“Depression is the most common cause of human death in the world”

Urban sociologist Pyotr Ivanov about stress management and treatment for depression in the city. Part 1

Urban life gives a pleasant opportunity not to split logs to heat the flat, not to think where to dispose of waste, not to have a household but eat cheese and hen’s eggs… However, we have to pay for comfort with stress and depression because of loneliness, the bleak urban environment, a crowd of strange people. In an interview with Realnoe Vremya, sociologist Pyotr Ivanov talked about life in the city, antidepressants and stress management.

“A person consciously or unconsciously narrows them and avoid a stressful situation to “other worlds”

How does modern man cope with stress?

Firstly, people cope with stress through distance, by excluding themselves from the environment, by creating a block on active perception, on stress factors. People who actively practise the same distancing from stress. In answer to the question “Where do you want to live?”, they will answer: “Somewhere in the suburbs, far from people, in my own house”. Other scenarios of exclusion from the stressful environment are dreams of a holiday, civic disregard, restriction of channels of perception, which are overloaded. In other words, a person consciously or unconsciously narrows them and goes from a stressful situation to Other Worlds. Other Worlds are a widespread model of coping via alcohol, drugs, fascination. Here I will explain this term. Coping is what a person does to fight stress.

On the other hand, we can try to influence different stressful situations through environmental factors, through a reduction of level: noise, vibration, visual pollution. It is also possible to influence by creating some designs of lighting installations so that they will make a favourable impact on us. There is a culture, community of “gloomy cities” that exchanges experiences at its conferences. Indeed, what should one do if you have six sunny days in winter? It is obviously bad, it is necessary to do something with it. It is necessary to make up how to compensate it so that people will go mad and committed suicide less.

There are different scenarios of how to harmonise and reduce the danger of these processes. I will explain now what it means. Urban life is full of abrupt, sudden movements. If they become smoother, safer, we can minimise stress in the city. The chances that you will be hit by a car in Minsk and Krasnoyarsk are 20 times different. In other words, you feel 20 times calmer when you go for a walk in Minsk because there are almost no traffic accidents with fatalities. I mean it is linked with harmonisation, softness and predictability of road traffic.

When road traffic researchers ask: “How should we analyse the danger of our roads?” They are replied: “You should look at near-accidents, that’s to say, sudden changes of speed or trajectory of movement”. Such risky movements grow into accidents then.

Photo: vgoroden.ru
Indeed, what should one do if you have six sunny days in winter? It is obviously bad, it is necessary to do something with it. It is necessary to make up how to compensate it so that people will go mad and committed suicide less

“The Ministry of Loneliness appeared in London”

Could you give other examples of stress management in the city?

Another area is work with colour and shape so that a person will consider the surrounding environment as something warm and favourable. Easy work with colour is when we look at some colour and it seems to us warm or cold. And we use warm colours in urban development.

There is a targeted work on stress management, for instance, the Ministry of Loneliness appeared in London. What’s the problem? Loneliness is associated with depression, cardiovascular and other diseases. If we narrow the problem to cardiovascular diseases, we can lose a lot of people.

Loneliness is a huge problem, it is a rift in society, loss of yourself and self-perception in society. In other words, it is necessary to provide people with a chance to cope with a critical condition easier in a soft, non-intrusive manner. Such a scenario often happens in life: a person moved to a new city, he doesn’t have school or university friends or everyone got married, while he can work from home or doesn’t have a desire to talk with his colleagues… Then there is a situation when the person can get lost, he won’t know where to go and whom to talk with. Bad things begin to happen then. Such people can be allowed to call somewhere, turn to somewhere. There must be some programmes, solutions that help a lonely person to reintegrate into society.

Photo: macos.livejournal.com
Another area is work with colour and shape so that a person will consider the surrounding environment as something warm and favourable. Easy work with colour is when we look at some colour and it seems to us warm or cold. And we use warm colours in urban development

“Constant stress has a very good chance of settling down”

You said in your lecture that mechanisms distancing people from each other work in the city. What are these mechanisms? Does it turn out that citizens are doomed to loneliness and isolation?

