Mental health: why we're all sick under neoliberalism

We don't understand mental health, allocating the label only to those who are struggling, so its political causes become invisible.

Ray Filar
1 April 2014


Credit: CC0 Public Domain.

You are in bed, sweating and trembling, dosed up on a selection of painkillers and herbal tranquillisers. Noises outside make you jump. Your heart beats frantically, furiously, unremittingly. You sleep for brief periods, twenty minutes, ten minutes. A police siren goes past and you wake up with a start, soaked in the physical outpouring of your own fear. The pattern repeats. 

You try focusing on breathing but your stomach is a twisting, churning ball of nausea. Everything is dislocated; objects become hyper-real. You cry quietly, trying not to wake anyone, then uncontrollably, without knowing why. 

For me, “mental health” is misnamed. An apparently mental sickness can be one of the most physical experiences there is. While the causes are often (but not always) situational, emotional, intellectual, the effects are felt throughout the body. The mind resides in the stomach, in the chest. You can't wish away anxiety or depression. You can't “put it to the back of your mind”. You can't fight it. Who could win in a battle against their own mind? 

Mental breakdown. It's an archaic term, possibly not a politically or medically correct one, but it's the only resonant term I've found so far to describe how I felt at the start of 2013. I was suicidal, and decided I would kill myself at the end of the month if things hadn't improved.

According to the World Health Organization, over 450 million people globally have a mental health issue. In the UK where I live, one in four adults has a diagnosable mental health “condition” during the course of a year. That's 25 per cent of the population. And yet mental health is something that most of us do not understand. We don't talk about it. Instead, we just hope it doesn't happen to us.

Ignoring the fact that everyone has mental health, the label is allocated only to those who are struggling. So good mental health becomes invisible: its causes – which might be to do with emotional, social and material privilege - go uninterrogated. In 1901 Seebohm Rowntree showed poverty was not the fault of the poor. Neoliberal governments since then have all but eradicated that insight. 

As inequality increases under late capitalist patriarchy, driving people into poverty, abusive relationships, or otherwise helpless conditions – free market ideology says we deserve it. Nobody who is trying hard enough should need state support. 

The only surprise is that more of us aren't sick.

Never-ending unemployment, living on £56.25 a week's Jobseeker's Allowance, moving back in with my parents, being left by a partner, struggling with gender identity, lacking community, feeling hopeless. These are experiences that many other people have had, particularly those of 'Generation Y', and many others have experienced far worse. I now know these events were catalysts for the emergence of deeper issues, rather than causes in themselves. But for whatever reasons, I crashed.

I gradually stopped being able to function normally. During the lowest times, I couldn't hear. I was so trapped in my own misery, other peoples' voices came to me as if from a distance, only vaguely intelligible. I stopped being able to eat. I threw up constantly, but with no food to bring up. Sleeping brought on intense fear. Drifting off for an hour wasn't worth it for the misery of waking up. I couldn't read or listen to music – while words floated meaninglessly, sounds carried too painful an emotional context. Even writing was impossible.

In lieu of being able to do anything else, I ruminated obsessively, constantly. Inhabiting an isolated, fantasy world, I had somehow become 18 again. The previous five years of my life, times of great growth, community-building, identity-discovering, were suddenly – in my mind – erased.

Over the next few weeks on Transformation, we will be running articles that question the links between the mental and the political, addressing questions of social and personal transformation. Mental health is not a mystery, nor is it something that happens to other people: it is as structural as it is individual. 

The silence and social stigma around mental health is deliberate, the product of an institutional refusal to talk about the affective impact of socio-political conditions. Some people get depressed, or psychotic, we think, because of chemical imbalances or individual traumatic experiences. They're just lazy or making it up. We don't talk about austerity, poverty, demonisation of the unemployed – the politically-driven stigmatising of the least privileged groups of people – but is it any wonder we're unhappy?

Of course it feels like shit when you're holding down three zero-hours contracts, because that's all you can find, to pay two thirds of your wages to live in a mouldy box-room. In a desperate scrabble to deny institutionally-sanctioned disadvantage, corporations, media and politicians conspire to promulgate a reverse reality. Their privilege is justified, they say: the mentally unwell are just skivers, they draw their curtains and lie around in bed all day, most sickness or disability is a pretense used to fund drug habits.

Our shame is that we buy into this paradigm: the “hard working families” who, in clinging to the myth that misfortune stems from a lack of hard work, can feel justified kicking down against the less well off.

My mental breakdown was a dislocating, dysphoric time. Yet visits to the Jobcentre to sign on for my £56 a week remain etched into my mind. It epitomises everything that is wrong. Queues of miserable, disenfranchised people with holes in their shoes. Women fighting. Bored, frustrated workers patronising bored, frustrated teenagers. And the pointless bureaucracy of it all – going through the tickbox exercises to convince the person behind the desk that you deserve to be able to eat this week.

This is a politics in which labour market potential is all that makes a person worthwhile. Perhaps neoliberal government's greatest success has been to reconstitute “work” - however mundane, drudging or undignified – as an unquestionable public good, in place of community, compassion, or support.

And under this regime mental health is simply an economic function. The British NHS is light on helping to address problems, but trigger-happy on the medications. We need more productive workers, after all. Meds can be a lifesaver, but few seem to question doling out pills as a political default. As series contributor Michael Richmond points out, it is notable that NHS-provided therapy takes the form of a brief course of Cognitive Behavioural Therapy, also popular within businesses who want a sedate workforce, happily content to be overworked and underpaid.

While often helpful, talking therapies can also act as a process of depoliticizing pain. Broader politics are barred from the cool blue counselling room. In therapy, as with neoliberal ideology, families become the problem; we ignore the ways in which structural oppressions – capitalism, patriarchy, white supremacy - create misery. Family becomes harmful within a political context; structures are about individuals.

By substituting drugs or therapy for tackling underlying social hierarchies, governments and global pharma can conveniently avoid or dismantle the collective empathy that might at the same time undermine their rule.

The truth is that more fulfilling lives will emerge from radical political and social change, both in how we are governed and in how we learn to relate to each other. 

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