Yesterday's Philadelphia Inquirer Health Science section reports on evoluationary psychologist Paul Andrews' unorthodox take on depression:
Andrews, an assistant professor at McMaster University in Hamilton, Ontario, thinks depression, miserable as it is, serves a positive role, much as fever does in fighting infection.In other words, according to Andrews, depression promotes left-brained thinking, which is key to solving the problems that caused the depression in the first place.
He argues that the lethargy, lack of appetite, sleeplessness, and rumination that accompany depression help people focus on and ultimately solve their problems.
"Depressed mood states seem to promote an analytical processing style," Andrews said, that helps people break complex problems into smaller bites.
Andrews' theory implies that taking medication, on the other hand, is counterproductive because, in as much as it alleviates the depression, it also curtails the analytical, problem-solving mindset. The problems persist, and once the patients go off the anti-depressants, the depression returns. Indeed:
In an analysis of 46 previous studies published last month in Frontiers in Evolutionary Psychology, Andrews and colleagues found that patients who used antidepressants were twice as likely to relapse when they stopped as those who were on placebos.This is the first time I've ever read of a placebo being more effective than the drug!
As the rest of the article makes clear, Andrews is talking not about the kind of debilitating, physiologically based depression that hits certain people regardless of what's going on in their lives, but about situational depression:
Most depressive episodes come in response to specific events such as a breakup or job loss, Andrews said. Depending on the study, 15 to 40 percent of people say they have had major depression, the kind in Andrews' study, but almost everybody has had milder forms.The Inquirer is skeptical, but, if Andrews' study is accurate, the burden is on his detractors to explain why, when it comes to certain sorts of depression, the placebo outperforms the drug.
What does this mean for patients? "It looks like, if you can get better without taking antidepressant medication, you'll have a much better chance of not having a relapse," said Andrews, who is not a clinician.