Treating depression with lifestyle changes has become a mantra of the mental health community. But do mindfulness exercises, baths and better diets really help or are we just deflecting from the harmful effects that the social conditions of late capitalism can have on the individual?
I have suffered from depression and anxiety since I was a child. In addition to taking psychiatric medication and seeing several therapists, I have, at the insistence of health professionals, Instagram infographics and random acquaintances alike, tried a number of lifestyle changes: exercise, diet changes, supplementation, mindfulness and baths. But my conditions remain.
And I’m not alone. Over 270 million people worldwide reportedly suffer from depression. We are all bombarded with the same information designed to help us to live ‘better.’ This information is often presented as hacks: seemingly simple tips designed to make us more efficient and productive. Once the reserve of the tech industry, they have trickled down into every corner of our lives, including mental health provision. Having interacted with mental health services for nearly two decades, I have noticed the shift towards the kind of apolitical self-help vernacular described above. Even a psychiatrist has recommended the mindfulness app Headspace to me and told me to enjoy the sunshine.
In March 2020, as the world plunged into lockdown, I made a number of lifestyle changes in a bid to rehaul my life. My mental health was flailing, I had numerous health issues, including insomnia and chronic pain. In spite of my scepticism, t was time for a change. I was also one of the lucky people with job security who was able to work from home, and I have no dependents, so I had more time to dedicate to this project of self-management. For six months I committed to a healthier diet and regular exercise. I stopped drinking caffeine, put my phone in another room after 9pm, took baths every night. A total overhaul. But the routine didn’t stick, nor did it affect my mood.
This is just a personal anecdote, but if we have all this information on how to live ‘optimally’ and people are still suffering, mental ill health can’t be explained as an individual failing. Prescribing ‘life hacks’ should only be one part of our approach to ill mental health, just as medication and talking therapy may also not be the singular answer either. A reliance on the biomedical model of mental health conditions and mental disorders, according to which mental illnesses stem from physiological abnormalities in the brain, dictates that treating these disorders is a question of boosting ‘happy chemicals’ in our brain. But this doesn’t take into account the external factors that contribute to ill mental health in the first place. Could it be, for example, that living alone during a pandemic and going long stretches without speaking to anyone in person was detrimental to my mental health?
When it comes to tackling depression and anxiety, at least at a macro level, a discussion of what might actually cause these conditions is conspicuously absent. It’s no wonder; thinking beyond the biomedical model would require us to reckon with the material conditions that contribute to ill mental health and the lack of support available to those who are struggling. It would require a complete overhaul of the way society is structured.
In a society that is increasingly fragmented, unequal and chaotic, it is unsurprising that so many of us are struggling internally. Poverty and income inequality, social inequities, and societal marginalisation all put a strain on the psyche that cannot be remedied through exercise, healthy eating and mindfulness alone. The existential threat posed by the climate crisis has also precipitated new anxieties and worsened existing mental illness, particularly among young people. And the management of the Covid-19 pandemic has laid bare structural inequalities and the gaps in community care that, if filled, might allow us to heal.
The argument that society is to blame for people’s mental illness is not new. In the 1955 book The Sane Society, the psychologist Erich Fromm elucidated the pathologies of the modern industrial capitalist society which, he argues, contributes to the sickness of individuals. He wrote:
“If he lives under conditions which are contrary to his nature and to the basic requirements for human growth and sanity, he cannot help reacting; he must either deteriorate and perish, or bring about conditions which are more in accordance with his needs” (p.19).
Over sixty years later, the conditions of society to which Fromm is referring – our unmet physical and psychological needs – are even starker.
When it comes to people’s mental health, these needs are often overlooked. We all need safe shelter, water and decent food. We accept these as essential to our basic functioning, and yet tend not to speak of homelessness, the housing crisis, stagnant wages or rising food bank use in the same breath as mental health. Beyond these basic needs, our need for intimacy, acceptance, belonging and meaning are also undermined by a society driven by profits, not care.
Yet the rituals of self-care espoused at every turn serve to reinforce more individualistic behaviour, telling us that the solution to our problems lies only in ourselves. Moreover, as Psychology Professor Svend Brinkmann writes in Stand Firm: Resisting the Self-Improvement Craze, the goal posts for optimised behaviour are widened in line with our ever-expanding economies and lives.
Many have highlighted the traumatic effects of society on those it marginalises, such as James Baldwin speaking about the trauma of discovering one’s sexual preference: “It’s a trauma because it’s such a traumatized society.”. Clinical psychologist Laura Brown has also highlighted “the constant presence and threat of trauma” for marginalised people, including women and girls, people of colour, non-cis and straight people, and people with disabilities.
In a society in which those deemed different are ostracised and where people’s basic needs are not met, there is a limit to what superficial tweaks to one’s lifestyle can do. Fromm and other thinkers have highlighted the human need for relatedness, rootedness and a sense of identity, which cannot be achieved through individual lifestyle changes alone.
What is also overlooked, in my experience, is that often people with ill mental health are too ill to implement these life changes. For a very depressed person for whom getting out of bed is a Sisyphean task, being told to exercise is an absurd suggestion. This is particularly the case for those experiencing psychomotor retardation, a phenomenon that occurs in Bipolar Disorder and Major Depressive Disorder whereby one’s mental and physical activity is slowed. When I implemented the lifestyle changes described above, I believe it was because I already had a certain level of mental wellbeing – in addition to more time – that enabled me to carry them out, rather than those changes helping me reach a higher level of mental wellbeing.
What’s more, when we fail to meet up to the demands of late capitalism: to be productive, optimized individuals that eat well, exercise, socialise, look good the answer is that we’re just not disciplined enough; that we lack purpose and direction, when really these lifestyle changes become an addendum to the endless demands of capitalism.
All of this is not to say that there aren’t people who find these hacks helpful, nor is it to say that we should expect mental health professionals to wave a magic wand over our lives, but adding to the burden of responsibility that this sort of lifestyle dictates rather than sitting with the immense pain many of us are feeling is misguided. We cannot focus only on the self as the site of healing and a society that creates malaise cannot be the one to dictate these hacks.
Genevieve works in policy analysis and is also an editor at the feminist webzine The F-Word.