The
puzzling reality is that human depression is increasing in an era when
environmental conditions are relatively benign. The average citizen in
Western society now lives longer, is less likely to starve, and enjoys
considerably greater wealth than his sixteenth-century counterpart.
Presumably these objective conditions for survival and
reproduction would cause depression rates to fall, not rise to nearly
one in five citizens. This environment-depression disconnect seems less
strange when we appreciate that there are additional human-specific
routes into depression.
has the dubious distinction of being a species that can become depressed without a major environmental insult.
There
is no scientific consensus about why human depression rates are rising
in the industrialized world, but several compelling possibilities exist.
Their common thread is our species’ unusual relationship with mood and
the doors it opens for unique routes into depression. A chimpanzee is
capable of feeling bad, but only a human being can feel bad
feeling
bad. Former tennis great Cliff Richey, in his memoir “Acing
Depression,” described how he became engulfed by low mood: “One of the
horrible things about depression—in addition to the foul, odorous, sick,
deathly mood you’re in—is that you’re now spending so much of your
time, almost all of it, just trying to fix yourself. You’re consumed by,
‘How can I fix this horrible thing?’”
Humans have a host of
unique thoughts and reactions to low mood, many of which are highly
cognitive. Only a human can keep a mood diary or write a book about
depression. We often think of what’s uniquely human as uniquely better.
Surely pride may be a reasonable emotion for the species that harnessed
fire and put a man on the moon. It’s easy to see traits such as
advanced language, the ability to be self-aware, and participation in a
rich shared culture as unalloyed virtues. Yet when it comes to “fixing”
mood, all of these special human assets can turn into liabilities, with
the unintended consequence of making depression worse.
A
hallmark human response to low mood is to try to explain it—as we do
with moods generally. We use language to construct theories about where
painful feelings come from. The basic idea is, “If I understand why I
feel bad, I will know how to fix it.” This impulse makes sense. It fits
with a main function of low mood, which is to help draw attention
to threats and obstacles in unfavorable environments. In a low mood,
behavior pauses and the environment is analyzed more carefully.
However,
exactly what “analyze more carefully” means depends on which species is
doing the analyzing. The schnauzer, Ollie, just separated from his
sister, may sit at the window for hours looking for signs of her return.
Visual search is the sum total of his environmental analysis. When a
human pines for a loved one, say a mother missing her son away at summer
camp, the analytical field is far wider. Our outsized language
capability draws in thoughts linked to the situation: “That head
counselor seemed awfully young.”; “Did I remember to pack sunscreen?”;
“I wonder why we haven’t gotten a postcard?” These thoughts may then
trigger further mental images—a flash of Tommy drowning, the
funeral—as well as feelings—a pang of guilt for ever letting him go
to Camp Meadowlark in the first place.
Such reflections on mood
have a purpose beyond self-flagellation. The mood system is practical
and most interested in what to do next, in finding the action that
will enhance fitness. What people brood about is not random but tracks
key evolutionary themes (finding a mate, staying alive, achieving
status, defending kith and kin, etc.). Mothers and fathers worry about
their children at summer camp because mistakes in child rearing are
evolutionarily costly. A mother who figures out that she’s dwelling on a
failure to pack sunscreen can send a remedial Coppertone care package,
and, the next time Tommy is sent away, he’s more likely to be
fully provisioned. Even the most backward-looking
counterfactual thinking (coulda, shoulda, woulda) has a
forward-looking element: understanding why bad things happened helps
us prevent their recurrence.
Reacting to low mood with thinking
has evolutionary logic; it enhances survival and reproduction (fitness).
Sadly, what’s good for fitness is not necessarily good for
happiness. Only
sometimes does thinking about mood enhance
happiness. We see this fairly reliably in certain brands of
psychotherapy, in which the process of thinking about mood and
discovering its meanings is specially structured and guided by an
expert. For a novice to think his or her way out of low mood and
depression to get to a happier place—that’s a dicier proposition. Humans
are understandably confident when trying to think our way out of a low
mood. We solve so many other problems by thinking, such as how to get a
stalled car to start or how to make a healthy meal out of scraps in the
fridge.
