Evolution Could Explain Why Psychotherapy May Work for Depression

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Simon Munro

This is an article about Depression and effective treatments for Depression, including Cognitive Behavioral Therapy (CBT), medications like Prozac and Lexapro and Chinese Herbs. It suggests that CBT could be more effective than medications because of the way we've evolved: "humans may become depressed to help us focus attention on a problem that might cause someone to fall out of step with family, friends, clan or the larger society—an outcast status that, especially in Paleolithic times, would have meant an all-but-certain tragic fate". The article suggests depression is maintained or worsened by dysfunctional rumination on the problem, like "My situation means I'm a bad person" and CBT is effective because it's a kind of functional rumination. Medications, on the other hand, may be less effective than CBT because they divert the client or patient from reflecting on the problem.

I'm all for exploring new explanations for how depression works and how we can treat it effectively but, to me, this article takes a pretty narrow view of what depression is and how it can be treated effectively. I kept re-reading parts of the article thinking that maybe I read it wrong - and maybe I did! It suggests that depression is as a result of a social problem that needs to be reflected on and figured out. I don't think all people who suffer from depression would agree with this. At the same time, it seems to minimize the huge benefit anti-depressant medications can have for millions of people worldwide. I hope I'm just missing something but this article just doesn't make sense to me - it seems to take some pillars of mental health (causes and symptoms of depression, the role and effectiveness of CBT and medications) and re-imagines them in a new light that don't ring true to me at least.

If you read the article, please leave a comment and tell me if you agree or if I'm way off!

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Cognitive Behavioral Therapy

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