As the terrible news of Andrew Koenig’s suicide and Michael Blosil leaping to his death, both after long depressive bouts, emerged over the weekend, the New York Times Sunday Magazine had aided and abetted Jonah Lehrer’s continued slide into unhelpful Gladwellian generalizations by publishing his sloppy and insensitive article claiming that depression really isn’t that bad. Lehrer, an alleged bright young thing who found his own tipping point with How We Decide, appears to have cadged nuanced examples from such thoughtful books as Kay Redfield Jamison’s Touched with Fire and Daniel L. Schachter’s The Seven Sins of Memory, proving quite eager to cherrypick tendentious bits for a facile sudoku puzzle, or perhaps print’s answer to a “fair and balanced” FOX News segment, rather than a thoughtful consideration.
Lehrer attempts to establish a precedent with Charles Darwin’s mental health: a troubling task, given that the great evolutionist kicked the bucket around 130 years ago and, thus, didn’t exactly have the benefit of psychiatric professionals watching over his bunk, much less a DSM-IV manual. Lehrer suggests that the “fits” and “uncomfortable palpitation of the heart” that Darwin referenced in his letters represented depression. While it’s difficult to diagnose a mental condition in such a postmortem manner, John Bowlby’s helpful book, Charles Darwin: A New Life, has collected various efforts to pinpoint what Darwin was suffering from. And Bowlby’s results tell a different story. Darwin, who was very careful to consult the top medical authorities of his time, described his “uncomfortable palpitation” in a letter to J.S. Henslow on September 1837, when he was hard at work making sense of his data after the Beagle had landed back. In 1974, Sir George Pickering made an analysis of Darwin’s symptoms from these shards and attributed this state to Da Costa’s Syndrome, more commonly known as hyperventillation. Da Costa’s is most certainly unpleasant, but it is not depression. Dorland’s Medical Dictionary describes Da Costa’s as “a manifestation of an anxiety disorder, with the physical symptoms being a reaction to something perceived to be dangerous or otherwise a threat to the person, causing autonomic responses or hyperventilation.” (Emphasis added.) This diagnosis was backed up, as Bowlby notes, by Sir Hedley Atkins and Professor A.W. Woodruff.
Later in his book, Bowbly suggests that Darwin may have suffered from fairly severe depression during the months of April and September 1865 — which corroborates the “hysterical crying” that Lehrer eagerly collects and that Darwin conveyed to his doctor. But where Bowbly is careful to note that the “hysterical crying” leading to depression is a speculation based merely on a phrase and an anecdote conveyed by Darwin’s son, Leonard, Lehrer conflates both Darwin’s “hysterical crying” and Bowlby’s other non-depression examples into depression. Furthermore, Lehrer fails to note that the reason that Darwin was “not able to do anything one day out of three” (as he noted in a letter to Joseph Dalton Hooker on March 28, 1849) was because, as Darwin noted, his father had died the previous November. (Lehrer does note Darwin’s grief following the death of his ten-year-old daughter and proudly observes that the DSM manual specifies that the diagnosis of grief-related depressive disorder “is grief caused by bereavement, as long as the grief doesn’t last longer than two months.” But David H. Barlow’s Anxiety and Its Disorders cites a 1989 study*, which points out that “it is not uncommon for some individuals to grieve for a year or longer” and observes that some people may need longer than two months to escape severe incapacitating grief. A major depressive disorder may not necessarily be the result after two months of grief. In other words, the human mind is not necessarily an Easy-Bake oven.)
The basis for Lehrer’s thesis — that Darwin conquered the totality of his apparent “depression” to “succeed in science” and that his “depression” was “a clarifying force, focusing the mind on its most essential problems” — is predicated on a willful misreading of the primary sources, one that apparently eluded the indolent army of Times fact checkers, who only had to consult Bowlby’s more equitable analysis. This was irresponsible assembly from Lehrer: bad and inappropriate badinage intended to back up a sensational headline and convey Darwin as a falsely triumphant poster boy for severe depression. But depression is a deadly disorder, a condition that requires a less specious summary.
Lehrer later cites David Foster Wallace’s short story, “The Depressed Person,” as a qualifying example for how the depressive mind remains in a “recursive loop of woe.” One may find comparisons between DFW’s real depression and the details contained in the story. But the story, written in third person and loaded with clinical details, might also be read as something which depicts the regular world’s failure to comprehend inner torment. Prescriptive analysis may very well apply to patterns of behavior, but fiction is an altogether different measure.
