agsandrew: Getty Images
A disturbing feature of our entropic universe is how many things can kill us. Chronic disease, accidents, acute illness (think COVID), old age, poisoning—the list is long and unsettling. However, one widely overlooked threat to life, in terms of both quality and longevity, begins with the psyche, not the body. This condition illustrates the mysterious phenomenon we call “mind over matter.” Patrick proved an unhappy case in point.
“I’m a wreck,” he told me at our initial session. “My doc says I’m depressed, so he sent me here.”
The “wreck” underway included abusing alcohol and prescription meds, a sedentary lifestyle, social withdrawal, a junk food diet, obesity, sleep deprivation and heavy smoking. These, in turn, created a growing list of downstream health problems, including metabolic syndrome, hypertension, inflammation, bronchitis and frequent illnesses. However, after thorough vetting, I concluded Patrick was not depressed in the classic sense. Rather, he was experiencing deep despair, a different psychological animal than your standard issue melancholia. What’s more, it can catalyze far more deleterious physical impacts... like death.
Patrick was quickly approaching what researchers call “death by despair.” What’s more, he fit the profile of those most susceptible to this mortal threat; which includes roughly one-third of the U.S. adult population. He was middle-aged, white, without a college degree, under-unemployed, battling chronic pain and embedded in a dysfunctional family. While average life span has steadily increased for many socio-economic groups, those like Patrick are experiencing the opposite, a development that first emerged in the 1990s. A similar trend appeared among African Americans beginning in the 1970s, one that continues today for many of the same reasons. When researchers examined all the variables contributing to despair among these two groups, the single most salient factor was the absence of a college degree.
Stay on top of the news of the day
Subscribe to our free, daily e-newsletter to get Milwaukee's latest local news, restaurants, music, arts and entertainment and events delivered right to your inbox every weekday, plus a bonus Week in Review email on Saturdays.
The Benefit of Hope
Now, those of us with that piece of parchment can affirm that, in and of itself, a college diploma does not pave the yellow brick road to happiness. However, because our socio-economic system rewards those with higher education or skilled crafts more than their less educated and untrained counterparts, a degree does provide a crucial psychological benefit—hope. Education and skills open doors to opportunity, which is often a prerequisite for hope.
Regarding Patrick and those of his ilk, the term despair is derived from the Anglo-French word “despeir,” which translates roughly as “total loss of hope.” Granted, hopeless feelings are common among those with depression. However, the emphasis here is on “total.” All emotions vary in intensity along a continuum from mild to extreme. Despair is extreme. When it sets in, even the faintest glow from hope’s lingering embers goes dark.
Researchers believe the potential for developing this condition during middle age forms earlier, often in one’s late teens and 20s, when people are coming of age and entering a key life-building phase. Deprived of the opportunities enjoyed by their more educated or affluent counterparts, they become increasingly aware that fewer doors are open to them. While not yet despairing, their hope gradually erodes, leaving them feeling left out, marginalized and disrespected. This, in turn, leads to increased abuse of alcohol, poor physical habits, less access to health care and low self-esteem, setting the stage for more serious impacts later in life.
While mental health types treat folks like Patrick, that does nothing to address what causes their distress, which is an increasingly rigid class system. Deaths by despair are rising in tandem with increasing income and wealth inequality, as well as decreasing opportunities to build a middle-class lifestyle. It is a socio-economically induced disease.
In describing people teetering between life and death, we often reference “the will to live,” which is another term for hope. Often, when that will vanishes, death’s door opens wide. When mind and spirit give up, the body usually follows. This form of self-destruction may culminate in a single act, like suicide, or draw out like Patrick’s version of death by a thousand cuts. Either way, in the absence of hope, the influence of mind over matter becomes ruinous, depriving psyche and spirit of the power to help sustain life.
For more, visit philipchard.com.
