Researchers call for new approach to some mental disorders
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How often do I have to say: I told you so? This research, finally, backs up what I have been saying and writing for 40 years, about some mental disorders, particularly mood disorders.
Some of the most common mental disorders, including depression, anxiety and PTSD, might not be disorders at all, according to the study by a team of biological anthropologists. In the paper, published in the Yearbook of Physical Anthropology, the researchers propose a new approach to mental illness that would be informed by human evolution, noting that modern psychiatry (and also some variants of psychology), in its use of drugs like antidepressants, has largely failed to reduce the prevalence of mental disorders. For example, the global prevalence of major depressive disorder and anxiety disorders remained steady from 1990 to 2010.
The authors also theorize that depression, anxiety and post-traumatic stress disorder may be primarily responses to adversity; therefore, only treating the “psychic pain” of these issues with drugs will not solve the underlying problem. The lead author on the paper compared it to medicating someone for a broken bone without setting the bone itself.
What the researchers say: “The pain is not the disease; the pain is the function that is telling you there is a problem,” she said. “Depression, anxiety and PTSD often involve a threat or exposure to violence, which are predictable sources for these things that we call mental diseases. Instead, they look more like sociocultural phenomena, so the solution is not necessarily fixing a dysfunction in the person's brain but fixing dysfunctions in the social world.” Amen. Amen.
The researchers advocate for biological anthropologists to enter the study of the “diseases of the mind,” to help find effective solutions, particularly for some problems that may be social instead of mental.
“Mental health research is still very much stuck in a view that comes out of the 19th century, and revived in 1980, of classifying everything by symptoms in the hopes of revealing underlying patterns that would lead to solutions, but it really has not,” they said. “Even though we're using new measurements, like genetics, biomarkers and imaging, these still haven't added up to the insights needed to really improve people's lives.”
Among the more problematic issues, the researchers point to the “chemical imbalance” theory of depression, which has helped create a boom in antidepressant drugs meant to modulate certain chemicals in the brain called neurotransmitters. A large meta-analysis of antidepressant trials in 2018 found that antidepressants had almost the same effect as a placebo, and their widespread use has not delivered measurable results. For example, in Australia alone, antidepressant use increased 352% from 1990 to 2002, yet there has been no observed reduction in the prevalence of mood, anxiety or PTSD. The same is true in most countries.
Instead of addressing mental issues by their symptoms, the authors propose approaching mental illness by their probable causes. They acknowledge that some psychiatric disorders like schizophrenia are likely genetic and often inherited, and others like Alzheimer's appear connected with aging.
However, they argue that some conditions might be a mismatch between modern and ancestral environments such as attention-deficit/hyperactivity disorder, also known as ADHD. They point out that there is little in our evolutionary history that accounts for children sitting at desks quietly while watching a screen or a teacher write on a board.
Other disorders such as depression, anxiety and PTSD are not hereditary, the researchers propose they may be responses to adversity and serve as signals, much like physical pain does, to make people aware of the need for help.
So, what? This is surely the most significant paper of the week as far as mental illness is concerned.
In Creating Optimism, Raising an Optimistic Child and in countless articles, Alicia and I have said that mood and other disorders were primarily a reaction to trauma either societal or individual. The greater the trauma, the greater the problem malady.
Also, as the researchers point out, the origin of many of our mental disorders lies in the mismatch with the way our society is presently organized and our genetic design-specs.
Some of our issues with mental health lie in the way we as a society observe and treat it. As most of you know, I lived with a band of African hunter-gatherers for a year, decades ago. I was able to observe firsthand how they, and similar bands that we came into contact with, treated members who had what we would call mood disorders. I, and other subsequent observers, recorded no instance of endogenous (long-lasting) major depression. Nor did I, or these other researchers, witness any instance of child abuse. When a band member suffered a trauma—loss of a spouse or child or failure to win the mate they wanted—they would become depressed, of course. But the members of the band gathered around the individual and through their support effected an eventual cure.
Generalized Anxiety Disorder and PTSD are practically unknown among them, as is ADHD. As to the latter it is mostly caused by children (especially boys wanting to be boys) being driven by their genes to learn by doing, by testing themselves, by being physically active and being prevented. Classrooms, kindergartens (and lockdowns) are the prime causes of the disorder—if it is a disorder at all and not just a reaction to inactivity.
We call someone who has “schizophrenia” mentally ill. Not so among the people I lived with (and other researchers have seen the same thing). These people can become powerful shamen and healers of various ilk. They are, according to the people, in touch with the spirits and given status and meaning through that.
Every mental illness has its roots in an evolutionary need. Each added to the stability and longevity of the little tribe as a whole.
As to psychotropic medications, the researchers point out that numerous studies (The Connecticut study of 1999, The Hull study of 2008 and the more recent 2018 study mentioned above) have all shown that antidepressants have no ability to actually cure depression or even alleviate symptoms in the long term.
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