Sunday, February 28, 2010

Jonah Lehrer - Depression’s Upside

A few years back, I posted an article on depression as an evolutionary adaptation to increase social connection - a lot of people, especially those who suffer depression took issue with that perspective.

Now there is more evidence to suggest that depression has value, and maybe should not simply be eradicated with drugs. As much as it sucks and is painful, there are benefits to depression that we might want to consider more closely.

Depression’s Upside

Ben Weeks

By JONAH LEHRER
Published: February 25, 2010

The Victorians had many names for depression, and Charles Darwin used them all. There were his “fits” brought on by “excitements,” “flurries” leading to an “uncomfortable palpitation of the heart” and “air fatigues” that triggered his “head symptoms.” In one particularly pitiful letter, written to a specialist in “psychological medicine,” he confessed to “extreme spasmodic daily and nightly flatulence” and “hysterical crying” whenever Emma, his devoted wife, left him alone.

While there has been endless speculation about Darwin’s mysterious ailment — his symptoms have been attributed to everything from lactose intolerance to Chagas disease — Darwin himself was most troubled by his recurring mental problems. His depression left him “not able to do anything one day out of three,” choking on his “bitter mortification.” He despaired of the weakness of mind that ran in his family. “The ‘race is for the strong,’ ” Darwin wrote. “I shall probably do little more but be content to admire the strides others made in Science.”

Darwin, of course, was wrong; his recurring fits didn’t prevent him from succeeding in science. Instead, the pain may actually have accelerated the pace of his research, allowing him to withdraw from the world and concentrate entirely on his work. His letters are filled with references to the salvation of study, which allowed him to temporarily escape his gloomy moods. “Work is the only thing which makes life endurable to me,” Darwin wrote and later remarked that it was his “sole enjoyment in life.”

For Darwin, depression was a clarifying force, focusing the mind on its most essential problems. In his autobiography, he speculated on the purpose of such misery; his evolutionary theory was shadowed by his own life story. “Pain or suffering of any kind,” he wrote, “if long continued, causes depression and lessens the power of action, yet it is well adapted to make a creature guard itself against any great or sudden evil.” And so sorrow was explained away, because pleasure was not enough. Sometimes, Darwin wrote, it is the sadness that informs as it “leads an animal to pursue that course of action which is most beneficial.” The darkness was a kind of light.

The mystery of depression is not that it exists — the mind, like the flesh, is prone to malfunction. Instead, the paradox of depression has long been its prevalence. While most mental illnesses are extremely rare — schizophrenia, for example, is seen in less than 1 percent of the population — depression is everywhere, as inescapable as the common cold. Every year, approximately 7 percent of us will be afflicted to some degree by the awful mental state that William Styron described as a “gray drizzle of horror . . . a storm of murk.” Obsessed with our pain, we will retreat from everything. We will stop eating, unless we start eating too much. Sex will lose its appeal; sleep will become a frustrating pursuit. We will always be tired, even though we will do less and less. We will think a lot about death.

The persistence of this affliction — and the fact that it seemed to be heritable — posed a serious challenge to Darwin’s new evolutionary theory. If depression was a disorder, then evolution had made a tragic mistake, allowing an illness that impedes reproduction — it leads people to stop having sex and consider suicide — to spread throughout the population. For some unknown reason, the modern human mind is tilted toward sadness and, as we’ve now come to think, needs drugs to rescue itself.

The alternative, of course, is that depression has a secret purpose and our medical interventions are making a bad situation even worse. Like a fever that helps the immune system fight off infection — increased body temperature sends white blood cells into overdrive — depression might be an unpleasant yet adaptive response to affliction. Maybe Darwin was right. We suffer — we suffer terribly — but we don’t suffer in vain.

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~ Jonah Lehrer is the author of “How We Decide” and of the blog The Frontal Cortex. This is his first article for the magazine.

Read the whole article.


3 comments:

Ronald Pies MD said...

Hi, Bill--

Lehrer's piece raised many good questions about the "value" of depression, but, alas, obscured as much as it illuminated, in my view.
Reasonable persons, of course, may disagree about these matters.

I would ask that you and your readers consider the blog I am doing for the Psychcentral website, which I hope will be posted within the next few days.
If you read the Lehrer article carefully, you will note that he conflates (and confuses) terms like "depression", "sadness",
"low mood", and "melancholy"--all quite different terms, with vastly different implications.

He also ignores paleontologist Steven Jay Gould's construct of "spandrels"--in effect, genetic "hitch-hikers" that have no adaptive value in themselves, but which "come along for the ride" on the back of adaptive traits. I make the suggestion, in my blog, that clinical depression may indeed be such a "spandrel", and that there is very little evidence that clinical depression (as contrasted with sorrow or grief) confers any great adaptive advantages. I'm sure the debate will continue, of course!

Cheers, Ron Pies

Ronald Pies MD

william harryman said...

Dr. Pies,

Thanks for sharing your thoughts on this article.

I am especially interested in your conceptions of the differences between the concepts of depression, sorrow, melancholy, etc. I read your article "The Anatomy of Sorrow" with great interest, and appreciated the integrated perspective you offered.

I will look forward to your article at Psychcentral.

I'm wondering if Gould's model might be true only for major depression, while other forms of "low mood" might have the adaptive benefits evolutionary psychology argues for (although I am not a huge fan of EP in general).

Peace,
Bill

Ronald Pies MD said...

Hi, Bill--Thanks for your thoughtful response. My blog is now posted on the Psychcentral website.

http://psychcentral.com/blog/archives/2010/03/01/the-myth-of-depressions-upside/

I appreciate your comment on my "Anatomy of Sorrow" piece. I do think it possible that certain mild states of what the romantic poets might have called "melancholy" (not to be confused with DSM-IV "melancholia")may enhance certain kinds of creativity or perhaps problem-solving; so, yes, the "spandrel" hypothesis may be more applicable to severe major depression.

The image that I use is this: ordinary sorrow is like a train trip through steep country and threatening storms; major depression is like standing on the track and getting hit by the train!

It's a pity that the general public still has trouble with the distinction, and that many popular journalists don't help much!

Best, Ron