Depression as an Evolutionary Adaptation – Implications for the Development of New Drug Treatments

Colin A Hendrie, Alasdair R Pickles
European Psychiatric Review, 2010;3(2):46-48
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Abstract

Depression is a widespread disorder and around 25% of people in the developed world can expect to experience this at some point in their lives. Females are up to three times more vulnerable than males. Most drugs used to treat depression are based on the monoamine hypothesis, even though there is very little evidence to support this theory. Unsurprisingly, the therapeutic value of these drugs is compromised. Up to 30% of depressives fail to respond to them, relapse rates are high and there is a dangerous therapeutic lag of several weeks. The route to further progress is, however, blocked by the failure to develop theories to displace the monoamine hypothesis. This article outlines the proposal that, rather than being a disorder, depression is an evolutionary adaptation that is expressed in response to damage to reproductive potential. The hunched posture and avoidance of eye-contact associated with depression are typical human behaviours in response to threat or the expectation of threat. The decrease in appetite and libido reduces the chances of conflict brought about by competition for these resources and sleep disturbance ensures a peak of activity when everyone else is asleep. Finally, social withdrawal places people at the edge of social groups and away from the conflicts that might ensue at their centre. Therefore, in functional terms, depression serves to reduce an individual’s attack-provoking stimuli and so facilitates their passage through to further reproductive opportunities. The understanding that depression is an evolutionary adaptation raises important questions about the mechanisms that mediate this response, and hence the nature of the drug treatments that need to be developed to manipulate them.
Keywords
Depression, selective serotonin reuptake inhibitors (SSRIs), evolutionary adaptation
Disclosure The authors have no conflicts of interest to declare.
Received: September 29, 2009 Accepted April 12, 2010
Correspondence: Colin A Hendrie, University of Leeds, Leeds, LS2 9JT, UK. E: c.a.hendrie@leeds.ac.uk

The World Health Organization (WHO) ranks depression as one of the most burdensome diseases in the world.1 Estimates are that at any one time 3–6% of the population are receiving treatment, although there are some variations across cultures.2 In the developed world there is a 15–25% chance of becoming depressed over a lifetime3–7 and females are two to three times more vulnerable than males.8

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