Storied Mind» Explanations

Depression Is a Creative Force in Human Evolution?

john — Fri, 05 Mar 2010 22:05:17 +0000

Some Rights Reserved by gutter at Flickr.

What is it about depression that draws people to search for the benefits it brings to its lucky victims? Since I’ve been writing this blog, many writers have had great success with books and articles describing its positive role in life – giving people a creative edge, helping them figure out their lives or simply serving as a healthy and normal response to misfortune. The problem with each of these essays is that they invite confusion between mild depression, or limited periods of deeper mood changes caused by life events, and the much more severe depressive disorders.

The latest contribution in this vein is Jonah Lehrer’s New York Times article, Depression’s Upside. It’s about a theory that takes depression’s virtues to a much higher plane than that of individual insight. Depression, it turns out, evolved as part of our genetic makeup because it enhanced the human capability for analytical thinking and problem-solving. In short, depression has helped the human race survive.

This isn’t his idea. He’s summarizing the conclusions of a scientific paper by J. Anderson Thomson, a psychiatrist, and Paul Andrews, an evolutionary psychologist, but he adds a lot of additional material to support the notion that depression has its brighter side.

The concept is that depression improves the mind’s ability to focus attention on “complex social problems” (failing marriage, loss of job) through the process of rumination – the repetitive analyzing of a single problem. (Hence, the theory is called the analytic-rumination hypothesis or ARH.) Rumination fires up the area of the brain that specializes in analytical thinking, making it easier to break apart the elements of a problem that might otherwise seem overwhelming and so make it easier to find a solution.

Isolation from the rest of the world supports this tight mental focus and keeps the mind from being distracted, as does – I presume – loss of interest in sex, food, human relationships and fresh air. Since all these symptoms are coordinated so nicely to help with problem-solving, the authors contend that they must represent an evolutionary adaptation rather than a malfunction.

If this is true, I’ve really bungled the gift of my genetic inheritance. In all the decades of dealing with severe depression I never solved a single complex social problem. Amazingly enough, my mind was infinitely distractible, incapable of clear decisions and subject to aimless drift into a cloud of nothingness. At other times, I obsessed about my failings and worthlessness in prolonged self-torture and often thought of suicide. Perhaps, though unaware of it, I did sharpen my analytical abilities while sleeping all the time. However, my isolation from my family, if you can believe it, seemed to create problems rather than solve them. Clearly, I’ve given evolution a setback, especially since I’ve likely passed on this my distorted version of this gift to our three sons.

But quite possibly, it’s not true at all – at least when you untangle the confused use of the word depression. Lehrer has taken a lot of heat for failing to do that. The psychiatrist Ronald Pies, for example, writes in his Psych Central post, The Myth of Depression’s Upside that Lehrer ignores many studies that reach the opposite conclusions about the effects of depression on thinking, relating both to mental function and the level of activity in the brain. He offers this anecdote:

The notion that severe depression may bring forth good things reminds me of a lecture I once attended on “fire safety” in the hospital setting. We were shown a movie of a house that had burned down in such ferocious heat that a package of frozen muffin dough had been completely baked. “So, the house wasn’t a total loss!” quipped one of the world-weary attendees. Yes, of course—people can learn from their severe depressive episodes, but often at the cost of emotional and spiritual conflagration.

Edward Champion at Reluctant Habits attacks Lehrer’s interpretations of the experiences of Charles Darwin, Kay Redfield Jamison and David Foster Wallace.
Peter Kramer also has little patience for the idea. That’s not surprising since Kramer produced a very convincing study, Against Depression, that attacked a long-standing tendency in our culture to glorify depression.

Prior to Lehrer’s article, Jerry A. Coyne, a Professor in the Department of Ecology and Evolution at the University of Chicago wrote a devastating two-part critique of the Thomson-Andrews paper itself. He’s an expert on evolution and author of the highly praised Why Evolution Is True. He methodically takes apart the speculative reasoning and “paper-thin evidence” supporting the conclusions of Thomson and Andrews about the evolutionary benefits of depression. He looks at the original research papers cited by them and brings out the way in which their interpretations distort the actual findings of the studies.

