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Depression is so debilitating! Years ago, I was the psychiatric liaison to a surgical ward. The most common consultation request involved patients who would not follow routine instructions after an operation: walk, cough, eat, breathe deeply. Depressed patients just gave up. They had no strategy, not even obedience to those they trusted. Retreat to the cave to lick your wounds, fine-but get licking. In demanding circumstances, how often is it adaptive to lose the capacity for action altogether? I mean, in this fashion, where death seems preferable to effort, where the signals of a supportive community-nurses, friends, family- are ignored?
Seeing the depressed fail regularly, in the face of challenges that others meet, might dispose anyone to the alternative possibility, that depression confers no benefit. Some illnesses, and some normal traits, represent happenstance in evolution.
In a famous essay, the late Stephen Jay Gould compared such evolutionary accidents to "spandrels." Spandrels are triangular spaces below the domes of Gothic churches. (The correct term of art for such a space is pendentive, but spandrel remains the word used in the evolution debate.) Long assumed to be purposive-they hold images of the apostles-spandrels turn out to be not planned decorations but incidental forms that result from the limitations of medieval architectural methods. If you mount a dome on pairs of rounded arches, you're stuck with spandrels. The apostles are late additions-a use that was conceived centuries after the construction of the Cathedral of San Marco in Venice and others.
Spandrels are by-products;
they represent limitations of engineering, an unintended consequence. It is the
main project that is shaped and optimized by natural selection, not the spandrel,
which comes along for the ride. Sometimes spandrels are later put to use, as in
the addition of mosaic portraits of saints. Gould coined the word exaptation to
cover this development, a late modification that manages to make the best of a
spandrel. Depression may be a spandrel-natural without having contributed evolutionary
advantage. And then there is no reason that depression would not be decorated
exaptively-for instance, by attracting a mythology regarding its value, or through
acquiring a role in song and story.
Reflection Exercise #5
Online Continuing Education QUESTION
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The test, which was first developed in rats, can identify the presence of 26 markers linked to major depression disorder.
According to a new study, people who live alone are more likely to use antidepressant medications than people who live with others.
The neurologist who has pioneered using implantable electrodes to ease treatment-resistant depression is seeking approval from the U.S. Food and Drug Administration (FDA) for the treatment.
Results from a new Penn State study suggest that mothers who suffer from depression may behave in ways that hinder their infantsâ€™ ability to sleep.
People who are depressed may be more likely to stop attending church service, which may help explain why those who attend church seem happier, experts say.
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