Researchers Doubt That Certain Mental Disorders Are Disorders At All

Forbes
depression a mood disorder Getty | James Alexander Michie

Is depression a mood disorder or an adaptive response? GETTY

What if mental disorders like anxiety, depression or post-traumatic stress disorder aren’t mental disorders at all? In a compelling new paper, biological anthropologists call on the scientific community to rethink mental illness. With a thorough review of the evidence, they show good reasons to think of depression or PTSD as responses to adversity rather than chemical imbalances. And ADHD could be a way of functioning that evolved in an ancestral environment, but doesn’t match the way we live today.

Adaptive responses to adversity

Mental disorders are routinely treated by medication under the medical model. So why are the anthropologists who wrote this study claiming that these disorders might not be medical at all? They point to a few key points. First, that medical science has never been able to prove that anxiety, depression or post-traumatic stress disorder (PTSD) are inherited conditions.

Second, the study authors note that despite widespread and increasing use of antidepressants, rates of anxiety and depression do not seem to be improving. From 1990–2010 the global prevalence of major depressive disorder and anxiety disorders held at 4.4% and 4%. At the same time, evidence has continued to show that antidepressants perform no better than placebo.

Third, worldwide rates of these disorders remain stable at 1 in 14 people. Yet “in conflict‐affected countries, an estimated one in five people suffers from depression, PTSD, anxiety disorders, and other disorders,” they write.

Taken together, the authors posit that anxiety, depression and PTSD may be adaptive responses to adversity. “Defense systems are adaptations that reliably activate in fitness‐threatening situations in order to minimize fitness loss,” they write. It’s not hard to see how that could be true for anxiety; worry helps us avoid danger. But how can that be true for depression? They argue that the “psychic pain” of depression helps us “focus attention on adverse events… so as to mitigate the current adversity and avoid future such adversities.”

If that sounds unlikely, then consider that neuroscientists have increasingly mapped these three disorders to branches of the threat detection system. Anxiety may be due to chronic activation of the fight or flight system. PTSD may occur when trauma triggers the freeze response which helps animals disconnect from pain before they die, and depression may be a chronic activation of that same freeze response.

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Source: Alison Escalante | Forbes

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