In any of the healing arts, whether addressing physical or emotional issues, it is understood that accurate and concise diagnosis (What is the matter?) must be settled before any intervention (How shall we treat this?) can be considered or applied. More simply put, effective help follows some clear understanding of what is wrong.
I suggest that these same principles can be applied to figuring out what is the matter with our economy as a necessary precursor to effectively treating it. Somehow, Psychiatric nomenclature (terms) can be applied to systems as well as to people. Let’s consider some of the more likely diagnoses first and then take a look at what each might suggest in terms of treatment.
We must all hope that the new President and his group of economic advisors turn out to be sharp diagnosticians as well as skillful social practitioners.
The most likely serious clinical diagnoses (all found in the American Psychiatric Association’s DSM-IV-TR) include 1) Major Depressive Disorder, Single Episode, 2) Major Depressive Disorder, Recurrent, 3) Major Depressive Disorder, Chronic and 4) Bipolar Disorder. Three of the four are one type or another of Depression because depression/recession is how the situation is most commonly referred to. The inclusion of #4 (Bipolar Disorder) will be explained in context.
Each of these illnesses generally requires medicine as a part of the treatment and is helped with concurrent ‘talk’ therapy… The ‘medication’ in the case of the economy may take many forms, amongst them the “Stimulus Package.”
Each diagnosis considered:
1) Major Depressive Disorder, Single Episode.
There are recognizable symptoms of a Major Depression. These include: Depressed mood most of the day most every day, diminished interest in pleasurable activities (anhedonia,) significant weight change (gain or loss), insomnia or hypersomnia (too little or too much sleeping,) fatigue and loss of energy, feelings of worthlessness, diminished ability to concentrate and recurrent thoughts of death are among the most noticeable symptoms of ANY Major Depressive episode.
People with real Depression tend to look at the world through glasses that are the opposite of “Rose Colored” … They are more likely the color and aroma of something far less attractive to behold and those glasses, a type of symptom in and of themselves, prevent the person from seeing the brighter side of just about anything. A pervasive societal negativity and cynicism would be the societal equivalent.
What points to the Single Episode type is exactly what it sounds like. The person (or, in our case, our society) has no previous history of such episodes.
Clinically, we would “Rule Out” this diagnosis because by history, our culture has suffered economic declines as well as both near and total collapses in the past. True, each one (just as each individual) is different (the current situation is not now the same as was the case during the Great Depression during the 1920’s and 1930’s.)
2) Major Depressive Disorder, Recurrent.
With the same symptoms of any Depressive Disorder, this diagnosis differs from #1 in that it recurs from time to time. At first glance, this may or not be the correct diagnosis of our economic situation, but is clearly more applicable than the preceding one.
3) Major Depressive Disorder, Chronic.
Just as it sounds. The person (civilization, economy, etc.) has always been this way and has never, so far as anyone can determine, felt any better than this. Sometimes alluded to as an ‘intractable’ depression (one unresponsive to most generally accepted treatments,) this is the disorder ECT (Electroconvulsive or “shock therapy”) is most often used on.
If this described the most correct diagnosis for our economy, measures more extreme than those in the Stimulus Package and various “bailouts” would be called for. Full nationalization of private enterprise, for example. This was, I infer, the diagnosis of the Marxist revolutionaries in Russia in the early 20th Century who believed that their system was chronically and irreparably ill. Revolution was required to change it from one thing into another.
Fortunately, this diagnosis can also be ruled out as history tells us that there have been and, we hopefully infer, will be better days ahead. Clearly, some populations would disagree and might argue, quite sensibly, that for them the situation has always been as bad as it now is for others. Those on the bottom may have been there always and seek relief, while those who have always been on the top hope to be left there.
4) Bipolar Disorder.
While there are at least several types of this illness (previously known as Manic-Depression.) They all have in common some element of mood fluctuations to and from extremes which render the person unable to successfully manage their behaviors, moods or life without medical intervention.
These disorders are generally characterized by mood ‘swings’ that take a person from periods of feeling so good they can lose control of their own better judgment (read: the high-tech or more recently bursting housing ‘bubble’) to periods of deep depression. The cycling can take many forms and can be slow and long or rapid and quick changing.
I would propose that this is, in fact, the most applicable clinical diagnosis for our society’s economic woes. When things are going well, we stop thinking about the possibly inevitable downside – unless, of course, we are living that downside while many others are living well. There doesn’t seem to be any animal type in between the Bears and the Bulls of Wall Street – It is one or the other. We are either on top of the world or are being crushed by the weight of that same world. Socially, we might regard the recently past ‘boom’ or Bull years as one of our society’s ‘manic’ episodes, while we currently find ourselves in the downside of a distressingly recurring cycle.
Bipolar Disorder. In Psychiatry, the treatment would include medication – most commonly of a type referred to as “mood stabilizers” that do exactly as the name infers. When they work well, the extreme highs fade down and the valleys of depression that cycle with them diminish. The mood of the person is more level.
Group treatment is a frequent adjunct to the medicine. In these groups, people learn some new coping skills and get help in dealing with the problem that often remains even after the medicine works: People are glad to be free of the downside of the cycling but often miss those times of feeling almost ‘too’ good.
Applying this notion to the economic situation currently faced by municipalities, states and nations, both large and small, a course of treatment might include:
a) The cultural equivalent of mood stabilizing medicine.
The Stimulus Package, Bail Outs and partial nationalization of some industries, financial institutions and possibly health care would be some of the social equivalents. As with medication for individuals, the clinician can prescribe it, but compliance with the prescription is in the hands of the individual patient (citizen.)
b) Societal group treatment.
A broad re-education of populations that have grown up with expectations which are no longer realistic is of the essence. This re-education would need to address things like the black/white thinking about our (in the USA) form of a representative Democracy (the Republic) vs. ‘Socialism.’
Clearly, they are not now can they ever be fully mutually exclusive. Psychiatrically speaking, the seeing only extremes, both in people and in other things, is an indicator of yet another (deep and characteralogical) condition known as a Borderline Personality Disorder.Arguably, together with the social ‘medicine,’ this re-educative process can be seen as one of the primary responsibilities of the Federal Government.
Good diagnosis must come before the implementation of any treatment. Let’s hope that this has been thought through and taken into account by the people we have elected to make these important decisions on our behalf.
