Post by Amtram on Feb 28, 2014 15:54:38 GMT -5
Usually, I'm pretty on board with most of the stuff Harriet Hall writes. But she put up a post on Science-Based Medicine that looked at it from the point of view of a new book, "The Depths: The Evolutionary Origins of the Depression Epidemic" and I have to say, I was really disappointed. She sums up the idea in a few points:
A defect in brain chemistry? This is the basis of drug therapy. The chemistry imbalance hypothesis is simplistic, misleading, and essentially wrong. Antidepressants do indeed alter brain chemistry as they relieve symptoms, but that doesn’t necessarily mean that a chemical imbalance caused the problem, and it doesn’t explain what caused the imbalance or why it happened when it did.
A defect in thoughts? This is the basis of cognitive behavioral therapy (CBT). Is mere thinking enough to think yourself into a depression or out of one? The evidence suggests otherwise.
A defect in childhood experience? This is the basis of psychoanalysis. Freud’s theories have been largely discredited, and people with the most appalling childhoods can have normal adulthoods.
Not a defect at all? This is what Rottenberg proposes.
I would propose that anyone who has never suffered Major Depressive Disorder would take issue with the idea that it's not a defect.
There doesn't seem to be an appreciation of the difference between a "low mood" and a level of depression that makes a person non-functional. The idea being proposed is to put up with it until it passes - without acknowledging the kind of depression that simply doesn't pass. Dr. Hall and the author both seem to believe that viewing this as an evolutionary adaptation will reduce the stigma, but I feel quite the opposite. I'm trying to comment rationally, but my meds aren't working well enough yet. Heh.
A defect in brain chemistry? This is the basis of drug therapy. The chemistry imbalance hypothesis is simplistic, misleading, and essentially wrong. Antidepressants do indeed alter brain chemistry as they relieve symptoms, but that doesn’t necessarily mean that a chemical imbalance caused the problem, and it doesn’t explain what caused the imbalance or why it happened when it did.
A defect in thoughts? This is the basis of cognitive behavioral therapy (CBT). Is mere thinking enough to think yourself into a depression or out of one? The evidence suggests otherwise.
A defect in childhood experience? This is the basis of psychoanalysis. Freud’s theories have been largely discredited, and people with the most appalling childhoods can have normal adulthoods.
Not a defect at all? This is what Rottenberg proposes.
Rottenberg calls his ideas the “mood science approach” to depression. He says:
The evolutionary perspective asks us to be patient, to learn to tolerate some degree of low mood, and to listen to what it is that low mood can tell us.
The evolutionary perspective asks us to be patient, to learn to tolerate some degree of low mood, and to listen to what it is that low mood can tell us.
?