So what’s going on? Why have there been so many claims about depression as a boon to human life, and why has there been a strong positive response from the public (excluding, of course, the hundreds of thousands of us who’ve lost so many years to the effects of this illness)?

I think part of it has to do with the confusion about what “depression” means. The same word is used to refer both to feelings of sadness or dejection in everyday life and to a set of clinically defined illnesses. Unfortunately, the psychiatric profession, however much it hopes to dispel this confusion with the Diagnostic and Statistical Manual (DSM), only reinforces it.

By setting the bar so low for a diagnosis of a major depressive episode (experiencing five out of nine listed symptoms for at least two weeks), the DSM invites psychiatrists and physicians to prescribe treatment for even isolated occurrences. To add to the prevalence of a depression diagnosis is the startling fact, reported in a recent study, that a quarter of psychiatrists and two-thirds of non-psychiatric physicians do not bother to use the loose DSM criteria when making a diagnosis.

Even when studies or popular books and articles do make the distinction between severe and mild depression, they tend to drop the qualifiers after that caveat, rely on the single word and make much more sweeping claims about depression’s beneficial impacts on life. The influence of drug industry advertising also encourages the idea that people shouldn’t put up with sadness but rather take the latest medication to restore a happy outlook on life. (But that’s a long story for another day.)

Many people do value depression as a factor that gives them a distinctive outlook on life, and they don’t want to sacrifice this dimension of mental experience to a drug-induced “cure.” I have no quarrel with that and respect whatever adaptation to depression people need to make. But individual experience and choices are one thing. Speculative theories about the brighter side of depression from psychiatric researchers are another. They have real-world consequences and need a lot of rigorous testing before put into practice. Unfortunately, that usually happens, if at all, long after the idea has gotten wide publicity and influenced attitudes of public and providers alike.

Is There Comfort in Depression?

john — Mon, 16 Nov 2009 18:12:32 +0000

Some Rights Reserved by Andy Saxton at Flickr

The question continues to puzzle me: How did I get over depression? That deep change began about 18 months ago, and it’s been a year since I knew for sure that something fundamental had shifted. The nemesis wasn’t after me anymore. In fact, I couldn’t find that thing anywhere near me.

After so many temporary recoveries, I was cautious about saying – or even thinking – that I could finally be free of it. So I just kept on moving through each day. That was fine for a few months until I finally had to admit that everything was different. I felt fully alive again.

Why did it take so long? I struggled with that question for a while and got nowhere. Then, I woke up one day and realized that at some point I had become strangely comfortable with depression. Even while working hard to get over it, I had also been working hard, half consciously, not to change.

That was a thought I did not at all want to accept, but at some level it rang true.

There had been a certain comfort in when I’d figured out that depression was far more pervasive than I’d ever imagined. The condition accounted for so many of the problems I had long taken as proof of how empty I was. Knowing myself as a depressed person was a big step up from knowing myself as a worthless one.

There was a big risk in the change I would have to go through to find another me – a recovered one. Even though I yearned to be free of the suffering, emotionally I was telling myself: I’m not ready yet.

I didn’t understand depression all at once. There were key moments when I suddenly grasped new dimensions of the condition. Each of them helped seal me into a depressed – and passive – identity.

The first was simply finding out in my twenties that part of what I was going through was called depression by a bona-fide psychiatrist. The word wasn’t just a general part of my vocabulary anymore. It was official. As far as I understood at the time, though, that simply referred to periods of despair when I had suicidal thoughts and no energy to move. The psychiatrists I saw shared a then common attitude that depression was a side issue. The important thing was to get to the depths of family history, trauma and all the hidden influences that had shaped me. In that context, depression could even be useful as a stimulus to probe more deeply into the real issues. Nobody talked about medication or any other special treatment for it unless I was in a full-blown crisis.

Much later, I realized that depression was a more serious and pervasive problem than I had thought. It may seem strange to say that, but I had convinced myself that the dark moods were a relatively minor problem. I thought I was highly functional most of the time, even when it became obvious to everyone close to me that I was often in trouble.

