As a species, homo sapiens, we have been around for about 200,000 years, it’s thought. Have we been depressed, on and off, for all that time?
As I pointed out in Whodunnit?, depression is a protective mechanism that has a purpose in our lives and generally works well. Occasionally it goes wrong when the link between the cause of the depression and the emotional state itself gets lost somehow.
Therapies like CBT work by finding the missing link. To a large extent, CBT is so quick and so successful because it is explicitly focussed on finding the missing link. Other therapies fish around for it in a haphazard way, which can mean they take much longer and are more likely to fail.
Homo habilis, and others
Our genus, homo, is thought to go back around 2½ million years, but it’s not clear that the early species of hominids like homo habilis had the same kind of consciousness that we have. It’s been difficult to draw firm conclusions from the research that has been done on mood disorders in primates. Here’s one critique.
A blog post by retired psychologist Philip Hickey last month makes some useful observations about depression as a diagnosis, while blurring the detail to the extent that the article as a whole is unhelpful (and in parts, laughable): Depression Is Not An Illness
This one sentence near the start gives the flavour of the whole piece:
In fact, depression is an adaptive mechanism which has served the species well for millions of years.
Adaptive mechanism — yes. Millions of years — very likely overstated.
Overstatement continues in a long rant about how depressed people have only themselves to blame. Here’s a fragment:
Many of these individuals lived on a diet of soda pop, cigarettes, and salami sandwiches.
(The last time I had a cigarette and salami sandwich, I hadn’t been drinking soda pop.)
Nevertheless, Philip Hickey does make some good points about pharmaceuticals and about the DSM.
Hat tip to Aqua at Vicarious Therapy who reviewed Philip Hickey’s post and sent him a long, angry reply. I do think her anger is a little misplaced, though.
Psychologists who find the concept of mental illness difficult to grasp in any detail are two-a-penny. They stagger through their careers by following guidelines imposed on them by others, largely without thinking things through for themselves.
At least Philip Hickey is doing some thinking, even if he has left it until after retirement to start. So he got some things hilariously wrong — perhaps he will improve with practice. Good luck to him, I say.
What does illness mean? Bacteria and viruses really have been around for millions of years, and we have always coexisted with them. They are part of our world and part of us. Indeed, they were here millions of years before us. Do they infect us, or did we infect them?
It makes no sense to dismiss, say, tuberculosis and swine flu by saying that we have coexisted with bacteria and viruses for “millions of years” and so their effects are not illnesses. That kind of faulty logic robs the term “illness” of all meaning.
On the other hand, the mere presence of bacteria and viruses does not make us ill. We live our lives in the constant presence of bacteria and viruses.
Illness means some unusual state that disrupts normal life and/or has the potential to cause lasting harm. It’s in that sense that depression is an illness.
Just like our immune systems, which maintain a constant equilibrium with everyday bacteria and viruses, we have systems of emotional regulation that maintain equilibrium too. It’s when those systems are overwhelmed that medical treatment becomes valuable.
CBT treatment for depression is not like an antibiotic or antiviral drug. Those drugs work by targeting the cause of the problem directly. CBT, in contrast, only identifies the target so that the mind’s normal mechanism for restoring equilibrium can deal with it.
As it happens, there is the possibility of a new class of drugs that does the same kind of thing for the immune system — helping it to identify and target disease-producing organisms: Kary Mullis’ next-gen cure for killer infections
Kary Mullis thinks about things with the kind of clarity that may be rare in psychologists, but thinking is good. Thinking works. It’s what homo sapiens is all about. And after only 200,000 years, it’s too early to say what thinking may yet achieve.