It is doubtful that DFW ever intended his story to be some smoking gun for lazy cognitive science, as Lehrer insists that it is, when Lehrer declares that those with “ruminative tendencies” are more likely to be depressed. Daniel L. Schachter’s The Seven Sins of Memory, a book that Lehrer appears to have relied upon for the Susan Nolen-Hoeksema example, pointed out that people “who focus obsessively on their current negative moods and past negative events, are at a special risk for becoming trapped in such destructive self-perpetuating cycles.” But what of those who are ruminating after a positive mood or after positive events? The danger of using a phrase like “ruminative tendencies” is that it discounts Nolen-Hoeksema’s clear distinction between dysphoric subjects inclined to ruminate (and feel worse) and “nondysphoric subjects [who] would show no effects of either the rumination or distraction inductions on their moods.” Perhaps by warning his readership of “ruminative tendencies,” Lehrer is encouraging them not to ruminate and therefore become mildly depressed about Lehrer’s dim findings. Lehrer is right, however, about the Loma Prieta earthquake data (also found in the Schachter book). But his failure to distinguish between the dysphoric and nondysphoric perpetuates a convenient generalization rather than an article hoping to contend with conditional realities.
Near the end of his piece, Lehrer confesses that the criticisms against the analytic-rumination hypothesis are often responded to “by acknowledging that depression is a vast continuum, a catch-all term for a spectrum of symptoms.” Well, if only he had told us this at the head of the article before leading us down a rabbit hole. He later writes, “It’s too soon to judge the analytic-rumination hypothesis.” Well, it wasn’t too soon to speculate on Darwin’s letters (not all the result of depression) or David Foster Wallace’s inner psychological state, as reflected through a story.
Lehrer also brings up Joe Forgas’s experiments at a Sydney stationery store, whereby Forgas hoped to get his subjects to remember trinkets. He played different music to match the weather. Wet weather made the subjects sad, and the sadness made the subjects more attentive. But in a Financial Times article written by Stephen Pincock, Forgas was careful to note “that any benefits that he has found apply only to the passing mood or emotion of sadness, rather than the devastating illness that is severe, clinical depression.” Once again, Lehrer neglects to mention this scientific proviso, leading readers to conclude that Forgas’s results are more related to depression.
It’s also important to note that the Paul Andrews study Lehrer relies on, which drew an interesting correlation between negative mood and improved analysis, defines “depressive affect” as “an emotion characterized by negative effect and low arousal.” This is a fundamentally different metric from outright depression, which Andrews’s study is clear to specify. But Lehrer confuses the two terms and retreats back to his clumsy Darwin metaphor of “embrac[ing] the tonic of despair.”
I don’t doubt that Lehrer wished to point out how depressive affect, or modest negative feelings, need not translate into a crippling existence. But his distressing conflation of “depressive affect” and “depression,” and his insistence that even a modest negative feeling might be categorized as depression, may very well suggest to readers that hard-case depressives in serious need of care and treatment might do without these essential long-term remedies. As someone who has offered assistance to friends living with this very real condition, I find Lehrer’s willingness to lump every sad behavioral pattern into “depression” truly shocking. I’m also greatly concerned that the New York Times — the ostensible paper of record — has failed to fact-check the selected studies, thus misleading readers into believing that depression is always a “clarifying force.” Depression, as Andrews attempted to convey to Lehrer, is “a very delicate subject.” Andrew did not wish to say anything reckless for the record. It’s just too bad that Lehrer did.
* Jacobs, Hansen, Berkman, Kasi & Ostfield (1989). Depressions of bereavement. Comprehensive Psychiatry, 30(3), 218-224
Psychoanalysis: An Elegy
by Jack Spicer
What are you thinking about?
I am thinking of an early summer.
I am thinking of wet hills in the rain
Pouring water. Shedding it
Down empty acres of oak and manzanita
Down to the old green brush tangled in the sun,
Greasewood, sage, and spring mustard.
Or the hot wind coming down from Santa Ana
Driving the hills crazy,
A fast wind with a bit of dust in it
Bruising everything and making the seed sweet.
Or down in the city where the peach trees
Are awkward as young horses,
And there are kites caught on the wires
Up above the street lamps,
And the storm drains are all choked with dead branches.
What are you thinking?
I think that I would like to write a poem that is slow as a summer
As slow getting started
As 4th of July somewhere around the middle of the second stanza
After a lot of unusual rain
California seems long in the summer.
I would like to write a poem as long as California
And as slow as a summer.
Do you get me, Doctor? It would have to be as slow
As the very tip of summer.
As slow as the summer seems
On a hot day drinking beer outside Riverside
Or standing in the middle of a white-hot road
Between Bakersfield and Hell
Waiting for Santa Claus.
What are you thinking now?
I’m thinking that she is very much like California.
When she is still her dress is like a roadmap. Highways
Traveling up and down her skin
Long empty highways
With the moon chasing jackrabbits across them
On hot summer nights.
