Mental Health, Capitalism and Activism

Presented by Alexandra Fox

When asked, people describe the abyss pretty consistently. In the first place, it’s dark. You are falling away from the sunlight toward a place where the shadows are black. Inside it, you cannot see, and the dangers are everywhere (it’s neither soft-bottomed nor soft-sided, the abyss). While you are falling, you don’t know how deep you can go, or whether you can in any way stop yourself. You hit invisible things over and over again until you are shredded, and yet your environment is too unstable for you to catch on to anything – Andrew Solomon, The Noonday Demon

In 2014, my work as a feminist and environmental activist triggered a relapse into depression and an onset of chronic anxiety. I’ve spent the majority of the last year and a half in a state of almost constant terror and immobility, and developed a fantastic relationship with my ceiling. My mental health has prevented me from being as much of an activist as I’d like –  I can’t participate or listen to conversations about climate change without feeling like I’m going to vomit, and I can’t discuss the upcoming election without uncontrollably shaking (although I do  believe these are sane reactions to insance circumstances). I spend more money on medication and therapy than my rent each month, and because of this illness I have lost people in my life I didn’t think it was possible to lose.

But, to regret my depression would be to regret the most fundamental part of myself.

As Kay Jamison beautifully describes it: Depression is awful beyond words or sounds or images; I would not go through an extended one again. It bleeds relationships through suspicion, lack of confidence and self-respect, the inability to enjoy life, to walk or talk or think normally, the exhaustion, the night terrors, the day terrors. There is nothing good to be said for it except that it gives you the experience of how it must be to be old, to be old and sick, to be dying; to be slow of mind; to be lacking in grace, polish, and coordination; to be ugly; to have no belief in the possibilities of life, the pleasures of sex, the exquisiteness of music, or the ability to make yourself and others laugh….So why would I want anything to do with this illness? Because I honestly believe that as a result of it I have felt more things, more deeply; had more experiences, more intensely; loved more, and been more loved; laughed more often for having cried more often; appreciated more the springs, for all the winters; seen the finest and the most terrible in people, and slowly learned the values of caring, loyalty, and seeing things through. I have seen the breadth and depth and width of my mind and heart and seen how frail they both are, and how ultimately unknowable they both are.

As I share these difficult experiences with my fellow activists, it becomes increasingly clear to me that burnout, depression, guilt, trauma, existential crises, and anxiety are common among activists and those on the left. Almost everyone I speak to has stories and experiences to share of themselves or someone they know.

So, what would be your first steps as an activist? mine was To look up left literature and support on the topic! Unfortunately – I was sorely disappointed.

The literature on the Left and mental health was abysmal, and mostly situated as individualistic self-care advice like take a bath, or do yoga!). Books and writings on capitalism and mental health are far and few between, and conversations like the one we’re having today are extremely hard to find.

The support I received in therapy  was along the lines of “well, just stop being an activist” or “try to think about more positive things”! I found that instead of focusing on outside systemic  issues that are contributing to mental health challenges, the focus was on my internal though processes – as if that is the reason I was sick.

This talk will first outline a brief history of mental health and activism – the different movements and perspectives, and then outline some of the questions I’m currently exploring. As there’s very little written about this topic, I decided that I would share with you some of the challenges and things I’m exploring in my head. Hopefully it will lead to a fruitful discussion.

Additionally, I’d like to note that as capturing the essence of depression, anxiety and other mental health challenges takes extreme talent, and is something that I have not managed to do well, throughout this presentation I will be quoting those who have adequately and beautifully managed to express this experience in words – in particular the work of Kay Jamison and Andrew Solomon.


1 in 4 people will experience a mental health problem, and mental illnesses are more common than cancer, diabetes or heart disease. Over 70% of the prison population has two or more mental health disorders, and mental and substance abuse disorders are the leading cause of disability world wide.