Becky, a college professor in Maryland, organizes a team
to analyze old production data from a distillery to figure out the
determinants of good whiskey quality and use this information to
ascertain why the distillery’s product loss between brewing and bottling
is nearly twice the industry standard. She is now in an episode of
depression. Every morning Becky wakes up and says to herself, “What can I
do today to solve this problem?” But even with a PhD degree,
considerable insight, and bookshelves filled with self-help books,
her depression hasn’t budged for thirteen months. If you speak with her,
even in her depressed state, it is immediately obvious that she is
intelligent. On paper, she has every reason to believe that she can
solve her depression.
Yet most humans, including Becky, are not
nearly as good at this as they think they are. And our confidence
in thought makes it more difficult to recognize when thinking is not
working. The pitfalls of such an approach are underappreciated. In fact,
“thinking your way out” might actually provide new ways
in, new ways for low mood to deepen into serious depression.
Our advanced language and ability to hold ideas in mind, called
working memory,
combine to create a formidable meaning-making machine. Yet this machine
can be too productive for our own good. It can easily churn out new
interpretations of a troubling situation well after the situation has
passed. On Friday, a worker can still be mulling over her boss’s hostile
comment from Monday and wonder, “Maybe it was that e-mail I sent three
weeks ago that set him off.” Once the meaning-making machine is in
overdrive, a bad mood can prompt a potentially unlimited number of
implications. We can generate dozens of seemingly plausible
environmental reasons for the question: “Why I am so blue?” (My job
is boring. I need to lose weight. We can’t stop global warming.) Even if
you are feeling only a tiny bit sad right now, take sixty seconds to
try this yourself. I doubt you will draw a blank on possible reasons.
You’ll have leads. Yet many of the leads will be false, that is,
irrelevant to the real source of the mood. When the real source of low
mood is a thyroid deficiency or a low-grade infection, an analysis of
the environment is moot. Or worse than moot, because with all
the attention we pay to the false leads (all the reasons I hate my job),
we may find fresh reasons to feel low. The generation of false leads
may be good for fitness (the value of an exhaustive search), but it’s
not always so good for happiness.
Given our natural reliance on
and our confidence in thought, the urge to repetitively think about the
causes and consequences of low mood can harden into a habit.
Researchers label this habit of thought
rumination. Some
people enter a ruminative mode even when facing minor troubles, or even
when their environment is benevolent. A consistent body of data—much of
it collected by the late psychologist Susan Nolen-Hoeksema—shows that
this is a dangerous habit. People who report a greater tendency to
ruminate on a short questionnaire have longer periods of depressed
mood in everyday life, are more pessimistic about the future, and have a
harder time recovering from the effects of stressors such as a natural
disaster or a recent bereavement.
The human meaning-making machine
is so good at what it does that it can generate interminable
interpretations. When persistent thinking gets stuck, it does not arrive
at a stable theory of the problem, does not solve it, and cannot come
to terms with it. Far from engaging in active problem solving, a person
may simply perseverate on the fact of the problem (or problems) for
months on end.
When the meaning-making machine gets caught in
this way, its analysis turns inward, shifting its focus from a
problematic environment to a problematic self. Analyses of various kinds
of thoughts have found that those that repeatedly focus on the failings
of the self are the kind most closely linked to depression. Insistent
problem solving by itself is not necessarily harmful. In fact,
therapeutic techniques that bolster active problem solving (say by
breaking a problem down into structured subparts) can be helpful for
depressed persons. It’s the deconstruction of the self that really
causes trouble.
As
Homo sapiens sapiens, we know, and we
know that we know. An elaborate conceptual self—another thing
that’s usually a point of pride—becomes a vulnerability. We’re committed
to our autobiographical self, our story. It’s as if we have films of
our own lives playing in our heads, with us cast as the heroes.
