Money worries and debt

It is the last week of Ramadan in Jatrabari, and the children have a list. “Abbu, Sumi’s Eid dress has lights in it,” says nine-year-old Lima. Hasib, 38, who works in accounts at a medicine distributor, raises an eyebrow. “Lights? Ki re, is she wearing a dress or a wedding gate?” Everyone laughs, Nipa included, and for a moment the flat feels the way it used to.

At two in the morning Nipa, 34, who sews blouses to order from home, finds him on the bed with the bank app open again. “Tumi abar app khule boshe acho?” He does not look up. “The EMI is due on the fifth. The salary comes on the tenth.” There is the motorbike loan, the credit card that paid for his father’s angiogram, and the samity Nipa joined without telling him. Lately he has a tight chest at work. She has started skipping lunch to save money, and they argue about her brother’s loan in whispers so the children will not hear.

An illustration drawn from common experience. The people are invented; the pattern is not.

Understanding money worries and debt

Money trouble is not a mental disorder, but it is one of the heaviest everyday stressors. Debt brings constant worry, shame and secrecy, and it strains marriages and joint families. It can trigger an anxiety disorder, insomnia or depression. The link may also run the other way: depression and anxiety can make it harder to open letters, plan and make calls, so debt can grow while a person is unwell.

How common it is

In a systematic review and meta-analysis of 65 papers on personal unsecured debt (such as credit cards and loans), people in debt had about three times the odds of having a mental disorder (odds ratio 3.24) and higher odds of depression (2.77) and problem drinking (2.68). There was also a strong relationship with suicide. Most studies found that more severe debt went with worse health, though the authors note that cause and effect are hard to establish. We did not find a comparable peer-reviewed figure from Bangladesh, so this evidence comes from studies elsewhere.

Signs worth noticing

• Checking balances again and again, especially at night
• Chest tightness, headaches or stomach trouble when bills come up
• Avoiding calls, messages or the bank
• Arguments about money, or hiding debts from each other
• Skipping meals or medicines to save money
• Smoking or drinking more, or thoughts of running away or of ending it all

How care helps

Chest pain needs a medical check first, not an assumption that it is stress. A psychiatrist then looks for an anxiety disorder, depression, sleep problems and suicidal thoughts, and treats what is found. CBT can help with the worry that circles at 2 a.m., and problem-solving therapy breaks a pile of trouble into a written list and one next step at a time. A joint session can help a couple put every loan on one page without blame. Debt advice, rescheduling and family support are practical matters, not psychiatric ones, but treating anxiety or depression often makes them easier to face.

What getting better can look like

A way forward for Nipa and Hasib might be a notebook on the kitchen table with every loan written down, one phone call to the bank on a Sunday morning, Nipa’s blouse orders before Eid, and an Eid dress from Gausia, without lights, that Lima loves anyway.

Common questions about money worries and debt

Can money worries cause anxiety and depression?

Debt and money problems are strongly linked with anxiety, depression and other mental health problems. In a meta-analysis of 65 papers on unsecured personal debt, people in debt had about three times the odds of a mental disorder. Cause and effect are hard to separate, and both the money problem and the mental health problem can be helped.

How do I talk to my husband or wife about debt?

Choose a calm time, not the night a bill arrives. Write down every loan and payment together so the whole picture is on one page, and agree that the aim is a plan, not blame. If talking always ends in a fight, a counsellor or doctor can help you have the conversation.

When to see a psychiatrist

If money worry is stopping you sleeping, eating or working for more than a few weeks, it is worth an assessment. If you have chest pain, seek urgent medical care. If you are thinking of ending your life, call 999 or go to the nearest emergency department now.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

Sources

• Richardson et al., Clinical Psychology Review, 2013 (PMID 24121465)