“The alarming increase in Insanity, as might naturally be expected, has incited many persons to an investigation of this disease.”
~John Haslam, 1809
On Madness and Melancholy: Including Practical Remarks on those Diseases
“Cancer, like insanity, seems to increase with the progress of civilization.”
~Stanislas Tanchou, 1843
Paper presented to the Paris Medical Society
“It cannot be denied that civilization, in its progress, is rife with causes which over-excite individuals, and result in the loss of mental equilibrium.”
~Edward Jarvis, 1843
“What shall we do with the Insane?”
The North American Review, Volume 56, Issue 118
“It is clear that if it goes on with the same ruthless speed for the next half century . . . the sane people will be in a minority at no very distant day.”
~Henry Maudsley, 1877
“The Alleged Increase of Insanity”
Journal of Mental Science, Volume 23, Issue 101
“Diabetes is a disease which often shows itself in families in which insanity prevails.”
~Sir Henry Maudsley, 1879
Pathology of the Mind
“If this increase was real, we have argued, then we are now in the midst of an epidemic of insanity so insidious that most people are even unaware of its existence.”
~Edwin Fuller Torrey & Judy Miller, 2001
The Invisible Plague: The Rise of Mental Illness from 1750 to the Present
Depression isn’t a single disease (apparently true of other examples such as Alzheimer’s, according to Dr. Dale Bredesen). Rather, it’s a set of symptoms with numerous causes and mechanistic explanations. This is why some have, according to evolutionary psychiatry, categorized major depressive disorder into subtypes (M.J. Rankala, et al, Depression subtyping based on evolutionary psychiatry: Proximate mechanisms and ultimate functions):
- infection
- starvation
- somatic diseases
- chemicals
- seasons
- postpartum events
- romantic rejection
- grief
- hierarchy conflict
- traumatic experience
- loneliness
- long-term stress
One of the most common underlying features is inflammation. This can be the result of infections, autoimmune disorders, unhealed injuries, malnutrition, stress, sleep deprivation, etc. At least as prevalent, if not more, is mitochondrial dysfunction (Chris Palmer, Brain Energy). But also typical is microbiome dysbiosis and gut problems, as the gut as the second brain has four connections to the brain, along with many other connections to systems throughout the body.
If less well known, low oxygen levels are found in epilepsy and mood disorders, the link between the two conditions having been known about for millennia (Joseph Everett, Is Depression Man-Made?). Sleep apnea, deep water diving, and being at high altitudes increases the risk of seizures. While fasting increases oxygen utilization, as well as fasting being an ancient treatment of epilepsy and depression. This is because, when fasting or on a very low-carb diet, ketosis improves cellular oxygen efficiency in requiring less oxygen to produce adenosine triphosphate (ATP), as compared to glucose or fatty acids — and helps with mitochondrial functioning, remediation for CO2 retention, oxidative damage reduction, anti-inflammation, etc.
Ketone bodies have been studied by the US Navy SEALs to assist divers being able to hold their beath longer, as well as ketosis and the keto diet having been considered by the military in general — funded by millions of dollars (Warren Duffie, Office of Naval Research, Deep Dive: ONR-Supported Research Combats Oxygen Toxicity in Navy Divers; Rich LaFountain, Parker Hyde, & Jeff Volek, HDIAC, Ketogenic Diet – Potential Benefits to Warfighter Health and Performance; Anne DeLotto Baier, USF’s hyperbaric physiology research extracts discoveries from extreme conditions; Fraulke Tillmans, Ketones, Manta Rays and Extreme Environments; Sean Sakinofsky, US NAVY SEALs: The Diet They Refuse to Adopt).
But the main problem is the military is required by law to follow federal dietary recommendations. At present, the only way to change the military diet is to change that official position for all US citizens. Until there is an edict from up on high, military leadership mostly has its hands tied. That’s a not a bad way of seeking change, since the various health problems such as obesity transcends the divide between military personnel and private citizens (Obese Military?). Turning the old food pyramid on its head was a great start.
While the keto diet was first developed to treat epilepsy, it’s also highly effective for metabolic diseases and mood disorders: “people with diabetes have 2 to 3 times higher risk for depression. And this paper explains that parts of the body in people with diabetes are commonly found to be low in oxygen” (Joseph Everett). Anyone familiar with depression knows that it often coincides with listlessness and lethargy that involves avolition, amotivation, apathy, and anhedonia. In severe depression, one’s limbs can feel too heavy to lift, which might indicate a lack of energy at the cellular level. That has everything to do with reduced oxygen availability and utilization.
