3.02.2010

On Depression

Could depression be an adaptive response to painful life stressors? You might wonder how anyone might think anything as unpleasant could be the least bit adaptive. However, if you think the question makes little sense, consider the fact that 1 in 18 or 14.4 million people in USA are estimated to become seriously depressed during their life.

What possible function could such distress or even mild suffering have? This is the question Jonah Lehrer considers in his article “Depression’s Upside” in this week’s New York Times Magazine. The question emerges within an evolutionary psychology framework that tries to account for human thought and action in terms of natural selection processes.

Darwin himself suffered from periodic bouts of depression that he came to believe allowed him to focus on his work. Lehrer quotes Darwin: “Work is the only thing which makes life endurable to me.” And later sadness “…leads an animal to pursue that course of action which is most beneficial.” “The darkness was a kind of light.”

The light it might shed has been taken up by a psychiatrist, Paul Andrews and an evolutionary psychologist, J. Thomson in their controversial paper “The bright side of being blue: Depression as an adaptation for analyzing complex problems.” According to Lehrer they began by focusing on rumination, one of the dominant thought processes of a depressed person. They wondered what purpose rumination might serve.

Andrews and Thomson claim there are real benefits to be derived from ruminative thinking even though it occurs while a person is suffering. They are the insights gained in thinking analytically about their depression. They call their view the “Analytic Rumination Hypothesis.

“The analytical rumination (AR) hypothesis proposes that depression is an adaptation that evolved as a response to complex problems and whose function is to minimize disruption of rumination and sustain analysis of complex problems.”

Andrews and Thomson respond to the many critics of their view by admitting depression cannot be so easily encapsulated into a single formulation, that it is a highly variable phenomena that takes many forms, often without any discernable benefits and that it has numerous alternative theoretical accounts. “To say that depression can be useful doesn’t mean it’s always going to be useful.”

I am sympathetic to Thomson’s view of the critical test for the AR Hypothesis, namely, “Do these ideas help me in my practice?” To find out he began cutting back on anti-depressive medications in the belief that they were actually making it harder for individuals to resolve their dilemmas. He relates the response of one patient who, when asked if her anti-depressants were working, said, “Yes their working great. I feel much better. But I’m still married to the same alcoholic son of a bitch. It’s just now he’s tolerable.”

Lehrer proceeds to discuss the mounting evidence that anti-depressants do not lead to lasting improvement and that the relapse rates for those on them is as high as 76 percent, whereas for those receiving the increasingly popular cognitive therapy it is 36 percent. In addition, he discusses recent research on the effects of negative moods (a sad video, gray/rainy days, negative performance feedback, etc.) that often lead to better decision-making and improved writing.

In one study he showed that unhappy writers write better than happy ones. This is consistent with the large body of research assembled by Kay Redfield Jamison in Touched with Fire that creative achievement in the arts is often associated with depression or manic-depressive illness.

The relationship between depression and improved writing skills seems like a paradoxical quirk of evolution. In an experiment he conducted on abstract-reasoning Andrews found that, “Depressed affect made people think better.” At least it did for some depressed individuals. A seriously ill depressed psychotic is clearly not going to think better or show any benefit from ruminating about their misery.

Lehrer concludes, “The challenge, of course, is persuading people to accept their misery, to embrace the tonic of despair. To say that depression has a purpose or that sadness makes us smarter says nothing about its awfulness….even if our pain is useful, the urge to escape from the pain remains the most powerful instinct of all.”

Telling someone then to embrace the tonic of their despair is easy. Getting them to do that is another matter. Perhaps one way writers try to escape from their despair is by writing about it. Since that rarely works for very long, is it any wonder our bookshelves are filled with so many unhappy novels and memoirs.

1 comment:

Dave Brook said...

Readers may be interested in this rebuttal to Lehrer's article "The Myth of Depression's Upside".

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