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Ever wake up one morning and ask yourself if anything really matters? Why do I stay alive?

These are but two of the existential questions that an increasing number of Americans are asking but are rarely discussed publicly. Asking such questions has been neutralized, mainstreamed, through self-help advice columns and books, psychotherapy or academic debates.

Sometimes political campaigns, like Donald Trump in 2016, can give voice – however misleading – to the deeper issues these questions identify. Acts of rage, like mass killings or personal suicides, can also give expression – however incoherent – to the truths such questions conceal.

Sadly, the deepening despair now being faced by a growing number of Americans has not become an issue in the upcoming presidential election and not raised by any of the leading Democratic candidates.

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Americans are suffering and a sense of despair is deepening throughout the country. In May 2019, the American Journal of Public Health released a disturbing study, “The Depths of Despair Among US Adults Entering Midlife,” by Lauren Gaydosh, et. al. Drawing on a sample of 18,446 “self-identified as non-Hispanic White, non-Hispanic Black, or Hispanic” Americans, it assesses “change in indicators of despair from adolescence to adulthood using multilevel regression analysis, testing for differences by race/ethnicity, education, and rurality.”

The study found a rise in despair among “the young adult cohort now reaching midlife that cuts across racial/ethnic, educational, and geographic groups may presage rising midlife mortality for these subgroups in the next decade.” It notes, “The factors underlying these patterns remain unknown.” But adds most provocatively:

However, current explanations point to labor market changes driven by globalization and technological change, leading to deteriorating job opportunities, wage stagnation, and declining rates of upward mobility for low-educated individuals. These economic factors undermined social support by eroding traditional family structures and religious participation, resulting in despair.

It adds: “Although these trends affected all racial/ethnic groups, scholars suggest that historical advantages lead to greater feelings of relative subordination among low-educated Whites compared with low-educated racial/ethnic minorities and that Blacks may be ‘inured to insults of the market” and insulated by strong support networks of kin and religion.’”

The National Institute of Mental Health (NIMH) reported in 2017 that

“an estimated 17.3 million adults in the United States had at least one major depressive episode. This number represented 7.1% of all U.S. adults.” The American Psychological Association claims that “approximately 40 million American adults ages 18 and older, or about 18.1 percent of people in this age group in a given year, have an anxiety disorder.” It adds, “major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.”

Among the most extreme symptom of despair and depression is suicide. The Centers for Disease Control and Prevention (CDC) reports that suicide “was responsible for more than 47,000 deaths in 2017, resulting in about one death every 11 minutes.” Going further, it adds, “Every year, many more people think about or attempt suicide than die by suicide. In 2017, 10.6 million American adults seriously thought about suicide, 3.2 million made a plan, and 1.4 million attempted suicide.”

In 2017, two Princeton economists, Anne Case and Angus Deaton (a Nobel Prize winner), released a revealing study, “Mortality and Morbidity in the 21st Century.” Their findings are alarming:

Around the turn the [21st] century, after decades of improvement, all-cause mortality rates among white non-Hispanic (WNH) men and women in middle age stopped falling in the United States, and began to rise. … Mortality declines from the two biggest killers in middle age—cancer and heart disease—were offset by marked increases in drug overdoses, suicides, and alcohol-related liver mortality in this period.

It goes further, reporting: “We find that mortality and morbidity among white non-Hispanic [WNH] Americans in midlife since the turn of the century continued to climb through 2015. Additional increases in drug overdoses, suicides, and alcohol-related liver mortality — particularly among those with a high school degree or less — are responsible for an overall increase in all-cause mortality among whites.”

This study followed a 2015 study by Case and Denton, “Rising morbidity and mortality in midlife among white, non-Hispanic Americans in the 21st century.” published in the prestigious Proceedings of the National Academy of Sciences. The economists’ found that “Over the 15-y[ear] period, midlife all-cause mortality fell by more than 200 per 100,000 for black non-Hispanics, and by more than 60 per 100,000 for Hispanics. By contrast, white non-Hispanic mortality rose by 34 per 100,000.”

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For many 21st century Americans, family, friends, a job, personal health and financial obligations anchor people to the tyranny of postmodern, globalizing capitalism. Daily life is anchored in personal existence, of getting up every day and living. Of eating, sleeping and going to the loo; of working, shopping and paying bills; of family, friends, neighbors and workmates; of making dinner, having fun, enjoying sex and raising kids; and of simply keeping up with the demands of daily life, including the welter of political issues, local, national and global.

All this can be overwhelming and lead to despair, even depression. And so, we live from day to day, from year to year. And the troubling existential questions persist and, for many, get worse. The media offers endless programming that distract, inform, frighten and exploit as an add rating point. The internet offers access to the world — and an ever-growing number of people who dwell on it — with nearly instantaneous connectivity through a host of social networking programs. It all seems so much of the same so much. So what?

Making matters worse, more intense, many feel overwhelmed by the apparent contraction of postmodern life. It’s tougher for a growing number of Americans to meet the costs of housing, health care and even food and clothing for their children. Sure, jobs are plentiful if one doesn’t expect to make a living wage comparable to that of your parents or grandparents.

Endless media reports compound the ever-intensifying horrors of 21st-century life, notably climate change, mounting global political instability and local random violence. These tales of woe are juxtaposed to feature stories celebrating the promises of postmodern life envisioned as a “smart,” ecologically grounded world that harmonizes the human and the natural, the same and the different. The goal of the 21st-century promise is to make the world whole as well as the people who call it home. Sadly, this vision seems increasingly unattainable, replaced by ever-expanding automation, the Uberization of people’s lives.

It’s time for the Democratic presidential candidates to address the deepening crisis of despair gripping the country. Despair anchors many of the problems ordinary Americans face and provided Trump with the legitimacy of his 2016 campaign promise, to “make America great again.” As conditions worsen and the 2020 campaign mounts, failure to address the issue of despair will be a fertile ground for a new round of Trump’s false promises.