A Cure for Poverty?
May 9, 2001 4:20 PM   Subscribe

A Cure for Poverty? (NYT, free registration required. It's worth it this time, really). "The depressed poor perceive themselves to be supremely helpless -- so helpless that they neither seek nor embrace support. This means that most people who are poor and depressed stay poor and depressed. Poverty is depressing, and depression, leading as it does to dysfunction and isolation, is impoverishing. " via FMH
posted by frykitty (29 comments total)
I admit it, I'm lazy and I usually ignore the NYT posts because I don't wanna sign in. But this time I did sign in, and I got an eyeful.

I've had way too much first-hand experience with depression, and I have no doubt that treatment can changes one's entire life. If the conclusions drawn by this article are true, and if it is acted upon, it could indeed mean a major change for our entire society.

Pretty damned exciting, if'n ya ask me.
posted by frykitty at 4:24 PM on May 9, 2001

no-reg backdoor.
posted by snowmelter at 4:27 PM on May 9, 2001

does this say "gleemonex for vagrants"?
posted by jcterminal at 4:38 PM on May 9, 2001

I was on Paxil (an SSRI) for a few months, ending just over a year ago. While I wasn't nearly as depressed as it sounds like the people discussed in this article are, nor in as dire straits, I do credit this treatment with helping me turn my life around in similar (if rather smaller) ways. There is no doubt in my mind that the vicious cycle revealed in the article is true: poverty is depressing; depression leads to poverty.

I've put that guy's book on my wish list.
posted by kindall at 4:46 PM on May 9, 2001

Two major problems with this:

1) It assumes that depression is the root cause of all poverty, or at least that all people living in poverty are clinically depressed. Neither of these things are even slightly true.

2) It is often not nearly as easy to cure or treat depression as we are told in all the PSAs. Some people have to go to their doctors for many many years, trying dozens of different combinations of antidepressants (each of which has to be taken for four to six weeks to test its effectiveness), before they find what works for them. Random airdrops of Prozac in the projects would not help more than a few lucky ones.

This is an interesting concept, and it would undoubtedly help some people get the emotional stamina to work their way out of poverty. But not many.
posted by aaron at 4:50 PM on May 9, 2001

It assumes that depression is the root cause of all poverty, or at least that all people living in poverty are clinically depressed. Neither of these things are even slightly true.

Quote from the article: "According to one recent study, about 42 percent of heads of households receiving Aid to Families With Dependent Children meet the criteria for clinical depression." I would say that if you could wave a magic wand and make nearly half of poor parents non-depressed again, it would make a huge difference. But as you say, it's not always easy. While I did well pretty quickly on a small dose of Paxil, I have a friend who is currently on two antidepressants (a horse-dose of Paxil and I think Wellbutrin) after trying dozens of other combinations and being in therapy for years.

But I think it's a worthwhile avenue to pursue. If you can help even some of these people, you may be able to keep their children from getting sucked into a self-defeating mindset and perpetuating the culture of poverty by default.
posted by kindall at 5:01 PM on May 9, 2001

There's also the question of whether those 42% are depressed because they're poor, or poor because they're depressed. If it's the latter, they might be helped. If it's the former, pills and therapy aren't going to help much.

In any case, I think mental health care should be 100% equal to physical health care, so any state or federal health programs these people are part of ought to be on the lookout for this sort of thing anyway. They usually aren't, though.
posted by aaron at 5:11 PM on May 9, 2001

The depression rate among the poor is the highest of any social grouping in the United States

Gee, I wonder why.
posted by lagado at 5:16 PM on May 9, 2001

At least people might enjoy their poverty more.
posted by rodii at 5:17 PM on May 9, 2001

I hear on the street that Paxil goes down rather well with a cocktail of heroin and crack cocaine.
posted by lagado at 5:20 PM on May 9, 2001

Ahh, yes, the poor are mearly mentally ill. There's nothing inherent in our society that causes and perpetuates poverty.
I suppose George W. Bush is wealthy because of, say, his cheery disposition?
What a load of crap. Being poor is depressing, but depression doesn't cause poverty.
posted by Doug at 5:40 PM on May 9, 2001

