The depressing effects of inequality

OECD research published last Thursday lays bare the surge in antidepressant consumption across the rich world over the past decade.  Figures illustrate that the use of antidepressants has more than doubled in the UK since 2000, while separate data from the US shows that over 10% of American adults use the medication.  
This rise in anti-depression consumption may be partly explained by both the greater intensity and duration of treatments since 2001 and changes, over the past decade, in people’s willingness to seek treatment during episodes of depression. 

However, in addition to increased medicalisation, the rise in consumption could also be attributable to economics.  The increase in use may be linked to not only recent economic changes, such as insecurity created by the economic crisis, but also to more long standing economic divides. 

The relationship between economic inequality and mental illness is well established in both internationalanalyses and single country studies.  The prevalence of depression is considerably higher in more unequal rich countries, and among US states, depression is strongly associated with state level income inequality – the more unequal the state the higher the rate of depression.   A finding that holds up after adjusting for income, age and education,

Although anti-depressant consumption does not necessarily directly equate to depression itself, we do know that our economic and social environment is crucial to our mental health and sense of well-being.  By placing people in a hierarchy, inequality exacerbates status competition, damages social integration and causes stress.    There is rigorous evidence to suggest that by undermining the bonds that provide us with self-respect and increasing our anxiety about our status inequality leads to poor mental health and lower life satisfaction across society.   

With austerity set to continue and inequality forecast to rise there is a real danger that both antidepressant consumption and depression itself could rise.  Perhaps it is time to look at the wider social and economic causes of depression and question why it is that in rich countries unhappiness, isolation and depression are so prevalent.

Maddy Power, Senior Research and Policy Advisor