How Everyone Became Depressed

The rise and fall of the nervous breakdown

Sad, Worthless, Hopeless?

These are terrible emotions. And more than one in twenty Americans feel this way

The National Health Interview Survey data for 2012 – the latest available – are just out and, boy, do they have depressing news for the out-of-sorts, the feeling-a-bit-downs, and the I-can’t –take-this-anymore’s. The National Center for Health Statistics of the federal government publishes this annual survey, which is widely ignored by the media (because copies of it are so hard to obtain). But it feels the nation’s pulse once a year. (DL Blackwell et al., Summary health statistics for U.S adults: National Health Interview Survey, 2012. National Center for Health Statistics, Vital Health Stat. 10 (260). 2014, tab 14, pp. 49-50)

Do you feel “sadness” all of the time or some of the time? 10.1 percent of the random sample (that mirrors the nation’s population) said yes. That’s one in ten people who are sad more or less frequently. In a subway car with a hundred people, ten of them will be sad.

But there’s more. Do you experience “hopelessness”? 6.1 percent said yes. How about “worthlessness”? 5.1 percent affirmed that they feel worthless.

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These are terrible emotions. Sadness is part of the human condition but lack of hope and lack of feeling worthwhile are not. And more than one in twenty Americans feel this way.

But these emotions are usually attached to clinical illnesses. If you feel hopeless it’s not because there’s no hope at all in your life. It’s because you feel there’s none. This feeling is typically a sign of melancholic depression.

Same with worthlessness. No one is worthless. Our lives are all worth something. But feeling that you’re worthless, again, is a sign of serious depression – melancholia.

Women are much sadder than men (7.8 percent vs 12.2 percent). This is because women bear worse than men the burden of loss, separation, and death – and the reason why, in many surveys, women have more “medically unexplained” symptoms than men do, because women tend to weave their sadness into their bodies and register their loss with back pain and headache.

Interestingly, there’s no big difference between men and women in “worthlessness”: Both genders clock in at about five-something percent. This is a happy result of the women’s movement and working: If you’ve got a regular job and feel “powerful,” you don’t feel worthless. And if you feel worthless despite all the evidence to the contrary, it means you’re seriously depressed.

Education? Huge differences. Of those with less than a high school diploma, 19.0 percent felt sad; with a bachelor’s degree or higher, only 5.2 percent felt sad. The difference is more than three times as great. Everybody has parents who die, friends with terrible illnesses, children who badly disappoint. Yet having that college degree permits people to cope. This point is never brought out in media discussions of whether it pays to go to college but, yeah, it gives you a certain psychological resilience.

Education also greatly reduces your feelings of hopelessness and worthlessness. The point is too obvious to bear statistical comment here.

Despite the fact that blacks often have more to be unhappy about than whites, they bear up equally well: around 1 in 20 in each race report hopelessness and worthlessness; 9.6 percent of whites sad some of the time or all of the time, 12.7 percent of blacks.

Where things really get dramatic is marital status, and the many followers of this blog who are single, divorced, widowed, or never married will be pained to learn that they are, in general, a lot less well off emotionally than those who are married. Since I myself am divorced and live alone, this finding is equally a surprise for me, but the numbers are what they are:

                                                 Sad          Hopeless    Worthless                                                               

Married                                       7.4                4.2             3.7

Widowed                                    20.8               14.2           8.8

Divorced or separated               16.3               10.0           8.7

Never married                            11.1               6.7             5.7

Living with a partner                   11.5               7.5            6.5

 

One has to be careful not to over-interpret these data as some of the smaller numbers are within each other’s margin of error.  But still:  Only 7.4 percent of the married are sad, 20.8 percent of the widowed.   The bereavement for many never ends.

Only 3.7 percent of the married feel worthless, 8.7 percent of the divorced or separated.  Wow!  In our society, failure at marriage really drags you down. 

6.7 percent of the never married hopeless, 4.2 percent of the married.  The difference is way bigger than the statistical margins of error.  I can see the grinning among my readers at this point, “Yeah, well they’ve got a lot to be hopeless about.”  But that’s not necessarily true.  Maybe they never found partners because they were chronically melancholic, too depressing to be around.  But melancholia, which is to say serious depression, is treatable.  It’s not one of life’s inscrutable fates.

So if there is a message from these data (aside how wonderful it is to be married . . . ), it is that a lot of the ambient misery out there is illness.  Not all.  Widowhood is not an illness.  But among the married, one in twenty hopeless, et cetera.:  This is illness.  It deserves to be treated. 

Edward Shorter, Ph.D., is the Jason A. Hannah Professor in the History of Medicine at the University of Toronto.

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