Hi janet marie: Do you think any of the people quoted here
have ever traveled the nine circles leading to the Hell of
full-blown Clinical Depression? Been there, done that. And
it takes more than happy thoughts and good intentions to
drag you back to any semblance of sanity. Sure, one's
environment, stressors, etc. affect depression, but the
point they're missing is that it DOESN'T MATTER what caused
the condition, what you are treating is a biological
illness, and while psychotherapy is enlightening and
productive (this is the testimony of a long time psych
nurse AND the recipient of more years of therapy than I
care to divulge), the cure involves medication. Depression
IS NOT comparable to diarrhea. It is insane not to treat it
when we have the cure.
Carole
--- janet marie paterson <[log in to unmask]> wrote:
> February 1, 2000
>
> Viewing Depression as Tool for Survival
>
> The case, Dr. Randolph M. Nesse said, does not fit tidily
> with the view that depression is only a matter of
> disordered brain chemicals:
>
> A woman sought help from a psychiatric clinic because she
> was desperately depressed. She had dedicated five years
> to becoming a professional musician, despite her
> teachers' admonitions that she lacked the talent to
> succeed. She persisted, the woman said, because it was
> her mother's dream for her.
>
> The psychiatrists at the clinic treated her with a
> variety of antidepressant medications and with
> psychotherapy. Nothing helped. But when, one day, the
> woman reached a decision, giving up music in favor of a
> career more suited to her abilities, her depression
> lifted.
>
> Dr. Nesse, director of the Evolution and Human Adaptation
> program at the University of Michigan's Institute for
> Social Research, collects many such cases (the details
> are altered to protect patients' identities) because he
> believes they offer clues to a deeper understanding of
> depression.
>
> In a recent article in the journal Archives of General
> Psychiatry, Dr. Nesse argued that while some forms of
> depression were clearly a result of genetic vulnerability
> and brain abnormality, others might have their roots in
> evolutionary history.
>
> Darwinian theory holds that evolution selects for
> fitness: organisms with traits that promote survival or
> reproduction pass on their genes; organisms without such
> traits die off.
>
> Depression may have developed, Dr. Nesse suggested, as a
> useful response to situations in which a desired goal is
> unattainable, or, as he has put it, "when one of life's
> path peters out into the woods."
>
> Locked in pursuit of the impossible, it makes sense for
> an animal to hunker down, take stock and figure out what
> to do next, Dr. Nesse said. In some cases, depression may
> help a person disengage from what has proved a hopeless
> effort; in other cases, it may protect the person from
> jumping ship too rashly, perhaps landing in even less
> hospitable seas.
>
> "If I had to put my position in a nutshell," he said,
> "I'd say that mood exists to regulate investment
> strategies, so that we spend more time on things that
> work, and less time on things that don't."
>
> In some respects, Dr. Nesse's conception echoes that of
> the psychoanalyst Dr. Emmy Gut. In a 1989 book
> "Productive and Unproductive Depression" (Basic Books),
> Dr. Gut described, among other cases, the experience of a
> biochemist, Albert, who frequently became depressed when
> a research strategy he was pursuing went nowhere. When
> the feelings of despair passed, he said, he saw "an
> entirely different way to tackle the problem, or else, I
> have recognized that the project was unrealistic."
>
> In an interview, Dr. Gut, who lives in Sweden, said: "I
> think that depression is a normal mechanism. It's an
> attempt toward adaptation to a problem."
>
> Dr. Nesse and Dr. Gut are not the first to ponder what
> evolutionary function depression -- and its close
> relative, sadness or low mood -- might serve. Thinkers
> from Schopenhauer to Freud have offered their views. Over
> the years, scientists have speculated variously that
> depression represents a plea for help, a strategy for
> manipulating others into providing resources, a signal of
> submission or yielding in conflict, or a way to conserve
> an organism's energy and resources in hard times.
>
> Other investigators see no point in viewing depression as
> anything other than a malfunction of brain chemicals.
>
> Dr. Nesse, however, is one of a growing number of
> scientists who over the past decade have systematically
> tried to bring a Darwinian perspective to medicine,
> hoping to learn more about how evolution has shaped
> humans' vulnerability to disease.
