Wednesday, November 4, 2009

Is There an Upside to Depression?

As Sharon Begley reports, there is currently something of a backlash against the wave of books, article, and posts about happiness. Link here.

For my part I don't think the problem is that we became too happy for our own good, but that the happiness that was being peddled, by the media and by the Pied Pipers of Prozac, was simply artificial.

To walk around with a goofy grin when the world is crumbling around you is not a sign of happiness. It signals obliviousness. Putting on a happy face when all around you are in pain is insulting and insensitive.

Barbara Ehrenreich is correct to write that when happiness becomes the slogan of a cult-like movement it becomes an excuse to ignore reality. And, absent artificial stimulants, none of us are going to be happy for very long if we ignore reality.

True happiness involves real achievements and real accomplishments. It feels like the humble satisfaction you gain when you have improved yourself. You gain happiness by fulfilling your ethical obligations, to yourself and to others.

That is how Aristotle understood it, and if Aristotle said so it deserves our respect. We should not now throw out happiness because a bunch of newly-minted hucksters are trying to get rich off of your insecurities.

We should not use the rage over happiness to return to the bad old days when therapy, at a loss to treat depression, declared that human existence was inevitably tragic and that only those who were depressed understood it fully.

The new breed of happiness crusaders insists, as Begley puts it, that you have a "moral duty to be happy." Aristotle would have said that if you fulfill your ethical duties you will be advancing toward happiness.

By these lights happiness is not just any old good feeling. A warm puppy may make you feel good; it will certainly make you feel better than a cold puppy will. And your ability to take pleasure in something small and simple may well be a sign that you have not descended into anhedonia-- the clinical term for people who are so depressed that they cannot feel pleasure.

Let's not confuse the absence of depression with happiness.

Perhaps it's inevitable, but backlashes often go too far. Begley reports that the backlash against happiness has now produced the peculiar notion that depression is an evolutionary adaptation, that that there is something beneficial to being depressed.

This suggests that the next time you fall into the slough of despond you should rejoice because evolution is doing you a favor.

To me this feels like another example of opinion masquerading as science.

When people become depressed they withdraw from society, ruminate, deliberate, and fail to experience pleasure or desire. They become paralyzed, detached, and dysfunctional.

Now, researchers have decided that this is adaptive. They believe that the experience of withdrawal can be useful if it leads us to ask where we went wrong and how we can set things right.

In fact, I find this excessively optimistic. Most people who fall into depression never come up with a plan of action for how to set things right. More often they need an outside intervention, an adviser, to point them on the right path.

Worse yet, many people who become seriously depressed do not recognize where the problem lies. If they go to see a therapist or a psychiatrist these professionals will try to disabuse them of the notion that some current life problem has caused them to be depressed.

A therapist might teach them that the root cause of their problem is in their forgotten past. Thus, that there is nothing they can do to solve it except ruminate about it. Clearly, this has been ineffective as a treatment for depression.

A psychopharmacologist, however, might tell them that they are suffering from a chemical imbalance. This means that they should just take a pill.

When researchers suggest that depression is adaptive because it encourages us to take a step back, to deliberate seriously about our problems before taking action, it is being seriously naive about this condition.

Begley explains it well: "... many people with depression report that although they indeed ruminate on their problems, their thinking is far from clear, focused, and analytical, and thus provides little insight into-- let along remedy for-- the illness."

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