Introduction and Depression

Hi all. Just a short introduction–I’m a graduate student in human-computer interaction and applied anthropology. I started off traditionally, learning about Don Norman and his work on human factors then did some international fieldwork on online communities, mobile phones and cybercafes. Recently I started taking more of an interest in the ethics and politics of mental health diagnosis and treatment as well as how mental illnesses are represented in American culture. Most of what I have been reading suggests that conditions such as depression are seen as a chemical imbalance to be treated with medication, so it was surprising to read in a “US News & World Report” article Get Healthier and Happier that anti-depressants actually only alleviate symptoms in 35-40% of depression cases compared with 15% on a placebo. Of more relevance to anthropologists are the stated impact of lifestyle on the diagnosis of depression.

As with diabetes, experts have begun to look for culprits in the 21st-century lifestyle. Might the isolating, sedentary, indoor computer culture explain, for example, why the disorder appears to be surging in young adults? Today’s 20-somethings have a 1-in-4 lifetime risk of experiencing depression’s hallmark black mood, joylessness, fatigue, and suicidal thoughts compared with the 1-in-10 risk of their grandparents’ generation. Americans are 10 times as likely to have depression today as they were 60 years ago, a development that is not merely a result of increased awareness and diagnosis.”

Unfortunately there are no citations for the above numbers and I’m inclined to be skeptical about making such comparisons–how would one even be able to judge the degree to which increased awareness and diagnosis would make a difference? We’re talking about a time before the DSM (the Diagnostic Statistical Manual which psychiatrists use) and before drugs such as Prozac had become a household name.

Even more intriguing for anthropologists:

Realizing that primitive societies like the Kaluli of Papua New Guinea experience virtually no depression, Stephen Ilardi, an associate professor of psychology at the University of Kansas, is now testing a cave-man-esque approach to treatment with promising results. His 14-week Therapeutic Lifestyle Change program entails large doses of simulated hunter-gatherer living in people suffering from prolonged, unremitting depression. Participants sign up for 35 minutes of aerobic exercise (running, walking briskly, biking) three days a week, at least 30 minutes of daily sunlight or exposure from a light box that emits 10,000 lux, eight hours of sleep per night, and a daily fish oil supplement containing 1,000 mg of the fatty acid EPA and 500 mg of the fatty acid DHA.

They also get plenty of time surrounded by the “clan,” in the form of frequent social gatherings with family members, Starbucks dates with friends, and volunteer work. “Hunter-gatherers almost never had time alone,” says Ilardi; even a generation or two ago, people grew up supported by extended family and much more engaged with their community. Too much time in isolation, he says, means “opportunities to ruminate,” the modern scourge.

Granted, the fish supplements and biking and light boxes go above and beyond what a hunter-gathering society might have access to without the harshness. Comparing a Starbucks date to life as a cave-man seems absurd. But it certainly sounds like a healthier and more holistic treatment than what goes on in traditional psychiatric institutions. I’m not very familiar with the literature on mental illnesses in other cultures, especially so-called “primitive” cultures so would love to get citations and opinions.

One thought on “Introduction and Depression

  1. I would tend to agree that social factors – sendentary lifestyles and the like play a large part in depression. The test case you point out sounds promising, although might be tough to reproduce for more people on a larger scale..Doctors will need to start prescribing social environments instead of medicine alone. This looks like its gonna be a tough one as the trends point towards more seclusion. Will computer mediated services help in bringing people back to health in some of these cases?

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