The move to the city that conditioned the appearance of such science as sociology is important here. Sociology had had nothing to study. It appeared during the industrialisation, mass migration to cities in the late 18-mid-19th centuries. Big factories appeared, big cities arose around them where a person meets a lot of unfamiliar people. Habitual mechanisms for regulating relationships almost don’t work there anymore. When you grow up in a small community, you have a big set of regulative strategies based on personal acquaintance. For instance, an old person’s authority in the countryside is higher because he can address the lawbreaker saying that he brought him up or saved from death when the latter fell to the water on a fishing trip and so on. Consequently, the lawbreaker will be ashamed, he accepts the authority. In the city, young people have a reasonable question: “Old man, why should I listen to you? You’re nothing to me”.

Relationships in the city are precisely the relationships like “you’re nothing to me”. Kinship, friendly relations that are characteristic of a small community and based on personal acquaintance don’t work in the city anymore. This is why there are social institutions and institutional roles. Then, acting within their institutional frameworks, people treat each other differently. Not from heart to heart, not as relatives, not as neighbours but as a seller in the shop, as a function that has some elements of social life in a big city. Consequently, it is a situation when the seller talks with a lot of people, but they all say the same thing to her: “A Coca-Cola, 2 litres, please”. She is tired of such communication, she wants to hear something different, for instance, a compliment or joke. She wants some cordial interaction, but this is impossible when working as a seller.

In general one of the important factors of stress is communication with a lot of unfamiliar people you know nothing about. In such a situation, a person tries to guess if the stranger will stab us or shout at us or help to something tasty. What should be expected of him? When we don’t know what’s the other person like, we haven’t spent much time with him, we become tense. Then our problems linked with people’s mental issues in the city arise because constant stress has a very good chance of settling down through a wrong coping strategy, and that’s it, here is depression or obsessive-compulsive disorder. Any affective disorder is linked with it if its origin isn’t endogenous.

In general one of the important factors of stress is communication with a lot of unfamiliar people you know nothing about. In such a situation, a person tries to guess if the stranger will stab us a knife or shout at us or help to something tasty. What should be expected of him? When we don’t know what’s the other person like, we haven’t spent much time with him, we become tense

“Depression is the most widespread affective disorder”

Can you say something about Russians’ mental health or disorders?

We simply don’t have accurate data because the diagnosis of mental illnesses is very weak. People with psychosis go to the hospital, for instance, they can run the streets with an axe. Such people are under psychiatric supervision. The odds are that a person who feels unhappy, who can’t even get up to go to work is unlikely under psychiatric supervision. He might think: “What’s up? We live in Russia…” On the other hand, there is a very serious social stigma of mental illness (a negative association of the person with something shameful, not prestigious, repulsive). If you have a medical note, you won’t find a job, get a driving licence. Though it isn’t so strict how it used to be in the Soviet era. A person with a psychiatric disorder unlikely will have problems with formal employment. Nevertheless, this image makes a person prefer not to appear in front of representatives of psychiatry: “Am I a psycho?” Some internal stigma appears too: “All normal people tolerate it, why did you start whining?” It turns out to be a full-fledged stigma by Erving Goffman that impedes diagnostic of affective disorders.

Then there is an extra scenario that impedes it — poor mental health, bad knowledge about how to work with your inner world. American schools introduce training in transcendental meditation as a means of stress management and emotion control. Neither our schools nor universities talk about what to do with our emotions. At least, it is taught how not to express them. It is good if you don’t express them, but they still exist. Then a wrong strategy of how to cope with this emotion is created, and in the end, there is affective disorder.

Photo: dailystorm.ru
The odds are that a person who feels unhappy, who can’t even get up to go to work is unlikely under psychiatric supervision

It is hard to say how better residents of Russian cities’ health is than that of citizens of American cities. America has its own problem of overdiagnosis. There is a feeling that statistics are too exaggerated there because doctors try to establish a diagnosis just in case. They try to prescribe patients some therapy, pills to somehow help the person.

What are the statistics on people’s mental health in the West?

If we talk about the statistics in the USA, for instance, 5,4% of men have at least one affective disorder, while women do 9,3%. Women are either better diagnosed or more inclined to mental disorders. Depression is the most common affective disorder (4,5% for men and 8% for women). Mania is the least common (0,2% for men, 0,4% for women).

To be continued

By Matvey Antropov