R.

Lissann Lichtenstein

ANTH 1020-013

Depression Research Paper

The word depression is commonly heard today throughout the medical community, often

tied in with topics such as clinical depression, PTSD and postpartum depression. According to

The New Oxford American Dictionary Second Edition, depression is defined as: severe

despondency and dejection, typically felt over a period of time and accompanied by feelings of

hopelessness and inadequacy. It can range from mild cases, often including seasonal depression

or temporary due to hormonal changes, to severe cases, referred to as major depressive disorder.

And according to the Depression and Bipolar Support Alliance, "Major depressive disorder

affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population

age 18 and older, in a given year. (Depression Statistics) Due to the potential severity of the

side effects, researchers are seeking answers as to why depression exists and what can be done to

more effectively treat it.

In the search for better treatment, researchers must identify those affected and likely to be

affected by depression. There is diversity in depression as it affects people of any age, gender,

race, etc. (Although one might say that due to this, it might not be considered diverse.) However,

there are certain groups more affected then others. According to Caroline Sonnenberg (2013),

women are around twice as likely to be depressed as their same age male counterparts. It is

believed that this may be caused by a higher exposure to risk factors that will be discussed later

in this paper. Stewart (2008) states that the Aboriginal peoples of Canada who live off reserve are

1.5 times more likely to be depressed then other Canadians. (It was mentioned by both of these

sources that the factors they measured were more environmental rather then genetic.) As well,
Flint (2014) discussed the possible genetic components of depression. They stated that those with

a family history of depression have a 2.84 ratio of increased risk of major depression. When they

combined several studies, they were able to estimate depression heritability to be 37% (95%

confidence intervals).

A study performed by Florida State University has helped to begin research in an area of

depression not previously explored. They focused on whether "the contribution of neighborhood

urban form and social environment [had effects on] depressive symptomology. (Coutts, 2012)

According to their results, living in a higher housing density neighborhood is associated with

fewer depression symptoms. This is was tied to possible easier access to services, more ability to

socialize with community members, and the ability to walk from place to place rather then use

motor vehicles, promoting exercise and physical wellbeing. They also stated that those living in

neighborhoods with a higher auto commuter density are associated with more depressive

symptoms and that those living in residentially stable neighborhoods displayed fewer

depressive symptoms, regardless of the level of neighborhood economic deprivation. (Coutts,

2012)

Since depression is defined as extremely negative feelings about oneself, one might want

to consider if happiness rates around the world reflect on the international depression rates. The

World Happiness Report determined happiness around the world with answers to questions from

8 different categories. These were the GDP (Gross Domestic Product) per capita, social support,

healthy life expectancy at birth, freedom to make life choices, generosity, perceptions of

corruption, positive affect and negative affect (see Appendix A for more information on the

specific definitions of these terms). The United States ranks 14th out of 155 countries, with the

top 5 countries mainly being located in Scandinavia and the top 20 countries mainly being
classified as first world countries. (The last 33 countries are mainly located in Africa.) Many of

the factors measured by this study are material, environmental or patient subjective and not

genetically based and so do not help to prove or disprove the role of evolution in happiness.

Another consideration from the World Happiness Report is how they define misery. The

classifications used were being poor (below 60% of the median household income)uneducated

(USA and Indonesia: no higher education), unemployed,not partnered,physical illness (below the

current 20th percentile of physical health) anddepression/anxiety (diagnosed/treated). While

these categories were not used to show misery rates in each country, they were used to illustrate

how they might fall on their own if the problem was eliminated. The majority of the countries

examined in this section, including the United States, experienced their highest improvement in

the area of mental health. This statistically shows that increased efforts in dealing with issues

such as depression can decrease overall misery, thereby increasing happiness, in nations as a

whole. (Helliwell, 2017)

There are theses out there that have tried to address the role of genetics in depression.

Some researchers say that it may be a response to our rapid brain development. Nesse (2000)

brought several theories together in his paper to try and address a genetic variable. The points he

emphasized were first, determining whether depression is a defense or a defect. Second that low

mood and depression are better formulated in terms of the situations that shaped them instead of

just their functions. (Nesse, 2000) And third, that generic low mood and the negative affect may

have been formed to deal with adverse situations by helping the organism not waste energy on

events that would not benefit them. However, this idea of thinking lacks evidence to say if

depression truly is an adaptation.

 There are many possible reasons why a specific genetic location has not been connected

with depression. In class lecture, it was addressed that there are many genes in the body that

serve more then one function. Some of the genes natural selection will select for can be labeled

as antagonistic pleitropy. In other words, genes may serve a good purpose early in the life of a

person, but can have negative consequences later. However, if those negative consequences

occur after the time of reproduction, natural selection will still select them for the positive

consequences earlier in life. Also, as we are unsure of the purpose of the vast amounts of junk

DNA in the body, it cannot be fully ruled out as a factor. And due to the lack of conclusion on

genetic location in depression, we cannot effectively examine ancient DNA to look for

similarities to see how evolution has played a role.

