Income & Mental Health ………………. Does it Matter what Rung of the Ladder You’re on?

Income & Mental Health ………………. Does it Matter what Rung of the Ladder You’re on?

As Valentine’s Day approaches we see articles concentrating on flowers, chocolates, love and hearts or some variation like heart health.  My Aging-with-Pizzazz variation includes health too – mental health.  Specifically, metal health from a societal prospective.  Maybe I have a little love snuck in here or there between the lines to honor the holiday.

During the 2016 presidential primaries (which many would like to forget), the idea of “income inequality” was front and center.  “Our Revolution,” the follow up organization of Bernie Sanders’ campaign, plans on maintaining the issue in that visible position.  But in our nation of independent thinkers, hardworking entrepreneurs, and ‘pulling oneself up by the boot straps’ is there any reason (as a collective county) to care about leveling things out?  Is there something in that idea for everyone?

Obviously more equality would benefit those less-well-off.  And in their defense, if we consider many of the rules devised by the governing rich (tax loopholes, corporate structure, deregulations, Wall Street maneuvers), it would seem that some leveling might be in order to create a fairer culture.  But what about the well-off?  I’m not asking about the concept of charity, love and kindness, or other such intangible rewards.  That is sufficient for some, but not all.  My question here is not about moral obligation, but about potential long-term advantage.  A question as to whether there is solid benefit to even consider the sacrifice and responsibilities of balancing wealth.  We know that probing any notion that sounds like “income redistribution” can provoke a tirade by those who would condemn such a questioner as a “commie.”   Still, would such reform be worth it only to the lower or middle-low income brackets, with nothing in it for ‘the rich?’

I hope it is obvious that this subject is far too massive for a part-time blogger like me to explore in-depth.  But I would like to share some ideas and research about mental health (and related drug use) spanning all steps on the ladder – and in different parts of the world.  And ask again; regarding the challenge of income inequality is there something in it for everyone OR NOT?


What’s your Mental State?

More often than not mental health makes the news only due to the ‘shooting du jour’ and beliefs that if we were able to keep guns from those with mental illness we could solve this one heartbreaking trend.  But what about the back pages of media where we see increases in teen suicides, children with ADHD (Attention Deficit Hyperactivity Disorder), common OCD (obsessive-compulsive disorders) at all ages, frequent bipolar diagnoses, eating and weight disorders, runaway depression, or opioid addictions sometimes stemming from treatment of depression (and pain).  Like others, I might shake my head in sadness and think “poor them.”

That is part of the problem.  I am part of the problem.  Seeing “them” — and being less willing to see “us” — unless it dramatically hits home.  Further it seems too easy to categorize mental health problems as concentrated only in the group of “them” types, such as lone gunmen.   What if we bring that loud bias down a notch?  And what if we first look at mental “well being.”   That too (even a definition) may be beyond my scope.  However, I wouldn’t mind borrowing from the National Association for Mental Health in the UK.  They published a booklet entitled “How to Improve your Mental Well-being.”

Mental wellbeing describes your mental state
how you are feeling and how well you can cope with day-to-day life….
[how you] cope with the ups and downs.

They point out that mental health isn’t something you have, but something you do.  It is “dynamic,” capable of changing “moment to moment, day to day, month to month, and year to year.”  And to possess mental health you must “value and accept yourself.”  That may sound like one of those “easy to say – hard to do”  trite pop-psychology statements, and the authors themselves would probably agree. But you have to put your foot somewhere on the path to start out.

Appropriating some of their ideas in less abstract terms, below is a division of several good and bad trait evaluations.

Good Well-being

Can look after themselves.

See themselves as valuable people.

Judge themselves by reasonable standards (example – their self-talk is not painfully irrational and mean).

Cope with daily stress,
(worry is in moderation).

Live and work productively.

Bad Well-being

Feel frightened by rejection
(more than ‘normal’).

Keep others at a distance – participate in little.

Become trapped in a vicious circle of loneliness.

Worry often about work and money.

Sleep poorly.

Are plagued by inactivity and lack of motivation.

The more we are able to “do” the good side of mental wellness, the more apt we are to break some of the negative cycles.  But other life influences play a major part in keeping us from such stress-free healing.  Surprisingly, along with several other factors, our ‘place in society’ has to be considered.

Two Random Points about Mental Health

Brain chemistry.  There is a good deal of research looking at the brain of those with depression. Two of the chemicals isolated as to their effect on mental illness are dopamine and serotonin.  Both have long been identified for their actions, and both are hormones. Sometimes called the ‘happiness hormones.’  Low levels of each have been linked to mental illness and depression.  [Another hormone, cortisol is conversely known as the ‘stress hormone’ and increased levels also relate to depression, mental illness and lower life expectancy.] Brain research seems to change daily.  However, according to my reading, while such studies are truly fascinating, and can be helpful in individual treatment, none of the research has shown that these chemical fluctuations are the cause versus the result of depression. Perhaps I just haven’t come across that, but I suspect the researches themselves would say this is not conclusively clear.
So, chicken or egg?