Every 17 minutes, someone in the US commits suicide. The second leading cause of death among young people (ages 18 – 30) is suicide, and between 1987 and 1995 more men died of suicide than of AIDS. In 1995, more people died of suicide than of influenza, aids, cancer, stroke, pneumonia, birth defects and heart disease – combined.

Suicide is famously a “permanent solution to a temporary problem”, but in this case the problem isn’t so temporary – Capitalism.

Although many instances of mental illness are triggered by factors beyond our control, we should be talking more about the ways that capitalism has not only created the conditions of violence on others, it has co-opted the means of violence to the point where we are committing acts of extreme violence on ourselves. This epidemic of mental illness will only continue to worsen as climate change and precarity increases, and we on the left need to begin to better educate ourselves on this mounting crises.


The entire history of madness in the western world is way too long to summarize here, but it has always been problematic. As Robert Whitaker outlines in Mad in America: During the nineteenth century, the perceived mental health of African-Americans was closely tied to their legal status as free men or slaves. Those who lived in free states, or those who were slaves and publicly exhibited a desire to be free, were at particular risk of being seen as insane. According to the 1840 U.S. census, insanity was eleven times more common among Negroes living in the North than in the South. …“Here is proof of the necessity of slavery,” reasoned Senator John Calhoun. “The African is incapable of self-care and sinks into lunacy under the burden of freedom. It is a mercy to give him the guardianship and protection from mental death.” ….The definition of sanity in Negroes was still tied to behaviour that a slave owner liked to see: a docile, hardworking laborer who paid him proper respect. Negroes who strayed too far from that behavioral norm were candidates for being declared insane and were put away in asylums, jails, and poorhouses. Nationwide, the incidence of “insanity” among Negroes rose fivefold between 1860 and 1880, and once again, such statistics were seen by many Southern doctors as evidence that the “colored race” simply couldn’t handle freedom.

In An Unquiet Mind, Kay Jamison speaks to the gendered aspects of diagnosing depression and bipolar illness: Depression, somehow, is much more in line with society’s notions of what women are all about: passive, sensitive, hopeless, helpless, stricken, dependent, confused, rather tiresome, and with limited aspirations. Manic states, on the other hand, seem to be more the provenance of men: restless, fiery, aggressive, volatile, energetic, risk taking, grandiose and visionary, and impatient with the status quo. Anger or irritability in men, under such circumstances, is more tolerated and understandable; leaders or takers of voyages are permitted a wider latitude for being temperamental. Journalists and other writers, quite understandably, have tended to focus on women and depression, rather than women and mania. This is not surprising: depression is twice as common in women as men. But manic-depressive illness occurs equally often in women and men, and, being a relatively common condition, mania ends up affecting a large number of women. They, in turn, often are misdiagnosed as schizophrenics, receive poor, if any, psychiatric treatment, and are at high risk for suicide, alcoholism, drug abuse, and violence. But they, like men who have manic-depressive illness, also often contribute a great deal of energy, fire, enthusiasm, and imagination to the people and world around them.

Although this is just a snippet of what is out there on the history of madness and the appropriation of madness as a tool to quiet the non-compliant (which Dana Cloud does a great job of outlining in her talk Capitalism, Socialism and Mental Health on, …aside from a few conversations around Critical disability that include Mental health, I have yet to see a CURRENT major movement in activism address some of these problems.

However there are three major movements in activism around mental health that I have become familiar with (but am no means an expert), and I’m going to outline them here below. Each of these is distinct in the ways that it views the mental health system and it’s suggested approaches for change.


The anti-psychiatry movement “takes the approach that psychiatric treatments are more damaging than helpful to patients,… and considers psychiatry a system of oppression due to unequal power relationships between doctor and patient and a highly subjective diagnostic process.” It has been around for almost 200 years and is particularly opposed to the use of Electroconvulsive therapy, lobotomies and over-prescription of pharmaceutical drugs, as well as the involuntary commitment of mental patients to mental health institutions. Anti-psychiatry movements refer to themselves as “survivors” of the psychiatric system instead of patients or consumers. They do not use terms like depression or hallucinations, but use terms such as sad/low energy and “seeing what others do not hear or see”.