This topic is of personal interest. I began showing signs of depression as early as elementary school. It was already having a major negative affect by 7th grade, contributing to my nearly flunking out. It got really bad starting in 11th grade. And it played a major role in my later dropping out of college. Then I was finally diagnosed after a suicide attempt. But it continued to dog me into my early 40s. I tried psychotherapy, psychiatry, psychiatric medications, supplements, vegetarian diet, exercise, yoga, meditation, self-help books and programs, body and energy work, and even a shamanic treatment.
Nothing made much difference, until the period right before Covid-19 hit. Inspired by the documentary The Magic Pill (2017), I tried a Paleo diet: organic, whole foods, nutrient-density, antinutrient elimination, and lower carb. I tried this diet simply in the hope of losing excess body fat I had gained and, like depression, couldn’t reverse. But after a few months on the Paleo diet, both my belly fat disappeared and my depression was effectively cured, neither to return.
I surely had been malnourished and suffering from metabolic disorder/syndrome. It’s possible I was prediabetic, as I overheated and sweated profusely at the time like my diabetic grandmother. But I likely had various chemical exposures, from lead toxicity in childhood to agrochemicals and food additives across my life. During one period, I was working at night and so mostly getting unnatural light, combined with an unnatural sleep cycle. I was self-medicating with caffeine and other stimulants. I’m sure I had inflammation, microbiome dysbiosis, and who knows what else. And increasingly, I suspect I fall under seasonal affective disorder to some degree.
Plus, at various times, I experienced poverty, sedentary lifestyle, nature deficit disorder, and general stress. Also, in living in a society where was declining nearly every indicator of health: economic inequality, public trust, political corruption, authoritarianism, etc. To exacerbate problems, I was at times socially isolated. For a number of years, my brothers and closest friend moved away. And I struggled with stable, long-term romantic relationships. So, all combined, I was hitting the causal factors for most of the depressive subtypes. The main exception might be trauma, although it depends on how it’s defined (Should Trauma be Broadly or Narrowly Defined?). I was dealing with severe chronic stress, which can be traumatizing.
As the research shows, I’m far from alone. Particularly in the West, and even more so the Unite States, major depressive disorder has become a disease epidemic. It not only is causing immense economic costs but often causing severe disability, enough that large swaths of society are crippled by it. It’s a drag on every aspect of society. And the saddest part of all, it’s almost entirely preventable.
As the subtyping indicates, depression isn’t really a disease in itself. It’s simply a common set of symptoms that occur in correlation with problems that interfere with otherwise normal health, as seen among those living outside natural conditions of evolutionary norms. But as many others have noted, there are numerous other overlapping diseases and health issues, spreading with ‘civilization’: modernization, industrialization, urbanization, and Westernization (Besides Palmer: Weston A. Price, Nutrition and Physical Degeneration; Mark Hyman, Food Fix; Nadine Burke Harris, The Deepest Well; & Aimie Apigian, The Biology of Trauma).
A great example of that is neurodivergence, from ASD to ADHD. Most people, especially neurodiversity advocates, presume that it’s a genetic condition. But the evidence doesn’t support this bias and belief. Autistics not only have higher rates gut issues, microbial dysbiosis, (neuro-)inflammation, and mitochondrial dysfunction but also increased de novo mutations. That’s to say those are mutations that happened after conception and so not inherited.
Whatever might be the connection, autistics are more likely be later diagnosed with mood disorders, dementia, metabolic diseases, etc. But it goes the other way around as well. Neurotypicals with metabolic diseases prior to conception are more likely to have children who later are diagnosed with autism. That proves that, even if genetics might predispose one, it’s environment and epigenetics that is determinant. Genetics are only relevant to the degree they express and how they express, such that the exact same gene can potentially be seen in an opposite phenotype.
“ADHD is simply the label given to a certain set of symptoms when no biological cause can be determined. So, it’s really a non-diagnosis, the doctor’s way of saying they have no clue. There is obviously a biological underpinning, as the author notes. But oddly the moment any biological explanation is offered, it’s no longer allowed to be technically described as ADHD. In particular with the cases she dealt with, she argues that many conditions that would sometimes present as ADHD-like were, instead, toxic stress. Of course, there is no such official diagnosis. Anyway, as social disruption can cause neurodivergence, Apigian notes that likewise “cancer is more prevalent in those with adverse childhood experiences” (p. 248). It’s all of one piece” (Metabolic Theory of Cancer: Past and Present).
