Another thing I wrote for this lame psych class. The prompt this time: why is depression & its treatment so popular in American society?

For better or worse, America is a highly individualistic society. Self-reliance is generally considered to be a major virtue. Once an adult, an American is expected to provide for him or herself with minimal dependence on family or friends. In general, people who have not attained the expected level of independence are considered lazy or slothful. A failure to perform well in school or work is usually called a flaw of that person’s work ethic before anything else. In short, Americans tend to believe that most of a person’s successes and failures are up to that individual, and too much help will make them weaker and dependent. While these beliefs have probably helped maintain strong economic performance, they have encouraged behaviors and attitudes that leave Americans vulnerable to psychological instability.

Historically, it has been the case that one’s lot in society was determined by two things: gender and family. Men inherited the profession of their fathers. Women were allowed to perform a narrow set of tasks outside of child-rearing. Marriages were arranged, and property – if any at all – was inherited. Today, we have more freedom than at any other point in history. Freedom is a beautiful thing – but with freedom, comes choice. It’s not just choosing clothes or cars, but professions, spouses, homes, and educations. The social psychologist Sheena Iyengar has done some fascinating research on the problems of choice overload, and her studies show that we become poorer decision-makers in the face of bountiful options.

[Americans] think that choice, as seen through the American lens, best fulfills an innate and universal desire for choice in all humans. Unfortunately, these beliefs are based on assumptions that don’t always hold true in many countries, in many cultures.

In the past, these choices were all made for us, and these are the choices that determine our role in society. Our role is what gives us purpose, that reason to get out of bed in the morning. When we don’t know our role, we are at risk of drifting aimlessly. This is a concept known as anomie, or normlessness. As much as we might like to believe that we decide our own fates, the truth is that we often need to be told what to do, or at least given a hint or two. Part of how we figure out how to do that is through our social circles – friends and family. But the American way is to disperse wide and far across the country, away from those who might know and understand us best. Friends and family are rarely considered in decisions about where to live or look for a job.

Barring any major disabilities, living with one’s parents past the early 20’s is often considered to be a sign of weakness, and past the 30’s it is almost anathema. Yet, in many other countries, it is the norm for multiple generations of a family to live together or in very close proximity to one another. American culture simply does not value familial bonds as highly as other cultures. It is common for children to take jobs that move them far away from not just their parents, but also their siblings, making frequent visits difficult or impossible. This distance from siblings is extremely important; studies have shown that relationships are among the strongest drivers of long-term happiness, and relationships with siblings are among the most powerful we can have. One study, the Harvard Grant Study, followed 268 Harvard graduates from the 1930’s up to 2010, checking in every few years to see how they were doing.

‘The men’s relationships at age 47, he found, predicted late-life adjustment better than any other variable, except defenses. Good sibling relationships seem especially powerful: 93 percent of the men who were thriving at age 65 had been close to a brother or sister when younger. In an interview in the March 2008 newsletter to the Grant Study subjects, Vaillant was asked, ‘What have you learned from the Grant Study men?’ Vaillant’s response: ‘That the only thing that really matters in life are your relationships to other people.’

For many, therapy becomes the only immediate option to replace these relationships. Multiple therapists have told me that some of their patients really just need friends. This is not to suggest that most depression is just a result of not having good relationships. I do believe, however, that the structure of American society makes Americans vulnerable to depressive attitudes and behaviors. The behaviors of depression are strongly self-reinforcing; poor sleep patterns can encourage anti-social behavior, poor eating habits can exacerbate anxiety and fear. Without trustworthy people nearby to interfere in our lives, we become prone to doing whatever we feel like. For many people – myself included – the tendency is to feel like doing nothing. The cycle begins there.