Depression, anxiety and PTSD may not be mental diseases at all

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In a new study, researchers found that some of the most common mental disorders, including depression, anxiety, and PTSD, might not be disorders at all.

The research was conducted by a team at Washington State University.

In the study, the researchers propose a new approach to mental illness that would be informed by human evolution, noting that modern psychology, and in particular its use of drugs like antidepressants, has largely failed to reduce the prevalence of mental disorders.

For example, the global prevalence of major depressive disorder and anxiety disorders remained steady at 4.4% and 4% respectively from 1990 to 2010.

The authors also theorize that depression, anxiety, and post-traumatic stress disorder may be primarily responses to adversity; therefore, only treating the “psychic pain” of these issues with drugs will not solve the underlying problem.

According to the team, depression, anxiety, and PTSD often involve a threat of exposure to violence, which are predictable sources for these things that people call mental diseases.

Instead, they look more like sociocultural phenomena, so the solution is not necessarily fixing a dysfunction in the person’s brain but fixing dysfunctions in the social world.

The team advocate for biological anthropologists to enter the study of the “diseases of the mind,” to help find effective solutions, particularly for some problems that may be social instead of mental.

Among the more problematic issues, the researchers point to the “chemical imbalance” theory of depression, which has helped create a boom in antidepressant drugs meant to modulate certain chemicals in the brain called neurotransmitters.

A large review in 2018 found that antidepressants had almost the same effect as a placebo, and their widespread use has not delivered measurable results.

For example, in Australia alone, antidepressant use increased 352% from 1990 to 2002, yet there has been no observed reduction in the prevalence of mood, anxiety, or substance use disorders in any country.

Instead of addressing mental issues by their symptoms, the team proposes approaching mental illness by their probable causes.

They acknowledge that some psychiatric disorders like schizophrenia are likely genetic and often inherited and others like Alzheimer’s appear connected with aging.

However, the anthropologists argue that some conditions might be a mismatch between modern and ancestral environments such as attention-deficit/hyperactivity disorder, also known as ADHD.

The team pointed out that there is little in our evolutionary history that accounts for children sitting at desks quietly while watching a teacher do math equations at a board.

Other disorders such as depression, anxiety, and PTSD are not hereditary, occur at any age, and are often tied to threatening experiences.

The team proposes they may be responses to adversity and serve as signals, much like physical pain does, to make people aware of the need for help.

These conditions also disproportionately affect people in developing countries. For instance, 1 in 5 people in conflict-affected countries suffers from depression versus 1 in 14 worldwide.

The lead author of the study is Kristen Syme, a recent WSU Ph.D. graduate.

The study is published in the Yearbook of Physical Anthropology.

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