How the economy is affecting sleep, diet, weight, relationships, addictions, well-being, and depression.
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Stressed out? How the economy wears you down

The economy, the economy, the economy — Americans seem able to think of little else. How could they? The negative reports on job losses, on tanking investments, housing prices and consumer confidence keep coming, leaving us not just unwilling to spend, but stressed out and fearful.

That stress takes a toll — on sleep, mood, physical health, relationships, eating habits (and thus weight) and, perhaps, our willingness to indulge in favorite vices.

“Times of economic stress lead to increased rates of depression,” says Dr. Christopher Palmer, director of continuing education at McLean Hospital in Belmont, Mass. “It exacerbates illness in people who have been chronically depressed. But it also causes new cases of depression. Just the fear of losing one’s job can put people over the edge.”

And, of course, depression itself can create a cascade of negative health effects.

The direct correlation between economic uncertainty and personal health is not clear. What follows is a statistical look, as best we can muster, at how Americans are faring.

— The Times Health staff ()
Depression, anxiety and chronic life stress all raise the risk of coronary artery disease. (Source: 1999 study in Circulation)

Stress, high blood pressure and smoking are major risk factors for cardiovascular disease. (Source: 2008 essay published by the U.S. Centers for Disease Control and Prevention)

Stressful events that are shared by an entire community, such as earthquakes and the Sept. 11 attacks, increase the incidence of sudden cardiac death. (Sources: 1996 study in New England Journal of Medicine, 1999 study in Circulation and 2004 study in Journal of the American College of Cardiology)

Job pressure and excessive work hours were linked to smoking in men in a study of 1,101 Australian workers. (Source: 2007 study in American Journal of Industrial Medicine)

A 33% to 40% increase in systolic blood pressure was reported among white-collar Canadian workers with high levels of cumulative work stress. (Source: 2006 study in American Journal of Public Health)

A direct link between psychological distress and poor cardiovascular health was found in a study of 6,576 Scottish men and women tracked for an average of more than seven years.

Risk of cardiovascular disease and death rose by more than 50% among people with depression and anxiety in the Scottish study. Smoking accounted for 41% of the risk; high blood pressure was responsible for an additional 13%. (Source: 2008 study in Journal of the American College of Cardiology)

Almost double the risk of heart attack or death was found in coronary artery disease patients with the highest level of anxiety.

Among those patients, a 10% increased risk of heart attack or death was found in those whose anxiety rose over time. (Source: 2007 study in Journal of the American College of Cardiology)

Among 735 older men (mean age 60), the 15% who were most anxious had a 30% to 40% increased risk of heart attack. The higher the degree of anxiousness, the higher the risk — even when age, blood pressure, cholesterol and other factors were taken into account. (Source: 2008 study in Journal of the American College of Cardiology)

Anger and hostility prompt behavioral changes -- such as smoking, overeating and lack of exercise -- that increase the risk of cardiovascular events. A 19% rise in risk was found among those who were previously healthy, along with a 23% increase in those who already had heart disease. (Source: 2009 study in Journal of the American College of Cardiology)

— Karen Kaplan  ()
Eighty percent of Americans say the economy is a significant source of stress. The number, recorded in September 2008, was up from 66% in April 2008.

Among those surveyed, 49% said they felt nervous or anxious; 48% reported feeling depressed or sad.

(Source: 2008 survey from the American Psychological Assn.)

Calls to the National Suicide Prevention Lifeline network ([800] 273-TALK) increased more than 20% from January 2008 to January of this year. Part of the rise probably can be attributed to increased awareness of the hotline, experts say, but the economy has also been a factor.

(Source: Dr. Richard McKeon, Substance Abuse and Mental Health Services Administration.)

Requests for financial counseling in employee-assistance programs grew by 13% from August through December compared with the same period in 2007, increasing at a rate twice that of other employee-assistance program services.

Among these requests, counseling related to serious financial issues increased markedly, including creditor problems, up 20%; collections, up 30%; and bankruptcy, up 24%.

(Source: Shepell-fgi Research Group)

A snapshot of three large psychiatric hospitals during the week of March 8:

* McLean Hospital, Belmont, Mass.: a 10% increase in inpatient admissions since Jan. 1, which has put the hospital at capacity almost every day this year.

* UCLA Neuropsychiatric Institute anxiety clinic: a 15% to 20% increase in patients in the last month.

* The Menninger Clinic, Houston: a 25% to 30% increase in clients this year expressing anxiety related to financial issues.

One in 3 people going through foreclosure are clinically depressed.

(Source: Dr. Craig Pollack, University of Pennsylvania)

— Shari Roan  ()
One-third of Americans report losing sleep over the economy.

Twenty percent say they are sleeping less than six hours a night, below the optimum seven to eight hours that sleep experts recommend.

Of these, 90% say they suffer from insomnia.

And nearly 40% say they have driven while drowsy at least once in the previous month.

(Source: 2009 poll of 1,000 adults conducted for the National Sleep Foundation.

People who sleep less than six hours a night have a 66% greater prevalence of hypertension.

(Source: 2006 Boston University School of Medicine study published in the journal Sleep.)

People who sleep less than six hours a night are more than five times more likely to develop prediabetes.

(Source: American Heart Assn.)

Those who sleep less than seven hours a night are three times more likely to come down with a cold.

(Source: 2009 study published in Archives of Internal Medicine.)

— Mary Engel  ()
They say money can’t buy happiness. But financial strain can certainly help undo a relationship.

