ON A RECENT visit to an inpatient psych unit, it becomes clear that several convalescents have more in common than spiritual anguish and labels culled from the Diagnostic and Statistical Manual of Mental Disorders.
They are unemployed.
"I'd be a lot better if I had a job," says one highly intelligent, credential-laden man, his crisis triggered by a paycheck deficiency.
Another patient lost a blue-collar slot as part of the great diaspora of U.S. factory jobs to Mexico, China and beyond.
Because Prozac and Zoloft were not conversation staples in his circle, despair crept up without announcing itself. The pronouncement of "severe depression" after too many leaden days came as a revelation.
But involuntary unemployment and depression, the medicos tell us, often go together like graveyards and darkness.
Jobs describe us. They fill the existential void, often giving much of the meaning to our brief visit on Earth. Blaise Pascal said all human unhappiness can be blamed on man's inability to sit quietly in a room. Having to sit in a room while the rest of the world creates, produces and earns, however, can be another form of misery.
Grief comes from loss, and "when we look at loss, it can be experienced in a variety of ways - where it's the loss of a relationship, where it's the loss of a job, where it's the loss of financial resources," says Dr. Thomas Koenig, assistant professor of psychiatry and behavioral science at the Johns Hopkins University's medical school.
"A lot of folks tend to define themselves by their professions, by the work that they do, so there's the loss of that role" after a layoff, he added. "There's also the loss of the role of the breadwinner, the role in the family."
Unemployed men get depressed more than unemployed women.
It is important to distinguish between full-blown clinical depression and what Koenig calls the "demoralization" that accompanies setbacks, although the frontier separating them may not be as neat as doctors seem to think.
But depression seems to be a threat for almost anybody who is without a job and wants one. An Australian study published three years ago found that 30.9 percent in a sample of unemployed people suffered anxiety and depression requiring medical treatment, compared with 14.6 percent for an employed group.
Of course, if lacking a job makes you depressed, being depressed fetters your ability to find and keep a job.
"It's going in both directions, I think it would be safe to say," says Dr. Mary Whooley, an associate professor of medicine at the University of California in San Francisco. She co-authored a study showing depression increased one's odds of being unemployed. "Patients can really end up in a downward spiral."
The U.S. unemployment rate in July was 6.2 percent, close to a nine-year high.
I am convinced that distress associated with the economic slowdown and the 2001 terrorist attacks generated the high medical bills that drove Columbia-based Magellan Health Services, the country's biggest mental-health insurer, into bankruptcy.
Describing problems is easier than prescribing solutions. Prohibiting layoffs is not the answer to unemployment and unemployment despair. Flexible labor laws enable layoffs, but flexible labor laws also are key to economic growth, which is the unemployment antidote. Europe has shown that if companies can't fire people, companies don't add jobs.
But layoffs are not inevitable. Corporate bosses invariably portray job cuts as the mechanical result of uncontrollable forces, and often they are. Layoffs are usually a choice, however, not a necessity. They are not without benefits; often they pave the way for national productivity growth and higher per-capita incomes.
But they are a choice.
One great void in modern culture is the fading of noblesse oblige, the duty of benevolent behavior toward the less fortunate that once was laid upon the privileged. The left, which rejects paternalism as an opiate of oppression, is as much to blame as the right, which preaches the dividends of self-interest.
But the duty is there. To whom much is given, Mr. Executive, much is expected. Next time your finger touches the layoff trigger, consider unemployment and the odds of clinical hopelessness.
And for those looking for jobs, sometimes the greatest comfort in distress is knowing others share your plight. According to the Bureau of Labor Statistics, there are 9.1 million of you.
Here's wishing that some steady, paid labor, befitting your training and expectations, soon gets you out of your room.