Shaky economy contributes to mental health woes
(August/September 2008 Issue)

“Through difficult times, we may find some development of self,” says Todd Farchione, Ph.D., assistant research professor at Boston University’s Center for Anxiety and Related Disorders. (photo by Tom Croke)

By Phyllis Hanlon

Psychologists are turning their attention to how current economic times are affecting mental health and what can be done to restore balance.

Even before the nation's financial climate imploded, Americans were feeling stressed. An American Psychological Association (APA) national survey last fall found one-third of Americans living with extreme stress; nearly half of Americans believe their stress has increased over the last five years.

The Associated Press, together with AOL, recently conducted a health poll that revealed physical symptoms as well as severe depression brought on by rising debt.

And, a study in the June issue of the Journal of Occupational and Environmental Medicine reports that employees who work overtime are at increased risk of anxiety and depression.

So are things getting worse and what can psychologists do to help?

Child/family specialist Kent E. Rude, Ph.D. who has a private practice in Reading, Mass., consults/trains to school programs and is affiliated with the Academy of North Reading, says that since 9/11 the American people have been "beaten down." He says, "[The terrorist acts] challenged the foundation we had about what we believe in."

The lending crisis, the collapse of long-time businesses, the rollercoaster stock market, rising gas and oil prices, unstable job situations and the "illness of some iconic industries" fuel fears about the economic future of the country, says Rude. "All these things lead to the impression that we're losing control."

Charles "Sandy" Cole, Ph.D., program manager for the outpatient adult mental health psychiatry division clinic at the Maine Medical Center, which Spring Harbor manages, points out that the dramatic rise in everyday costs has a huge impact, especially on the public sector population, which operates on a fixed income.

While the need for psychological help is greater during these economic times, fewer people are seeking it. Cole points out that in Maine, residents must drive long distances to his clinic. "Gas prices make an impact on whether they can be seen here or not," he says. "People are coming less frequently or calling at the last minute to cancel an appointment because they can't afford the gas."

Rude cites managed care as another factor. He points out that premiums are increasing while benefits are decreasing and co-pays have gone up, especially for out-of-network providers. Some psychologists are developing cash-only practices because of low reimbursement from managed care, according to Rude. He sees a few self-pay clients and says, "In recent times, some of these clients have either left therapy or decreased the frequency [of visits]. It's clearly an economic piece. Therapy is seen as a discretionary expense. People are paying more for food and gas. They have to cut back somewhere."

The ability to obtain information instantaneously through radio, newspaper, television and the Internet also amplifies anxiety. Todd Farchione, Ph.D., assistant research professor at Boston University's Center for Anxiety and Related Disorders, says "Media is irresponsible in the way they present news sometimes. As a larger community, we're in a state of unrest to begin with. We're likely to latch onto this negative information. [The media] have a lack of appreciation for the repercussions."

Cole recommends limiting exposure to newspaper and television news. He attempts to reframe clients' thinking and suggests realistic lifestyle changes to regain a sense of control. "One thing that is well known is that people get very focused on immediate needs. They overvalue immediate needs and undervalue future needs," he says. "I try to help with reality testing. I try to incorporate behavioral economics principles."

Farchione uses a combination approach to treat stress related to economic factors, including cognitive behavioral therapy, a practice acceptance model, increased awareness and appreciation and recognition of the negative emotional state.

Farchione says, "As a culture we've lost the desire and ability to tolerate a negative state. As a culture we want to feel good, which leads to a pattern of avoidance," adding that emotions like anger and frustration are vital to human nature. By recognizing and accepting a situation, an individual can learn how to adjust his response appropriately.

Elaine Ducharme, Ph.D., a psychologist in private practice in South Glastonbury, Conn., helped to interpret the data collected from the APA survey and urges individuals to first understand what stress is. "Heart rates go up, you get nauseous," she says, equating the symptoms to the fight-or-flight response. Some of those responses might include panic attacks, domestic fighting or acting out. While seeing a therapist ranks at the top of the list, she suggests some healthy outlets for stress as well. "Exercise rather than eating or drinking, which will create more problems and drive up the stress level," she says, noting that setting realistic goals will help alleviate the problem without creating frustration. "Figure out what works for you," Ducharme says.

The perceived lack of empathy from those in leadership positions as well as those in higher socioeconomic situations aggravates the problem, according to Cole. "This fuels resentment and anger. People on limited incomes have recognized the growing divide between their situations and that of the affluent," he says. "People with a lot of assets have a way of benefiting during economic down times."

Rude, however, does see an upside to the bleak economic environment. "Families are doing more things together," he says. They are trying to simplify life and pay better attention to what is good for the environment. "We can't control the whole, but we can do something about the little things," Rude says. He suggests that letting go of factors beyond our control can be "freeing and therapeutic."

Farchione agrees that some good can come of a negative situation. "Through difficult times, we many find some development of self," says Farchione. "People learn what's important to them."

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