As Alix Fillingham notes in his book on Foucault Think of the patients in the back ward of a modern day mental institution. These people’s lives are tightly controlled. Can they resist? of course, and they do all the time.  but does anyone they see acknowledge that resistance as a rebellion against a power system that has defined them as abnormal and taken control of their lives, that lets them go only if they will live up to society’s idea of normality? Doctors and nurses will hear all of these statements not as political resistance, but as “uncooperative behaviour,” part of what justified locking these people up in the first place. Only acceptance of the power system and its terms will get them defined as normal, and thus get them released.

Differing from the anti-psychiatry movement in some ways is the Mad Pride movement. It was originally started here in Toronto in the 90’s and sought to reclaim terms such as “mad”, “psycho” and “crazy” from misuse. The movement hopes to re-educate the general public on causes of mental disabilities, the experience of those using the mental health system and the global suicide pandemic, and it has been linked to the critical disability movement. Although there is overlap between the anti-psychiatry movements and the Mad Pride movement,  Bonnie Burstow, a well-known anti-psychiatry advocate in the city, outlines some of the major differences in language and thought between the Mad movement and anti-psychiatry in her essay in  “Mad Matters,  A Rose by any other name”.

The downside of the antipsychiatry discourse,arises precisely from its most sterling strength—it is oppositional, it speaks truth to power, and for that reason alienates officials and even some potential allies. Correspondingly, it can be upsetting to survivors who do not see themselves as harmed, who view psychiatry as a benign or rapidly improving resource… …they keep us honest. They keep us on track. And they are the surest safeguard against co-optation.

The third major movement that I have come across in my research is the more mainstream Recovery Movement, which emphasizes and supports a person’s potential for recovery. “Recovery is generally seen in this approach as a personal journey rather than a set outcome, and one that may involve developing hope, a secure base and sense of self, supportive relationships, and meaning.

William Anthony, Director of the Boston Center for Psychiatric Rehabilitation says “Recovery is a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.” Originating from the 12-step program of alcoholics anonymous and emerging as deinstitutionalization resulted in more individuals living in the community, the recovery program is now explicitly the guiding principle of the mental health policies of many countries and states.

Here are three different areas that I’ve been mulling around in my head and want to get your thoughts on.


As the threat of environmental destruction grows larger, and modern activism retreats into individualistic forms of protest, the collective agency that activists feel with respect to their ability to create change has greatly decreased. “It is oppressive to have these views” is something a friend of mine from Newfoundland recently said to me in conversation on activism and mental health. Speaking of what she called “activist stress disorder”, she spoke of the anxiety that partaking in activism has caused her, that largely remains hidden in society. She spoke of isolation from friends and family because of views that were quote “too radical”, and spoke of the feelings of burnout and guilt that were ever-present. I believe that these feelings are extremely common, yet conversation in activist circles on this topic are slim to none.

As mentioned earlier, the examples of these conversations that I came across in my own struggles had to do with self-help and often suggested very individualistic ideas on what to do (yoga, movies, bubble baths, etc), rather than looking at the systemic roots of burnout and mental health struggles among activists (and the general population).

The fabulous article “We are all Very Anxious” by the Institute for Precarious Consciousness outlines many of the anxieties that capitalism and activism causes: Anecdotal evidence has provided many horror stories about the effects of such tactics – people left a nervous wreck after years awaiting a trial on charges for which they were acquitted, committing suicide after months out of touch with their friends and family, or afraid to go out after incidents of abuse. The effects are just as real as if the state was killing or disappearing people, but they are rendered largely invisible. In addition, many radicals are also on the receiving end of precarious employment and punitive benefit regimes. We are failing to escape the generalised production of anxiety.