Genetics.  You may hear from both laymen and professionals that “it runs in the family” – and some sufferers with mental illness do have a genetic vulnerability.  This is extremely clear, and cannot be ignored.  But other authors and researchers have pointed out that over the last few decades there has been an usual rise in mental illness in society as a whole.  [This is after accounting for population explosions.]  Yet, our ‘genes’ just don’t evolve that quickly.  It is not like a virus capable of rapid dissemination across the population.  So, why the dramatic rise?  Personally, I might be lucky with helpful genetic predispositions, but they aren’t a guarantee of mental well-being or of a sunshiny outlook.  At times I feel the dark clouds for sure.  Other things besides genes have to be at play when you consider the uptick in mental illness and a decrease in mental wellness.

The Unexpected Significant Factor

Surprising or not, one of the close correlations of drug use and mental illness is income inequality.

It’s no shame to be poor……
But, it’s no great honor either.
— Tevye, Fiddler on the Roof

Drugs.  The World Drug Report, developed and published by the UN Affairs on Drugs and Crime every year (since 1997), tracks use of opioids, heroin, cocaine, cannabis, ecstasy, amphetamines and others.  Now those on the wealthy end of the ladder can afford (and use) drugs, often the newest ‘designer’ drugs.  No doubt this may lead to life disruptions, legal problems or worse.  Still, the percentage of related problems (from drug use) is not as high for the wealthy, and reasons for their drug use tend to be different (which I will note later).  In the book The Spirit Level : Why Greater Equality makes Societies Stronger, authors Richard Wilkinson and Kate Pickett (associated with the Spirit Level: Equality Trust) combine and track these data points for many countries.  The data shows that in countries with the greatest inequality, drug use is (clearly) more common.  Further they show that this tendency toward addiction (and drug overdose deaths) is higher within those US states that are most “unequal.”

Low position in the social status hierarchy is painful to most people,
so it comes as no surprise to find out that
the use of illegal drugs such as cocaine, marijuana and heroin,
is more common in more unequal societies.
— The Spirit Level (p. 70)

Whose Fault is it?

Psychologists talk about events from background case studies which relate to drug and alcohol addictions.  The term is Adverse Childhood Experiences (ACE).  This can be defined in numerous ways: deprivation, physical, mental or emotional abuses – to us or those we love.  [There are quizzes to take to see how many of these measures have played a part in your life.]

I bring this to our attention only because the rate of these ACEs is far greater in low-income families or those brought up in a low-income family.  To put a number on this, the Wisconsin Children’s Trust Fund did a study to evaluate and compare our scores versus income.  Most people I know agree that “all families are dysfunctional.”  But what that really means has wide latitude.  The study basically divided those who went to college and those who are from the “working class” with lower income (while these are not always mutually exclusive we know).  Scores were based on a self-grading, but clear, 10 point scale.  Most people who have gone to college have a score less than 50% for one incident of an ACE.  Those in the working class scored over 50%.  But the multiple ACE scores put the gap in painful clarity; those with college degrees scored less than 29% as a group.  The lower income group scored over 40% for multiple ACEs.

These ‘experiences’ are not only linked to proliferation of alcohol, drug abuse and early death, but to anxiety, relationship problems, depression, underperformance in school and work, and hostility.  Worse is that the “re-wiring” that occurs in our brains due to these events during childhood remains into adulthood.  They remain even if problematic situations no longer exist.   Sadly, high ACEs scores can predict the tendency to invent a problematic situation when it is uncalled for (especially with exaggerated hostile reactions).

Perhaps those with a score of zero, or the 29% group who “make it out,” have little sympathy for those who do not.  That’s simply a questioning assumption on my part.  But I ask myself where does the blame stop?  Frankly, I believe there ARE times for blame.  But when?  At what point is the person at fault (and there are those times)?  And when do we have to acknowledge that lost opportunities (little support and little imparted knowledge of how the world works) handicapped that person from the beginning.  Apparently, it isn’t just “who you know,” it’s also how and what you know, which is supposed to be imparted early-on through our families.