There is no way to separate out the different areas of health: physical and mental, social and moral, private and public, individual and collective. Weston A. Price and others were writing about this generations ago. Some were observing the links even earlier (The Crisis of Identity), as the beginning quotes evidence. But still others argue that the diseases of civilization, including mental illness, were becoming more apparent as a concern in early modernity or even the late middle ages (Edwin Fuller Torrey & Judy Miller, The Invisible Plague; & Barbara Ehrenreich, Dancing in the Streets). We are a long way into this emerging public health epidemic, verging on an existential crisis.
* * *
Below are two other quotes about the worsening of health conditions that preceded the present disease epidemic by many generations. But if you want a detailed analysis of the earlier period when diseases of civilization were spreading, from a healthcare expert of the time, read Weston A. Price’s 1939 Nutrition and Physical Degeneration. Price began his career as a dentist in the late 1800s. Then starting in the 1920s, he traveled the world to study the surviving traditional populations that remained healthy. In his book, he also compares and synthesizes data on physical health and development, neurocognitive and mental health, and crime; along with lab testing of minerals in soil and nutrients in food.
- “Stroke, cancer, and, most of all, heart disease leaped to the forefront as causes of death. By 1920 heart disease had taken the lead as the top cause of death; by the end of the decade, based mainly on evidence developed by Dublin and other insurance industry statisticians, health policy analysts came to believe that heart disease was also catching up with tuberculosis in terms of its total financial burden on the nation (despite the fact that heart disease tended to kill its victims later in their wage-earning years). Imposing double the economic burden of cancer, which would soon become the second greatest cause of death, heart disease had unquestionably become Public Health Enemy Number 1 by 1930. […] The [early 20th century] findings indicated a clear association between overweight and excess mortality. […] In 1930, Louis Dublin used this type of information as the basis for a groundbreaking actuarial study that specifically correlated overweight with heart disease.”
~Nicolas Rasmussen, Fat in the Fifties - “But this was New York City in the mid- 1930s. This was two decades before the first Kentucky Fried Chicken and McDonald’s franchises, when fast food as we know it today was born. This was half a century before supersizing and high-fructose corn syrup. More to the point, 1934 was the depths of the Great Depression, an era of soup kitchens, bread lines, and unprecedented unemployment. One in every four workers in the United States was unemployed. Six out of every ten Americans were living in poverty. In New York City, where Bruch and her fellow immigrants were astonished by the adiposity of the local children, one in four children were said to be malnourished. How could this be?”
~Gary Taubes, Why We Get Fat
* * *
Is Depression Man-Made?
by Joseph Everett (Wil)
So could depression be a man-made thing?
In Chapter 8 of the 2022 textbook Evolutionary Psychology, they argue that clinical depression is a disease of modern lifestyle. Anthropologists who examined various hunter gatherer societies report that the incidence of depression is exceedingly rare in these populations. For example, a 1986 study of the Kaluli people of New Guinea found that only 1 in 2000 people could be considered depressed. Yet as of 2023, 1 in 6 American adults have depression and 1 in 3 have experienced it at some point in their lifetime.
In fact, evidence suggests that the more modernized a society becomes, the higher the rates of depression. You’d think depression would be totally figured out by now – since the 1950’s, tons of research has been done into various treatments for depression. Yet there’s a paradox, despite more and more treatment, there’s not less depression – there’s more nowadays. Use of antidepressants has quadrupled since 1988 … but depression rates just keep going up.
Evolutionary Perspectives on Depression
by Markus J. Rantala & Severi Luoto
The prevalence of MDD varies greatly between countries. For example, a World Health Organization survey found that the prevalence of lifetime MDD varies from 19.2% observed in the US to 3.3% observed in Romania (Merikangas et al., 2011). The prevalence of MDD has also increased over time. For example, Chinese people born after 1966 were 22.4 times more likely to suffer from a depressive episode than Chinese people born before 1937 (Lee et al., 2007). A meta-analysis of Minnesota Multiphasic Personality Inventory data of American college (N = 63,706) and high school (N = 13,870) students found that young adults were 6–8 times more likely to meet the diagnostic criteria of MDD in 2007 compared to peers in 1938 (Twenge et al., 2010). A population study in Lundby, Sweden, found that the point prevalence of depression in 1957 was 0.8%—in 1972, it was 2.6% (Hagnell et al., 1993), and in 2009, it was 10.8% in Sweden overall (Johansson et al., 2013). It has been estimated that the total number of people living with MDD worldwide increased by 49.86% between 1990 and 2017 (Liu et al., 2020).
