Why Feeling Bad Can Be Good: Depression as an Adaptation, Not a Disease

People argue endlessly about what causes depression, and attorneys are no exception. The molecular and physiological machinery behind depressive disorders still isn't fully mapped. Journals and self-help shelves fill up with attempts to explain why the condition takes hold, how its symptoms might be eased, and whether it can be headed off before it starts. Treatments described as cures remain few and often doubtful, and the safety and effectiveness of drug therapy keep drawing hard questions. A different angle comes from Darwinian Psychiatry, sometimes called Evolutionary Medicine. Researchers in that camp spend less energy on the mechanics of depression and more on its purpose. One idea holds that depression is an old defense mechanism, something refined over generations to help us get through unwanted and stressful circumstances. By this reading, we respond to life's pressures by thinking harder and chewing over our troubles.

That chewing-over has a name: analytical rumination. It describes the way someone turns a problem around in their mind again and again, shutting out almost everything else in the hunt for a way through. The brooding, scattered-seeming thoughts that come with depression usually get written off as useless. Some scientists see it differently. They suggest the rumination sharpens focus and deepens analysis of hard problems, which can produce real insight. Studies point in the same direction: people in a low mood show more cognitive processing, greater accuracy on complicated tasks, and stronger attention to detail when the work calls for careful, deliberate thinking. In some cases they do better than their non-depressed counterparts.

Framed this way, depression starts to look less like something broken. Instead of treating it as damage or a chemical imbalance, evolutionary psychologists propose that it can be the body's push toward the kind of deep analysis needed to grasp a stressor and work out what to do about it. That shift matters for how clinicians assess and treat patients. For certain kinds of depression, the better move might be to let the reflection run its course rather than cut it short with medication or a therapy built around pulling the person out of their ruminating state.

A study at McMaster University tested some of this. The sample drew from the student body: 308 women (53 percent) and 271 men (47 percent), average age around 19. Just seven percent said they were taking any antidepressant. The researchers built a 20-question instrument, the ARQ, to gauge where a patient sits in their problem-solving, from first naming the problem all the way to resolving it. It's quick to administer and fits into ordinary family health care settings. The point is to flag the patients who stand to gain from this sort of approach and to shape a strategy tailored to each person's path toward settling whatever set the depression off.

Skye Barbic, a post-doctoral research fellow at the Centre for Addiction and Mental Health, put it plainly: the tool gives clinicians and researchers a set of items for understanding how people with depression are actually thinking, and the answers let them match the level of care and support to the individual. Her colleague at CAMH, Zachary Durisko, added that with many chronic health conditions, depression is often what holds recovery back. The test can show, fairly fast, whether a person is stuck naming their problems, struggling to set goals, or trying to push forward. Each of those stages, he suggested, probably calls for a different kind of support.

Consider the two ends of the ARQ. Someone scoring low hasn't yet pinned down the pieces of their problem or found the best solution, and here the therapist's job is well defined. Exposure-based approaches, mindfulness, and problem-solving therapy can raise the person's awareness of what's actually troubling them. That awareness is worth a great deal for these patients, since standard antidepressants tend not to help them. At the high end, the patient already knows the problem and the goal but needs a hand building the plan to get there, which is where goal-oriented cognitive therapies come in.

Paul Andrews, an assistant professor of Psychology, Neuroscience and Behaviour at McMaster, summed up the stakes. Depression, he noted, has long been treated as nothing more than a defect. The question his group is asking is whether it might instead be a natural adaptation the brain reaches for when facing certain problems, a response that can be useful and even necessary when the issue is large, tangled, and resistant to quick understanding.

The takeaway: depression may be a natural evolutionary adaptation meant to ramp up the brain's problem-solving.

Laura A. Wells

Barbic, S., Durisko, Z., & Andrews, P. (2014, November 14). Measuring the Bright Side of Being Blue: A New Tool for Assessing Analytical Rumination in Depression. Retrieved November 20, 2014, from http://www.plosone.org/article/info:doi/10.1371/journal.pone.0112077

McMaster University. (2014, November 19). A new test measures analytical thinking linked to depression, fueling the idea that depression may be a form of adaptation. ScienceDaily. Retrieved November 20, 2014 from www.sciencedaily.com/releases/2014/11/141119125105.htm