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2002 On the of Mike W. Martin Chapman University, [email protected]

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Recommended Citation Martin, Mike W. "On the evolution of depression." Philosophy, , & Psychology 9.3 (2002): 255-259.

This Article is brought to you for free and open access by the Philosophy at Chapman University Digital Commons. It has been accepted for inclusion in Philosophy Faculty Articles and Research by an authorized administrator of Chapman University Digital Commons. For more information, please contact [email protected]. On the Evolution of Depression

Comments This article was originally published in Philosophy, Psychiatry, & Psychology, volume 9, issue 3, in 2002.

Copyright Johns Hopkins University Press

This article is available at Chapman University Digital Commons: http://digitalcommons.chapman.edu/philosophy_articles/15 MARTIN / THE EVOLUTION OF DEPRESSION I 255

On the Evolution of Depression

Mike W. Martin

KEYWORDS: Depression, , mental disorders, psy- difficult to distinguish depression from grief, sad- chobiology, evolutionary psychiatry. ness, gloom, and a host of additional ways to feel down—especially because today many people use “I’m depressed” as a blanket expression for vir- N “DEPRESSION AS A MIND–BODY PROBLEM,” tually any low mood. For the purposes of this Walter Glannon outlines a psychosocial-phys- paper, it is not necessary to attempt a full-blown Iiological explanation of depression as a psy- analysis of depressed moods (and emotions). I chological response to chronic stress—today, es- would emphasize, however, that depressed moods pecially social stress—in which cortisol imbalances involve values. They involve negative evaluations disrupt neurotransmitters. Accordingly, treatment of ourselves, major events in our lives, life in its for depression should combine psychopharma- entirety, or the values that have been guiding us. cology and psychotherapy—a valuable reminder Typically, to be depressed is to experience such in light of the current restrictions on funding for things as feelings of worthlessness, dejection about health care (Hobson and Leonard 2001). My failures, despair and hopelessness, and loss of comments focus, however, on Glannon’s objec- caring and commitment. Thus, we might be sad tions to evolutionary theorists who explain our or grieving but not depressed because we retain a capacity for depression as adaptive to the natural solid grip on what is valuable and worthwhile. In and social environment. His objections are im- any case, there should be no general presump- plausible because he fails to distinguish depres- tion that depressed moods are all bad or undesir- sion as a mood and a disorder. able. Instead, we should be prepared to appreci- ate the importance of depressed moods in What Is Depression? connection with questions of value, identity, and Explaining the psychology, sociology, physiol- even moral insight (Martin 2000). Depressed per- ogy, and evolution of depression presupposes sons are not necessarily sick. knowing what depression is and hence what is In contrast, depression as a is, being explained. As a blunt but important dis- by definition, pathologic. Moreover, usually it is tinction, let us contrast depression as a mood not a depressed mood, although it involves de- and as a mood disorder. pressed moods. On the one hand, depression as a As a mood, depression is a state of low spirits, disorder is defined as pathologic, a notion that is typically involving painful and low affect (of a itself understood in terms of values—the values kind needing further specification). Not all nega- of health and, indirectly, moral values that define tive low moods are depressions. It is notoriously what is culturally acceptable. Thus, even severe

© 2003 by The Johns Hopkins University Press

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grief can be nonpathologic, even though it in- My main concern, however, lies elsewhere. In volves depressed moods, when it is within the a brief section titled “An Adaptive Response?” range of “culturally-sanctioned responses” (APA Glannon calls for a sweeping rejection of expla- 2000, xxxi). On the other hand, only sometimes nations developed by evolutionary psychiatrists and is depression a single pathologic mood, as in psychobiologists to explain why we have evolved major depressive episodes that can strike with a as creatures who suffer depression (and lots of it). terrifying and suicidal severity (APA 2000, 375). According to these evolution theorists, depres- Usually, however, the is not a single sion serves various adaptive purposes. Glannon depressed mood, but instead a longer-term state argues that these theorists are mistaken because involving recurring depressed moods and addi- depression is a set of maladaptive disorders: “de- tional features, such as poor concentration, in- pression is an adaptive disorder consisting in an somnia, poor appetite or overeating, and so on. individual’s inability to adjust to the social envi- For some purposes, such as research funding and ronment. It is not a defense mechanism serving billing insurance companies and government an adaptive purpose for the survival of the or- health providers, these can be equat- ganism.” In making this claim, he assumes that ed with what is currently in the DSM. Yet, there the evolution theorists mean what he means by are many additional states of suboptimal health, depression—namely, mental disorders. Do they? in which the DSM criteria are only partly met. What does Glannon mean by depression? He Maladaptive Disorders Versus does not define it, but he makes it perfectly clear Adaptive Defenses that he intends depression as a disorder. Or rath- Are the evolutionary theorists trying to ex- er, it is a set of mental disorders, including the plain (a) the evolutionary purposes of depressed “depressive disorders” of major depressive dis- moods (both healthy and unhealthy ones) or (b) order, dysthymic disorder, depressive disorder the evolutionary purposes of depression as a mood not otherwise specified, and a variety of bipolar disorder only? Glannon assumes (b), but (a) is disorders and some anxiety disorders. Glannon closer to the truth. I say closer to the truth sometimes indicates his primary topic is “severe because evolutionary psychiatrists also sometimes depression,” which of course is not a DSM cate- fail to distinguish (a) and (b). Even so, Glannon gory (nor always a mark of pathology). For the fails to engage the evolutionary theorists on their most part, however, he says his topic is “chronic own terms, and sometimes he seems to attack a depression,” which might suggest dysthymia, “a straw man. chronically depressed mood for most of the day, As an example of someone who clearly in- for more days than not, as indicated either by tends (a) rather than (b), consider Randolph M. subjective account or observation by others, for Neese’s “Is depression an ?” (2000), at least 2 years” (APA 2000, 380). I suspect, an essay that Glannon explicitly targets. After however, that Glannon intends something broader noting the unclarity about what depression means, than dysthymia, perhaps including most patholog- Neese stipulates that for his purposes “depres- ic states that significantly involve depression that sion will refer to severe states of negative affect is severe and recurrent. Such a broader conception that are often but not necessarily pathologic, and would allow him to bypass the vagaries of the low mood will refer to states in the common DSM classifications, which fluctuate as its editions range of normal experience” (Nesse 2000, 15). change. Nevertheless, he seems to target disor- He notes the intuitive starting point that much ders that involve primarily depressed moods, rath- low mood and depression are normal and be- er than bipolar disorders, and he explicitly sets come pathologic only in some forms and under aside posttraumatic stress disorder. In any case, some conditions. Then he seeks an explanation because parts of his paper are concerned with the of both depression and low mood, concluding physiology of depression, it might be helpful to that although many depressions are pathologic more fully specify the disorders being explained. (maladaptive), many other depressions and low

