Looking at Depression Through an Evolutionary Lens
Preconference to Explore Varied Treatment Approaches
COLUMBUS, Ohio—Psych Congress cochair Charles Raison, MD, gave attendees a “10,000-foot view” of what depression is at the Psych Congress Regionals meeting here, and will explore the idea more at the upcoming Psych Congress 2018 preconference.
As 1 of 4 speakers who presented “New Perspectives in Advanced Psychopharmacology: Improving the Quality of Care for Patients With Depression,” Dr. Raison provided attendees with a new way of thinking about depression, based on work which he and other researchers have done.
“I’m not claiming that this provides a universal understanding of depression or even necessarily that it’s right,” Dr. Raison said in opening his talk. “But it’s good to think about things, sometimes raise our head a little bit above the intense struggle we have on a daily basis in the clinical world and just think about a 10,000-foot view.”
Dr. Raison is the Mary Sue and Mike Shannon Chair for Healthy Minds, Children & Families and professor, Human Development and Family Studies, School of Human Ecology, and professor, Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison.
Although there is little known about the genetic causes of depression, Dr. Raison said much has been established about the environmental causes. The most depressing things in the world, he said, are getting sick and experiencing circumstances that induce or cause the perception of loss, primarily in personal relationships. When the cause of a suicide is known, he noted, it is related to disrupted relationships half of the time.
“These are the things that really are depressogenic—loss of status, loss of connection with somebody that you rely upon for your sense of who you are, being shamed, failing at what you think you should be doing in life … and then this feeling that you are trapped in your circumstances and you can’t get out of them,” Dr. Raison told attendees.
“So it’s this combination of losing one’s health and wellness in the world and then having losses that make you feel like a failure as a human being, compared to other human beings.”
Why is it that these experiences contribute to depression? The answer, Dr. Raison said, may be rooted in human evolution.
Humans are naturally driven to survive, reproduce, and leave offspring in order to pass on their genes. Dr. Raison suggested that things that indicate to humans that they are failing at this evolutionary mandate are the things that make them the most depressed.
For example, being ostracized from a group you were born into 10,000 years ago was an almost certain death sentence, he said. Today, being left out of a group would not have the same practical effect, but can still lead to serious depression.
“The things that make us depressed today that seem unrealistic were not unrealistic 10,000 years ago, 50,000 years ago,” Dr. Raison said. “They were true signals that you were at risk of failing at these twin mandates—survival and reproduction.”
He urged clinicians to remember the theory when talking to patients about the things in their life which are making them depressed. The concept may provide a clue as to why certain factors contribute to depression, when it may not be clear on the surface, he said.