I am thinking that her body could be California
And I a rich Eastern tourist
Lost somewhere between Hell and Texas
Looking at a map of a long, wet, dancing California
That I have never seen.
Send me some penny picture-postcards, lady,
Send them.
One of each breast photographed looking
Like curious national monuments,
One of your body sweeping like a three-lane highway
Twenty-seven miles from a night’s lodging
In the world’s oldest hotel.
What are you thinking?
I am thinking of how many times this poem
Will be repeated. How many summers
Will torture California
Until the damned maps burn
Until the mad cartographer
Falls to the ground and possesses
The sweet thick earth from which he has been hiding.
What are you thinking now?
I am thinking that a poem could go on forever.
Thanks for taking the time to critique the article. As a fan of your blog, I’m obviously disappointed. A quick response:
1) Obviously, there can be no definitive psychiatric diagnosis of Darwin, nor was I trying to offer one. However, that Darwin suffered from a form of depression (perhaps in addition to other maladies, such as lactose intolerance or hyperventilation/anxiety syndrome) is no longer a controversial idea among Darwin scholars. In fact, even Bowlby, whom you cite extensively, writes (on p. 11): “Darwin had a strong tendency to respond to adversity with both acute and chronic anxiety and sometimes also with depression.” Among the Darwin scholars I talked to, a diagnosis of major depressive disorder was much more widely accepted than, say, the diagnosis of Da Costa’s. But, of course, reasonable biographers can disagree. It’s worth pointing out, though, that Darwin himself speculated in his Autobiography on the adaptive purpose of pain, suffering and depression. This was clearly an issue he struggled with. That, I think, is undeniable.
2) I certainly didn’t intend the DFW short story to be a “smoking gun for lazy cognitive science”. I merely thought it was an eloquent example of the ruminative thought process that defines depression. (I also think DFW’s tragic life subtly complicates the analytical rumination hypothesis, since his severe depression clearly wasn’t “adaptive”.) I made no claims for the DFW short story other than that it’s a harrowing portrayal of a mind in the grip of depression, which I think is the entire point of the story. You claim that I speculated on DFW’s inner psychological state. I did no such thing.
3) You seem to assume that the last quarter of the article is an attempt to sneakily conflate sadness and depression. I beg to differ. As I explictly noted at the start of the section, I was trying to position this speculative theory within a larger scientific re-evaluation of negative moods. (If you read Andrews and Thomson’s paper, which you clearly have not, you’ll see that they make much stronger claims about the work of Forgas and others on negative moods and its relationship to depression.) I never claim, nor use language to insinuate, that Forgas was testing depression, nor do I claim that sadness and depression are the same thing. Instead, I cite the Andrews’ research on depressed affect, which suggests, according to him, that “depressive disorder is an extreme form of an ordinary thought process”. That idea is controversial and, as I note repeatedly in the article, it remains unclear if it’s true. But that’s still a very long way from saying that sadness is equivalent to depression, or that depression is not a “very real condition” or “really isn’t that bad”. As I note again and again in the article, this speculative theory about the evolution of depression (and the larger link between negative moods and analytical focus) says nothing about the abject awfulness of depression, or the very real and very debilitating pain that comes with it.
There are many important criticisms to be made of the analytical-rumination hypothesis, many of which I tried to include in the article. I hope that one day we might get to have a more interesting discussion about these issues.
Jonah: Thanks very much for your civil response. As I indicated, I think that the article does provide readers with an interesting overview of how “depressive affect” and low-level negative mood can result in a more clear-minded approach to life and labor. My problem with bringing up the DFW story is that it is used, like the speculation on Darwin, as a linchpin for the main thesis, establishing depression as a “clarifying force.” Should the fact that DFW suffered from severe depression have anything to do with us appreciating the way he “chronicles a consciousness in the grip of a ruminative cycle?” No. It would be just as foolhardy as attempting to diagnose Poe’s grief from “Ulalume” (a poem which also chronicles a consciousness in the grip of a ruminative cycle). And yet there is the parenthetical aside in your article, which subtly invites the reader to pursue this speculation, instead of specifying that the author and the character are two different animals.
While it is true that you do not explicitly state that sadness and depression are the same thing, when you follow up your summary of the Forgas study with this sentence, “The enhancement of these mental skills might also explain the striking correlation between creative production and depressive disorders,” you are inviting the reader to conflate “the new research on negative moods” with the association, implied earlier by the DFW parenthetical and the Darwin postmortem armchair diagnosis, involving “creative production” (or Darwin’s workaholicism) and “depressive disorders.” Had you been clearer about the differences between sadness and depression when moving onto the Andreasen study, you would have been on solid ground here. But I hope you can see how your failure to explicitly delineate between the two types causes me to draw concerned comparisons between you and Malcolm Gladwell. It’s very clear that you comprehend these studies more than he does. I’m just worried that it’s not there in the article. But I do hope that future articles and essays from you will demonstrate greater care.