Seventy percent of Americans said they had so much debt it contributed to distress in their home lives. (Source: 2004 book “The Two-Income Trap: Why Middle-Class Mothers and Fathers are Going Broke.”)

Money is the No. 1 source of disagreement in the early years of marriage. (Source: 2003 study in Psychological Reports.)

In a survey of 1,001 people, more than half considered money a sensitive topic in their households; 40% admitted they lied to their spouses about how much they spent on something. (Source: 2005 survey in Money magazine.)

The odds of violent behavior are nearly six times higher for people who lose their jobs. (Source: 1993 study in Hospital and Community Psychiatry.)

The financial strain associated with job loss increases depression in both partners and reduces overall satisfaction in a relationship. (Source: 1996 study in Journal of Personality and Social Psychology.)

Losing a job can cause depression or other symptoms of poor mental health. It can also affect a spouse’s mental health. (Source: 1988 study in Archives of General Psychiatry.)

Women are more likely to become distressed when their husbands lose their jobs than vice versa, not because their husbands’ jobs pay more but because there is more social pressure on men to work. (Source: 2004 study in Journal of Family Psychology.) ()
Cutting back on spending may not mean cutting down on calories.

The more “energy dense” a food is — i.e., the more calories it contains per unit weight — the less it costs per calorie. For instance, the lowest-cost vegetables, per calorie, are potatoes; cheese costs less per calorie than fresh spinach; and the sugar in fresh raspberries is 100 times more expensive per calorie than ordinary table sugar. (Source: 2004 University of Washington study published in Nutrition Today.)

Not surprisingly, as the prices of foods go down, the purchases of those foods go up, and vice versa. Between 2004 and 2006, the prices of very-high-calorie foods dropped by an average of 1.8%, while the prices of very-low-calorie foods went up by an average of 19.5%. (Source: 2007 University of Washington study published in the Journal of the American Dietetic Assn.)

So, by spending less on food, we could end up gaining weight. And there’s not a lot of margin for error in that respect.

Here’s where we stand now:

More than 1 in 3 adult Americans are obese — 33.3% of men and 35.3% of women. The rates have more than doubled since the late 1970s.

Since that time, children have grown increasingly overweight, with rates rising from 5% to 13.9% for 2- to 5-year-olds, from 6.5% to 18.8% for 6- to 11-year olds and from 5% to 17.4% for 12- to 19-year olds.

Obesity is a risk factor for cardiovascular disease, some kinds of cancer and Type 2 diabetes. (Source: Centers for Disease Control and Prevention.)

Spending on food is down by $56 billion this January compared with January 2008, according to the Commerce Department. That could mean we’re eating less food, which might not be a bad idea for some of us. Then again, we could just be eating less expensive food.

A September 2008 survey found that Americans had made these changes in their eating habits because of the bad economy:

* 43% were eating out less often than they used to.

* 39% were eating at less expensive restaurants.

* 35% were eating at fast-food restaurants less often.

* 35% had started packing a lunch for work.

* 32% had started eating more leftovers.

* 32% had started using coupons.

* 32% were buying more store-label groceries instead of name brands.

* 30% were ordering less food when they went out to eat.

* 22% were drinking tap water instead of soda and noncarbonated drinks.

* Less than 10% had switched to a less expensive brand of alcohol or beer.

(Source: September 2008 Consumer Spending Behavior Study conducted by Booz & Co.)

-- Karen Ravn  ()
In good economic times and in bad, we like our vices.

In boom times, drunk-driving rates, alcohol-related illnesses and spending on alcohol all increase. (Source: A 2000 article in the Quarterly Journal of Economics, and a 2008 by the Swedish Business School at Örebro University)

Since the economy went south, consumers have cut back on drinking in restaurants and bars but are spending more on alcohol to drink at home, according to Mintel International, a Chicago-based market analysis firm.

In 2008, the sale of alcohol to be quaffed at home reached $77.8 billion, an increase of 32% in 2008 over the 2003 level, Mintel estimates.

Over the next five years, spending on alcohol to be consumed at home will increase 5% annually, while drinking at bars and restaurants will decline by 2% this year and 1% yearly after that, Mintel projects. (Source: “Mintel expects strong ‘sin stock’ markets during economic downturn,” Mintel International, Chicago)

The connection between hard times and hard drinking isn’t clear. In the U.S., a state’s alcohol consumption declined by 3% for every one percentage point increase in that state’s unemployment rate, according to one study. Hard drinkers cut back, but light drinkers consume more. (Source: A 2002 study, in the Journal of Health Economics)

But another study found that rates of binge drinking went up 8% when unemployment rose 5%. (Source: A 2001 study in Health Economics) The increase in binge drinking was concentrated most heavily among adults who were still employed.

The unemployed are more likely to decrease their alcohol consumption. (Source: A 1997 study in Social Science & Medicine)

A UCLA researcher has estimated the current economic downturn’s effect on drinking as follows:

In California, between January 2008 and January 2009, unemployment rates increased from 4% to 10.1% (nationally, from 4.8% to 8.1%). The study estimates that during this economic decline, those who drink alcohol will consume 12% less (10% less nationally), there will be a 13% reduction in alcohol-impaired driving, and a 1.2% decrease (1% nationally) in the number of people who drink at all.

The probability of being a heavy drinker (consuming 60 or more drinks per month) is predicted to decline in California by 31%. (Source: Andrew Barnes, UCLA School of Health Services)

-- Melissa Healy  ()