Evolutionary Psychiatry Definition On Depressive Subtypes

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In Rantala, Luto, Krams and Karlsson’s (2018) paper on evolutionary psychiatry, it is believed the main reason for no evolutionary based treatment for depression is due to the deficient explanation for its theoretical framework. As reported many major depressive disorders are one of the leading causes of disability (Vos et al. 2015). Many clinicians diagnosed patients solely on the assumption depression is a single condition and all symptoms are indication. Yet, evidences have depicted groups of separate syndromes from depressive patients where they displayed symptoms of the opposite features. xample, some depress patients can experience insomnia and others, hypersomnia (Fried & Nesse 2015). Though it is argued the manifestation of the depressive symptoms are dependent on the subtypes of depressive episode. Every individual’s lifestyle varies; therefore, it is not the personality of the patient but rather their experiences (Keller et al. 2007).

Recent research has shown depression as a common disorder within the hunter-gather society. For example, the indigenous people who changed their lifestyle to the modern ones faced major rates of suicide which were even tripled in numbers (Rantala et al. 2018). Those who are diagnosed with depression does not necessarily have to encounter a major tragic event. Incidences like mood swings and sadness most of the time does not transform into a major depression to the hunter-gatherers and Old people. In modern society, the possible factors like low mood or sadness do change into major depressive conditions. Some reasons associated with this are the reduced quality of the food items, sedentary lifestyles, low sun exposure, social isolation, etc. Due to this, poor and bad lifestyle changes created a major impact on physical health as well as increase the vulnerability of stress. In addition, the modern lifestyle events also increase modern diseases like obesity, cancer, hormone-related illness others that influences mental health as well. Furthermore, due to the mismatch of environmental factors in the modern lifestyle, depression becomes more vulnerable (Durisko et al. 2015).

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With evolutionary and neurobiological approaches, they have classified 12 subtypes based on proximate mechanisms and ultimate functions referred to figure. Infection causes depression mainly due to parasite and pathogens. The prime symptom associated with it is behaviour sickness. Long-term stress which slows down the immune system and produces pro-inflammatory cytokines, triggers sickness behaviours (Olga et al. 2005). It can be caused by loneliness which increases the likelihood of social isolation then may lead to chronic stress state. Individuals who experienced an unfortunate event such as dramatic threat or injury, are more likely to develop post-traumatic stress disorder (PTSD) if they have low stress hormone levels. Hierarchy conflict causes low self-esteem to the individual and lessen their motivations to strive for success. This can lead to unemployment, social exclusion and bullying. Loss of a loved one causes grief which is a temporary low mood, but severe patients fall into depression. Yet, the individual who grief does not necessarily result in low self-esteem or suicidal ideation. Traumatic rejection from the loved ones is a common cause to clinical depression. In extreme cases, the individual may partake in murder or suicide. Postpartum depression is mainly visible in a woman after six months of childbirth. It is linked to the mother feeling despair and incapability to care for the child, potentially resulting in crying or harmful intentions towards the baby. Seasonal affective disorder (SAD) affects the person every year, often begins in autumn and mild hypomania during spring and summer (Montgomery 2018). It is characterised by fatigued, decreased libido and increased appetite. Substance abuse can lead to depression or serve as a form of self-medication for temporary relief (Abraham & Fava 1999). Somatic diseases like Alzheimer’s disease or cancer contribute to depression as it decreases quality of life (Beltman el al. 2010). There are three main proximate causes: finding out you are chronically ill causes stress and anxiety, treatments like chemotherapy or surgery leads to sickness behaviours and the illness itself. Starvation from food shortage increases the depression ration in one person as the body is malnourished for survival. Understanding the 12 subtypes based on evolutionary psychiatry could help find effective treatments as it treats the underlying triggers. This allow doctors to develop more advanced treatments targeting each depressive subgroups.

In the case of clinical depression, medication accompanied by the obscure representation of depressive symptoms becomes challenging to diagnose for proper treatment. This clinical depression period is very difficult to deal with. The patients’ inability to address their problems effectively thus doctors may misinterpret the actual issue. It is not always straightforward with its symptoms because of various reasons. Sometimes it occurs because of the heavy dose of some drug or therapy. Therefore, the treatment can’t be done through the study of the symptoms only. Doctors need to observe the entire life history of the patient that is very much important for the treatment. Sometimes the symptoms are covered with various diseases so it becomes more difficult for the doctor to recognise the clinical depression. So, the doctor needs to identify the actual cause behind the disease of the patient. They also need to understand the life history of the patient for the proper diagnosis (Rantala et al. 2018).

To identify depressive symptoms there are some proximate mechanisms and ultimate functions that guides the doctors to detect the issue of the patient. Every individual has different indication and leads to diagnose the depressive nature. Mainly doctors are trying to observe the number of symptoms reported by the patient that helps to recognise the depression. Therefore, it is crucial for doctors to understand the proximate mechanisms and ultimate functions of the symptoms (Rantala et al. 2018). This diagnostic tool is important for the recovery and optimal treatment of the patient. Proximate mechanisms aid the doctor to detect the proper indicators of the depression so it is essential because hyper-depression can be the cause of many risky diseases. The proximate mechanisms helped to compare the symptoms with the non-depressed person, so it has become easier for the doctor to understand the actual problem of the patient. So, the doctors need to identify the manifestation so that they can start the treatment as soon as possible (Trimmer et al. 2015).

Rantala el al. (2018) paper is based upon the various themes of the depression and its treatment. The idea presented with depression is not a single condition and there are 12 possible root causes. As depression is becoming a worldwide issue to modern society, it is important for clinicians to further research on underlying causes and interpret patient’s lifestyle and problems thoroughly, to allow the development of more effective and precise treatment.

References

  1. Abraham, H.D. & Fava, M. 1999. Order of onset of substance abuse and depression in a sample of depressed outpatients. Comprehensive Psychiatry, 40(1): 44-50.
  2. Beltman, M.W., Oude Voshaar, R.C. & Speckens, A.E. 2010. Cognitive-behavioural therapy for depression in people with a somatic disease: meta-analysis of randomised controlled trials. The British Journal of Psychiatry, 197(1): 11-19.
  3. Durisko, Z., Mulsant, B.H. & Andrews, P.W. 2015. An adaptationist perspective on the etiology of depression. Journal of Affective Disorders, 172: 315-323.
  4. Fried, E.I. & Nesse, R.M. 2015. Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR*D study. Journal of Affective Disorders, 172: 96-102.
  5. Keller, M.C., Neale, M.C. & Kendler, K.S. 2007. Association of different adverse life events with distinct patterns of depressive symptoms. The American Journal of Psychiatry, 164(10): 1521-1529.
  6. Montgomery, J. 2018. Evolutionary mismatch, emotional homeostasis, and “emotional addiction”: A unifying model of psychological dysfunction. Evolutionary Psychological Science, 4(4): 428-442.
  7. Olga, J.G.S, Marieke, C.W. & Maes, M. 2005 Cytokines and major depression. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 29: 201-217
  8. Rantala, M.J., Luoto, S., Krams, I. & Karlsson, H. 2018. Depression subtyping based on evolutionary psychiatry: proximate mechanisms and ultimate functions. Brain, Behavior, and Immunity, 69: 603-617.
  9. Trimmer, P.C., Higginson, A.D., Fawcett, T.W., McNamara, J.M. & Houston, A.I. 2015. Adaptive learning can result in a failure to profit from good conditions: implications for understanding depression. Evolution, Medicine, and Public Health Advance Access Published April 26, 2015

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