Romancing Depression (Or Not)

The past few years have brought us a rash of popular studies in evolutionary biology […]

David Zahl / 1.24.12

The past few years have brought us a rash of popular studies in evolutionary biology and psychology that seek to assign redemptive purposes to negative emotions such as anxiety, anger and depression. An upside, if you will, such as increased problem-solving skills. Clinicians have, by and large, expressed considerable skepticism about these findings, decrying the “pastoral” naivete of such claims. Dr. Richard Friedman is one such voice, and he offered up a refreshing perspective in The NY Times last week, “Depression Defies the Rush to Find an Evolutionary Upside.”

Dr. Friedman raises a couple of objections that we might share. Above all, he challenges the “nature equals good” notion that has crept into much of our discourse these days, including the theological. It may sound fairly obvious, but his claim that something can be both natural and, well, bad (rather than just a different sort of good) is not exactly a popular one. The deeper implications naturally have to do with something more universal – one might go so far as to label these theories a-religious attempts to exonerate humanity, to establish a kind of infallibility. Which, ironically, is pretty close to what we term original sin.

There’s something rather manic about the need to give every negative emotion some positive spin, as if that makes the feelings themselves any more pleasant or easier to deal with (I mean, how has that tactic worked when someone’s used it on you?). Not that negative emotions can’t or don’t ever serve positive functions — they obviously do on occasion — just that one has to wonder about any system that refuses to tolerate even the possibility of fundamental ugliness (or fallenness), but instead always rushes to find some justification for it. It’s the scientific equivalent of the person who can’t allow there to be any silence in a conversation (or in their lives). Surely there’s some fear at work here about value judgments — what precisely constitutes mental health (and illness) is a lightning rod in that respect — but this trend strikes me as an increasingly ridiculous one. A elaborate dodge, in other words, and one dangerously detached from lived experience… How’s that for a value judgment? Ha! We certainly couldn’t have asked for a better lead-in to the long-awaited new Leonard Cohen record:

Under close scrutiny, the case for depression’s adaptive benefits has problems — big ones. For one thing, the ruminative thinking of depression is often not particularly effective in solving problems. As another patient of mine once said: “I would think the same things over and over and could never decide what to do. It’s not a creative way of thinking.”

More critically, depression can arise without any psychosocial stressor at all, which makes it hard to argue that depression is a response to a difficult situation or problem. Dr. David J. Kupfer, a psychiatrist at the University of Pittsburgh, has found that a major life stressor almost always precedes a first episode of depression, but that episodes recur with milder stressors, or even none at all…

Why, then, does the notion persist that depression confers special insights and benefits?

I got a clue recently from one depressed patient. He was an educated and articulate young man, unhappy because the world was such an awful place, he said. Because he had so many other symptoms of depression — insomnia, fatigue, low libido and poor self-esteem — I told him that he was clinically depressed and that his Hobbesian worldview was probably a result of depression, not its cause.

He scoffed, but he was willing to try a course of cognitive-behavioral therapy and antidepressant medication, if only to feel better. Months later, when he had recovered, I asked him again about his worldview.

The world was just as dire, he said, but he felt better. Still, he speculated wistfully that his newfound cheerfulness was not his authentic self, which he described as brooding and creative.

This cuts to the heart of why depression is increasingly romanticized. What is natural, the thinking goes, is best. If we are designed to suffer depression in response to life’s ills, there must be a good reason for it, and we should allow it to take its painful and natural course.

Even if depression is “natural” and evolved from an emotional state that might once have given us some advantage, that doesn’t make it any more desirable than other maladies. Nature offers us cancer, infections and heart disease, which we happily avoid and do our best to treat. Depression is no different.


P.S. Harper’s has made David Foster Wallace’s classic short story “The Depressed Person” available for free. As much as there can be a final word on the subject, he said it.