I see what you're saying doug, but there's still something to this in a very commonsense way - I know lots of people who's lives, financial and otherwise, have been ruined by depression, so depression certainly *can* cause poverty. And as pointed out above, being poor sure as hell doesn't discourage being depressed. I'd sure as hell be a lot more depressed if I was poor on top of the regular shit I have to deal with. So there is a certain argument that it can become a spiral.

that being said however, I do see a lot these days attempting to marginalize the poor in the manner you're implying. Shove 'em into something labellable, and we don't have to worry about them anymore...
posted by DiplomaticImmunity at 5:52 PM on May 9, 2001

Well I'm totally old-fashioned here, but lots of smart people think that the cure for poverty is decent jobs and decent wages, not pills. But they're probably wrong, and soon we'll have Viagra for poverty and everybody will be happy and rich, just like that. I hope so
posted by matteo at 5:55 PM on May 9, 2001

Take your SOMA and repeat after me

I love being a GAMMA
posted by Dillenger69 at 5:58 PM on May 9, 2001

I have clinical depression myself and I think there is a lot to be said for that article. Before Zoloft I could not manage to handle a job -either I would consistently screw up or I couldn't handle the stress-and this with an IQ as high as the average doctor....mind you this had gone on for years and years. I thought I was a defective human being.

Now I LOVE my job-have held it over a year, and can function!
I know there is such a thing as laziness and apathy......but I was surprised to discover that my problem was simply misbehaving brain chemistry......and for the first time in my whole life I have been able to know what it is like to LIVE.
posted by bunnyfire at 6:33 PM on May 9, 2001

Poverty is a frame of mind. Most anyone can get a job (or two) and put in the hours to get above the poverty line. Then, with time, they can gain experience, or learn some skill that is in demand and get more money. Yeah, it's hard as hell, but as millions of immigrants have already proven, it can be done.

Hard work is never easy but that's exactly what is needed to get out of poverty. I can see how this may be demoralizing on an individual, and in this respect, the article makes a valid point: depression should be addressed.
posted by Witold at 6:35 PM on May 9, 2001


Hey, I think its working!

My girlfriend is watching the Country music awards right now. I am SSSOOO depressed right now. Good thing I have Unreal Tournament to turn to in times of need.
posted by a3matrix at 7:13 PM on May 9, 2001

well, THAT was special......:P
posted by bunnyfire at 7:29 PM on May 9, 2001

Being poor is depressing, but depression doesn't cause poverty.

This is just a lie. Also being diagnosed with clinical depression, I know exactly what its like not to want to finish school, get up, look for a job, and be dysfunctional in almost every way. Trust me, a few years of this and you'll find yourself poor and suicidal.

The Soma comments are poop-joke level comedy. If meds were such an instant high they'd replace illegal controlled substances in a second. Meds help but they're no cure all.

I'm more interested in seeing if this treats the disenfrachisement the poor feel not just their pocket books.
posted by skallas at 8:51 PM on May 9, 2001

I see the blame-gamers are out in force. "You're a rotten human being! You don't want to work! You must suffer, like in the Old Testament, because that is the way it has always been! You don't have a sickness, you have Lack of Character!" Shut the hell up, you all should be ashamed of yourselves.

While SSRIs are not a magic cure, they are just as effective overall as older types of anti-depressants, with fewer side-effects, and almost no risk of suicidal overdose. They are not "happy pills". My own experience with Prozac was not that it made me feel happy; it was that I was raised up from a dull sense of pain everywhere to be aware of things around me including my own feelings, happy and sad alike. I also found, after a few weeks, that I was thinking much more clearly and making better decisions about my life.

Will treating the presently-untreated depression among the poor eliminate poverty? No, of course not. People experience poverty for a wide variety of reasons, and as recent MeFi discussions have noted, a certain amount of unemployment and underemployment is actually better for the economy than mythical full employment. But people treated for depression are much more likely to make better use of the resources available to them, from job-training to job-finding, and may be less likely to make bad decisions, like having more children they can't afford. I think this is clearly an important insight that should be followed up with practical studies to find out if treatment does, indeed, help move people off of welfare and other programs more quickly and more permanently.
posted by dhartung at 9:17 PM on May 9, 2001

C'mon folks.

