Links between Unemployment and Anxiety, Depression, and Suicidality

09/25/2012

When considering the effects of unemployment, it is important to consider the terrible emotional and psychological effects of such unemployment. Such effects are well-documented, but rarely mentioned in articles or blog postings.

A well-regarded 2010 study by the John J. Heldrich Center for Workforce Development at Rutgers, the State University of New Jersey, "The Anguish of Unemployment," quantified the tremendous emotional suffering engendered by unemployment. "'The lack of income and loss of health benefits hurts greatly, but losing the ability to provide for my wife and myself is killing me emotionally,' wrote one respondent to the survey." (See PDF for Powerpoint presentation of results.)

Just last April, the Centers for Disease Control (CDC) released a study that showed that suicide rates rise and fall in tandem with the business cycle. The study covered the years 1928-2007. According to the CDC press release:

"The overall suicide rate rises and falls in connection with the economy, according to a Centers for Disease Control and Prevention study released online today by the American Journal of Public Health. The study, 'Impact of Business Cycles on the U.S. Suicide Rates, 1928–2007' is the first to examine the relationships between age-specific suicide rates and business cycles. The study found the strongest association between business cycles and suicide among people in prime working ages, 25-64 years old.

"'Knowing suicides increased during economic recessions and fell during expansions underscores the need for additional suicide prevention measures when the economy weakens,' said James Mercy, Ph.D., acting director of CDC's Injury Center's Division of Violence Prevention. 'It is an important finding for policy makers and those working to prevent suicide.'"

As a practicing psychologist, I can say that the current economic recession has had a terrible effect on the people I see. I have also heard about more suicides in a short period of time than I have in years -- actually, ever. While this could be a statistical fluke, and I myself would never draw stark conclusions from the sample of one clinician, the spike in reported suicides is certainly something that fits the known epidemiological risks that accompany high unemployment.

Because of confidentiality issues, I can't talk about my own clients, but let's consider some other academic studies over the years about the effects of economic stressors, such as unemployment.

"After unemployment, symptoms of somatization, depression, and anxiety were significantly greater in the unemployed than employed." -- "Effects of unemployment on mental and physical health." American Journal of Public Health, May 1985.

"Controlling for a number of individual characteristics, unemployed individuals are found to suffer significantly higher odds of experiencing a marked rise in anxiety, depression and loss of confidence and a reduction in self-esteem and the level of general happiness even compared with individuals in low-paid employment. This finding highlights the involuntary nature of unemployment." -- "The effects of low-pay and unemployment on psychological well-being: A logistic regression approach." Journal of Health Economics, January 1998.

"Unemployment was associated with an increased risk of suicide and death from undetermined causes. Low education, personality characteristics, use of sleeping pills or tranquilizers, and serious or long-lasting illness tended to strengthen the association between unemployment and early mortality." -- "Unemployment and Early Cause-Specific Mortality: A Study Based on the Swedish Twin Registry." American Journal of Public Health, January 2004.

"Unemployed individuals had lower psychological and physical well-being than did their employed counterparts." -- "Psychological and Physical Well-Being During Unemployment: A Meta-Analytic Study." Journal of Applied Psychology, Jan. 2005.

"SPRC conducted a literature review of relevant research published in the past two decades. The review shows that a strong relationship exists between unemployment, the economy, and suicide. A common “chain of adversity” can begin with job loss and move toward depression through financial strain and loss of personal control. In fact, this chain leads to myriad financial, social, health and mental health outcomes—all of them negative. The most common (but by no means the only) mental health outcome is depression, which significantly increases suicide risk. The associated financial outcomes (such as mortgage foreclosures and loss of retirement security) have not been researched with respect to suicide. However, the potential link is that for vulnerable individuals, losses (whether real or anticipated) that result in humiliation, shame, or despair can trigger suicide attempts." -- "Relationship between the Economy, Unemployment and Suicide." Suicide Prevention Resource Center (SPRC), November 2008.

"There was a strong independent association between suicide and individuals who were unemployed (odds ratio 2.6; 95% confidence interval 2.0 to 3.4) and permanently sick (2.5; 1.6 to 4.0).... The association between suicide and unemployment is more important than the association with other socioeconomic measures." -- "Suicide, deprivation, and unemployment: record linkage study." British Medical Journal, Nov. 1998.

"Socioeconomic events are known to produce important fluctuations in suicide mortality. Unemployment, in particular, seems related to suicide risk along direct and indirect pathways. Blakely and co- workers’ paper in this issue adds to evidence indicating a causal association between unemployment and suicide. Their results indicate that this association is not attributable to confounding factors linked to the socioeconomic status and that it is only partly related to health selection or mental disorders." -- "Unemployment and Suicide." Journal of Epidemiological Community Health, 2003.

As a clinician and therapist, there is only so much one can do to change the larger-scale social and politicial problems of our society. But for the individual caught up in the immense and often overwhelming challenges of "making it" in this society, there is much that one can do if personal effort and social support seem to be failing us. That's where therapy can come in.

Psychotherapy, or counseling, can help us through these rough patches, be like a life preserver when the whirlpools of stress, depression and anxiety seem to be pulling us under. That's when you pick up a telephone and make that first appointment. 

Therapy can be empowering, and it means you have someone in your corner, an expert who both knows what it means to be suffering, but also has some strategies to help you come out of it alive. When depression takes over, it can seem as if there is no way out. Simple things, like calling work to find out about COBRA coverage, or getting a temporary deferment on student loans, or calling a credit card company to tell them you're going to be short this month, can seem insurmountable.

It's the rare person who has not, at some point in their life, found themselves in a dark place, feeling alone and that life is not worth living. It is the shame of our society that not enough is done to help those who have gotten the rotten end of the boom-and-bust cycle that plagues our world. But it is not the person's own shame.

If that person is you, pick up the phone now and get the help you deserve.