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MODR 1770 Lecture Notes - Jonah Lehrer, William Styron, Chagas Disease

Modes Of Reasoning
Course Code
MODR 1770
Jai Chetram

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Published: February 25, 2010
The Victorians had many names for depression, and Charles Darwin used them all.
There were his “fits” brought on by “excitements,” “flurries” leading to an
“uncomfortable palpitation of the heart” and “air fatigues” that triggered his “head
symptoms.” In one particularly pitiful letter, written to a specialist in “psychological
medicine,” he confessed to “extreme spasmodic daily and nightly flatulence” and
“hysterical crying” whenever Emma, his devoted wife, left him alone.While there has
been endless speculation about Darwin’s mysterious ailment — his symptoms have been
attributed to everything from lactose intolerance to Chagas disease — Darwin himself
was most troubled by his recurring mental problems. His depression left him “not able to
do anything one day out of three,” choking on his “bitter mortification.” He despaired of
the weakness of mind that ran in his family. “The ‘race is for the strong,’ ” Darwin wrote.
“I shall probably do little more but be content to admire the strides others made in
Darwin, of course, was wrong; his recurring fits didn’t prevent him from succeeding in
science. Instead, the pain may actually have accelerated the pace of his research, allowing
him to withdraw from the world and concentrate entirely on his work. His letters are
filled with references to the salvation of study, which allowed him to temporarily escape
his gloomy moods. “Work is the only thing which makes life endurable to me,” Darwin
wrote and later remarked that it was his “sole enjoyment in life.”
For Darwin, depression was a clarifying force, focusing the mind on its most essential
problems. In his autobiography, he speculated on the purpose of such misery; his

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evolutionary theory was shadowed by his own life story. “Pain or suffering of any kind,”
he wrote, “if long continued, causes depression and lessens the power of action, yet it is
well adapted to make a creature guard itself against any great or sudden evil.” And so
sorrow was explained away, because pleasure was not enough. Sometimes, Darwin
wrote, it is the sadness that informs as it “leads an animal to pursue that course of action
which is most beneficial.” The darkness was a kind of light.
The mystery of depression is not that it exists — the mind, like the flesh, is prone to
malfunction. Instead, the paradox of depression has long been its prevalence. While most
mental illnesses are extremely rare — schizophrenia, for example, is seen in less than 1
percent of the population — depression is everywhere, as inescapable as the common
cold. Every year, approximately 7 percent of us will be afflicted to some degree by the
awful mental state that William Styron described as a “gray drizzle of horror . . . a storm
of murk.” Obsessed with our pain, we will retreat from everything. We will stop eating,
unless we start eating too much. Sex will lose its appeal; sleep will become a frustrating
pursuit. We will always be tired, even though we will do less and less. We will think a lot
about death.
The persistence of this affliction — and the fact that it seemed to be heritable — posed a
serious challenge to Darwin’s new evolutionary theory. If depression was a disorder, then
evolution had made a tragic mistake, allowing an illness that impedes reproduction — it
leads people to stop having sex and consider suicide — to spread throughout the
population. For some unknown reason, the modern human mind is tilted toward sadness
and, as we’ve now come to think, needs drugs to rescue itself.
The alternative, of course, is that depression has a secret purpose and our medical
interventions are making a bad situation even worse. Like a fever that helps the immune
system fight off infection — increased body temperature sends white blood cells into
overdrive — depression might be an unpleasant yet adaptive response to affliction.
Maybe Darwin was right. We suffer — we suffer terribly — but we don’t suffer in vain.
ANDY THOMSON IS a psychiatrist at the University of Virginia. He has a scruffy gray
beard and steep cheekbones. When Thomson talks, he tends to close his eyes, as if he
needs to concentrate on what he’s saying. But mostly what he does is listen: For the last
32 years, Thomson has been tending to his private practice in Charlottesville. “I tend to
get the real hard cases,” Thomson told me recently. “A lot of the people I see have

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already tried multiple treatments. They arrive without much hope.” On one of the days I
spent with Thomson earlier this winter, he checked his phone constantly for e-mail
updates. A patient of his on “welfare watch” who was required to check in with him
regularly had not done so, and Thomson was worried. “I’ve never gotten used to treating
patients in mental pain,” he said. “Maybe it’s because every story is unique. You see one
case of iron-deficiency anemia, you’ve seen them all. But the people who walk into my
office are all hurting for a different reason.”
In the late 1990s, Thomson became interested in evolutionary psychology, which tries to
explain the features of the human mind in terms of natural selection. The starting premise
of the field is that the brain has a vast evolutionary history, and that this history shapes
human nature. We are not a blank slate but a byproduct of imperfect adaptations, stuck
with a mind that was designed to meet the needs of Pleistocene hunter-gatherers on the
African savanna. While the specifics of evolutionary psychology remain controversial —
it’s never easy proving theories about the distant past — its underlying assumption is
largely accepted by mainstream scientists. There is no longer much debate over whether
evolution sculptured the fleshy machine inside our head. Instead, researchers have moved
on to new questions like when and how this sculpturing happened and which of our
mental traits are adaptations and which are accidents.
In 2004, Thomson met Paul Andrews, an evolutionary psychologist at Virginia
Commonwealth University, who had long been interested in the depression paradox —
why a disorder that’s so costly is also so common. Andrews has long dark brown hair and
an aquiline nose. Before he begins to talk, he often writes down an outline of his answer
on scratch paper. “This is a very delicate subject,” he says. “I don’t want to say
something reckless.”
Andrews and Thomson struck up an extended conversation on the evolutionary roots of
depression. They began by focusing on the thought process that defines the disorder,
which is known as rumination. (The verb is derived from the Latin word for “chewed
over,” which describes the act of digestion in cattle, in which they swallow, regurgitate
and then rechew their food.) In recent decades, psychiatry has come to see rumination as
a dangerous mental habit, because it leads people to fixate on their flaws and problems,
thus extending their negative moods. Consider “The Depressed Person,” a short story by
David Foster Wallace, which chronicles a consciousness in the grip of the ruminative
cycle. (Wallace struggled with severe depression for years before committing suicide in
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