Good News About Depression and Suicide

In this post, Barry claims:

Even if well-being is trending up in the U.S., so too is clinical depression (including suicide).

I’m not sure that this is true in the case of depression, and I’m pretty sure it isn’t for suicide.

Estimates of the incidence of depression may be vastly overinflated due to a number of considerations laid out with great force by Jerome Wakefield and Allan Horwitz in this 2005 Public Interest article, and in their forthcoming book, The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. Reporting on a new study headed by Wakefield, the New York Times says:

About one in four people who appear to be depressed are in fact struggling with the normal mental fallout from a recent emotional blow, like a ruptured marriage, the loss of a job or the collapse of an investment, a new study suggests. To avoid unnecessary diagnoses and stigma, the standard definition of depression should be redrawn to specifically exclude such cases, the authors argue.

Moreover, there is a straightforward tension between the happiness data and data that appear to show a large increase in the incidence of depression: the percentage of people placing themselves in the lowest happiness category has either fallen or stayed stable (in the U.S., at least). If depression (or even normal, non-disordered sadness) is really rising rapidly, why isn’t the proportion of the population reporting low life satisfaction expanding?

Regarding suicide, the long-term trend appears rosy. The U.S. National Center for Health Statistics indicates [xls] that the number of suicides per 100,000 people was 13.2 in 1950 and 10.8 in 2003 in the United States. The suicide rate has never been worse than that since 1950. There are ups and downs through the 1960s and ’70s, but there’s a pretty steady downward trend from 1985 to 2000, in which year the suicide rate hit the lowest point in recent memory: 10.4 per 100,000 Americans. The rate increased to 10.9 by 2002, but was down a notch in 2003, the last year for which I have data. Unless there has been a big spike in the last few years, the worst we can say is that the suicide rate in 2003 was as bad as in any year since 1998 — which had a lower suicide rate than any of the previous 50 years. This is better than bad: it’s good!

Taken at face value, this result would seem to support the validity of the happiness measures, which show no increase in dissatisfaction, and undermine the validity of the depression measures, which you would expect to be positively rather than negatively correlated with suicide rates.

Good news!

Also from this issue

Lead Essay

  • The Pursuit of Happiness in Perspective by Darrin M. McMahon

    In this month’s lead essay, Darrin McMahon, Ben Weider Associate Professor of History at Florida State University and author of Happiness: A History, puts the contemporary obsession with happiness in historical and philosophical perspective. Tracing our current notion of happiness back to “a dramatic revolution in human expectations” in the seventeenth century, McMahon argues that we have come to see happiness as not only something that is possible in this life, but which ought to be the aim of life. Noting that the recent spate of worried meditations on happiness is a luxury of the already wealthy and secure, McMahon argues against the single-minded focus on happiness as both an individual and social goal. Casting a critical eye on the aspirations of the new “happiness research,” McMahon argues that there may be natural limits to happiness, agrees with John Stuart Mill that “The only chance is to treat, not happiness, but some end external to it, as the purpose of life,” and asks us to heed Aldous Huxley’s warning of a society in which everyone is happy “and yet the world is a nightmare.”

Response Essays

  • Why Societies Should Pursue Happiness by Barry Schwartz

    Swarthmore College psychologist Barry Schwartz, author of The Paradox of Choice: Why More Is Less, argues that Darrin McMahon’s cautionary tale is based on the confusion of happiness with pleasure. For Schwartz happiness “rightly understood” is “authentic happiness” centered on the development of virtue and excellence. We should not be afraid to apply such a conception of happiness to policy, for “figuring out what does and does not bring happiness, or utility, might vastly improve the ability of national policies to increase welfare.” Schwartz suggests we will find that not only does happiness not rise in lockstep with wealth, but that happiness in fact begins to decrease at a certain level of affluence. Free-market capitalism, Schwartz argues, tends to turns us into “infantilized pleasure-seekers” not oriented toward authentic happiness. “No one is going to get rich in a society full of seekers of human excellence,” Schwartz says.

  • The Data Tell a Different Story by Ruut Veenhoven

    Ruut Veenhoven, editor of the Journal of Happiness Studies and director of the World Database of Happiness, argues that happiness levels are not stagnant, as McMahon maintained in his lead essay. Citing the most recent data, Veenhoven observes that levels of average happiness have increased over the past 30 years in the United States and the European Union, while the increase in the expected number of “Happy Life Years” is even more dramatic. “This increase in overall quality of life is unprecedented in human history,” Veenhoven writes. McMahon’s concerns about an overemphasis on happiness are misguided, Veenhoven argues. Far from making us complacent, happiness improves health, creativity, and citizenship. Though Denmark is the happiest country on record, Veenhoven notes that “this does not seem to have damaged the Danes.”

  • The Quest for a Scientific Politics of Happiness by Will Wilkinson

    In his reply to McMahon, Cato Unbound managing editor Will Wilkinson lays out three “enormous problems” for the “quest for a scientific politics of happiness.” First, happiness is just one value among many. Second, no one knows for sure what happiness is. Third, Wilkinson sets up a dilemma. On the one hand, if a scientific politics of happiness is understood as the active management of social welfare by political elites, then it pseudoscience. On the other hand, if it is understood as a science of social coordination, then the specific aim of happiness becomes secondary to the requirements of effective coordination. This “institutionalist” conception of a scientific politics of happiness can overcome the problems of pluralism and definition, Wilkinson argues, but at the price of losing focus on the preeminent value of happiness.

The Conversation