Anthropologists who examined hunter-gatherer societies that have lifestyles closer to those of our ancestors have reported that MDD (that fulfills the diagnostic criteria of DSM) has been very rare compared to people who have a modern lifestyle. For example, a study of the Kaluli people of New Guinea found that only one in 2,000 people interviewed met the criteria for being clinically depressed (Schieffelin, 1986). Similar findings have been reported from the Thai-Lao of Thailand (Keyes, 1986), the Toraja of Indonesia (Hollan and Wellenkamp, 1994, 1996), and the Bushmen of the Kalahari (Thomas, 2006). Cross-cultural analyses have found that the degree of modernisation correlates with higher prevalence of MDD in a dose-dependent manner (Colla et al., 2006).
The best evidence that the prevalence of depression is associated with modern lifestyle comes from the Old Order Amish, who still have a lifestyle resembling that of the 18th century. Egeland and Hostetter (1983) studied the prevalence of MDD for five years and found that only 41 out of 8,186 adult Amish individuals met the diagnostic criteria, suggesting that the prevalence of MDD is only 0.5%. The one-year prevalence of MDD among other Americans is 10.4% (Hasin et al., 2018). Thus, the difference in the prevalence of major MDD is at least 20-fold. However, this may be an underestimate because among other US citizens the estimate is given as a one-year prevalence, while Egeland and Hostetter (1983) gave the five-year prevalence. Naturally, the low prevalence of MDD does not mean that hunter-gatherers or the Old Order Amish do not experience periods of low mood, sadness, or grief. However, it seems that in hunter-gatherers or the Old Order Amish, such periods just do not transform into episodes of MDD that would fulfill the diagnostic criteria of DSM-5 or ICD-10.
“An Evolutionary Psychoneuroimmunological Approach to Major Depressive Disorder
by Markus J. Rantala & Javier I. Borráz-León
from The Evolutionary Roots of Human Brain Diseases
ed. by Nico J. Diederich, et al
MDD has become one of the leading sources of disability worldwide and is believed to be a major contributor to the overall global disease burden. It has been estimated that over 300 million people suffer from MDD, equating to approximately 4.4% of the world’s population (World Health Organization 2017). Surprisingly, its etiology is still poorly known, and there has been no significant improvements in its medical treatment for decades. […]
[P]revious studies have shown that Hadza do not suffer from physiological chronic stress, and they often describe their life as “relaxed” when asked whether they experience any worries or anxieties (Fedurek et al. 2023).
There are also some counterarguments in the literature suggesting that depression might not be as rare among hunter-gatherers as anthropologists living with them have reported (Chaudhary and Salali 2022). However, these counterarguments do not stand closer scrutiny. For example, a study on postpartum depression prevalence among the Hadza people in Tanzania using the Edinburgh Postnatal Depression Scale reported that 52% of women with infants under the age of 12 months had scores that are commonly used as a threshold for postpatrum depression (Herlosky et al. 2020). However, the problem in the study was, as the authors themselves reported, that interviewed participants “never used any owrds that described ‘depression’, or any other comparably translated term.” Instead, “they tended to associate labor pain with unhappiness.” since one question on the Edinburgh Postanal Depression Scale asks whether hte mother has felt unhappy that she has been crying, whereas another question asks whether she has been so unhappy that she had diffiulty sleeping, the apparently high prevalence of postpartum depression seems to be the result of misunderstanding the terms used in the test. Thus, this study should not be used as evidence for a high prevalence of postpartum depression among hunter-gatherers.
Comparing the prevalence of mood disorders between people who still live traditional lifestyles and people living modern “Western” lifestyles can help to assess the extent to which modern Western lifestyles may contribute to the development of mood disorders. For example, the Old Order Amish are known to live a lifestyle that was more typical in the 18th century. They still live without electricity and plow their fields with horses. A 5-year long mental health study on a population of 12,500 Old Order Amish, of which 8,186 were adults, found that the 5-year prevalence of MDD was only 0.5% among Old Order Amish People in the United States (Egeland and Hostetter 1983). A more recent study on Old Order Amish and other old order groups found that the point prevalence of depression was 1% in Lancaster Amish, 1% in Groffdale Mennonite, )% in Weaverland Mennonite, 1% in Mifflin County Amish, and 4% in Somerset County Amish (Yost et al. 2016). The point prevalence of depression in other people living in North American has been reported as high as 13.4% (Lim et al. 2018). Thus, the prevalence of MDD among Old Order Amish and other old order groups is substantially lower than observed among Americans living “Western” lifestyles.
