Of all the topics discussed during last Wednesday's presidential debate, the recession and the critical issue of job creation rightfully took center stage. Work is our livelihood, our identity, and the structure of our days; it is how we describe ourselves at parties when someone asks, "And what do you do?"
Of course work generates income, but it is, in other ways, immaterial.
If work lends a sense of self, meaning and purpose to our lives, what happens to our mental state when we are unemployed? In the context of a global recession, I can't help but wonder.
So, as any responsible public health student would do, I looked at the data.
It appears that this year's World Mental Health Day topic, depression, is a timely one. Depression is related to the economy and to unemployment in a number of ways, and the relationship manifests itself differently throughout the world.
But, in all, the economic climate poses a serious threat to mental health. Here are some examples.
- A telephone survey carried out in Greece revealed a 36 percent increase in the reported number of attempted suicides between 2009 and 2011, a period of serious economic turmoil.1
- Back in the U.S., analyses of data from the Epidemiologic Catchment Area panel revealed that, of employed respondents not diagnosed with major depression at first interview, those who became unemployed had over twice the risk of increased depressive symptoms and of becoming clinically depressed as those who continued their employment.2
- On the flip side, overwork also effects health, sometimes severely. Take Japan, for example, a wealthy nation whose citizens work the longest hours of any industrialized country. Due to low base pay, many workers are forced to put in more overtime, holiday hours and night shifts, with occasional "voluntary" work for suggestion programs, employee-generated ideas to increase productivity.
- Many Japanese also have homework (furoshiki zangyou, or "wrapped work") to do after they leave the office. In 2011, Japanese workers spent 26 percent of each day working, the highest of all 26 OECD countries.
These trends help explain the problem of Karoshi, the Japanese term for death from overwork. Although depression in Japan might be a taboo topic, Karoshi is all too well known. The first case was recorded in 1969, when a 29-year-old man died of a stroke thought to be the result of the stress and exhaustion of extended work time coupled with ill health.5
- Most Karoshi victims had been working more than 3,000 hours per year prior to their deaths. That comes to at least 58 hours per week, every week, each year. In 1994, the Japanese government's Economic Planning Agency in the Institute of Economics estimated that Karoshi causes 1,000 deaths per year in the 25 to 59 age group.6 But this number pales in comparison to the number of work-related suicides: In 2007, there were 2,207 work-related suicides in Japan, and the most common reason (672 suicides) was overwork, according to government figures.
Both overwork and underwork significantly affect depression and mental health in general.
I believe this is a structural problem that cannot be attributed to individual failings, and governments must play a larger role in regulating the job market to increase job growth. Stricter limits on work hours also are needed.
Depression and employment are strongly tied together; thus they must be considered simultaneously on a societal level, especially in the light of economic reform.
Thanks to Joanna Jungerman / PsychCentral / Psych Central
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