Taming the black dog

KIRAN MATHUR MOHAMMED

kmmpub@gmail.com

It is usually too late by the time we hear about depression or anxiety. When the young man breaks into an airport intent on crashing a plane. Or the policeman quietly succumbs to what Winston Churchill referred to as his ‘black dog’, and takes that final, drastic step. Several years ago, my best friend took that step.

For some, depression and anxiety can consume their entire lives. Others live life through a grey haze. And anxiety is the constant companion of ambition.

You don’t feel able to get out of bed, and you call in sick. Or you sit in front of your screen staring; and put off calls you need to make. You are late for the start of your shift or you sit listlessly in the warehouse. Quotas don’t mean much.

This is being quantified. Thomas Insel has estimated in the American Journal of Psychiatry that serious mental illness predicts a mean drop in earnings of US$16,306 per person; at least in the United States. The World Health Organisation estimates the cost at between three to four per cent of European gross national product; a grand statistic that does not fully convey the extent to which anxiety and depression eat into our daily productivity. The data is sparse in Trinidad. But the consensus among psychiatrists is that it is expensive for businesses and constrains growth.

Mental illness particularly hits anyone working on projects with shorter, defined timelines (think factory workers, engineers, or salespeople). Investing in mental health may not make immediate sense for every manager or business owner. It is costly. But it makes sense for companies that can easily and directly measure productivity.

Popular culture has already recognised this. In Netflix’s Billions, a psychiatrist advises the fictional investor Bobby Axelrod. In real life, Ray Dalio, founder of Bridgewater, the world’s largest hedge fund, has mandated meditation sessions for his traders in Westport, Connecticut. Mindfulness is well-nigh ubiquitous in Silicon Valley.

I’ve had the opportunity to support a panel discussion on depression, put together by Anissa Osman and the Global Shapers. It was useful, and there was rightly a call for greater government investment. But people need help now. How can we broaden access in ways that are immediate, and cheap?

Technology is no substitute for effective talk therapy or formal medical treatment. But it can be a powerful tool to broaden access to treatment. Mobile ‘mindfulness’ applications like Calm and Headspace have surged in popularity (if being number one in the Apple iTunes store is any gauge). Sound therapy is equally easy to access. Binaural beats therapy (in which the right and left ears listen to two slightly different frequencies but perceive the tone as one) is said to be calming and focusing.

Virtual reality headsets are not just used for gaming. Oxford VR, a University of Oxford spin-out company, uses a virtual facilitator for a programme that treats users’ anxiety and fear of heights. You slip on the headset and take part in treatment, beginning on the tenth story of an office building. This experience helps to instil a sense of control within a safe space. In a study published by The Lancet, this reduced participants’ fear by two thirds. A headset isn’t cheap – it costs a few hundred US dollars. But it is still less expensive than traditional talk therapy.

In fact, much of this technology is relatively inexpensive and accessible. Some of it is free. Companies can encourage their employees to use these tools, even as individuals can use them on their own.

There is also an opportunity for local, private entrepreneurs and non-profits to step in and fill the gap. I’ve spoken with a few that are already doing so. In an Inter-American Development Bank backed project, Keron Joseph has been working in rural and at-risk communities to help people use online media to tell their stories. In doing so, they can find catharsis out of tough experiences – and learn media skills that they can monetise. David McCartney’s start-up MasterMind facilitates mindfulness and therapy sessions for companies and individuals.

The best approach is always to seek professional medical help. But so many are shut out. These tools and companies do not replace medical help and can lead people to it.

The late Dr Eric Williams, TT's first prime minister, and Sir Winston Churchill, Britain’s wartime leader, both showed signs of mania and depression. It did not prevent their greatness. Acknowledging and treating mental health is not a luxury for the lily-livered. It is a hard-headed decision that can make us richer, and freer.