In The Noonday Demon, Andrew Solomon speaks of activists in Poland in the 1980’s after martial law was imposed: “Being imprisoned was something they all accepted – what they could not bear was the loss of hope:. The public sphere in which they had expressed themselves had simply ceased to exist. “That was the beginning of a kind of political depression, a time when these men lost their belief in communication of all kinds: if they could say nothing in a public context, they would not say anything in a private context either.” The same men who had been organizing rallies and writing manifestos now lost or gave up jobs and sat at home, watching TV for hours on end and drinking. They became “morose, monosyllabic, disconnected, uncommunicative, closed.”

So, what about the families of activists that are being left behind? Another friend of mine often talks about how “doing what’s necessary” and having a family of his own often comes into tension. He would be much more willing to get arrested and take radical action if he wasn’t a father of young children and married. How do we settle this tension? Why is our activism set up so that activists may have to choose between having a family and taking radical action to do what’s necessary?

However, at the same time that we need to consider our own mental health (and the mental health of our loved ones) when participating in social movements and protest, it is important to remember those for which protest is not an option. As Mia McKenzie from Black Girl Dangerous says : “The fact that you get to “opt out” to protect your feelings shows how white you are. The rest of us don’t have that option. When we talk about racism, we are told to shut up. We are told that we are over-reacting, or that we are seeing things that aren’t there. We are told to get over it, because slavery ended years ago and we have a black President. We are insulted and demeaned. And we keep talking anyway. Because we don’t have a choice.”

What kind of accommodations can we really make? There are hundreds of families where protest is not an option. How do we, the privileged, balance doing what’s necessary with protecting our mental health and that of the ones we love?

Activist groups are becoming better and better at becoming allies (or at least talking about how to be allies) to people of colour, and queer identities and those with physical disabilities. I am unsure that we are at the same level of conversation with those who are struggling with their mental health. How can we advance this conversation within activist circles, and how can we make sure our activism is accessible to those suffering from anxiety and depression and other mental illnesses (and especially those suffering from anxiety and depression that stems from their work in activism itself)?

I’ll end this section with a hopefully optimistic quote from Derrick Jensen’s article, Beyond Hope: People sometimes ask me, “If things are so bad, why don’t you just kill yourself?” The answer is that life is really, really good. I am a complex enough being that I can hold in my heart the understanding that we are really, really fucked, and at the same time that life is really, really good. I am full of rage, sorrow, joy, love, hate, despair, happiness, satisfaction, dissatisfaction, and a thousand other feelings. We are really fucked. Life is still really good.


Another question I have is why is the left has such an aversion to talking about mental health? In my experience, the right and centre actually speak about mental health issues more than left-wing politics and activism does. It takes one look at the tv on Bell Let’s Talk day to see the mainstream advertisements about “destigmatizing” mental health. Where are these conversations on the left, with an even better critique of concepts like “destigmatization”?

Anne Sheffield says: I believe the answer is rooted in the American system of values. We are a nation founded on principles of self-determination, where—we are told—anyone can succeed if he or she simply tries hard enough. We are strong adherents of the bootstrap approach, which dictates that adversity can be overcome by the application of character and willpower. Because the mentally ill don’t look sick, many people suspect them of making excuses for their shortcomings and as lacking in gumption.

I believe that part of the problem is the traditional left’s tendency to reject spirituality and non-rational thinking (except when it’s sometimes co-opted and tokenistic). Depression, anxiety, PTSD, and Schizophrenia don’t make sense – and they’re not supposed to. That’s part of their challenge, but also part of their beauty.

In August, the members of Ideas Left Out had a similar conversation on this topic at the final day of Ideas Left Outside – how do we better combine academic and activist spaces? I think we can further ask, how do we, in a capitalist society, better express vulnerability and a willingness to support those in emotional need, by transcending some of the rigidity and structure of academic activism?

