Tomorrow is Independence Day in the United States. Signed in 1776, the Declaration of Independence put forward a bold vision on a profoundly flawed foundation that included only white male property owners. This vision and exclusion set the future for what would become the United States of America.
In 2020, it is time to rethink what independence means – and for whom – in the United States and globally. Our individual experiences of the mosaic related to this ideal, and the extent to which we identify with having access to realize the unalienable rights of life, liberty, and the pursuit of happiness have profound relevance to our individual mental health, our variable and shared history and our collective future.
1. Independence: freedom from the control, influence, support, aid, or the like, of others. Developing healthy independence is the natural order of human development. Autonomy is an essential component in the development of one’s sense of self and overall psychological health. Individualistic cultures, like the United States, Germany, and Australia, prioritize the individual over the group and place great value on autonomy, independence, uniqueness, and self-reliance. Within the world of mental health, much has been written recently about preserving independence for older adults in the service of the greater mission of promoting mental health. But have we gone too far, and not just with older adults? The well-documented loneliness epidemic, especially for older adults, also applies to young adults and is quite literally, deadly. It is equivalent to smoking up to 15 cigarettes a day. And for young people, the experience of being disconnected – sort of independence that has spun out of control – is associated with higher rates of suicide.
2. Dependence: the state of relying on or needing someone or something for aid, support, or the like. We all start out highly dependent. In fact, our survival depends on effective care from others. But in highly individualistic societies, dependence is something to outgrow quickly. Given that dependence is employed to describe problematic drug use and addiction, it generally carries a negative valence and is something of a dirty word. No one says, ‘Let me introduce you to my dependent friend.’ Among mental disorders, excessive dependence is a dimension that can be part of a personality disorder. Colloquially, people with dependent personality symptoms are often referred to as being clingy or emotionally needy. But, again, have we gone too far? Is dependence always so bad? Don’t we all need to rely on others for support? Don’t we all need others for aid sometimes?
3. Dependable: capable of being depended on; worthy of trust; reliable. This incarnation of the same Latin root word (dependere) has a positive valence. Being dependable most definitely appears in personal introductions as well as referrals for employment and educational advancement. Serious mental illness such as depression, schizophrenia, and anxiety can interfere with an individual’s dependability. Someone with depression may be overwhelmed by low mood and energy and have to cancel a day of appointments. Someone with schizophrenia may have delusions sufficient to interfere with the ability to recount an incident in a way that appears trustworthy to others. For individuals with anxiety, it can be extremely difficult to dependably show up for work in the midst of a global pandemic. Lack of dependability is not core to a mental disorder but secondary to it, in the same way that might be the case for individuals with other serious health conditions. But for individuals with mental disorder, the shame associated with reduced dependability can be far worse if the community does not understand their condition. Treatments exist that can help, but seeking care requires that we acknowledge that we need help, support and aid from others. It is a paradoxical power play that asking for help from others has a negative valence whereas being the provider of that support is valued.
4. Co-dependence: a quality of relationship in which one person is physically or psychologically addicted, as to alcohol or gambling, and the other person is psychologically dependent on the first in an unhealthy way. Not an official diagnosis, co-dependence is a form of relationship that gained recognition within the twelve-step programs, beginning with Alcoholics Anonymous. It has been widely studied in association with addiction to describe a quality of relationship where one person aids and abets another person’s substance use or poor mental health. Individuals typically have the best of conscious intentions when they engage in co-dependent behaviors, but various aspects of their own mental health needs lead to enmeshment, over helping, and boundary distortions that interfere with recovery and mental health for the individuals with the addiction.
5. Interdependence: the dependence of two or more people or things on each other. Interdependence implies a balance of power in relationship. Interdependence is not co-dependence. Instead, interdependence honors each party’s self and individuality while recognizing the ways in which each party in the relationship can also be vulnerable and ask for help and support. It is okay to depend on the other party as needed just as it is okay to support the other party as needed. Interdependent relationships rest on high levels of trust. Interdependent relationships mean that roles are not fixed. Instead, individuals in interdependent relationships can see that each party brings strengths and vulnerabilities to the relationship. With trust, openness and mutual respect, each party contributes and each benefits. In relationships defined by interdependence, each member feels valued and respected. The relationship is a safe place to learn, make mistakes, and grow.
Whereas establishing independence from Britain was paramount for America’s founders in 1776, as we consider the current global public health pandemic, the environmental trends around climate change, and bear witness to the heinous systemic racism within the United States, we need to make interdependence paramount in 2020. In fact, the closing line of the Declaration of Independence states, “And for the support of this declaration … we mutually pledge to each other our lives, our fortunes, and our sacred honor.” Life, liberty and the pursuit of happiness can only be realized if we are in it together. No exclusions. Interdependent. All of us.