People in debt are more likely to be depressed. And once they are depressed, people are more likely to get into debt.
A British study in 2007 found that adults in debt were three times more likely than those not in debt to have common mental disorders.
The situation was exacerbated among those with addictive behaviours. People who had to obtain money from loan sharks and pawnbrokers had the highest rate of depression and other common mental disorders.
The researchers from Leicester, London and Sydney concluded that debt was one of the major risk factors. They found that among those in debt, 38 per cent were assessed as having anxiety, depression or another common mental disorder.
It's not easy to separate debt from other common causes of anxiety and depression such as job loss, low income, illness, relationship breakdown, compulsive shopping, substance abuse and gambling. But the researchers found that debt interacted with and compounded these other problems.
Other research from the University of Southampton in Britain found that those in debt were more than three times more likely to have a mental health problem than those who were not in debt. Less than9 per cent of the 34,000 participants with no mental health problems were in debt, compared with more than a quarter of participants being in debt and with a mental health problem.
The results of that study also suggested that people who die by suicide are more likely to be in debt than the average person.
That correlates with research published in the British Medical Journal, which found that during the global financial crisis the European Union had a 13.3 per cent increase in suicide. Canada and the US saw their suicide rates increase by 8.8 per cent. Globally, there was a 3.3 per cent rise, according to the study.
Thomas Richardson, a clinical psychologist at the University of Southampton, who led the research, said it showed debt could lead to worse mental health because of the stress it causes.
Debt can be good when the money is borrowed for purposes such as mortgages or businesses that help build capital. It can be good if it allows someone to buy something they really need (not want) for their life or work and they can afford to make the repayments. It can also be a good way to fund tertiary education if it leads to the debtor gaining better employment and remuneration than he or she could without the qualification.
In short, debt is okay if you can manage it, says Clements. It's when debt repayments become unmanageable or a burden that it can lead to depression and mental distress and percolate into every aspect of life. Not getting into debt in the first place is one way to deal with the problem.
That may not be possible if you've been made redundant or are on a very low income. But a lot of people who see credit card and hire purchase debt as normal don't need the things they're buying.
Sometimes the first inkling that the debtor also is in mental distress is when they arrive at a budget advice service.
Richardson says debt counsellors should consider asking about mental health when speaking to members of the public.
"Similarly, mental health professionals should ensure they ask about whether their patients are in debt. Further research is now needed to show exactly how debt leads to poor mental health, so that interventions can be designed to try to prevent those in financial trouble developing mental health problems and vice versa," he says.
In New Zealand, budget advisers working at the coalface in local services receive professional development training to help them identify stress and possible depression, says Raewyn Fox, chief executive of the New Zealand Federation of Family Budgeting Services. But they aren't psychologists and cannot diagnose depression. Often, clients give clear signals that they need more than budget advice, says Fox.
"Often they've lost confidence and the debt really affects their self-esteem and clouds their judgment."
When Fox was a rookie budget adviser, a client walked into her centre, told Fox she was so stressed about her debt situation that she feared harming her daughter, and walked out leaving Fox with the child.
In many cases budget advice centres are in community centres or locations where other social services, such as Whanau Ora, are based and the client can be introduced to professionals who can help them.
Quite often, says Fox, new debt clients behave like a possum in the headlights and are unable to make even basic decisions about what to do about the debt problem until they've received treatment for their stress, anxiety or depression.
"We can't do anything quite often to help stabilise their finances until [the depression, compulsive spending or other problem] gets addressed," she says.
When debt descends into "mental distress", it usually comes with symptoms such as not sleeping, not eating properly, using too much alcohol, a raised heartbeat or stomach cramps, says Clements.
To get out of debt you need a plan, which budget advisers can help with. It's not impossible, but you might first need to seek help to improve your state of mind.
For people already suffering mental distress as a result of debt, Clement suggests they build five actions into their day:
• Connect
• Give
• Take notice
• Keep learning
• Be active
Connecting is about becoming involved in groups or the community, getting out with friends and doing things together as a family.
Giving is anything from giving compliments to giving time and helping others. Neuroscience, says Clements, shows part of the brain lights up when someone gives, which backs up the old adage that it's better to give than to receive.
Taking notice involves being curious about what is around you, enjoying your environment, being mindful and noticing the people and things around you.
Learning helps improve your mental health. It doesn't need to be a degree. It could be learning an instrument or cooking new foods.
Being active reduces stress and improves your mood. It doesn't need to involve running a marathon. Take the stairs instead of the lift, walk to colleagues to talk to them, try a new sport, dance, join walking tours, or visit your local pool, gym or yoga class.
Other tips from the Ministry of Health include:
• Making sure you look after yourself so that you can support your loved ones.
• Getting a good night's sleep.
• Avoiding alcohol and recreational drugs.
• Planning your days.
• Talking openly about what's going on for you with people you trust.
• Seeking budget advice.
Where to get help:
• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (4pm to 6pm weekdays)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• The Word
• Depression helpline: 0800 111 757 (available 24/7)
• Rainbow Youth: (09) 376 4155
• CASPER Suicide Prevention
If it is an emergency and you feel like you or someone else is at risk, call 111.