My Brief Brief Against "Mental Illness is Just Capitalism, Man, the System"

Someday I will do this long-form and with a lot of sources and such, but I’m writing at the moment out of considerable annoyance. In short, I am so sick and tired of being told by leftists that our mental illness problems (my mental illness problem) are the fault of capitalism, or perhaps some such vague and useless thing as “the system.” Sometimes they say this specifically about suicide as well. I would like to ask compassionate people to stop doing this, and I have the following questions and complaints.

1. Capitalism is fairly young, while mental illness is not. There are all manner of mental disorders with etiologies strikingly similar to those of modern diseases described in texts from antiquity. How would capitalism cause mental illness thousands of years prior to its birth?

2. There is no simplistic relationship between the generosity of a country’s social safety net and its rates of mental illness and suicide. The Netherlands, a very generous social state and one that has invested a great deal of money and energy into modern psychiatric services, nevertheless suffers from high rates of mental illness. The Nordic social democratic model not only does not prevent suicidality, it is in fact associated with slightly higher than average rates. The USSR, supposedly home to an alternative economic system, had disturbingly high rates of mental illness. The Democratic People’s Republic of Korea has some of the highest suicide rates in the world. Meanwhile the advantages that more redistributive states might enjoy in mental wellness are hopelessly confounded by their overall status as wealthy and technologically advanced countries. If the problem is capitalism, why do various approaches to the market economy and attempts to ameliorate its ills not produce stable and significant advantages in mental wellness?

3. Everyone in our society lives under capitalism, yet only a small fraction have severe mental illnesses. Saying that the problem is capitalism is thus no more justifiable than saying that breathing air causes mental illness; whatever the relationship between capitalism and mental illness, it cannot be said that life under capitalism itself is causative of mental illness based simply on observing the presence of both. The 1% of the American population that suffers from schizophrenia lives under the same capitalism as the 99% of the population that does not. What is the causative explanation that functions here?

4. Women commit suicide at a small fraction of the rate at which men do. Why is capitalism falling especially hard on men in this way?

5. There are consistent and significant racial differences in suicide rates. White people in America commit suicide some 10 percentage points higher than Asian people do. Why is capitalism having this odd effect?

6. There are differences in rates of suicidality between occupations. The military is hit especially hard, and yet military life is the closest Americans come to living under socialism. What explains this phenomenon?

7. Why do relative rates of mental illness and suicide rise and fall in countries where the economic system remains stable? Are they getting more or less capitalist in concert with these developments?

8. If suicide is purely a product of environment, why does prosperous and technologically advanced Japan have a far higher suicide rate than Syria, a country that has been ravaged by a brutal civil war for over a decade?

9. Why did I develop bipolar disorder in late adolescence where so many of the people who share my exact socioeconomic characteristics did not?

10. What does “it’s the capitalism/it’s the ‘system’” offer us? Analytically, emotionally, as a guide to immediate action? How am I supposed to interpret that sentiment, when it comes from someone who expresses skepticism about my medications and psychiatry in general? How does this statement help me? How does it help researchers hoping to develop better treatments for these diseases? How does it help doctors attempting to treat people who suffer from them? What actionable and practical reforms does it suggest? Where do we go from “it’s the capitalism, man”?

Listen. I am very open to discussions of mental illness that include environmental, social, economic, and cultural factors. It would be foolish not to be. I do think that we can make political and economic changes that would help the mentally ill and the people who help them immensely. And I have wanted a socialist economy since I was old enough to know what an economy was.

But my mental illness is a disease of the body. I feel it, physically. It is not some trick being played in my mind; it’s not the sum of “traumas” in my past. (My siblings share the same traumas but not the disorder.) I am telling you that the things that happen to me when I am unmedicated are as corporeal and vividly physical as a sprained ankle. I know how it feels to come up through mania into full-blown psychosis, and it is not a little trick of capitalism. Yes, the serotonergic vision of clinical depression was an oversimplification that too many in the media rushed to identify as the one certain answer. But the overreaction against it has been worse: now, many proudly ignorant people proclaim that there simply is no neurological, even no biological, origins to mental illness at all. It’s hard to imagine a more obvious case of “absence of evidence is not evidence of absence.” The people who insist that mental illness is just our society’s fault don’t know that, it’s absurd that they pretend that they know that, and their certainty stands in the way of more effective treatment. My disorder is in my body.

I will work with you to build a more humane world and a post-capitalist future. And I understand that your facile diagnosis stems from an instinct of caring. But it insults me, and many others, to take the achingly complex terrain of the disordered mind and turn it into a witless slogan for political changes you already wanted. You instrumentalize the mentally ill when you use us as a cudgel with which to beat your political opponents. The origins of mental illness will take decades to untangle, and I will bet my life that they will prove to be a massive tangle of many factors and influences, including physiological. In the meantime, I ask that you not simplify that which is not yours to simplify. I ask that you accept living in the long shadow of these irreducibly complex and punishing disorders.