Before we pass a verdict about whether addiction is a matter of being weak-willed or conversely a lack of opportunities, consider this experiment (assuming it relates to humans).  In North Carolina, 20 macaque (cynomolgue) monkeys were observed and studied by the Wake Forest School of Medicine.  At first they housed the monkeys in individual cages, then later in groups of four.  In one section of the experiment they scanned their brains at different points before and after the relocations.  They were observed for social behavior and development of hierarchies between the dominant and subordinate individuals.  In a second segment of the study, another piece of the puzzle was added.  The monkeys were allowed to press levers bringing them cocaine as they wished.  The result surprised me, as I assumed perhaps those in ‘power’ would take what they wanted, when they wanted it.  However “the dominant monkeys took much less cocaine than the subordinate monkeys.”  The subordinate (less ‘wealthy’ in their social realm) had less control over their environment.  They were evidently medicating themselves against low social status especially during their stressful periods (as determined by the brain scans). The low-status, stressed subordinate monkeys often chose cocaine over food.

Different types of Addiction – at Both Ends of the Ladder

As we saw, mental Illness is displayed more often by the poor among societies or groups with greater inequality.  Nevertheless, poor mental health and addiction is certainly not unknown to those in the upper tax brackets.  Some addictive behaviors (with underlying mental wellness issues) are not easily recognized as addiction.  Yet, they still plague our inequitable society and do little for the individual.

Gazingus Pins are a different kind of addiction than the cocaine used by our monkey friends.  Some people, well-off or not, frequently have this different type of addiction.  Despite income levels, the root is the same – a way to make one feel more satisfied and perhaps socially admired.  A Gazingus Pin (popularized in an older book entitled Your Money or Your Life) is “any item you just can’t pass by without buying.”  This can be anything: shoes, coffee mugs, earrings, magazines, political books, pens, keyrings, camping gear or sporting equipment, socks, wrist watches, hand cream – whatever.  You very well may have one, admitted out-loud or not.  Generally, while not admirable, these addictions aren’t as life destroying or disrupting as drug addictions, but they stem from similar insecurities.

In the book Hillbilly Elegy: A Memoir of a Family and Culture in Crisis, author J.D. Vance laments that self-defeating drug use is not the only addiction in the white-working class of multi-state Appalachia.  He explains the resentment felt by many ‘Hillbilly’ hard-working folks when they view the consumerism of their neighbors “on the dole.”  The author states that often these ‘hill people’ resort to unfairly blaming government instead of their fellow citizens.  Vance postulates that this is because they understand the unfulfilled desires that come with being poor, even if they can’t understand the irrationality of their neighbor’s irresponsible consumer behavior.

Luxury fever.”   In my mind, I can’t help but recall recent Lincoln car commercials as I cover this ‘condition.’  TV commercials prey on this craving, which affects different groups but in similar ways — creating an unhealthy struggle for more-more-more.  Economist Robert Frank describes this phenomenon in which most of us desire an ever-increasing amount of luxury goods (up and down the income scale).  At first, it is keeping up with the Jones.  Later, for the less well-off, it can lead to hating the Jones (while still trying to compete with them).  And for those who internalize this hatred and resentment (stemming from inequality), it can lead to depression and mental illness when they decide that they themselves are ‘failures’ or ‘unworthy.’

Affluenza.”  Oliver James explains it as a “set of values which increase our vulnerability to emotional distress.”  The distress escalates when we don’t reach the anticipated level of ‘affluence.’  [For a sobering hour long video lecture by Dr. James on Affluenza “virus,” see:  ]

Addiction to Income.”  According to Richard Layard, this obsession reflects behaviors that can devastate our life – our family, work, relationships and all quality of things we profess to hold dear. You might visualize a beloved ‘workaholic’ to realize how it affects the wealthy. Excessive time spent at income production also takes away from community life and participation.  Layard explains this addiction as a situation in which “people’s past standard of living affects in a negative way the happiness they get from their present living standard.”   [This can be a high standard that turns low, or a low standard that continues to influence feelings despite new-found wealth.]

Status Anxiety.”  Alain de Botton states this type of anxiety is a “worry so pernicious as to be capable of ruining extended stretches of our lives.”  For those well-off there is worry, concern and striving to reach or maintain a desirable rung on the social hierarchy ladder, and not lose what they have.  For those who fail at their goals, or for those less well-off, it increases divisions and hostilities.  Considering US inequity levels it may not be an exaggeration to guess that 90% of the population could find themselves (or at least ‘feel’ themselves) in this category. Without change, de Botton describes those with such anxiety as “condemned to consider the successful [people] with bitterness, and ourselves with shame.”

None of these ‘addict’ types, whether at the top or bottom of the ladder, succeeds at the intended goal in the long term — namely feeling more satisfied.  Few win, and there is high price tag – either in money or mental wellness.

