Big Cities are Safer Places

Last night at my in-laws house in the middle of nowhere I really wanted a Reese’s Cup. At home, in a dense neighborhood in Philadelphia, I could walk to the corner and pick one up at the 7-11. I’d see a few people, probably say hello. At my in-laws, to satisfy a craving for chocolate and peanut butter requires a car and about a half-hour. Needless to say, the desire passed.

Big cities have a lot of stuff, a lot of places to go, and, above all else, a lot of people. They’re caldrons of stress and intensity, and people have long thought that this obviously leads to more people with mental illness, especially depression. However, a carefully researched paper published by the National Academy of Sciencesfinds the per capita prevalence of depression decreases systematically with city size.

The reason: more contact with a more diverse group of people.

I’ve always maintained that the most important factor in recovering from a mental illness is community. People need other people, and to have contact with people you have something in common with and people who can support you in your efforts is crucial. The study not only confirms this, it goes further and states that just having people around, seeing people every day, being out and around them, is beneficial regardless of the status of your relationship with them.

Instead of being isolating and lonely, big cities give us big opportunities for social connections. The greater number of social connections in larger cities on the whole may provide a social buffer against negative affect and depression in the most vulnerable people. In fact, explicit in all the intricate math of the study is the conclusion that the larger the city, the more dense and diverse its population, the better.

It's one of the faults of modern psychiatry and psychology that treatment focuses on the individual’s inner experience. This constant self-reference can only lead to a person exaggerating their own dysfunction as they go deeper and deeper inward and further and further away from interconnection with others. The therapist model can lead a person to believe they can only fruitfully disclose their demons and desires to a professional in a one-way relationship, and the disability model re-emphasizes this isolation instead of encouraging people to get out and be productive in community and with others.

However, the selfish, self-absorbed focus of many in the mental health field does not positively impact the need for community that truly heals. Of course a person with depression who feels worthless will feel better if they get out and interact with other people. And they will feel even better if they do something positive for someone else. Big cities offer tremendous opportunities for this kind of healing.

The authors of the study state that simply walking amongst crowds greeting people can do much to reduce depression. So get out, see somebody, go to a crowded place. You’ll feel better.

Here We Go Again

Returning with restrictions on our social interactions prompted by a resurgence of Covid-19 is the anxiety that gripped so many people throughout the pandemic. If you or someone you know are feeling the difficulties of this anxiety, I’ve written a book that people who have read it tell me helps. Please, pick-up a copy of Resilience: Handling Anxiety in a Time of Crisis and/or subscribe to this newsletter. If you’d like to be in touch, please reach out at

By the way, I wish the people calling for another shutdown and a return to social distancing would read the study referenced above. It would be foolish to counter a surging Delta variant with policies that force a surge in mental illness, as keeping people apart will certainly do – again.