Some scientifically proven risk factors are discussed by Sonnenburg (2013). In dealing

with late life depression, it lists the presence of chronic physical disease, diminished physical and

mental activity and functioning and functional limitations as some of the physical risks. It also

includes the loss of partner, a lower socio-economic status, low social and interpersonal support,

personality characteristics that do not promote healthy social interaction and both chronic and

short term effects of medications (which can be known to change as a patient ages). Again, it is

seen that these are not factors that suggest evolution playing a role in depression distribution and

more represent environmental and personal factors.

While research about the genetic causes of depression has currently proved inconclusive,

forms of treatment have continued to evolve with new knowledge about those affected and new

technologies now available. Donna Stewart (2008) reported that in Canada, one of their most

effective trials for depression treatment was the program Partners in Care. This trial compared

the care from an average primary care clinic to care from a quality-improvement clinic. The
quality-improvement clinic focused on intuitional commitments, more education for clinicians

and patients, and more effective follow up options, including access to medications. Over the

course of a year, it was shown that those who received care from the quality-improvement clinic

were able to more proactively take charge of their treatment and make use of the options

available. Also, these groups showed better outcome and progression overall. This study brings

attention to the idea that traditional screenings are not enough to aid successful treatment.

Securing more options for patients and clinicians for more personalized treatment leads to

better outcomes for the patients.

De Choudhury (2013) introduced an idea of using technology, specifically social media,

to help predict depression in a person. They first state that there is no reliable laboratory test for

diagnosing mental illness. This normally comes from a patient and their close circle relating their

observed experiences in conjunction with a mental status examination. As social media is a

platform for expressing personal opinion, it makes sense that clues might be found within the

posts. After reviewing the posts of 476 Twitter users a year prior to their onset, the

qualification system they developed had a 70% accuracy rate in classifying the likelihood of

depression in a subjects.

Depression is a very widespread illness that affects many people around the world, both

directly and indirectly. There are an estimated 300 million people worldwide suffering from

depression (De Choudhury, 2013). And in the search for understanding of this illness, genetic

and evolutionary theses have been explored and conclusions have yet to be reached due to lack

of evidence. Even in the face of this setback, strides are being made to further our knowledge

of this illness so as to help with the diagnosis and treatment. Hopefully, with more time and

technological advances, scientists will be able to find a genetic link to depression.

 Works Cited:

Coutts, Christopher, Rebecca Miles, and Asal Mohamadi. "Neighborhood urban form, social

environment, and depression." Journal of Urban Health 89.1 (2017).

De Choudhury, Munmun, et al. "Predicting Depression via Social Media." ICWSM. 2013.

Depression. The New Oxford American Dictionary Second Edition. New York: Oxford

UP, 2005. Electronic.

"Depression Statistics." Depression and Bipolar Support Alliance. N.p., n.d. Web.

Flint, Jonathan, and Kenneth S. Kendler. "The genetics of major depression." Neuron 81.3

(2014): 484-503.

Helliwell, J., Layard, R., & Sachs, J. (2017). World Happiness Report 2017, New York:

Sustainable Development Solutions Network.

Nesse, Randolph M. "Is Depression an Adaptation?." Arch Gen Psychiatry 57 (2000): 14-20.

Stewart, Donna E. "Battling depression." Canadian Medical Association Journal 178.8 (2008):

1023-1024.

Sonnenberg, C. M., et al. "Gender differences in the relation between depression and social

support in later life." LATE LIFE DEPRESSION 25.1 (2013): 67.

 Appendix A

Meaning of terms used in World Happiness Report

I realized that there would not necessarily be room in my paper to include explanations

on the variables used in the World Happiness Report. However, I recognized I needed to include

them somewhere, as they may not make sense otherwise.

GDP per capita is in terms of Purchasing Power Parity (PPP) adjusted to constant 2011

international dollars, taken from the World Development Indicators (WDI) released by the World

Bank in August 2016.

Social support is based on responses to the question If you were in trouble, do you have

relatives or friends you can count on to help you whenever you need them, or not?

The time series of healthy life expectancy at birth are constructed based on data from the

World Health Organization (WHO) and the World Development Indicators (WDI).

Freedom to make life choices is based on responses to the question Are you satisfied or

dissatisfied with your freedom to choose what you do with your life?

Generosity is based on responses to the question Have you donated money to a charity in

the past month?

Perceptions of corruption are based on the responses to two questions: Is corruption

widespread throughout the government or not? and Is corruption widespread within businesses

or not?

Positive affect is defined as the average of previous-day affect measures for happiness,

laughter and enjoyment for GWP waves 3-7 (years 2008 to 2012, and some in 2013). It is

defined as the average of laughter and enjoyment for other waves where the happiness question

was not asked.

 Negative affect is defined as the average of previous-day affect measures for worry, sadness

and anger for all waves.

(Definitions taken from Technical Box 2: Detailed information about each of the

predictors in Table 2.1, pg. 17 of the World Happiness Report 2017)