Why are Chileans so unhappy?

SANTIAGO, Chile — Franco Carcuro seemed to have it all going for him. The 32-year-old son of a well-known TV sports commentator led a quiet life and had a successful career as sports director at a private university. But last September, he went up to the 10th floor of his apartment building and jumped.

Carcuro’s death was not exceptional: suicide is the leading cause of death among men between 20 and 44 years of age in Chile, according to the Health Ministry. Among women the same age, it is the second cause after traffic accidents. (In the U.S., it was the 11th cause of the death in 2006, according to the U.S. National Institute of Mental Health.)

Like more than 20 percent of the Chilean population, Carcuro suffered from depression. The country has unusually high rates of depression, particularly in the capital Santiago. Daily consumption of antidepressants in Chile rose by more than 470 percent between 1992 and 2004, says a study published last year in the Chilean Medical Gazette.

But the United Nations’ Human Development Index ranks Chile as the best country in which to live in all of Latin America. The index measures three main aspects of human development: living a long and healthy life, receiving education and having a decent standard of living. This year’s ranking placed Chile 44 among 182 nations.

So why are Chileans so depressed?

“We are moving toward better standards of living and Chileans are having a hard time adapting. The hyper-demands, traumas, competition and access to top technologies are posing problems that Chileans are struggling to deal with,” said Dr. Mario Quijada, a psychologist and former president of the Chilean Association of Mental Health.

Day-to-day rhythms of life with all its demands, especially in the capital, are weighing on the Chilean conscious. Workers endure long work hours — officially 45 hours a week, but often more. And for blue-collar workers, the stressful daily routine in the capital is compounded by the several extra hours they spend getting to and from their jobs on overcrowded buses or the metro.

Chileans regularly complain that the time and energy left for family life, recreation and even sex is far too scarce. As almost everywhere, it is worse for women who continue with domestic chores after work.

With average wages low and the constant pressure to match up with neighbors in material goods or appearances, as well as authentic aspirations for a better life, Chileans have become massively indebted over the past decade, either with consumer debts, mortgages or bank loans. Stable income for the 40 percent of the population who are independent or sporadic workers is unattainable.

And in the midst of all of this is the fact that income distribution in Chile is one of the worst in the world, breeding resentment and frustration when the enormous effort of keeping up with life does not bear the expected fruits.

For Patricio Montes, 56, it’s the pressure of social ladder-climbing that has Chileans sick. “We live in an environment in which people feel pressured to succeed. We compete with our neighbors and get indebted to show what we don’t have. And if you fail, you have to hide it and act as if nothing is wrong."

Montes has been in treatment for depression for about a year with medication and therapy mainly as a result of frustration stemming from many years of unstable work, long periods of unemployment and economic hardship.

“I would spend all day sleeping and I didn’t want to see anyone. I closed in on myself. Now I am recovering, but I still need to be pushed into action,” he said.

Women are much more vulnerable to depression, statistics suggest. But it is men who take their own lives more often — about five times more than women, said Quijada.

This is no contradiction. “Actually, many more women than men try to commit suicide, but they use different methods. Women usually resort to overdose, but men go straight to more lethal — and effective — means: they jump from buildings or shoot or hang themselves,” he said.

Teenagers are following a perilous trend as well. Up to 21 percent of 13- to 15-year-old girls and 8 percent of boys the same age have seriously considered killing themselves, according to a “Global School-based Student Health Survey” conducted by Chilean officials in four regions around the country. About 16 percent had actually planned it.

In 2006, depression rose to such high proportions that it was included in a public health program called AUGE that guarantees free or low-cost health care for a set of chronic illnesses in public and private health centers.

Since then, depression has become the fourth most frequent illness of the 56 covered by AUGE and is the reason behind one-third of patients who seek help in primary health centers.

The Health Ministry has also developed a Mental Health Unit especially focused on the most vulnerable to depression: teenagers, women and the elderly. But a major problem with these programs is the acute lack of psychologists and psychiatrists working in the public health system. Most migrate to the private sector in search of better salaries, working conditions and benefits.

Rising depression rates might not just be a reflection of the times, but also of better bookkeeping and statistics, said Irma Rojas, an expert on suicide and depression at the Health Ministry.

“Including depression in AUGE has allowed a systematic record of cases both in the public and private health systems," she said. "At the same time, the population in general has become more aware that depression is an illness that requires seeing a doctor to receive treatment."