SEATTLE — Mental health has become a global concern, but serious epidemics are strikingly more common in developing countries than developed ones. Poverty predisposes people to a host of mental health maladies. This means that the mental health of 836 million people could be forever altered by their temporary circumstances.
It is important to understand the common ways that poverty hurts mental health, the demographics most affected and the various contributing factors. These disorders are common in developing countries and encompass the ways poverty hurts mental health:
Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder is typically a result of violence, and violence is more common in lower-income families and housing. Severe addiction, depression, anxiety and a host of other disorders become much more common for sufferers of this disorder. Studies have shown that kids who grow up in areas with more violence have “weaker real-time neural connections” in areas of the brain that manage “ethical and emotional processing”.
The trauma is not always caused by violence; sometimes it can be overwhelming pressure on a developing mind. The sheer immensity of the disorder among the world’s poor has yet to be calculated, but signs of its prevalence are clear in many studies. One study found that 30 to 70 percent of people living in war-affected countries suffer from PTSD. Another found there are currently two billion people living in countries where violence affects their development.
Generalized Anxiety Disorder
Poor people in emerging economies and developing nations live under the constant threat of everything they have being lost or taken from them. Some are at risk of losing it all to war and violence, others by more subtle forces of aggression like debt collectors, job and food insecurity or gentrification. Typically, there is never only one thing at stake either: losing a mode of transportation means missing out on food or a job, then possibly a home, medical care and the lives of loved ones. A study in 2012 found that poverty is likely a main cause of generalized anxiety, especially for women and mothers; women make up 70 percent of the 1.3 billion people in poverty.
Paranoid Personality Disorder
The consistent and very real looming threat that poor people in developing countries face daily can leave a lasting impression on their psyche, resulting in distrust and suspicion of everything. Typically, negative early developmental experiences and a hostile home life are known to be the conventional causes, and symptoms do not become problematic or clear until early adulthood.
Children in developing countries and poor areas are at risk for the personality disorder due to extreme domestic situations, lack of education and the prevalence of violence or deception from adults. In September, UNICEF published this finding: children make up the vast majority of the poor population, around 47 percent to adults’ 27 percent. With 19.5 percent of the global child population being poor, that means there are over 380 million children living in dire circumstances that could alter their mental health forever.
Major Depressive Disorder
Depression is a dangerously elusive way that poverty hurts mental health in the developing world. Finding sufferers is hard because it is mostly felt rather than communicated. The ambiguous somatic aspects and the dependence on language make understanding the severity of each case difficult. For example, a study conducted in Zimbabwe noted that it is “vital to understand the culture-specific terminology.”
Every culture has a word or phrase that explains depression-like symptoms, but most of these countries have few, if any, mental health clinics or psychiatrists available to help. This is severely debilitating, especially for those whose livelihoods depend on physically strenuous work. Among 36 nations, an estimated $1 trillion is lost every year due to an absence of investment in mental health provisions for depression. In 2014, a study in Pakistan found that half of women were depressed due to oppressive cultural standards. In Uganda, some areas hit hardest by the HIV/AIDS epidemic saw a spike in depression by 21 percent.
Like depression, bipolar disorder can sometimes be hard to detect and treat. Some areas in developing countries often stigmatize sufferers. From traditional or ritualistic care to outright imprisonment, many developing countries do not have the resources required to aid them. Around 25 to 50 percent of people in developing countries with the disorder are estimated to attempt suicide, and 15 percent succeed, a rate that is 30 times higher than the general population. The most common contributing factors besides genetic predisposition are substance abuse and trauma, both of which are associated with living in impoverished areas. Onset is estimated to occur between ages 18 and 24, with instances of the disorder being three times more common in urban areas than rural farmlands.
Unfortunately, psychological treatment is uncommon throughout the world; in countries like the U.S., only 44 to 70 percent of patients get help. But in developing countries, it is even less: around 90 percent go unnoticed. Access to mental health-related services like psychiatric clinics help limit the impact but often do little on the side of rehabilitation and treatment due to fewer intensive resources. Hygienic facilities, proper sewage, shelter, violence-reducing efforts and various human resources help minimize the prevalence of mental illness societally, while talk therapy, motivational counseling, sensitivity training and education helps individuals personally.
The relationship between poverty and mental illness is complex, but understanding and stopping it is not.
– Toni Paz