Depression may be our brain's way of telling us to stop and solve a problem
At any given time, about 5% of Americans are reporting symptoms of moderate or severe depression. Major depressive disorder is so common that it's estimated one in six Americans will have it at some point in their lives.
The prevalence
of depression presents economic problems as well — it's one of the most common
causes of disability, it has effects in the workplace, and it's responsible for
a host of suicide-related costs. The economic burden of depression in the US
was estimated to be $210.5
billion in 2010.
So why does
such a debilitating condition affect so many people?
The
traditional understanding is that depression is a breakdown in the way things
are supposed to work in the brain — chemical imbalances that can be righted
through a combination of medication and behavioral shifts.
But there's
also a theory that instead of being purely a disorder, depression might be a
specific behavioral strategy that we've evolved — a biological adaptation that
serves a purpose. As Matthew Hutson explains in a Nautilus feature on the potential evolutionary roots of depression and suicidal behavior,
that purpose might be to make us stop to understand and deal with an important
problem.
Hutson says
the evolutionary psychologist Paul Andrews and the psychiatrist J. Anderson
Thomson first elaborated on this idea, called the "analytical rumination
hypothesis," in an article
published in Psychological Review in
2009.
The basic
concept is that what we think of as a disorder is actually a way our brains
analyze and dwell on a problem in the hopes of coming up with a way to deal
with it. The researchers suggest it's possible that a difficult or complex
problem triggers a "depressive" reaction in some people that sends
them into a sort of analytical mode.
With
depression, Hutson writes, "there's an increase in rumination, the
obsessing over the source of one's pain" along with increased analytical
activity in the brain and REM sleep, which helps with memory processing. A
major symptom of depression is anhedonia, the inability to get pleasure from
normal activities. According to this approach, those things could be disrupting
this "processing" phase.
This
hypothesis would account for the fact that most depressive episodes occur after
a significant life event like a death or the end of a relationship.
In their 2009
paper, Andrews and Thomson even suggest that this idea could explain why
depression and anxiety frequently occur together.
"We
hypothesize that depression and anxiety often co-occur because some problems
require both analysis (promoted by depressed affect) and vigilance (promoted by
anxiety)," they wrote. Analysis allows someone to understand the inciting
factor; vigilance is a way of trying to prevent it from happening again.
Implications
for treatment
As
fascinating as evolutionary explanations are, it's hard to prove they are
correct, especially if they haven't yet been reinforced by other research.
The
idea that depression might be a biological adaptation rather than a mental
disorder is not the consensus of the mental-health community. And even if the
hypothesis is correct, it's likely incomplete and doesn't explain all facets of
depression.
Complex
problems usually have several causes. About 20% of depression
cases aren't preceded by a major life event — there may be some
cause in the past, but we don't know for sure. We also know that genetics
can play some role in a person's susceptibility to depression. As Andrews and
Thomson point out, there are different types of depression, some of which may
have different causes. They also say there are alternative evolutionary
explanations that could coexist with their hypothesis.
But
if the analytical rumination hypothesis could be further validated, it could
have major implications for how we treat this kind of mental illness in the
future.
In
that case, the approach to treating depression could shift to deal more with
the underlying cause rather than just treating symptoms. One anthropologist
told Hutson that if the theory is right, treating depression with
antidepressants might be like treating a broken bone with painkillers instead
of providing both painkillers and a cast to help the break heal. By that logic,
therapy would be an important part of treatment, since it can help people
better understand and cope with what could have caused their depressive
episodes.
Traditional
antidepressants have been very effective,
even life-changing, for some. But those approaches don't work in the long term
for everyone, which is why researchers are
investigating all kinds of different therapies.
Even
if depression were found to be some sort of evolutionary "tool" or
adaptation, it wouldn't necessarily help people solve the problem that caused it.
But new theories may help us think about new or better forms of treatment —
something that's always welcome.
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