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moods are adaptive in helping us deal with de- To confuse (or clarify?) matters further, let me feat and danger. suggest that evolutionary psychiatrists often in- It seems likely that low mood and related terweave two different types of explanation of negative affects were shaped to help organisms mood disorders, what I will call adaptive-sick- cope with unpropitious situations. Some nega- ness explanations and malfunctioning-defense tive and passive aspects of depression may be explanations. Adaptive-sickness explanations useful because they inhibit dangerous or waste- explain why mood disorders sometimes serve ful actions in situations characterized by com- purposes beneficial to individuals and groups. mitted pursuit of an unreachable goal, tempta- These explanations seem paradoxical, because tions to challenge authority, insufficient internal by definition disorders are maladaptive or dys- reserves to allow action without damage, or lack functional. In fact, the paradox is superficial. A of a viable life strategy (Neese 2000, 18). disorder can be maladaptive in some ways (indi- In Evolutionary Psychiatry, another work tar- cated in its defining criteria) and adaptive in geted by Glannon, Anthony Stevens and John other ways (given serendipitous circumstances). Price (2000) give credence to “attachment theory It is commonplace, but interesting, that maladies explanations” of depression, as well as to Neese’s of many kinds can have good side effects (Sand- escape-and-avoidance theory that focuses on com- blom 1995). For example, the maladies that take petition and rank conflicts. Attachment theory away a writer’s ability to walk might provoke the emphasizes that love and other deep bonds of writer into greater commitment and concentra- affection involve (as one mark of “depth”) grief, tion that result in an explosion of creativity (Price sadness, guilt, shame, and other forms of distress 1995). Similarly, it is amply documented that when the love is lost or threatened. These emo- mood disorders sometimes play creative roles in tions can easily degrade into pathologic states. the lives of artists (e.g., Lord Byron), leaders Stevens and Price are less careful than Neese in (e.g., Abraham Lincoln), and others (Jamison defining depression, but it is clear they are ex- 1993). plaining a wider range of low-mood states and Malfunctioning-defense explanations seek to then subsuming pathology as a maladaptive dis- explain a broader category of moods (or other tortion. Depressive disorders, they tell us, are mental states) as frequently adaptive psychologi- best “understood as chronic exaggerations of cal defenses against stress and anxiety, and then innate behavioural potentials with which all hu- they portray mood disorders as breakdowns or man beings are equipped by virtue of their hu- distortions of those defenses. That is, they do not manity” (2000, 48). portray pathologies as adaptive; on the contrary, Glannon is not accurate, then, when he says, the disorders are maladaptive perversions of pro- tout court, that evolutionary theorists portray cesses and states that normally functions adap- and explain pathologic depression as adaptive. tively. Glannon, too, provides explanations of The theorists are not saying there is pathology in this sort. (In doing so, I might add, he distin- every depressed-mood withdrawal from compe- guishes psychological defense mechanisms, which tition and response to the loss of love. Instead, he says help us to avoid harm and social realities, the theorists are explaining how humans came to and disorders. Yet, defense mechanisms, the idea possess general capacities for depressed moods introduced by Freud and refined by neo-Freud- that enter into a continuum from adaptive to ians, can serve healthy or unhealthy purposes.) maladaptive. These general types of explanations have great interest and promise, in my view, and One Cheer for Depression Glannon provides no reason to reject them. Stat- Clarity about definitions and distinctions, I ed more positively, Glannon’s psychophysiologic have suggested, is essential in gaining clarity about explanation of depression as a disorder is com- what is being explained and assessed in evolu- patible with the work of the evolutionary theo- tionary psychiatry and psychobiology. It is also rists. important in connection with therapy and self-