>
> The approach is yielding a richer understanding of
> illness, and in particular, is helping scientists
> distinguish between diseases and medical conditions that
> developed as defenses against other more serious threats
> to survival.
>
> Coughing, for example, is not a disease in itself but is
> the body's attempt to rid itself of bacteria in the
> lungs. Diarrhea and vomiting, though unpleasant, also
> serve as defenses, evolving as ways to evade danger, and
> thus to preserve fitness. And the ability to feel pain is
> essential for an organism's survival. "People who are
> born without any capacity to feel pain are usually dead
> by early adulthood," Dr. Nesse said.
>
> Similarly, emotions like anxiety, fear and depression can
> be viewed as defensive strategies. Such defenses make
> sense, Dr. Nesse noted, because they have a low cost,
> especially when compared with their potential for
> protection. Vomiting, for instance, involves only the
> loss of few hundred calories, but might save an animal's
> life if the substance ingested is poisonous. In the same
> way, being frightened and anxious when no threat exists
> is a small price to pay for the readiness to fight or
> flee when true danger looms. Yet these tactics also
> sometimes go awry, and illness results: chronic pain
> syndromes or panic attacks, for example.
>
> Dr. Nesse believes the need to gain a deeper
> understanding of what purpose depression might serve is
> especially pressing at a time when the illness is so
> prevalent. Surveys indicate that 10 percent of Americans
> suffer from clinical depression; millions more endure a
> darkness that is not severe enough to earn a diagnosis
> but still interferes with their lives.
>
> Researchers have also found that the rates of depression
> have increased in people born after World War II.
>
> "The irony," Dr. Nesse said, "is that here we have
> finally created a society where not many people are
> hungry, we stay warm, we can take baths, we can travel
> and have relative freedom, and yet so many people are so
> miserable."
>
> One thing that has changed over the eons is the increased
> pressure people feel to set ever larger goals. Ancestral
> hominids may have striven to pick enough berries to last
> for a week; modern humans want to look like supermodels,
> make a million dollars in the stock market or produce
> flawless children.
>
> In shaping his ideas, Dr. Nesse has drawn upon the work
> of psychologists like Dr. Eric Klinger, at the University
> of Minnesota, who studies how people become committed to
> goals, and how they reach those goals or abandon them.
>
> Dr. Klinger's studies indicate that depression plays a
> crucial role in the process of disengaging from a goal.
> To illustrate this, he uses the analogy of a soda
> machine. "You put your 75 cents into the machine and
> nothing happens," he said. "Then you go through a series
> of phases: your behavior gets more invigorated, you pay
> more attention to the signs, you pull on levers, you put
> in more change. If it still doesn't work you may start to
> rough up the machine. But at some point," he said, "you
> walk away, feeling down, feeling disappointed. It's a
> minor depression."
>
> The fact that depression sets in after someone is
> prepared to suffer a failure or a loss, Dr. Klinger said,
> is important. "It slows you down, and makes you take your
> bearings," he said, "and at the same time it's very
> unpleasant, so that people are not going to be attracted
> to giving up quickly."
>
> Dr. Nesse believes there are many varieties of
> depression, not all of them captured by official
> diagnostic categories. An evolutionary view, he and
> others hope, might encourage a broader, more nuanced
> search for treatments.
>
> For instance, if depression is a defense, it might not
> always make sense to block its defensive properties with
> medication. When drugs are used to treat chronic diarrhea
> caused by the shigella bacteria, he noted, complications
> often result.
>
> "For my money," said Dr. Paul Gilbert, a psychologist at
> the University of Derby in England, who has written on
> depression and evolution, "the key thing really is
> recognition that the environment is key to many of these
> disorders. And if you really want to affect depression,
> it's nice to have therapies that work, and it's nice to
> have drugs that work. But do we really want a society
> where we drive everyone mad and then give them drugs to
> get them out of it?"
>
>
> By Erica Goode
> Copyright 2000 The New York Times Company
>
> janet paterson
> 52 now / 41 dx / 37 onset
> a new voice: http://www.geocities.com/janet313/
> 613 256 8340 PO Box 171 Almonte Ontario Canada K0A 1A0
>
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