Pathology of the Mind
by Henry Maudsley, 1879
pp. 210-214
[I]t must have chanced to every physician who has had much to do with nervous diseases to have seen cases in which a parental apoplexy [a stroke or sudden neurological impairment caused by bleeding into an organ or the loss of blood flow to it] has seemed to have distinctly predisposed to insanity in the offspring. […] This has been the real order of events, I believe, in other cases in which apoplexy has appeared to predispose to insanity: in one generation might be noted irritability, a tendency to cerebral congestion, with passionate and violent outbreaks, ending perhaps in an apoplectic stroke; in the next generation a tendency to cerebral haemorrhage, and the appearance of such neuroses as epilepsy, suicidal disposition, and some form or other of mental derangement.
There is reason to think than an innate taint or infirmity of nerve-element may modify the manner in which other diseases commonly manifest themselves; for example, where it exists, gout flying about the body will occasion obscure nervous symptoms […] and it will sometimes issue in a downright attack of insanity. […] On the other hand, there is no doubt that a parental disease which does not affect specially the nervous system may not withstanding be at the foundation of a delicate nervous constitution in the offspring […] [I]nsanity [is] by no means uncommon amongst the parents of scrofulous and tuberculosis persons […] In estimating the value of observations of this kind, however, we may easily be deceived unless we are careful to reflect that, independently of any special relation between the two diseases, the enfeebled nutrition of scrofula would be likely to light up any latent predisposition to insanity which there might be, and so might seem to have originated it when it was only a contributory factor, and, on the other hand, that insanity, and especially those forms of it in which nutrition was much affected would foster the development of a predisposition to scrofula or phthisis [wasting away or consumption].
Several writers on insanity have taken notice of a connection between it and phthisis which they have thought to be more than accidental. Schroeder van der Kolk was confident that a hereditary predisposition to phthisis might predispose to or develop into insanity, and, on the other hand, that insanity predisposed to phthisis. With phthisis, however, there commonly goes, as is well-known, a particularly eager, intense, impulsive, and sanguine temperament, which may breed a more insanely disposed temperament in the offspring, apart from any influence which the actual tubercular tendency may be supposed to have or to have not. […]
When we are searching for the predisposing conditions of a morbid neurosis in a particular case, and fail to discover any history of antecedent insanity or epilepsy, we shall do well then to inquire whether phthisis is a family disease. […] [T]ubercular deposit is twice as frequent in the bodies of those who die insane as it is in the bodies of those who die sane, and […] a distinctly greater frequency of hereditary predisposition to insanity among the tubercular than among the non-tubercular patients. […]
Diabetes is a disease which often shows itself in families which insanity prevails: whether the one disease predisposes in any way to the other or not, or whether they are independent outcomes of a common neurosis, they rae certainly found to run side by side, or alternatively with one another, more often than be accounted for by accidental coincidence or sequence. For the present I am content to note that the children of a diabetic parent sometimes manifest neurotic peculiarities. Perhaps I might set it down as a true generalization that the morbid neurosi, when it is active and gets distinct morbid expression, may manifest in four ways—(a) in disorder of sensation—for example, paroxysmal neuralgia; (b) in disorder of motion—for example, epilepsy; (c) in disorder of thought, feeling, and will—mental derangement; (d) in disorder of nutrition, whereof diabetes is the earlier and phthisis the later stage.
The late M. Morel of Rouen prosecuted some original and instructive researches into the formation of degenerate or morbid varieties of the human kind, showing the steps of the descent by which degeneracy increases through the generations, and issues finally, if unchecked by counteracting influences, in the extinction of the family. When some of the unfavourable conditions of life which are believed to originate disease—such as the poisoned air of a marshy district, the unknown endemic causes of cretinism, the overcrowding and starvation of large cities, continued intemperance or excesses of any kind, frequent intermarriages in families—have engendered a morbid variety, it is the beginning of calamity which may gather force through generations, until the degeneration has gone so far that the continuation of the species along that line is impossible.
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