Depression is hard on friends. You make what by the standards of the world are unreasonable demands on the them, and often they don’t have the resilience or the flexibility or the knowledge of the inclination to cope”… Some friends can process a severe depression right up front, and some can’t. Most people don’t like one another’s unhappiness very much. Few can cope with the idea of a depression divorced from external reality; many would prefer to think that if you’re suffering it’s with reason and subject to logical resolution… I try to be cautious with my friends who are too sane” Andrew Solomon

During my relapse, I was not able to lean on my fellow activists in the way that I expected. I felt isolated and ostracized by those who did not understand my politics and those in the mental health system, and then additionally felt alone and isolated from my activist friends and community. Supporting me through my depression and anxiety required a vulnerability that very few had, and capitalism as a system does not allow us to have. Even financially, my health rested on my shoulders and that of my previous partner, and my parent’s – and I was extremely lucky to have family and loved ones that could afford to take time off work and financially support me through this difficult time. For the majority of people in this world, that is not an option.

I honestly believe that the only way we’d be adequately able to support each other is in a non-capitalist society. Yet, as we still live in one, even for the left it is difficult to transcend these barriers and offer the support truly needed. We can do better – but we need to be having conversations like this one more.


A good friend of mine works at an organization called Choices for Youth, a youth homelessness organization in St. John’s. She was explaining to me their strategy which is “housing first” model, which means that the basic human needs of food, shelter and clothing are the first priority, and then when those needs are met their next priority is working with the youth on supporting their mental health. After primary basic needs are met, it is when mental health issues are most likely to arise.

There is other evidence to prove this idea that mental health issues follow Maslow’s hierarchy of needs. When one is in survival mode – searching for food shelter, clothing and water – your body in many ways prevents you from going into a state of extreme depression or anxiety as a survival tactic. Once you are in a stable position, your body allows you to go into stress-mode.

My own experience was like this – the first time I felt truly safe in several years is when my anxiety and depression started to brew.  There is a reason it is called post-traumatic stress disorder and soldiers, for example, only face it once they have returned from battle and are out of physical harm’s way.

Anyways, the question that this brings up for me is, and I always get a lot of dubious looks when I ask this,.. what if we were to snap our fingers and solve world hunger and have equal distribution of goods on the planet. Everyone would have access to the food shelter water and clothing that’s needed. My question is …would we have an epidemic of mental health issues and PTSD? If so, we are woefully unprepared to deal with it.

Now, I want to be sure that no one thinks that I am I suggesting that that would be worse, or that we should stop working towards solving these problems of distribution…. but I do ask the question as we talk of socialism and anti-capitalist activism a lot these days in order to ensure that everyone on the planet has equal access to material goods (especially when talking about climate change), but I wonder sometimes if we’re missing the point. To me this question reminds us that our fight for socialism needs to be more grounded in dignity, instead of just meeting humans’  material needs. What are we actually fighting for when we say we want  a socialist, anti-capitalist society? We need to remember why we do what we do.


As I’m running out of time, and I’ve said a a lot, I want to end with one last quote.

Many people say.. so what? What can I do to help someone who’s suffering? Andrew Solomon puts it beautifully:

It is at least as awful to be alone in a mind that has gone against you. What can you do when you see someone else trapped in his mind? You cannot draw a depressed person out of his misery with love (though you can sometimes distract a depressed person). You can, sometimes, manage to join someone in the place where he resides. It is not pleasant to sit still in the darkness of another person’s mind,.. it is almost worse to watch the decay of the mind from outside. You can fret from a distance, or you can come close and closer and closest. Sometimes the way to be close is to be silent, or even distant. It is not up to you, from the outside, to decide; it is up to you to discern. Depression is lonely above all else, but it can breed the opposite of loneliness. I love more and am loved more because of my depression. So many people have asked me what to do for depressed friends and relatives, and my answer is actually simple: blunt their isolation. Do it with cups of tea or with long talks or by sitting in a room nearby and staying silent or in whatever way suits the circumstances, but do that. And do it willingly.

Thank you.