I will, however, look less cursorily into the Andrews-Thomson collaboration into rumination, per your suggestion. And I’m sorry that your additional criticisms did not make it into the final piece. Perhaps the release of a director’s cut might be in order?
As a sufferer from severe major depression, I will say that, in my personal experience, the idea that “depressive disorder is an extreme form of an ordinary thought process” does not ring true at all. I’ve always found DFW’s descriptions of depression in his first published story and Infinite Jest as the closest thing I’ve read to describing the actual physical feeling. In IJ it’s described as as a looming billowing shapeless black form–an It–that is psychically haunting in its mere prescience, in its just being there, looming. (I think this falls in line w/ many depressive’s descriptions of it being a sort of black blanket that settles over them.) And in his first story he describes it as an intense all-body agony, where every atom in you hurts in a psychological way. (e.g. your foot, your toes, can actually feel sad, tormented, ready to burst.) I associate this with the unbearable sensory overload that I think depressives sometimes experience, where even the slightest sense impressions (the sound of your kitty grooming himself, the sound of fellow library patrons sniffling because of a runny nose) can infiltrate and dominate your mind and become utterly unbearable.
None of this, to me, has ever felt even vaguely like a normal thought process. It very much feels physical, a bodily imposition.
mere presence*
Thank you. This article really angered me quite a bit. The author seemed to not make any distinction between chronic depression and situational depression, and it seemed like the same old argument that people who suffer from depression just need to buck up and get out of it already.
Thanks, Mr. Champion, for a fine deconstruction of Jonah Lehrer’s article. First, a word of sympathy for Mr. Lehrer: I know what it’s like to be “pounded” on various websites, and I believe Mr. Lehrer undertook his writing in good faith, with good intentions.
Nevertheless–even allowing for his apologia, above–his article simply did not look critically or deeply enough into the counter-arguments or opposing studies. Nor did it examine the actual experiences of those with severe major depressive disorders.
My own detailed critique may be found on the Psychcentral website, at:
http://psychcentral.com/blog/archives/2010/03/01/the-myth-of-depressions-upside/
And, an elegant dismantling of the “rumination” hypothesis, by a psychologist, may be found at:
http://news.psydir.com/Psychology-Articles/depression039s-cognitive-downside/
Ronald Pies MD
Readers following this may be interested in my post on this whole kerfuffle — which Dr. Pies was kind enough to engage there — at my blog Neuron Culture: Does depression have an upside? It’s complicated.
Depression as suggested by the name is a decrease in the spread of stimulus throughout the brain and /or body. I lump body and brain together as they are inseperable neurologically. If the left controls the right hemisphere and the right the left hemisphere except in recent advances in evolution where asymetry is advantageous e.g. language we can note that it is possible to be active in a disadvantageous asymetric way. Thus reducing the spread of the stimulus of the brain. The same parts become active time and again. As the association grows so does the strength of the connection; creating a recursive loop of neurology (not thought).
The shake it off, pull your socks up ideas come from those that have had a believe that they can. In times of belief almost anything is possible. The same is true if I am in a complicated and dark unrelenting veil of depression… All of a sudden my autobiographical self has locked me in… One problem with the pull your socks up idea is that there are different ways to pull up your socks; e.g. adrenalin pathway and oxytocin pathway. The adrenalin pathway has been found to fire the same brain patterns but more hence seemingly the more you pull your socks up the longer your leg becomes. In the relaxation response of a calm confidence the socks are pulled up and much effort is needed to keep the socks pulled up. But the evaluation of improvement that the veil is lifted and then stays is a cognitive fault in those mislead by a cause and effect idea in medicine.
We at first get breaks in the storm, these breaks become more and more frquent and then last longer until the revised state of my self (one of them; no personality disorders meant) becomes the one with the highest average of operation- what I normally do / be / feel / cognitise / or interact as / with…
The most neuroplastic part of our brain is the hypothalamus and this is responsible for hormones. Hormones change cellular function. When enough cells are altered then physiology starts to change.
I can understand the cultural limitations of pain in that it stops us… The cultural story is very important to our health… Leading thought is also important but one must realise that leading thought is in the moment and moments change..
We begin life exploring the world relative to our inner workings. The internal milieu is our key to different ways of being… Even in cases of neurological infections taking away function some have simply changed their internal representations to match and have thus found new ways to interact with their world…
Lifting the veil of depression is possible and this is the key message I’d take from Jonah’s article… we can evolve… moving away from the semantics of nomencalture is key; follow in your own evolution and there you will notice a new you is possible…
sorry I’m a bit late on the comments, just found your blog and am liking it