Monday, March 1, 2010

Depression's Adaptive Value

Johah Lehrer’s interesting piece, The Upside of Depression, in the Feb 28 NYT Magazine argues for the adaptive value of depression. The basic idea, taken from evolutionary psychology, is that depression must have an important survival value or it would have been selected out long, long ago. Certainly, Lehrer’s sources argue, it wouldn't as prevalent as it is today. Depression, they say, is like an emergency brake, forcing patients to halt, disregard distractions, and focus on a central problem. Like any emergency system, it can malfunction and cause big problems of its own. Suicide, for example, certainly isn't adaptive.

But the point of Lehrer's article is that patients who are simply given anti-depressants may not address the root cause of their depression. Andy Thomson, a psychiatrist at the University of Virginia, tells the story of a patient “who came in and said she needed to reduce her dosage. I asked her if the antidepressants were working, and she said something I’ll never forget," Thomson says. “‘Yes, they’re working great,’ she told me. ‘I feel so much better. But I’m still married to the same alcoholic son of a bitch. It’s just now he’s tolerable.’ ”

Lehrer doesn’t talk about it in his piece, but there must be profound society-wide ramifications of broadly quelling individual discomfort with anti-depressants. There are global-scale versions of that “alcoholic son of a bitch” and we live with and tolerate them at our peril. Are widespread war and famine depressing enough to stop us in our tracks and move us to re-consider the compulsively consumptive behaviors that make them possible? How about threats from environmental collapse, nuclear annihilation, or terrorism? If we disable the idiot lights of our personal depressions with drugs, then we may also disable the collective ones too, allowing ourselves to march cheerfully along toward a very depressing future. That would be maladaptive in the extreme.

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