Depression, I now found, accounted for problems of mental clouding, lack of focus, slowed thinking and talking, intense anxiety and many other symptoms. The relief in that moment came from understanding that I wasn’t the only one going through this and that those mind- and will-cripplers weren’t evidence of my inadequacy as a person. Instead, all these problems came together in the illness of depression.

The next eye-opener was that periods of depression had no cause in immediate experience. I believed it was the background condition of my life. It was always there and would keep on returning.

In the 90’s, a doctor let me know that new drugs could effectively treat depression, and for the first time I regularly took medication. The drug was called Prozac, and I felt great for a few months. Then it stopped working, and I was off on a long journey to find the right drug with the promised cure. I never found it, but now I was looking outward for medication combined with other treatments to take care of the illness.

Then I found there was a term for the disappointing results with all the treatments I tried. They were not ineffective. I was the problem because I was treatment resistant. Now it seemed inevitable that I would never get away from depression. My version was self-sustaining and could not be treated successfully.

Later I discovered my full DSM diagnosis and the number assigned to it, and I felt more settled than ever into a life built around a struggle with depression. There was a strange security and comfort in having this bad news. I knew, or believed, that I had found the answer. I was a depressed person for life. That’s who I was.

It was painful, to be sure, but this identity gave me answers for everything I went through. I had constructed a home where I lived with depression. We were on intimate terms. It made me desperate at times, and I couldn’t understand how it could keep returning and ruining so much that I tried to do. I’d scream at it, but always felt – that’s me, and that’s it. Nobody can end it, so I have to accept a life of constant struggle.

That certainty was my comfort.

But another mind-flip suddenly made life much more complicated. There was a different way to look at this. How could I possibly get back to real living if I didn’t put myself at the center of recovery and stop waiting for “treatment” to take care of me? That was the beginning of real change, but the idea was both empowering and scary.

How would this work? Why did I imagine that I could trust the progress I might make? Would this turn out to be false hope once again? At times I was a determined warrior steadily advancing. At times I was afraid of the future and made a cautious retreat. My fallback position wasn’t so bad. I’d read many stories about people who had come to terms with lifelong depression, even finding a spiritual meaning to their lives. Surely, I could live with that.

But I kept at. I may never know exactly how or why I changed for the better and for the first time trusted recovery. But I do know how I got out of the trap of comfort that might have prevented me from trying.

A Wheel of Emotions

john — Sat, 05 Sep 2009 00:33:04 +0000

Some Rights Reserved by http://commons.wikimedia.org/wiki/User:Ivan_Akira at Wikimedia Commons

Here’s something that caught my eye – a highly original classification of the emotions. This image is the work of Robert Plutchik, a psychologist who saw emotions, apparently as Darwin did, as playing a role in the evolution of animal life. He posited that all animals, including humans, share the “primary” emotions.

Those primary are the eight shown in the middle of the three circles of this figure, and he groups them as four pairs of opposites: fear vs. anger, surprise vs. acceptance, joy vs. sadness and acceptance vs. disgust. These occur at different levels of intensity – he shows the less intense in the outer circle and the most intense in the center. For example, the progression goes from annoyance to anger to rage, serenity to joy to ecstasy, acceptance to trust to admiration, etc. (I can’t see, though, how boredom is the less intense form of loathing – but there’s lots to quibble about here.)

He also proposed that all other emotions – like colors – are combinations of the eight primaries. Those “secondary” emotions appear in the white spaces between the colored spokes. So love is derived from a mixture of optimism and amazement, contempt from anger and disgust, awe from fear and surprise, and so on.

There’s a lot I don’t agree with in this classification. Partly, that may result from some of the name choices he makes, such as submission. That seems more appropriate word for the action that follows an emotion rather than the emotion itself. Some of the associations are questionable – why does boredom lead to disgust? It’s interesting, though, to think about this classification and how emotions are linked and blended.

I spent a while learning something by alternately agreeing and arguing with the whole thing. That was fun as well as instructive. I hope it works the same way for you.

What do you think of this?