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understanding, in determining what is unhealthy scopic: it observes big and complicated terrain from or not, and in understanding the continuum be- a great distance. In contrast, physiology is micro- tween health, suboptimal health, and full-blown scopic: it sees big and complicated terrain from disorders. Indeed, our choice of terminology al- close up. Telescopes and microscopes reveal much, ready reflects our attitudes. If we think of nega- but they also neglect much that is important in tive low moods as inherently undesirable then appreciating the nuances of the value-permeated we will tend to use the word depression to con- world of human beings. Worse, they carry the note sickness. If we discern value in many nega- danger of reducing complex value dimensions of tive low moods we will be more likely to use the human life to something simpler—a danger to word depression to refer to a broad range of which sociobiology fell prey (Midgley 1995). moods, most of which are normal and some of Glannon’s interest is mental health, but even which are pathologic (Neese 2000, 15). our conceptions of mental health are immersed Furthermore, if we view all depressed moods in a broader set of values than survival—values as bad, we will have to usurp some other term to about morality and meaningful life. Furthermore, connote the wider range of healthy emotions. many psychologists have come to appreciate the For example, Lewis Wolpert (1999) stipulates need for focusing not only on disorders and that (all) depression is pathologic and then uses threats to survival, but also on positive concep- sadness for wider range of emotions: depression tions of health as well-being beyond the mere is malignant sadness. For reasons I gave earlier, I absence of disease (Snyder and Lopez 2002). I think we should keep the broader sense of de- suspect that psychologists’ current explorations pression, and not equate depressed moods with in positive health will yield new insights into the sadness. No doubt that reflects both my attitudes positive contributions of depressed moods to and my idiolect. meaningful life. In any case, depression as a mood Historically, attitudes toward depression (mel- raises important questions about moral values at ancholy, acedia, etc.) have varied greatly (Rad- several junctures: the value judgments internal to den 2000). At one extreme, much everyday de- the mood (e.g., self- or world-denigration); the pression is defended and even celebrated, a view values under assault by the mood (e.g., loss of associated with Romanticism. (I still remember caring); defining the line (blurry) line between that in an undergraduate course on English Ro- healthy moods and depressive disorders; thera- manticism I was graded down for failing to ap- peutic judgments about the best course of treat- preciate how much the Romantics value states ment for depressive disorders and suboptimal health. that today we pathologize.) Some philosophers continue that positive emphasis on the desirable References aspects of depression as part of a value-guided American Psychiatric Association (APA). 2000. Diag- life (Solomon 1976). At the other extreme are nostic and statistical manual of mental disorders. the pathologizers, not just some Prozac-profli- 4th ed. Text Revision. Washington, DC: Author. gate psychiatrists but also many up-beat Ameri- Edwards, R. B. 1997. Value dimensions of ‘mental cans who require steady and ever-increasing states illness” and “mental health.” Ed. R. B. Edwards. Ethics of psychiatry (pp. 17–21). Amherst, NY: of augmented cheerfulness to get through the Prometheus Books. week. In between are a variety of nuanced atti- Hobson, J. A., and Leonard, J. A. 2001. Out of its tudes, including Susanna Kaysen’s (2001) aptly mind: Psychiatry in crisis. Cambridge, Mass: Per- expressed realism in giving “one cheer for mel- seus Publishing. ancholy” as unpleasant but often useful. Jamison, K. R. 1993. Touched with fire: Manic-de- Evolutionary explanations of depression blur pressive illness and the artistic temperament. New over most of the nuanced roles of depression in York: Free Press. Kaysen, S. 2001. One cheer for melancholy. Ed. N. individual lives and . Their broad-brushed Casey. Unholy ghost: Writers on depression. New explanations focus on only one value, however York: William Morrow. important: survival. Evolutionary theory is tele-

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Martin, M. W. 2000. Depression: Illness, insight, and Sandblom, P. 1995. Creativity and disease: How ill- identity. Philosophy, Psychiatry, and Psychology ness affects literature, art and music. New York: 6:271–86. Marion Boyars. Midgley, M. 1995. Beast and man. Revised ed. New Snyder, C. R., and Lopez, J. S., eds. 2002. Handbook York: Routledge. of positive psychology. New York: Oxford. Nesse, R. M. 2000. Is depression an adaptation? Ar- Solomon, R. C. 1976. The passions. Notre Dame, IN: chives of General Psychiatry 57:14–20. University of Notre Dame Press. Price, R. 1995. A whole new life: An illness and a Stevens, A., and Price, J. 2000. Evolutionary psychia- healing. New York: Plume. try: A new beginning, 2d ed. London: Routledge. Radden, J. (ed.). 2000. The nature of melancholy: Wolpert, L. 1999. Malignant sadness: The anatomy of From Aristotle to Kristeva. New York: Oxford depression. New York: Free Press. University Press.

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