John S. Tamerin, M.D. Depression in the midst of affluence
The tragic recent deaths by suicide of Kate Spade and Anthony Bourdain highlight that great success and recognition are no protection against depression and its most tragic consequence — suicide.
These events lead to reflection on the prevalence of depression in our community, particularly among privileged and often gifted young people.
In affluent communities such as Fairfield County visible and even quantifiable success is a high priority. It is evident in many, if not most, of the people who choose to move here. The average income in our community is more than three times the national average. Another evidence of success is a high level of achievement and societal recognition.
Many people assume an inevitable accompaniment and result of these achievements, accomplishments and other manifestations of success is happiness. This may or may not be evident in the adults who live in our community but can certainly not be assumed for their children even while growing up in towns rated as among the most desirable places to live in America. So, what is the problem?
There have been no formal studies on the prevalence of unhappiness or its clinical manifestations as anxiety or depression in our community. However, research studies suggest that adolescents in less affluent communities are actually happier!
Suniya Luthar, a professor of psychology at Arizona State University who obtained her PhD from Yale, was surprised to discover from her extensive research studies that American teens from upper-middle class families were more likely to have higher rates of depression, anxiety and substance abuse than any other socioeconomic group of young people.
To bring this close to home, a recent article in Greenwich Magazine reported that in Darien, Greenwich, New Canaan and Stamford there has been a 38-percent increase in self-injurious behavior among children and teens during this year’s first quarter, as compared to the same period last year. What might explain this?
One explanation may lie in a prevailing perspective in many affluent families that only success is acceptable. So, what happens if a member of that family fears failure and/or actually experiences failure? Sadly, for some, the result is quitting, giving up and perhaps avoiding challenges and/or the possibility of risking failure in the future. This may result in a pattern of avoidance which ultimately leads to a lack of belief in oneself and significantly diminished self-esteem. If this pattern progresses, in addition to anxiety we may see full-blown depression, perhaps substance abuse and ultimately even suicidal thoughts, feelings and behavior.
The opposite of success is not failure but avoidance, and success is possible only if one is willing to risk failure. Quoting Senator John McCain: “Without my failures I would never have been successful” and equally powerful from Michael Jordan: “I’ve missed more than 9,000 shots in my career. I’ve lost almost 300 games. Twenty-six times I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed.”
This perspective goes all the way back to the Book of Proverbs which said 2,500 years ago: “For a righteous man falls seven times, and rises again.” Falling down does not make us a failure, but staying down and not trying to get back up will.
Avoidance never results in success and ultimately leads to feelings of insecurity, low self-esteem, anxiety and eventually depression. The same principle applies to the concept of pleasure. Most people think that the opposite of pleasure is pain. They are wrong. The opposite of pain is “comfort” — the unwillingness to face any pain or suffering — because without being willing to endure pain and discomfort one can never learn through life experience to really believe in oneself and achieve the pleasure of genuine accomplishment.
There are solutions. Young people struggling with these issues need to be able to share their concerns and insecurities with others in a non-judgmental group where “success” is redefined and the discussion of vulnerability and of “failure” is not merely acceptable but encouraged. These support groups should be developed in a wide variety of settings from schools to religious institutions. After 50 years of clinical experience facilitating support groups I am confident that they work. If you have any reservations, consider the genius and efficacy of Alcoholics Anonymous.
Dr. John S. Tamerin lives and practices psychiatry in Greenwich. He is a clinical associate professor of psychiatry at the Cornell/Weill School of Medicine and has facilitated a local pro bono depression support group for 18 years. For more details visit www.dbsagreenwichct.com