Depressed people, however, recast their movies with themselves as
villains and play them in an endless loop. A depressed chimp, lacking a
deep autobiographical self, is spared this screening and will never have
the experience of lying awake at night thinking, “I am a terrible
mother.” Our capacity to dwell on our own failings makes us more
vulnerable to depression than our fellow mammals.
Humans also have
a special category of failings because of our heightened ability to
self-monitor: our failures to change mood. This was true for Becky, who
said of herself, “As a goal-oriented person, I keep looking for (and
trying) things I can do to snap out of the depression.
Medication, meditation, sleeping pills, trying to spend time doing
‘things that bring me joy’ (which just backfires, because I end
up feeling hopeless while I’m doing them).” Every day that
the depression goes on, failures to change mood turn into
nagging thoughts: “Why can’t I just get over this?”; “Why am I so weak?”
These self-monitoring statements become further fodder for rumination,
which becomes further fodder for depression, and we are reminded once
again that our powers of language are a decidedly mixed blessing.
All Cheered Out: Culture and the Pursuit of Happiness
We
are the only species to look to culture to guide us on what feelings
are desirable and how undesirable feelings should be managed. And as
humans try to “fix” low mood, they are never alone. No creature ever
living has had available so much advice—spiritual, medical,
psychological, folk-inspired—about what to do when it’s feeling down.
In the past fifteen years we have seen an ever-growing stream of
psychological and popular science books examining happiness and how
people can increase it. Ideally, these resources should serve as
bulwarks against depression. Perversely, the opposite may be the case.
Our predominant cultural imperatives about mood, though surely
well-intentioned, are worsening the depression epidemic.
In the
West there is a powerful drive to experience happiness. This tradition
is particularly strong in the United States. Indeed, it’s difficult to
think of anything more American than the pursuit of
happiness.
Along with life and liberty, it’s written into the Declaration of
Independence as a fundamental right. Wanting happiness is as American as
apple pie. But how happy should we expect to be? Happier than
other people around the globe?
It would appear so. Analysis of
thousands of survey responses found that when people in different
countries were asked to rate how desirable and appropriate it is to
experience varying psychological states, positive states like joy and
affection were rated more desirable and appropriate in Australia and the
United States than in Taiwan and China. Cross-cultural research by
Jeanne Tsai of Stanford University has also found that European
Americans place the highest value on specific forms of happiness,
idealizing states like enthusiasm or excitement, termed
high arousal positive states. By
contrast, Chinese and other Asian test subjects place the highest value
on other forms of happiness, idealizing states such as calm and
serenity, termed
low arousal positive states.
Consistent
with the notion that culture inculcates ideals about feeling states,
cultural differences show up early in life. When young children judge
smiling photographs, American children prefer the expression that shows
an excited smile to the expression that shows a calm smile. Taiwanese
children do not show this same preference. American preferences for high
arousal positive states probably have many roots, but they stem in part
from a media environment that values peppy happiness. An image analysis
of smile photos in American women’s magazines found that they
contained more excited smiles and fewer calm smiles than smile photos in
Chinese women’s magazines.
So what’s the problem? Everyone I know
wants to be alive, free, and happy. What’s wrong with pursuing
happiness to the fullest extent possible? The more you value your
happiness, the happier you’ll be, right?
Wrong, says compelling recent research.
Two studies led by psychologist Iris Mauss found evidence for an alternative hypothesis: people who value happiness more are
less likely to
achieve their goal of feeling happy. In the first study the researchers
administered a questionnaire designed to measure the extent to which
people valued the experience of happiness as a fundamental goal.
Mauss and colleagues found that some people put an especially high value
on happiness, endorsing items like, “If I don’t feel happy, maybe there
is something wrong with me”; and “To have a meaningful life, I need to
feel happy most of the time.” Surprisingly, women who said that they
valued happiness more were actually less happy than women who valued it
less. Specifically, women who valued happiness highly reported that they
were less satisfied with the overall course of their lives and were
more bothered by symptoms of depression. Strangely enough, valuing
happiness seemed most problematic for women whose lives were low in
stress—the people for whom happiness should have been within
easiest reach.
