Depression: Chronic Stress as a Way of Life

A few decades ago, responding to the growing market for improved anti-depressant drugs, several drug companies developed “selective-serotonin re-uptake inhibitors” (Prozac, Zoloft, etc.).  While under its exclusive patent (20 years), a new drug is expensively-priced, thus generating huge profits for its maker.  (This accounts for the constant introduction of new drugs which, despite claims to the contrary, may not be any more effective than their now-generic precursors.)  Nonetheless, the SSRIs, with fewer side-effects, seemed a distinct advance.  The drugs focused on the neurotransmitter serotonin: by inhibiting its re-absorption, the drugs artificially prolonged its active circulation in the brain, thus modulating mood in a favorable direction.

If depression, periodically a response to loss and bereavement, was actually experienced in their daily lives by tens-of-millions of people, then the notion of a “serotonin deficiency” seemed plausible.  Ironically, serotonin production is stimulated by sunlight exposure and vigorous exercise–of which the typical employed person, confined in an office, is deprived.

But this “deficiency” hypothesis–which still has its skeptics–never answered the simple question: why?  Why, by the end of the highly industrialized 20th century, did a deficiency of serotonin apparently exist for countless millions?  Surprisingly, few researchers seemed interested in answering this question.  Depression had become so endemic, almost the norm of everyday living, that the traditional ideal of living a happy life was rapidly becoming a quaint anachronism.

Sociologists focused on the very real transformations in the quality of daily living–notably the ever-changing, increasingly demanding conditions imposed by the now-reigning mega-corporations of a plutocratic order–as the primary cause of chronic stress.  The physiological reactions to stress were first studied by biologist Hans Selye (cf.The Stress of Life, 1956).  Adrenalin (epinephrine) surges in response to sudden fight-or-flight dangers.  But the most activating stress hormone is cortisol (a natural steroid not to be confused with synthetic cortisone).  In conditions of prolonged stress, overproduction of cortisol may continue indefinitely.

Perusing the abstracts of innumerable research reports (cf., I noticed several studies suggesting “an inversely proportional” relationship between cortisol and serotonin levels.  That is, elevated cortisol, when sustained over time, produces a compensatory reduction in serotonin.  One team of medical researchers summed up their findings: “elevated cortisol induced by stress increases serotonin uptake…which is overtly expressed in symptoms of depression.” ((G. E. Tafet et al.  Enhancement of serotonin uptake by cortisol: a possible link between stress and depression.  Cogn. Affect Behav. Neuroses. 2001 (March): 96-114; also by the same authors: Also: same authors.  Correlation between cortisol level and serotonin uptake in patients with chronic stress and depression. Cogn. Affect Behav. Neuroses. 2001 (December): 388-393.))   (Remember that SSRIs work by inhibiting such (re)uptake, thereby keeping optimal serotonin levels circulating in the brain for an extended period.)

By now, of course, the stress-inducing institutional structures which dictate our daily lives are simply taken for granted as the “environment” in which we live, and to which we must somehow adapt. The subjective feelings of freedom, dignity and “peace-of-mind”–another archaic phrase?–have been crushed by oligopoly capitalism, with its endless mergers, outsourcing, automation, collusive price-fixing (inflation), and even invasion of the once-hallowed private domain of life.

Family farms were replaced by giant agro-corporations.  Working in small neighborhood businesses, where camaraderie, informality, and a relaxed pace of work existed, was replaced by anonymous, sped-up work in Big Box stores and warehouses.  On the white-collar level, to become employed by such giant, impersonal corporations required humble compliance to all their arbitrary demands: suitable college majors and grades, up-to-date technical expertise, indignities such as drug tests and mandatory indoctrination sessions–as well as the lengthy, high-speed commute in congested traffic to the worksite.  And with the new technologies, such companies could relentlessly monitor, speed-up, and constantly evaluate each employee’s “performance.”  (“This call may be monitored and recorded for quality assurance.”)