We need another 20 posts arguing chicken vs egg theories.
posted by dogmatic at 9:18 PM on May 9, 2001

Although the article (and my posting of it on Follow Me Here) was titled "A Cure for Poverty", I think it's a misreading of it to portray it as suggesting that depression causes poverty. The author clearly took the position that poverty predisposes to depression, although I agree we shouldn't get into a chicken-and-egg thing. And it's a mistake to find the article's observations trivial, IMHO. We're talking about treatable, clinical depression here, not just being bummed out about your circumstances. The discussion of how difficult, and important, it is to even *recognize* depression in the first place in the setting of poverty is the heart of the matter and the basis for the profound policy implications.

The second fascinating point to me, as a clinical psychiatrist, is the portrayal of the degree of coercive treatment some are interested in applying to the problem. Justifications range from simple compassion to the societal burden of not treating a remediable condition, but the degree of paternalism suggested is alarming, and usually reserved for patients found legally incompetent and an overt danger to themselves and others.
posted by emg at 9:50 PM on May 9, 2001

By the way, someone suggested channel.nytimes.com as the no-reg backdoor. On FmH, I've been assiduously changing all the "www.nytimes.com" URLs to "partners.nytimes.com", thinking that would get everybody in without registration. But since I'm registered and have an active NYTimes cookie on my machine, I can't test if "partners" works without registration. Anyone know? You can respond offline if you want to. Thanks.
posted by emg at 9:57 PM on May 9, 2001

Re: chicken vs. egg theories

It doesn't matter what gets you into the cycle -- whether you're depressed because you have no prospects, or whether you can't see your prospects because you're depressed -- what matters is that once you're in the cycle, it is self-reinforcing and extremely destructive. Just breaking the cycle can improve your outlook immeasurably and allow you to explore opportunities you might have previously overlooked.

Obviously, not everyone who's poor is in some evil poverty depression cycle. But having had some personal experience with depression, I have no doubt many are in such a cycle, and that therapy (with or without drugs) might help enough of them to be worth trying on a large scale. Certainly I'd like to see a well-organized pilot program in a major city so we can all stop debating whether it'd help or not and examine the data to see whether it actually does.

I agree that there is a fine, fine line to be walked regarding coercion. But I think if it can be shown to work, you can go a long way without even starting down that path. You just have to let people know there is hope, and keep letting them know it, and let their friends and family know it, and eventually some will have a lucid day and decide to try it. If you can help just the ones who will try therapy voluntarily, I think you'll make a worthwhile impact on tens of thousands of lives.
posted by kindall at 10:20 PM on May 9, 2001

Skallas, I didn't mean to imply that depression can't cause poverty in a person. Any number of illness, mental or physical, can cause a person to be poor. Depression is not, however, the cause of poverty in our nation.
This, to me, is just another way of saying that the poor are lazy. And I don't buy that.
posted by Doug at 11:11 PM on May 9, 2001

I'm concerned that the tone set by the headline is another attempt to transform a social problem in to a medical one. Previous attempts at blaming the victim have included employing Freudian psychoanalysis to find out why people are poor.

It's about economics really.
posted by lagado at 1:11 AM on May 10, 2001

Excuse me for butting in here.....economics may play a part, but as someone who has lived among poor people and at times been poor right along with them, that is not the whole story.......when you are poor and feeling hopeless, it is incredibly easy to go for the instant gratification instead of making decisions that lead to long term stability......the poor are not the only ones by any means that indulge their vices-the difference is that things such as children out of wedlock, drug and alcohol abuse, poor work habits, etc. make it that much harder to climb out of the pit.....and how many of these activities can be indulged in as a distraction from depression?
posted by bunnyfire at 3:34 AM on May 10, 2001

I think it's beside the point whether or not depression causes poverty. Depression sucks, and if people are depressed they deserve to get the treatment they need, no matter who they are.

If 75% of the poor have diabetes, it doesn't matter whether the diabetes causes poverty or not, they need treatment for their diabetes! The real importance of this article is that there are a lot of poor people who are suffering from something we know how to treat, and they should get help, whether it "cures" their poverty or not.
posted by straight at 7:37 AM on May 10, 2001

Treat the problem at hand. If it's depression, provide access to medication (if necessary) and counselling. If it's unemployment, make it easier to get into work. Prescribing meds for poverty is like suggesting that people who aren't getting laid become prostitutes.
posted by holgate at 7:51 AM on May 10, 2001

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