THE DEPTHS

A call for a new “diagnostic and therapeutic” paradigm for treating depression by framing it as a mood disorder rather than a disease.

Rottenberg (Psychology/Univ. of South Florida; co-editor: Emotion and Psychopathology: Bridging Affective and Clinical Science, 2007) calls attention to the epidemic increase of depression—not only in America, but also in England, Canada and Italy. With more than 15 percent of the population affected by depression, he writes, it is threatening to become “a preeminent public health menace.” Despite the massive resources devoted to research and treatment of the disease, “it is striking people at younger and younger ages.” Drawing on his own experience as director of the USF Mood and Emotion Laboratory and as someone who himself underwent a multiyear bout of deep depression, he points to disappointing progress in the development of effective antidepressants over the past 60 years, when the rate of recurrence is factored in. The author explains that mood serves an evolutionary function that we share with other mammals; it helps to tune behavior “to situational requirements” in ways that we are mostly unaware of. From an evolutionary perspective, an ordinary sad mood “makes people more deliberate, skeptical and careful in how they process information from their environment.” In Rottenberg’s opinion, our cultural emphasis on being upbeat can be counterproductive. The human capacity for reflection can derail this semiautomatic process when we seek to enhance pleasurable upbeat moods and worry about being depressed. By shifting our attention to our own mental processes, we risk losing sight of broader goals. Rottenberg does not dismiss the benefits of talk therapy and medications to treat depression or deny the role of genetic predisposition. His laudable aim is to broaden the discussion.

An important contribution to his stated aim of promoting “an adult national conversation about depression.”