To survive, a person must endure daily stressful pressures which insidiously undermine his dignity and sense of autonomous control over his own life (e.g., arbitrary work overloads, sped-up jobs requiring unfailing accuracy, chronic uncertainty about job security due to mergers, automation, and outsourcing, etc.).  With the government allowing big banks (i.e., real estate) to limit supply and thereby intensify demand, millions of couples are forced to take out mortgages on wildly overpriced houses, “extravagantly large for their inhabitants…[who] seem to be only vermin which infest them”.  ((Henry David Thoreau, Walden, 1954.))

Privacy, once the cherished birthright of the homeowner, is another value insidiously being undermined, if not destroyed, by constant, stressful intrusions (telemarketing, smartphone surveillance, even gadgets that observe and record one’s daily habits, etc.). Children, an easy target for the data-merchants, are manipulable for marketing purposes by algorithmic-devised  “entertainment,” Instagram-induced insecurities, ad nauseam.   For the adults in the room, daily watching of the “news”–an exercise in self-torture–is guaranteed to maintain those high cortisol levels.

At the same time, deluded, stressed-out parents incredibly still conform to the “success” mystique–an incredibly banal, contemptible goal imposed on their offspring–basically, to maximize their eventual “market-value.”  Children, deprived of the carefree fun and improvisational creativity which is their birthright, are saddled with excessive schoolwork, homework, and extracurricular activities–all to attain the “privilege” of being “admitted” into sacrosanct, ivy-enshrouded halls of “learning” (sic).  Meanwhile, if a child seems unwilling or unable to cope with such demands, he may be placed on Ritalin or Zoloft–whatever will induce the predictably machine-like behavior required to “get into a top-ranked college.”  (In startling contrast, fifty years ago the humanistic educator John Holt wrote Escape From Childhood: The Needs and Rights of Children, among other things a liberated proposal for a non-coercive, student-centered educational experience, ideally at home.)

And what about role-conflict as a daily source of stress?  Stay late at the office–missing time with the family–or risk the boss’s displeasure.  Or stay late on purpose–to avoid “the problems at home.”  Like almost all human interactions these days, marriage–however ill-defined and possibly anachronistic–is a contract.  Mutual obligations are explicit or presumed: “satisfactory” sexual relations–with harsh sanctions against episodes of “infidelity” (i.e., violating the exclusive right to the partner’s sexual interaction).  But foremost, of course, is the obligation to earn a sufficient income, generally requiring both partners to have transport, wardrobe, marketable degrees, references, and consistently outstanding “performance reviews.”  (Ultimately, of course, to afford to live in a “good neighborhood,” with a few consoling luxuries such as a Jacuzzi and big-screen TV.)

This brief sketch of the stress-ridden, overly-complicated, work-driven cage mistakenly called one’s “life” merely outlines today’s socio-economic structure in which the individual constantly struggles to adapt and “succeed” (with the necessary palliative of mood-regulating drugs).  Simply to maintain his status quo, the individual undergoes countless daily ordeals–from the alarm-clock and traffic-choked commute, to the relentless demands and problems–to be wrestled with at work and at home.

A true sense of well-being (eudaimonia) requires a solid pride in one’s autonomy and freedom, which allows for self-directed, personal growth–most critically, in my opinion, for sympathetic identification and the generosity of spirit which strives to help others struggling daily, with unappreciated courage, against seemingly insuperable difficulties.  And equally crucial is the right to uninterrupted, quiet solitude–now only possible by discarding the gadgets which chain us to the arbitrary demands and impositions of others.  Almost 60 years ago, Herbert Marcuse wrote that “the idea of ‘inner freedom’…designates the private space in which man may become and remain ‘himself”’. ((Herbert Marcuse.  One-Dimensional Man, Boston: The Beacon Press.))

Intellectual historian and psychoanalytic anthropologist, William Manson (Ph.D., Columbia) has published numerous scholarly books and papers, and is a longtime contributor to Dissident Voice. Read other articles by William.