Depression: Not just a rich man’s disease
In what might appear to be a relatively insignificant scene in the 2019 Academy Award-winning movie “Joker”, Arthur Fleck, the protagonist and the eponymous character talks to a social worker of the Public Health Department about his mental issues. It is fairly obvious that Arthur is suffering from depression and the fact that he is struggling to make ends meet with a miserable job and constantly ill-treated by everyone doesn’t make his life any better. After telling Arthur that this will be his last therapy session since the department will be closing down its offices due to a cut in funding, the social worker in a moment of rare candour, without so much as twitching a muscle in her face, says, “They don’t give a sh*t about people like you, Arthur and they really don’t give a sh*t about people like me, either”.
This one dialogue encapsulates almost everything that’s wrong about the way we treat depression. Perhaps no other disease is so ubiquitously belittled and so often met with such cavalier attitudes. While most common diagnoses include over-thinking and over-reacting, an equally disturbing myth which is propagated is that depression is a “rich man’s disease”; a consequence of having too much money and spare time to waste on psychiatrists who are nothing but quacks and charlatans out to fleece money from unsuspecting patrons.
Apparently, the poor are too busy earning their livelihood and hence do not have the luxury to worry about something as trivial as mental health. Not only does such a proposition reek of callousness, but it betrays a complete ignorance of the facts and reality. Depression, or for that matter any mental illness, is not a phase that will pass away on its own with time or a state of mind such as boredom which can be cured by simply having fun. It is a disease that needs proper medical treatment and attention. And like any other disease, it affects people irrespective of their status in the class hierarchy. From the poor man drowning his sorrow in a seedy tavern to the worker unburdening himself of his grief to a fellow co-worker in the local teashop or the labourer unable to sleep at night on the pavement as he stares at the stars in the sky, crying out for help in the losing battle which he is fighting with his inner demons, depression affects the underprivileged as much as the affluent. In fact, a study has revealed that people living in poverty are twice as likely to be depressed than those who are financially able. The truth is that the writing has always been on the wall; it is we who either knowingly or unknowingly, look the other way.
Harsh as it may sound, many victims of depression who are downtrodden might not even be aware that they are suffering from depression and those who do realise it might be reluctant to avail of medical assistance. Not only does this speaks volumes about our failure when it comes to spreading awareness about mental health issues with the same fervour as is being done about physical ailments, but it also highlights the need to provide free or affordable health-care to those who need it the most. The step-motherly treatment which mental healthcare receives is evident from reports of the Union Ministry of Health and Family which reveal that in India there is just one psychiatrist to cater to the needs of over 2 lakh people.
The World Health Organisation defines health as a state of complete physical, mental, and social well being and not merely the absence of disease or infirmity. Article 47 of the Constitution of India makes it the duty of the State to improve the health and raise the standard of living of the people. Even the Supreme Court of India has held that since the right to health is an integral part of the right to life to which every person is entitled, it is the constitutional obligation of the government to provide health facilities. However, bureaucratic apathy and lack of funding have ensured that all these provisions remain mere paper tigers.
And if someone is still bent on trivializing mental health and dismissing psychiatry as mumbo-jumbo, then he or she must watch the “Joker” till the end. We realize that not just Arthur, but his mother too was a victim of a mental disease that was left untreated, arguably because of her poverty. As a result, she along with her boyfriend had physically abused Arthur when he was a child, an incident that caused him a head injury and most likely is responsible for his sudden, uncontrollable, and inappropriate bouts of laughter. This proves to the be the proverbial last straw on the camel’s back for Arthur who kills his mother and descends irretrievably into insanity leaving behind a trail of carnage and mindless violence wherever he goes. The transformation of Arthur into the Joker thus becomes complete.
One cannot help but wonder if all this could have been prevented if some people had realized that no matter how poor the person suffering from it is, a mental illness should never be treated as a joke.
