Politics & Policy

Politics-Related Depression: Is It Real?

(Photo: Katarzyna Bialasiewicz/Dreamstime)
Fragile types in liberal enclaves have a hard time coping with Trump’s election.

The nation’s politically liberal coasts have seen a months-long outbreak of depression. Here in the San Francisco Bay area, among patients, neighbors, friends, and colleagues, there is palpable gloom. They cite as the reason “the news.” Ever since the election, people have been unable to pull themselves away from our ongoing political soap opera.

“Election depression” has turned into the more chronic “political depression.” In an interview, several psychologists characterized this mood disorder as being commonly marked by nightmares, insomnia, digestive problems, and headaches, with anxiety, jitteriness, chest tightness, and “a hallucinatory sense of slow-motion doom” also possible. Sufferers may describe feeling demoralized and powerless, and even a sense of unreality. People have been missing work and school. They have seen relationships impaired and a decline in daily functioning (these are particular red flags for therapists). One woman even described an inability to put her children to sleep on time due to difficulty tearing herself away from the news.

Although many of these symptoms do overlap with internationally recognized psychiatric mood and anxiety disorders, medicalizing our emotions in relation to a particularly intense political atmosphere may be a slippery slope.

For one thing, genuine depressive disorders and generalized anxiety disorder require therapy; medication and psychotherapy are both standard treatments. In more treatment-resistant cases, electroconvulsive therapy has proven beneficial. Patients with vague symptoms of anger and frustration related to the political climate have requested medication or even medical marijuana to help provide a kind of numbing relief. However, in the absence of a previously diagnosed mood or anxiety disorder that may have been exacerbated by the outcome of the election, we’re not sure that drugging away political outrage is desirable. Instead, for a start we’d recommend a therapeutic trial of comfort food, something along the lines of roast turkey, dressing, and mashed potatoes (with extra gravy), or maybe a half-pint of a favorite ice cream.

Non-drug treatment options could provide potential benefit without the associated side effects. A form of Cognitive Behavioral Therapy, or CBT, has been suggested as a potential treatment. CBT is a usually short-term, goal-oriented psychotherapy treatment that relies on a problem-solving approach of changing patterns of thinking or behavior related to one’s difficulties and, in so doing, changing the way one feels. (Maybe include reruns of Leave It to Beaver? Downton Abbey? More comfort food, more often?)

During the last presidential cycle, one psychologist suggested approaching politics-induced depression by practicing the four C’s: Change Cognition, Chart Connection, Channel Activity, and Contain Thinking and Talking. In other words, change your outlook on the situation, make a connection between your frustration and an action you can take to make a change, channel your energy into action, and then stop thinking and talking about the issue.

Sounds doable, but we wonder whether the last of those elements is good advice. “Stop thinking and talking about it” sounds more like the commands of Big Brother in George Orwell’s 1984 than the road to recovery. And speaking of dystopian fiction, pharmacotherapy reminds us of Aldous Huxley’s Brave New World, in which the greater good for society was achieved by minimizing and subduing negative emotions or feelings. In order to accomplish this, whenever individuals became unhappy, they took a gram of soma, a narcotic that transported them into a state of unfeeling unconsciousness. The catchphrase was “A gramme is better than a damn.”

A ‘cry in’ was organized by students at Cornell University, with tissues and hot chocolate provided by staff.

Psychoanalytic psychotherapists have proposed theories about political depression as well, suggesting intensive therapy with a psychoanalyst to delve into patients’ parental relationships in order to get in touch with subconscious feelings towards Hillary Clinton and Donald Trump. In their model, she represents the cold, unloving, secretive mother who failed us (her “children”) by not being a better candidate, and in return we punished her with our lack of love (votes). Mr. Trump represents the scary, persecutory, domineering father who will fail us in the end.

Unfortunately, the average psychoanalyst charges upwards of $200 an hour and usually recommends two to five sessions per week. And research shows that psychodynamic psychotherapy may be of questionable effectiveness. Thus, sufferers might be better off channeling those unresolved childhood conflicts into marching for political change. At least they could get some exercise and conserve financial resources for when manufacturing jobs fail to return by the millions as promised.

Many schools and universities chose the route of crisis management to deal with election depression during the second week of November. Exams were postponed. Some classes were canceled. The University of Michigan offered college students “play time” equipped with coloring books and Play-Doh. Tufts University supplied arts-and-crafts sessions. A “cry in” was organized by students at Cornell University, with tissues and hot chocolate provided by staff. (It was near the height of the flu season, so we hope the students washed their hands before sucking their thumbs.)

While all these activities may provide some temporary relief — in no small part by utilizing the useful defense mechanism of avoidance — normal, intelligent adults can’t go on squeezing Play-Doh and coloring pictures for the next four years.

So what is one to do? “Political depression” suggests that sufferers must be treated or fixed to be happy and function normally again. It takes away self-ownership, or the idea that one can and should change what one can. Health care has reached a point where even a minor discomfort needs to be avoided at all costs — but not all types of emotional discomfiture need to be numbed.

Rather than turning common emotions into diseases that need to be treated, why not adopt a “feel something, do something” ethic? We suggest harnessing that frustration and anxiety to spur political action rather than medicalizing emotions. In any case, the malady is likely to be self-limited, with symptomatic improvement expected in no more than eight, but possibly four, years.

— Mia Zaharna is a psychiatrist specializing in sleep disorders. Henry I. Miller, a physician and molecular biologist, is the Robert Wesson Fellow in Scientific Philosophy and Public Policy at Stanford University’s Hoover Institution. Twitter: @henryimiller.

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