An Anthropological Perspective on Depression and Bipolar Disorder

It is somehow reassuring to know that there is more than one model of mental health on the planet, and that there are other ways of looking at our symptoms. This doesn’t mean that anorexia and Koro are not real, or that those who have them are somehow faking or making up the pain. We are stuck within our own culture, and that culture will guide what mental illnesses we get and which treatments will work. But knowing that there are alternative ways of being helps free up a bit of space to think differently about our own suffering.

One section of Small’s book is devoted to evolutionary psychiatry, which suggests that what we call mental disabilities today are actually more like defense mechanisms that were beneficial to our survival as a species. Like some monkeys, we are a “weed species” which means that we can thrive in many different environments because there are a variety of traits among us that are useful depending on the conditions we find ourselves in. “For all we know, our ancestors may have had better reproductive success not because they were smart, but because they were emotionally sensitive, dynamically moody, and ridden with anxiety," (37).

If we suffer social anxiety every time we leave the house, we may see no useful benefit to it. But if we have it before a job interview or a dinner party at our boss’s house, the anxiety can serve to remind us how important our performance will be in determining our success. A little anxiety at the right time can make us perform better. It can even save our life, especially out walking in the jungle on a moonless night.

Knowing that our distressing symptoms might have had useful evolutionary purposes can help us think a little differently about them. So, too, can an acknowledgement of our needs as social animals. “Both monkeys and people need close attachments in order to be sane," (59). In our individualistic culture, we are much more isolated, living far from our extended families and the support systems they offer. Small says that because of this, we need to form other social groups. Friends become our family. Or we join support groups made up of people like us, who can understand what we’re going through. It is not a weakness or failing to need this emotional support. It is simply a necessity for the species we evolved to be.

In taking the broadest view possible of mental illness, Small also looked into the research of psychiatrist and National Institutes of Health researcher Joseph Hibbeln, who has found that we are experiencing an epidemic in cases of depression. According to Hibbein, our brains were used to being fed a 50-50 ratio of omega-6 to omega-3 fatty acids, which essentially means eating a lot of fish. “But our modern Western diet has filled our brains with an imbalance of fats that actually hinders the brain’s electrical connections and lowers mood," (75).

When I asked Small how relevant she thought this research was, she said “I was totally convinced by the data.” Small has changed her own diet and her family’s to include more omega-3 and less omega-6 fats. “This is not easy,” she said, “because omega-6 is in everything we buy in the supermarket.” It won’t be easy, but for those of us suffering with depression, changing our diets is certainly worth a try.