Financial Hardship Changes Your Brain

Published on November 16, 2012

The role of hardship in the association between socio-economic position and depression

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The World Health Organization reports “Depression is the leading cause of disability as measured by YLD (Years Lost to Disability)”1 Depression could be described as a general feeling of sadness or unhappiness. There are several mechanisms used to discuss the cause of depression. Geneticists talk of gene defects that might make us more susceptible to depression; biochemists point to hormonal and neurotransmitter imbalances; and neurologists blame anatomical changes in the brain. Most however agree that these traits are not predictive of depression, but simply predispose us to it.

Given the right environmental conditions, a predisposed person might manifest depression along with any number of other mental and so-called physical illnesses. The question is—what are those conditions? The list is long; death of a loved one, major disease, loss of job, etc.

According the American Psychiatric Association (ASA)2 , “increasing evidence supports the link between lower SES (Socio-Economic Status) and learning disabilities or other negative psychological outcomes…” The ASA continues, stating on their website, “perception of family economic stress and personal financial constraints affected emotional distress/depression in students and their academic outcomes….”3

Peter Butterworth and his coauthors wrote a paper that was recently published in the Australian and New Zealand Journal of Psychiatry4 titled “The role of hardship in the association between socio-economic position and depression”.

child poorThe paper asserts, “there are few studies examining the link between financial hardship and diagnosable depression at a population level.” Given that two-thirds of the poorest people on earth live in Asia5, and “in 2030 depression will be the single biggest cause for burden out of all health conditions”, it seems sensible to update the existing data with this worthwhile research.

The role of socio-economics is more striking when we look at the fact that “about 800,000 people commit suicide every year, 86% of them in low- and middle-income countries”7 Part of this alarming statistic may be attributable to the fact that most low- and middle-income countries have only one child psychiatrist for every 1 to 4 million people.8

The Butterworth study examined several measures of socio-economic position to determine which had the greatest correlation with depression. On of those measures, ‘financial hardship’ is a term used when you don’t have enough money or resources to provide the basic necessities of life, such as food and shelter. Related to that is ‘household income’ which is an estimation of the disposable income for a household unit.

“Main source of income” was considered also because various jobs result in differing levels of stress. AsianOne.com for example reports, “among so-called blue-collar jobs, firefighter, police officer and taxi driver topped the high-stress list, while jobs such as bookbinders, photo process workers, musical instrument repairers and auto assemblers are considered low-stress.”9

Finally, labor-force status, area-level disadvantage and occupational skill were assessed. The study used the Composite International Diagnostic Interview to assess the 12-month prevalence of depressive episode of 8,841 participants aged 16-85 years of age from Australia’s 2007 National Survey of Mental Health and Wellbeing.

After considering the variables, the Butterworth study found that “financial hardship was more strongly associated with depression than other socio-economic variables”.

As to the real world relevance, the study concluded, “ social and economic policies that address inequalities in living standards may be an appropriate way to reduce the burden attributable to depression.”

This is particularly interesting from a biological perspective because there are established neurological correlates to financial hardship. Said differently, financial hardship can change the structure of your brain

In the paper “The association between financial hardship and amygdala and hippocampal volumes: results from the PATH through life project”, the authors used structural magnetic resonance imaging to determine “whether middle-aged adults exposed to poverty in childhood or current financial hardship have detectable brain differences from those who have not experienced such adversity.”10  The amygdala, a sort of neuronal store house for stressful memories has been implicated in anxiety and fear in humans.

The study concluded that, “after controlling fordalipidated house well-established risk factors for atrophy, adults who reported financial hardship had smaller left and right hippocampal and amygdalar volumes than those who did not report hardship”.  Interestingly, the changes identified in adults were not found in children who were exposed to the same levels of financial hardship.  “In contrast,” the paper states, “there was no reliable association between hardship and intra-cranial volume or between childhood poverty and any of the volumetric measures.”

Another study which considered the neuropsychological correlates of the amygdala concluded that a larger left amygdala was associated with patients who were exposed to stressful situation11.  All tolled, we can anticipate at least a filamentous triangular correlation between depression--financial hardship—amygdala size.  How wonderful it is to live in the period when medicine has begun to interpret mental illness from a bio-psycho-social perspective.

If you are connected to this story personally or otherwise, we would like to get your input.  Until next time…KEEP THINKING!
 

Resources

1 http://www.who.int/mental_health/management/depression/definition/en/

2 http://www.apa.org/pi/ses/resources/publications/factsheet-education.aspx

3 http://www.apa.org/pi/ses/resources/publications/factsheet-education.aspx

4 Butterworth, Peter; Olesen, Sarah C.; Leach, Liana S. The role of hardship in the association between socio-economic position and depression. Australian and New Zealand Journal of Psychiatry, Vol 46(4), Apr 2012, 364-373.

5 www.adb.org/themes/poverty/overview

6 http://news.bbc.co.uk/2/hi/8230549.stm accessed August 7, 2012

7 http://news.bbc.co.uk/2/hi/8230549.stm accessed August 7, 2012

8 http://news.bbc.co.uk/2/hi/8230549.stm accessed August 7, 2012

9 http://www.asiaone.com/Business/Office/Hot%2BJobs/Story/A1Story20110429-276405.html  accessed August 7, 2012

10 Butterworth P. et al. The association between financial hardship and amygdala and hippocampal volumes: results from the PATH through life project. Soc Cogn Affect Neurosci. 2012 Jun;7(5):548-56. Epub 2011 May 6.

11 Monash University (2006, January 19). Studying Brain Activity Could Aid Diagnosis Of Social Phobia. ScienceDaily. Retrieved August 8, 2012, from http://www.sciencedaily.com­ /releases/2006/01/060118205940.htm


Category(s):Depression

Written by:

Tony Brown

Tony Brown is a former U.S. Army (Reserve) Medical Officer, and currently completing his studies as an M.D./PhD/MBA candidate, with a research thesis titled, “Pharmacology and the Neurological Correlates of Consciousness.”