Given the importance of social relationships for mental health,
it is not surprising that societies with low levels of trust and weaker community life
are also those with worse mental health.
 — The Spirit Level  (p. 70)

Hidden Consequences

From most studies and the World Drug Report mentioned earlier, it’s clear that the poor “hit bottom” more frequently and that they suffer from mental health problems more than the rich.  But much of this seems a matter of gradation.  With few exceptions, all but the 1% silently struggle against their discontent with social placement, finances, and their climb up the ladder.  I can’t imagine what the 1% struggle with – although I admit that I would like to give it a try.  Still, success is something we all want, so where does this situation leave us?

Would it spoil some vast eternal plan,
if I were a wealthy man?
–Tevye (Fiddler on the Roof)


My thought is first to consider how income inequality (especially high in the US according to the UN reports) affects the well-off or rich in terms of the mental wellness of everyone in their community.  Because this is not the common approach, we often read about effects on the poor only.  But even if mental illness were confined only to the poor, the fall-out touches the wealthy as well.   Mental illness simply upsets both ends of the ladder, even when not statistically observed or acknowledged as a direct link.

Here are some examples of how income inequality burdens the whole community:

  1. It creates significant gaps in income leading to a less happy low-wage work force – saddling the high earners, middle management or ownership crowd with the negative consequences.
  2. It increases needed funds and tax dollars required for mental health care of the indigent who have no other options.
  3. It hurts our economy and productivity due to less-robust workforce and consumer base. Although the US still manages to be quite productive in many industries, this remains a time-consuming and worrisome burden.
  4. It increases the tax payer’s burden to provision more prisons, where so many of the mentally ill are held in the U.S. (Note: I realize there are some in power or facility owners who benefit from unreasonably filling prison beds to capacity or overflowing, but I am not including them.  There is a special place in hell for that bunch.)
  5. It makes all of society less safe when combining mental illness with gun ownership.
  6. It creates a political division that may be detrimental to our future government structure or a civilized society.
  7. It deprives the “have(s)” of peace-of-mind from fear of rebellion by “have-not(s)”. This can be seen in an extreme example from the New Yorker Magazine article “Doomsday Prep for the Super Rich”  (Jan. 30 2017)

Thinking Ahead

Approaches are not evaluated similarly regardless if the facts are similarly presented.  A recent Harvard survey (January 2017) explored the idea of corporations and government’s influence on help to the poor and unemployed.  According to the study, whether such aid (or ‘balancing’) is seen as positive help for the poor, or whether it is seen as ‘enabling’, depends on your political views or political party.  One of the concerns was that competitiveness for corporations, innovation and worker skills may not do well with increasing income inequity.   Michael Porter (Lawrence University Professor) was quoted in the survey report commenting:

“We face a bit of a fork in the path.
The low road is where America devolves into narrow self-interest,
companies exit, the tax base goes down, and the skills base goes down.
It’s a win-loss scenario.
Then there’s a win-win scenario,
where we see a vastly expanding pie where companies invest in innovation and skills.”

Why Discuss this?

Did you ask yourself, “What does income inequality have to do with Aging with Pizzazz?”  Why review or consider these observations?  It sounds too political.  And anyway, what can we do?

This is not written as a call to action, but more a call to awareness. Aging with Pizzazz is certainly easier in a healthy society.  I am asking myself these questions as well as readers.  I realize there are many more answers — and many more questions for that matter.  But here are a few take-a-ways for us, which hopefully will give us pause to think, no matter our penchant for political views, one way or another.

  1. As we age, we can choose to look back at good things we have done and accomplished as opposed to concentrating on what we did not. Or what others have done.  Or how much they have.  It would help us to make different choices in our self-talk language.  Meaning to be a kinder to ourselves, realizing how mental health can be affected by our social status, and more often than not just our perception of that social status.
  2. We can realize that mental illness is more severe in countries (or states) with larger equality gaps. Keep that in mind as we consider current events.
  3. When it comes to massive inequality, what is the true fiscal cost to everyone? Decide for yourself what level of welfare support versus mandatory personal economic independence and responsibility is worth the cost to society.  While we all believe in personal responsibility on some point located along a sliding scale, where is it most advantageous to lend a helping hand?
  4. Consider a conversation with a friend or acquaintance with another political point of view, regarding how this subject affects everyone in different ways. Whether societal solutions are worth the cost?  How might our tax money benefit both rich and poor in this matter?  Where would practical, long-lasting reforms best be pursued?


  Final Thought

It is no measure of health
to be well adjusted
to a profoundly sick society.
              …………………….. — Krishnmurti

Should we bake a bigger pie?

And to mix metaphors, I ask: do we need to add more rungs to the ladder so that the shortest among us can achieve the climb?



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2 thoughts on “Income & Mental Health ………………. Does it Matter what Rung of the Ladder You’re on?

    • Thanks Darrow. For those who think about income a good deal – or those who ponder Mental Health – may have more to offer. But you are correct, good for us all to ponder within our own situations. Appreciate your comment.

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