have been hit by lots of dust and micrometeorites, so the current state of its surfaces is also of interest. Experts are curious to know how reflective the rocket is at this point, valuable information that can help planners of future long-term missions anticipate how well a craft out in space for extended periods will remain able to reflect sunlight.</p>
Shannon Lee shares lessons from her father in her new book, "Be Water, My Friend: The Teachings of Bruce Lee."
- Bruce Lee would have turned 80 years old on November 27, 2020. The legendary actor and martial artist's daughter, Shannon Lee, shares some of his wisdom and his philosophy on self help in a new book titled "Be Water, My Friend: The Teachings of Bruce Lee."
- In this video, Shannon shares a story of the fight that led to her father beginning a deeper philosophical journey, and how that informed his unique expression of martial arts called Jeet Kune Do.
- One lesson passed down from Bruce Lee was his use and placement of physical symbols as a way to help "cement for yourself this new way of being, or this new lesson you've learned." By working on ourselves (with the right tools), we can develop the skills necessary to rise and conquer new challenges.
How to deal with "epistemic exhaustion."