The second study was a clever experiment in which
the researchers tried to briefly increase how much the
participants valued happiness. They did this by having one group of
participants read a bogus newspaper article that extolled the importance
of achieving happiness (the other group read an article that did not
discuss happiness). Later in the experiment participants watched
different short films. Those women who had read the happiness-extolling
article reported feeling less happiness in response to a happy film. The
authors again concluded that, paradoxically, valuing happiness more may
lead people to be less happy, especially when happiness is within
reach.
These experiments help us understand why
predominant cultural imperatives about mood might be worsening the
depression epidemic. Our current cultural ethos is that
achieving happiness is like achieving other goals. If we simply
work hard at it, we can master happiness, just as we can figure out how
to use new computer software, play the piano, or learn Spanish. However,
if the goal of becoming happier is different from these other goals,
efforts devoted to augmenting happiness may backfire, disappointing—and
potentially depressing—us because we can’t achieve our expected
goal. Mauss and colleagues concluded that setting a goal to
become happier is like putting yourself on a treadmill that goes
faster the harder you run.
Rising happiness standards widen the
gap between what we want to feel and what we actually feel. We know
from Jeanne Tsai’s work that people in the West generally
idealize excitement and other high arousal positive states.
Although this is a general tendency, she has also shown that people
vary in how strong their positive ideal is. Importantly, for people who
have that strong positive ideal, there is potentially a large gap
between what they would like to feel and what they actually feel. The
size of this gap predicts depression. People who have a larger gap
between their ideal and actual positive affect have more depressive
symptoms.
This is not surprising: to someone with high
happiness goals, low moods are as demoralizing as a foreclosure
notice is to an aspiring billionaire. If you believe that a
high positive mood should be easy to achieve, a prolonged low mood is an
insult, which probably prompts the isolating and stigmatizing question:
“What’s wrong with me?” Negative feelings about negative feelings make
them a greater threat. People who set unrealistic goals for mood states
may be less able to accept or tolerate negative emotional experiences
like anxiety or sadness. Oddly enough, being able to accept negative
feelings—rather than always striving to make them disappear—seems to be
associated with feeling better, not worse, over the long run. There is
evidence that when people accept negative feelings, those experiences
draw less attention and less negative evaluation than they would
otherwise. Some research shows that people who report an ability
to accept negative feelings when they arise are less likely to
experience depressive symptoms in the future.
Ultimately, the
strong cultural imperative toward being happy bumps us up against a
wall: our mood system is not configured to deliver an end state of
durable euphoria. Happy euphoria is a reward the mood system metes out
along the way, on the road to pursuing other evolutionarily
important goals. For example, euphoria is a reward for having sex or
for when your first-choice date to the prom says yes. By design, these
rewards are meted out sparingly rather than liberally.
Yes,
pleasure after eating the carrot rewards the bunny for finding the
carrot, yet a well-designed bunny does not stay satiated. It’s the
end of the pleasure and the promise of
more that
gets the bunny hopping off to find more carrots and ultimately to
survive long enough to make more bunnies. So clearly does intense
happiness fade after a goal is achieved that psychologists and
economists have given the experience its own label:
hedonic adaptation.
It is powerful, and studies show it to be virtually omnipresent:
whether after purchasing a zippy new sports car, getting a big
promotion, or moving to a cool new apartment, with time (often
surprisingly little) the euphoria fades.
Hedonic adaptation and
our unattainable cultural imperatives make for a cruel combination.
People will usually fall outside the zone of intense pleasure, and they
will consider that failure. In this scenario, shortcuts are tempting.
Forget having to realize an evolutionarily important goal and just give
me the pleasure now, please. The high from smoking crack is almost
immediate, but it does not last. In the long run, the shortcuts
backfire. The mood system has the last word.
Excerpted from “The Depths: The Evolutionary Origins of the Depression Epidemic”
by Jonathan Rottenberg. Published by Basic Books, a member of the
Perseus Books Group. Copyright 2014 by Jonathan Rottenberg. Reprinted
with permission of the publisher. All rights reserved.
Bill 
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